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Postsecondary students’ information needs and pathways for help with stress, anxiety and depression

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Surveys indicate that prevalence rates of depression, anxiety, and other disorders in postsecondary students are equal to or higher than those in the general population; however, students often do not access help for these problems. Moreover, those who do seek help are confronted by a range of choices involving psychological, pharmacological, or combined treatment, along with multiple sources of information regarding treatment options. In an effort to identify the information needs and preferences of Canadian university students, we conducted a survey of students seeking counselling or medical services on campus. Results indicated that students were more likely to initially seek advice from romantic partners or friends rather than counsellors or health care providers. When asked to consider what information is important when seeking help, students reported that treatment effectiveness, advantages/disadvantages of treatment, side effects, and what happens when treatment is stopped were all very important. Training and experience of service providers were seen as more important than providers’ recommendations for type of treatment. Meetings with a counsellor were preferred over medication as a treatment modality. Preferred sources of information included health care providers, information sheets, and the Internet. Implications of the survey for postsecondary mental health service delivery are discussed.
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356 Canadian Journal of Counselling and Psychotherapy /
Revue canadienne de counseling et de psychothérapie
ISSN 0826-3893 Vol. 48 No. 3 © 2014 Pages 356–374
Postsecondary Students’ Information Needs and Pathways
for Help with Stress, Anxiety, and Depression
Les besoins d’information des étudiants postsecondaires
et les parcours conçus pour réduire le stress, l’anxiété, et la
dépression
Donald W. Stewart
John R. Walker
Brooke Beatie
Kristin A. Reynolds
Ken Hahlweg
Mark Leonhart
Alexandria Tulloch
University of Manitoba
e Mobilizing Minds Research Group
Toronto, Ontario

Surveys indicate that prevalence rates of depression, anxiety, and other disorders in post-
secondary students are equal to or higher than those in the general population; however,
students often do not access help for these problems. Moreover, those who do seek help
are confronted by a range of choices involving psychological, pharmacological, or com-
bined treatment, along with multiple sources of information regarding treatment options.
In an eort to identify the information needs and preferences of Canadian university
students, we conducted a survey of students seeking counselling or medical services on
campus. Results indicated that students were more likely to initially seek advice from
romantic partners or friends rather than counsellors or health care providers. When asked
to consider what information is important when seeking help, students reported that
treatment eectiveness, advantages/disadvantages of treatment, side eects, and what
happens when treatment is stopped were all very important. Training and experience of
service providers were seen as more important than providers’ recommendations for type
of treatment. Meetings with a counsellor were preferred over medication as a treatment
modality. Preferred sources of information included health care providers, information
sheets, and the Internet. Implications of the survey for postsecondary mental health
service delivery are discussed.
R
Selon les sondages, les taux de prévalence de la dépression, de l’anxiété, et d’autres troubles
chez les étudiants postsecondaires sont équivalents ou plus élevés que dans la population
en général, et pourtant, dans bien des cas, ces jeunes n’ont pas recours à de l’aide pour
ces problèmes. De plus, ceux et celles qui se décident à chercher de l’aide doivent choisir
parmi une gamme de services qui va du traitement psychologique, en passant par la
Postsecondary Students’ Information Needs and Pathways 357
pharmacologie ou une combinaison des deux, ainsi que de multiples sources de rensei-
gnements au sujet des options de traitement. An de dénir les besoins et préférences
des étudiants postsecondaires canadiens en matière d’information, nous avons mené un
sondage auprès d’étudiants à la recherche de services de counseling ou médicaux sur le
campus. Les résultats indiquent que les étudiants sont plus susceptibles de rechercher, dans
un premier temps, l’avis de partenaires de cœur ou d’amis plutôt qu’auprès d’un conseiller
ou d’un fournisseur de soins de santé. Lorsqu’on leur a demandé de rééchir au type de
renseignements qu’ils jugeaient importants dans leur recherche d’aide, les étudiants ont
répondu que l’ecacité du traitement, les avantages et inconvénients qu’il comporte, ses
eets secondaires, et ce qui advient à la n du traitement sont tous des aspects très impor-
tants. Ils considéraient aussi la formation et l’expérience des fournisseurs de services des
facteurs plus importants que les recommandations de ces fournisseurs concernant le type
de traitement. Comme mode de traitement, les étudiants ont dit préférer les rencontres
avec un conseiller plutôt que la médication. Parmi les sources de renseignements privi-
légiées sont les fournisseurs de soins de santé, les ches de renseignements, et Internet.
