Early intervention increases the likelihood of eating disorder recovery but many young people delay help-seeking. We developed a smartphone-friendly, online decision-making tool to address this gap (FREED-Mobile (FREED-M)).

To conduct a randomised controlled feasibility trial of the FREED-M decision-making tool with 16- to 25-year-olds with a suspected eating disorder and no previous treatment for this.

Participants were randomly allocated to FREED-M or an active control in a parallel group, two-arm trial. Outcomes were measured at weeks 0 (baseline), 4 (post-intervention) and 12 (follow-up). The primary feasibility outcome was attrition at follow-up. Other outcomes included motivational, clinical and economic measures.

We over-recruited with 204 randomised participants (including 20 fraudulent participants). Main analyses were conducted with 184 genuine responders (FREED-M: n = 91, control: n = 93). At baseline, participants’ mean age was 21.0 (s.d. 2.0) years, 89% identified as female and 64% as White. Mean body mass index was 23.1 kg/m2 (6.3). N = 83 participants had an anorexia nervosa-like disorder, 101 had another eating disorder or high eating disorder risk. Attrition at week 12 was n = 112 (61%). Of the n = 42 FREED-M participants who provided acceptability ratings, 79% liked the intervention and 66% found it useful. Between-group effect sizes for motivation and readiness to change were small to medium at 4 weeks (d = 0.27 and d = 0.15, respectively) favouring FREED-M, but differences were not sustained at follow-up (d = −0.02 and d = −0.12, respectively).

Although the attrition rate was high, recruitment exceeded expectations. Acceptability of FREED-M was high among participants who provided acceptability ratings. Motivation/readiness to change and help-seeking are candidates for primary outcomes in a future randomised controlled trial.

Mental health problems have long-lasting impacts and often begin in adolescence, yet young people face multiple barriers to accessing care and support, including a fragmented system, limited awareness of services and stigma. Afloat was developed to guide users to suitable support.

This study aimed to (a) co-develop a mobile app to support young people’s access to mental healthcare and support; and (b) evaluate its acceptability, potential impact on service use, mental health outcomes and economic implications.

Afloat was co-developed with young people to provide information on available support, and included personal stories from peers and links to care resources. A pilot evaluation involved 105 participants aged 16–25 years from London, UK. Participants completed surveys at baseline and 3 months to assess changes in mental health, service use, stigma and self-identification of mental health issues. App usage was monitored through analytics. A budget-impact analysis estimated financial implications of Afloat implementation.

Participants reported high acceptability and satisfaction. After 3 months, there was an increase in the likelihood of help-seeking and a reduction in mental health symptoms. The increase in actual service use was significant only among those with mild-to-moderate symptoms. Budget-impact analysis indicated potentially increased costs from additional service use.

Afloat shows preliminary promise as a tool associated with increased help-seeking and improved mental health. Long-term benefits of timely intervention may offset short-term costs from increased service use, although this requires formal evaluation. Further research is required to assess long-term outcomes and economic implications.

Campaigns to enhance public awareness and attitudes towards mental health problems have been a feature of mental health policy and practice for several decades. In Australia, Beyond Blue, an independent, not-for-profit organisation which was launched in 2000, marked a turning point in the national approach to improving population mental health. From the outset, it prioritised a systemic approach including national awareness campaigns, support for consumers and carers, early intervention, primary care reform and investment in research.

Over the past 25 years, Australia has seen substantial improvements in mental health literacy, stigma and help-seeking. To explore Beyond Blue’s contribution, we drew on nationally representative surveys of mental health literacy, stigma and service use. Analyses of surveys from the mid-2000s showed that respondents in states with greater exposure to Beyond Blue had higher awareness, better recognition of depression and more accurate treatment beliefs. Later studies confirmed that engagement with Beyond Blue was associated with higher mental health literacy, including among young people. National surveys have also shown significant reductions in stigma towards people with depression, changes not observed in other countries. Longitudinal data suggest that engaging with Beyond Blue predicts lower stigma and greater help-seeking over time.

