Date of Award

2023

Degree Name

Master of Philosophy (School of Health Sciences)

Schools and Centres

Health Sciences

First Supervisor

Dr Amanda Timler

Second Supervisor

Dr Khaya Morris-Binelli

Third Supervisor

Professor Gerard Hoynes

Fourth Supervisor

Mental Health, Mental Health Literacy, Help-Seeking, Rural Health, Male Mental Health

Abstract

Background and Aim: There is strong evidence to support that mental health concerns become most prevalent among emerging adult males (18-25 years) due to their reluctance to seek-help. Mental Health Literacy (MHL) comprises knowledge, beliefs, and attitudes towards mental health with some evidence suggesting it also enhances help-seeking. However, research has reported that rural residents are less likely to seek help compared to their urban counterparts, despite similarities in MHL. Other factors that impact help-seeking include self-stigma towards mental illness, masculine norms, wellbeing, and access to care. Despite this, there is limited research investigating the influence of MHL in unison with these factors on help-seeking in urban and rural emerging adult males. Therefore, the aim of this study was to investigate the individual and collective influence these factors may have on help-seeking intentions in urban and rural emerging adult males.

Methods: An online questionnaire comprising of five validated measures of help-seeking factors was distributed through community organisations, universities, Technical and Further Education (TAFE) colleges, and sporting clubs. A total of 118 rural (n = 41) and urban (n = 77) Western Australian emerging adult males completed the questionnaire.

Data analysis: Independent samples t-tests and a chi-square test were used to examine differences between help-seeking and associated factors in rural and urban groups. Subsequently, univariate General Linear Models (GLMs) were run to determine whether the geographical location of participants (urban and rural) influenced the relationship between factors of help-seeking (MHL, self-stigma, masculine norms, wellbeing) as independent predictors of help-seeking intentions. In addition, separate univariate GLMs were run with perceived access to care (low or high) as the predictor of help-seeking intentions.

Results: No significant differences were observed between MHL, masculine norms, self-stigma, or help-seeking in rural and urban participants. However, rural residents reported significantly lower wellbeing than their urban counterparts

MENTAL HEALTH LITERACY AND HELP-SEEKING BEHAVIOUR

(t = 2.09, p = .040). The GLMs indicated significant interactions between location and self-stigma (β = -.894, p = .004), and location and MHL (β = .399, p = < .001), suggesting that MHL and self-stigma predicted help-seeking intentions in urban, but not rural participants. Further, perceived access to care (e.g., mental health services such as psychologists) significantly predicted help-seeking intentions (β = -4.50, p = .041), with urban participants perceiving significantly greater access than rural (ꭓ2= 3.87, p = .049).

Conclusion: Although MHL did not predict help-seeking intentions in the rural group, perceived access to care seems to be an important predictor of help-seeking intentions, with rural residents reporting significantly lower access than urban. These findings suggest future research and policy should consider MHL alongside access to care and residential location. Therefore, this study could guide future health promotion campaigns to focus on important barriers to help-seeking, such as self-stigma and access to mental health services in addition to knowledge-based mental health campaigns.

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