L’article présente une discussion des implications du sondage pour la prestation de services
de soins de santé mentale chez les clients au niveau postsecondaire.
Mental disorders are common among young adults, with the prevalence of the
most common disorders, such as anxiety and depression, reaching a peak between
ages 18 and 24 (Kessler, 2007). When considering postsecondary students more
specically—where academic, nancial, and interpersonal stressors compound the
age-related risk factors—the prevalence of mental disorders may be even higher
(Cooke, Bewick, Barkham, Bradley, & Audin, 2006). One national U.S. survey
found that almost half of the students sampled met the DSM-IV criteria for at
least one mental disorder in the previous year, including 12% for an anxiety dis-
order and 18% for a mood disorder (Blanco et al., 2008). More recently, a North
American survey of students indicated that more than 80% of respondents felt
exhausted and overwhelmed, with nearly half reporting that they felt hopeless
at some point in the past academic year (American College Health Association,
2013). In line with these ndings, rates of suicidality are also high among postsec-
ondary students, with one U.S. national survey indicating that more than half of
students surveyed had considered suicide at some point in their lives, including an
alarming 8% of undergraduates who reported at least one suicide attempt (Drum,
Brownson, Burton Denmark, & Smith, 2009).
Given the high levels of mental health concerns among postsecondary students,
one might expect that mental health service utilization would be similarly high;
however, this is not the case (Kiley, 2013). A national U.S. survey showed that
fewer than half the students screening positive for mood or anxiety disorders re-
ported receiving any mental health services during the preceding year (Eisenberg,
Golberstein, & Gollust, 2007). Although there have been apparent increases in
the willingness of postsecondary students to access campus mental health services
(Hunt & Eisenberg, 2010), young adults are among the age cohorts least likely
to seek help for their mental health problems (Statistics Canada, 2011; Wang et
al., 2005). In addition, when young adults do seek treatment, they may not be
basing their decisions on complete information or seeking this information from
358 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
reliable sources. As such, it is worthwhile to explore the ways in which mental
health information and treatment resources can be made more accessible for this
vulnerable cohort.
Much of the information that young adults want or need about mental health
problems and treatment options can be understood within the framework of
mental health literacy, which may be dened as the extent to which individuals in
need of treatment are able to recognize and identify their symptoms as a condition
requiring access to mental health resources (Coles & Coleman, 2010). e role of
mental health literacy in service accessibility is highlighted by a recent Australian
study that found only 26% of students would seek help from a general practitioner
and only 10% from a student counsellor should they experience a mental health
problem (Reavley, McCann, & Jorm, 2012). Results from a U.K. survey of 3,000
young people aged 16–24 showed similar results (Klineberg, Biddle, Donovan, &
Gunnell, 2011). In this study, participants were asked to identify if characters from
a vignette had depression, and what they thought the characters would do in terms
of seeking help. Interestingly, about one third of the participants who recognized
severe mental health symptoms in the vignettes thought that the characters would
do nothing about their mental health problems (Klineberg et al., 2011).
In addition to low rates of mental health literacy, previous research has identied
a number of psychological factors that are related to reduced rates of help-seeking,
including lack of emotional openness (Hunt & Eisenberg, 2010), degree of
symptom severity (Leahy et al., 2010; Wilson, 2010), and self-stigma (Eisenberg,
Downs, Golberstein, & Zivin, 2009). Of these factors, self-stigma is of particular
concern because of its pervasive nature and impact. For example, in a study by
Vogel, Wade, and Haake (2006), self-stigma, above all other factors measured,
uniquely predicted participants’ willingness to seek counselling and other forms
of help. Self-stigma is likely to have such a high degree of impact because it in-
volves a perception that one is socially unacceptable (Vogel et al., 2006), which
may lead people experiencing psychologically distressing symptoms to forego
seeking treatment in order to maintain a positive self-image (Miller, 1985; Vogel
et al., 2006; Vogel, Wade, & Hackler, 2007). In an eort to address this concern,
Romer and Bock (2008) looked at whether improved provision of treatment
information would help to reduce self-stigma among people who had previously
faced troubling mental health symptoms and those who had not. ey found that
providing counterstereotype information and information on treatment eective-
ness was helpful in reducing stigma in both groups. ese ndings underscore the
importance of ensuring that young adults have sucient information to increase
their knowledge regarding symptoms and treatment options and also to decrease
the risks associated with self-stigmatization.