National Surveys of Mental Health and Wellbeing have shown steady increases in professional help-seeking and perceived need for support since the late 1990s. While there are multiple reasons for this, recent national survey data link engagement with Beyond Blue to increased contact with health professionals and informal supports.

Globally, Beyond Blue is unique in its long-term, multi-pronged approach to improving population mental health. Its sustained focus and demonstrated impact on mental health literacy, stigma and help-seeking for depression and anxiety remain largely unmatched among comparable national initiatives.

People with hoarding behaviours (PwHB) need to be able to access a range of support options in a timely manner for their own wellbeing as well as that of friends and family. In response to recent calls to understand more about support groups and the role of peers in relation to hoarding, we investigate an online forum for PwHB.

To explore the types of messages exchanged on the popular online discussion platform Reddit and the sort of information and support that is available.

We randomly scraped 100 threads from a hoarding subreddit or subcommunity on Reddit and undertook a thematic analysis of the 1297 individual messages collected.

The analysis produced three themes: Emotional and practical support for help seekers; Seeking help on behalf of others; and Practical problems with discarding. The forum provides a place for exchanging emotional and practical support where posters detail their lived experience of practical strategies for reducing their ‘hoard’. Progress updates provide a sense of continued connection and posters seeking advice on behalf of someone else are welcomed and supported. The forum exposes debate and frustration around the practicalities and ethics of disposing of items, highlighting additional obstacles for PwHB and the limitations of geographically dispersed support groups.

The online forum provides both opportunities and challenges for PwHB. The type of content exchanged within the online forum helps us better understand support issues for PwHB and points to clinical implications for therapy.

Accurate and up-to-date epidemiological data on the prevalence and treatment of common mental disorders are essential for evidence-based healthcare policy and resource allocation. However, large-scale, representative epidemiological surveys on common mental disorders in China—particularly those incorporating insomnia disorder and applying the latest diagnostic criteria alongside validated assessment tools—remain notably lacking.

We conducted a population-based, cross-sectional epidemiological survey to assess the prevalence and treatment of common mental disorders among adults in Beijing, China, using a multistage clustered probability sampling design (n = 10,778). Licensed psychiatrists administered standardized diagnostic interviews based on DSM-5 criteria to assess both lifetime and current mental disorders through a single-stage assessment protocol.

Among all lifetime mental disorders assessed, depressive disorders constituted the most prevalent diagnostic category (7.7%), with major depressive disorder representing the most common specific diagnosis (5.4%). Individuals aged 65 years and older exhibited significantly higher 1-month prevalence of both depressive disorders and insomnia disorder compared with younger age groups. Alcohol-related disorder was more prevalent in men than in women, and in urban residents than in rural residents. Help-seeking patterns revealed a predominant reliance on informal support over professional services among individuals with lifetime mental disorders. Only 13.4% sought help from mental health professionals, and 12.7% received mental health professional treatment.

The improved access to treatment did not translate into a reduction in population-level mental disorder prevalence, which may be attributable to the low rate of professional mental health treatment. Governments must optimize mental healthcare access.

Despite the high prevalence of mental disorders, knowledge about mental health, its promotion, prevention, and pathways to care in the general population remain limited. Mental Health First Aid (MHFA) seeks to increase mental health literacy in the general population and enable individuals to support others with mental health problems until professional help is available. This study aimed to investigate the feasibility and initial effects of MHFA training on (i) mental health literacy, (ii) stigmatizing attitudes toward individuals with mental health problems, (iii) social distance, (iv) trainees’ mental health, and (v) quality of life.

In an uncontrolled pilot study, individuals aged 18–75 years who participated in MHFA courses in Germany were recruited. Outcomes were assessed at baseline, post-training, and 6-month follow-up.

