title: Help-seeking in emerging adults with and without a history of mental health referral: a qualitative study.
abstract: BACKGROUND
  Young people are generally reluctant to seek professional help when experiencing problems. However, past experience of services is often cited as increasing the intention to seek help, therefore those with a history of mental health referral may adopt more adaptive help seeking strategies. The current study investigated whether the pattern of different help seeking strategies and barriers to help seeking differed as a function of previous referral history.
  
  
  METHODS
  Semi-structured interviews were conducted with 29 emerging adults (12 males, 17 females); 17 with a history of mental health referral and 12 without and analysed using thematic analysis.
  
  
  RESULTS
  Overall, those with a referral to services were more likely than those without to rely on avoidant coping, especially techniques that depended upon suppression. This could help account for the increased use of strategies involving self-harm and substances in those with past referral. An exploration of barriers to help seeking showed those with a history of mental health referral were much more likely to self-stigmatise and this became attached to their sense of identity.
  
  
  CONCLUSIONS
  Emerging adults with a history of referral are more likely to adopt avoidant coping strategies when dealing with problems and self-stigmatise to a greater degree than those without a history of referral. This suggests that current approaches to mental health in emerging adults are not decreasing the sense of stigma with potentially far-reaching consequences for the developing sense of self and choice of help seeking strategies.
authors.affiliation: Centre for Abuse and Trauma Studies, Middlesex University, The Burroughs, London, NW4 4BT, UK. r.spence@mdx.ac.uk.
authors.forename: Ruth
authors.initials: R
authors.lastname: Spence
authors.affiliation: Mood Disorders Research, University of Exeter, Exeter, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Owens-Solari
authors.affiliation: Developmental Psychiatry, Cambridge University, Cambridge, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Goodyer
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008603:Mental Health; D036301:Qualitative Research; D012017:Referral and Consultation; D055815:Young Adult
keywords: Emerging adults; Help-seeking; Mental health; Qualitative research; Stigma