In working with young adults, however, it is also important to recognize the
signicant role that relationships play in help-seeking (O’Callaghan et al., 2010).
For most, the rst act of help-seeking is made to friends and family (Klineberg
et al., 2011). Although friends and family may not be the best source to provide
accurate mental health information, a study by O’Callaghan et al. (2010) found
Postsecondary Students’ Information Needs and Pathways 359
that having a family member involved in the help-seeking process was associated
with shorter help-seeking delays. erefore, families may play a vital role in initiat-
ing treatment and increasing service utilization among individuals experiencing
problems. However, it is also possible that family inuence may result in a nega-
tive outcome. For example, depending on their experiences, people with a family
history of mental health problems may be less likely to seek help due to a lack
of condence in the ability of available health services to successfully address the
problem (Chen et al., 2005). erefore, receiving unbiased and reliable informa-
tion is important in promoting help-seeking behaviour.
Overall, untreated mental health problems are of great concern for postsec-
ondary students who are expected to function at peak levels of psychological
and intellectual performance. In addition to complicating their adjustment to
postsecondary education, mental health problems can adversely aect students’
physical health, personal development, academic achievement, and quality of life
(Bayram & Bilgel, 2008). For these reasons, insight regarding the preferred ways
in which students would like to receive information about mental health problems,
treatment options, and means of accessing help would be valuable in identifying
ways to meet their needs more eectively.
e aim of the present study was to explore the opinions of university students
regarding their information needs and pathways for help with common mental
health problems. More specically, our research asked: If a young adult were to
experience a signicant problem with stress, anxiety, or depression,
1. Who would they likely turn to for advice?
2. What information would be important to them in considering the types of
help available?
3. What types of assistance would they see as being helpful to them?
4. How would they prefer to receive information?
5. How much information would they prefer to receive?

Participants
All participants were students at the University of X, an intermediate-sized
comprehensive Canadian university with a student population of approximately
29,000. Participants were solicited from the waiting rooms at the universitys
separate student counselling and health centres. Participants were 187 students
(122 females, 60 males, and 5 unspecied) between the ages of 18 and 25 (see
Table 1 for details).
e counselling and health centres are both dedicated to providing services
to students, and each serves a large number of students seeking help for mental
health concerns. All counselling services are provided free of charge; costs for medi-
cal services are covered through the provincial health services plan for Canadian
citizens or through mandatory private insurance for international students. e
counselling centre is a multidisciplinary unit with psychologists, counsellors, social
360 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
workers, and career specialists on sta. According to annual utilization statistics,
the primary presenting issues at the counselling centre are stress, anxiety, depres-
sion, and relationship concerns. More than 1,000 students access counselling
services at the counselling centre each year. e university health centre is a family
practice-style medical clinic providing a full range of medical services, including
care for acute and minor health problems, check-ups, prenatal care, health and
travel counselling, immunizations, and health promotion programming. According
to the clinic administrator, depression and anxiety are among the top ve concerns
for students seeking health services, with approximately 30% of physician time
devoted to student mental health problems.
Table 1
Sociodemographic Characteristics of Respondents
Mean age (SD) 23.1 years (4.78)
Female/male proportion 72%/28%
Racial origin
Caucasian 54%
Asian 23%
Aboriginal/First Nations 9%
Black 7%
Other 7%
Born in Canada 73%
Marital status
Married & living together 16%
Never married & never lived with someone in a marital-like relationship 73%
Divorced/separated 10%
Participants’ mean years of education (SD) 16.0 years (8.37)
Mothers’ mean year of education (SD) 15.0 years (8.76)
Fathers’ mean year of education (SD) 14.8 years (3.94)
Program working toward
Bachelor’s degree/diploma 80%
Graduate degree 14%
Professional degree 6%
Recruitment location
University Health Services 15%
Student Counselling and Career Centre 85%
Main activity in the last 12 months
School 54%
Working (full-time) 12%
Working (part-time) 4%
Work part-time/school part-time 25%
Other 5%
Depression Anxiety Stress Scale-21
Depression mean score (SD) 7.5 (6.17)
Anxiety mean score (SD) 5.9 (4.99)
Stress mean score (SD) 8.1 (5.03)
K10 distress scale mean score (SD) 14.9 (8.49)
Have received professional help for stress, anxiety, or depression (% yes) 50%
Was there a time when professional help for stress, anxiety, or depression would
have been helpful? (% yes)
63%
Note. N = 187.