In total, 362 participants (mean age 43 years, 78% female) enrolled in the study at baseline. Retention was about 50% for post-training and 60% for follow-up assessment. At post-training, mental health literacy was increased (adjΒ = 6.77, 95% CI = 5.69 to 7.84) and social distance (adjΒ = −2.30, 95% CI = −2.73 to −1.87) and stigmatizing attitudes (adjΒ = −2.61, 95% CI = −3.25 to −1.97) were reduced. These effects were also evident at 6-month follow-up. There were no effects on trainees’ mental health. At the 6-month follow-up, 89% of trainees had talked to someone with mental health problems at least once, and 65% of trainees were quite or very confident in offering help.

Our findings suggest initial beneficial effects of MHFA training as implemented in Germany. A randomized controlled trial of MHFA in Germany is now warranted.

Although workplace mental health screening is often implemented to aid early identification of mental health symptoms and facilitate access to treatment, supporting evidence is limited.

We aimed to evaluate the effect of independently conducted, confidential, online mental health screening, paired with automated tailored feedback recommending referral services, on help-seeking and psychological distress.

We conducted a cluster-randomised controlled trial with firefighters from an Australian fire and rescue service. Randomisation occurred by station (N = 264). Firefighters at stations allocated to the intervention group received tailored information detailing suitable mental health services based on their Kessler-6 psychological distress score (K6). The control group received generic feedback on services irrespective of K6 score. The primary outcome was help-seeking at 3-months post-intervention for those with at least moderate levels of psychological distress at baseline (K6 ≥14). The study was registered with Australian New Zealand Clinical Trials Registry (no. ANZCTR 12621001457831).

Of the 459 firefighters screened, 141 (30.72%) scored ≥14 on K6. Among this subgroup at 3 months, no differences were observed in rates of overall help-seeking between the intervention and control groups (P = 0.31). In contrast, levels of psychological distress remained high in the intervention group but declined in the control group (t[111] = 2.29, 95% CI: 0.24, 3.23, P = 0.024). The difference in psychological distress associated with workplace mental health screening equated to an effect size of −0.42 (95% CI: −0.04, −0.79).

Our findings suggest that independent, confidential online mental health screening, paired with tailored online feedback and information on available treatment, does not significantly increase help-seeking and may sustain psychological distress over time compared with receiving generic information. As such, it should not be implemented to promote help-seeking and reduce levels of psychological distress. These findings are relevant for workplaces, mental health researchers and practitioners alike, highlighting the potential risk and potential harm of mental health screening conducted in this way on individuals.

Elder abuse (EA) often remains hidden, and many victims do not interact with formal systems. Concerned persons (CPs) are family, friends, and neighbours who play an essential role in supporting EA victims.

The aim of this study was to understand CPs’ role and help-seeking experiences.

Nineteen self-identified CPs shared their experience of being involved in an EA case via an interview and/or survey, with responses analysed qualitatively.

CPs were primarily the victims’ female relatives, often related to the perpetrator, and had sought help from a wide range of formal and informal sources, facing many barriers in protecting victims from harm. Challenges commonly related to formal services and EA perpetrators. Through knowing about the abuse and/or seeking help, participants experienced negative impacts, particularly psychological ones.

Findings suggest that CPs can play a key role in supporting EA victims but require further support and recognition from services to fulfil this role.

Self-harm is a significant problem in university students because of its association with emotional distress, physical harm, broader mental health issues and potential suicidality. Research suggests that fewer than half of students who have self-harmed seek professional help when at university.

This study aimed to explore the help-seeking journeys of university students who had engaged in self-harm, to identify perceived facilitators and barriers to securing both formal and informal support.

Participants comprised 12 students who had self-harmed during their university tenure. Engaging in two semi-structured interviews over the academic year, they shared insights into their help-seeking behaviours and proposed enhancements to local services. Data underwent reflexive thematic analysis within a critical realist framework.

The analysis identified four themes: ‘The initial university phase poses the greatest challenge’, ‘Perceived criteria for “valid” mental health problems’, ‘Evading external judgements, concerns and consequences’ and ‘The pivotal role of treatment options and flexibility in recovery’.

