title: When self-reliance is not safe: associations between reduced help-seeking and subsequent mental health symptoms in suicidal adolescents.
abstract: The majority of suicidal adolescents have no contact with mental health services, and reduced help-seeking in this population further lessens the likelihood of accessing treatment. A commonly-reported reason for not seeking help is youths' perception that they should solve problems on their own. In this study, we explore associations between extreme self-reliance behavior (i.e., solving problems on your own all of the time), help-seeking behavior, and mental health symptoms in a community sample of adolescents. Approximately 2150 adolescents, across six schools, participated in a school-based suicide prevention screening program, and a subset of at-risk youth completed a follow-up interview two years later. Extreme self-reliance was associated with reduced help-seeking, clinically-significant depressive symptoms, and serious suicidal ideation at the baseline screening. Furthermore, in a subset of youth identified as at-risk at the baseline screening, extreme self-reliance predicted level of suicidal ideation and depressive symptoms two years later even after controlling for baseline symptoms. Given these findings, attitudes that reinforce extreme self-reliance behavior may be an important target for youth suicide prevention programs. Reducing extreme self-reliance in youth with suicidality may increase their likelihood of appropriate help-seeking and concomitant reductions in symptoms.
authors.affiliation: Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA. labouli@nyspi.columbia.edu.
authors.forename: Christa D
authors.initials: CD
authors.lastname: Labouliere
authors.affiliation: Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA. kleinmam@nyspi.columbia.edu.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Kleinman
authors.affiliation: Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA. gouldm@nyspi.columbia.edu.
authors.forename: Madelyn S
authors.initials: MS
authors.lastname: Gould
mesh_terms: D000293:Adolescent; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009518:New York / Q000453:epidemiology; D011340:Problem Solving; D012307:Risk Factors; D059020:Suicidal Ideation
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