Students felt isolated and misunderstood, which amplified self-harming tendencies and diminished inclinations for help-seeking. A prevalent belief was that for self-harm to be deemed ‘valid’, it must manifest with a certain severity; however, concurrent fears existed around the ramifications of perceived excessive severity. Participants expressed a desire for streamlined pathways to mental health resources, encompassing both university and external mental health services. Insights from this study could guide future research and inform current service paradigms within academic and healthcare systems.

Children and adolescents with a history of adverse childhood experiences (ACEs) are more likely than their peers to develop mental health difficulties, but not enough is known about their help-seeking behaviours and preferences. We aimed to determine whether ACEs are associated with access to and perceived unmet need for mental health services and support amongst secondary school students.

We used multi-level logistic regression with data from the 2020 OxWell Student Survey to assess whether ACEs were associated with (1) prior access to mental health support and (2) perceived unmet need for mental health services in a community sample of English secondary school students. We assessed ACEs as a cumulative score from the Center for Youth Wellness Adverse Childhood Experiences Questionnaire: Teen Self-Report version and accounted for current mental health difficulties as measured by the 25-item Revised Children’s Anxiety and Depression Scale (RCADS).

Our analysis included 2018 students across 64 schools, of whom 29.9% (598/2002) reported prior access to mental health support. Of those not reporting prior access, 34.1% (469/1377) reported a perceived unmet need for services. In the unadjusted models, cumulative ACE scores were significantly positively associated with both prior access to mental health support (odds ratio (OR) = 1.36; 95% confidence interval (CI): 1.29–1.43) and perceived unmet need for mental health services (OR = 1.47; 95% CI: 1.37–1.59), meaning that students who had experienced adversity had a greater chance of having previously accessed support as well as perceiving an unmet need for services. After adjusting for mental health difficulties and other sociodemographic variables, cumulative ACE scores were positively associated with prior access (adjusted OR (aOR) = 1.25; 95% CI: 1.17–1.34 with a significant interaction between RCADS and ACE scores, aOR = 0.88; 95% CI: 0.84–0.93) as well as perceived unmet need (aOR = 1.32; 95% CI: 1.21–1.43 with a significant interaction between RCADS and ACE scores, aOR = 0.85; 95% CI: 0.78–0.91).

Although it is encouraging that adolescents with experience of adversity are more likely than their peers with similar levels of depression and anxiety symptoms to have accessed mental health support, there remains a concern that those who have not accessed support are more likely to perceive an as-yet unmet need for it. Mental health support must be available, accessible and acceptable to all who need it, especially for those groups that traditionally have not accessed services, including the more marginalised and vulnerable populations.

People with hoarding behaviours often struggle to engage in treatment. This study aimed to explore the experiences of a sample of people who identify as engaging in hoarding behaviours and who are seeking support. Exploring motivation to seek help, the barriers those who hoard face in accessing support and what facilitates accepting help, can aid understanding of how best to intervene.

Eight individuals who self-identified as seeking help in relation to hoarding behaviours were recruited via social media and support groups. Interviews were conducted by telephone or video call, before being transcribed and analysed using interpretative phenomenological analysis.

Participants described complex help-seeking narratives and reported continued ambivalence about addressing their hoarding behaviours. The four group experiential themes identified were Wrestling with identity; Who can I trust?; Services don’t fit; and Being overlooked: ‘they’re too busy looking at the thing, not the person’. Difficulties trusting others and services were identified; services were experienced as rejecting and many participants sought help for problems other than their hoarding. Problems accessing appropriate help for hoarding were predominant in the narratives, although participants who had accessed peer support described this as valuable.

There are both internal (e.g. fear of judgement; feeling overwhelmed) and external (e.g. service gaps) barriers that make finding useful help for hoarding behaviours very difficult. Services may facilitate those seeking help by taking a compassionate and person-centred approach to hoarding problems.