Postsecondary Students’ Information Needs and Pathways 361
Procedure
is study was approved by the University of X Research Ethics Board. When
recruiting participants, a research assistant approached students who appeared to
be between the ages of 18 and 25 in the waiting rooms of the separate counselling
and health centres. Students who provided written informed consent were invited
to complete the questionnaire while waiting for an appointment and to return it
in a sealed envelope. Students were given a survey package that was gender-typed
for their gender. If students were called for their appointment before they had
completed the survey, they had the opportunity to complete the survey after their
appointment or to take the survey home with them and return it later. When
surveys were returned to the research assistant or to reception sta, participants
received a $10 gift card for campus food services. e survey took approximately
30 minutes for participants to complete. Of those approached about the study,
71% agreed to participate, and 84% of those who agreed to participate returned
completed surveys.
Measures
Sociodemographic information. Participants provided information regarding their
age, gender, racial/ethnic background, education, occupation, parents’ education,
and living situation.
Emotional distress. Emotional distress was measured using the Depression Anxi-
ety Stress Scale (DASS-21; Lovibond & Lovibond, 1995). e DASS-21 assesses
symptoms over the previous week on depression, anxiety, and stress subscales. Items
are rated on a 4-point severity/frequency scale ranging from 0 (Did not apply to me
at all) to 3 (Applied to me very much, or most of the time). Additional information
on participants’ emotional distress was obtained using the Kessler Psychological
Distress Scale (K10; Kessler et al., 2003), which measures past-month symptoms
of anxiety and depression. e 10-item survey contained questions such as “In
the past 4 weeks, about how often did you feel tired out for no good reason?”
Items were rated on a 5-point Likert scale ranging from 1 (none of the time) to 5
(all of the time), with total scores of distress ranging from a category of likely to
be well (score of 10–19) or likely to have a mild (score of 20–24), moderate (score
of 25–29), or severe (score of 30–50) mental disorder (Andrews & Slade, 2001).
Previous psychometric analyses indicated excellent internal reliability for the
DASS-21, with a Cronbach’s alpha of .93 for the total score and individual subscale
coecients of .88 for depression, .82 for anxiety, and .90 for stress (Lovibond &
Lovibond, 1995). e DASS-21 has been shown to possess adequate construct
validity in measuring general psychological distress and shows good convergent
and discriminant validity when compared with other valid measures of depression
and anxiety (Antony, Bieling, Cox, Enns, & Swinson, 1998; Clara, Cox, & Enns,
2001; Henry & Crawford, 2005).
In comparison to the 42-item DASS, Antony et al. (1998) reported lower
intercorrelations of factors, higher mean loadings, and fewer cross-loading items
362 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
in the shorter DASS-21 version. A study by Henry and Crawford (2005) further
examined the validity of the subscales and concluded that the DASS-21 subscales
can validly be used to measure depression, anxiety, and stress. Additionally, the
K10 was shown to produce high discrimination scores between community and
noncommunity cases of DSM-IV-dened psychiatric disorders, including anxi-
ety, mood, and nonaective disorders (Kessler et al., 2003). Similarly, previous
psychometric analyses indicated excellent internal reliability for the K10, with a
Cronbach’s alpha of .93 (Kessler et al., 2003).
Information preferences. With the purpose of providing context for the survey
questions, respondents were asked to read brief vignettes describing two young
adults of the same gender as the respondent (male or female). e rst vignette
described experiences of signicant distress and impairment from symptoms
of panic disorder, and the other described symptoms of depression. In the rst
question in the information preferences section, respondents rated how familiar
they were with dierent types of help available to people experiencing mental
health problems on a 9-point scale ranging from 0 (not familiar at all) through
4 (moderately familiar) to 8 (very familiar). In answering subsequent questions,
respondents were asked to consider that at some time in their lives, they, a close
friend, or a close family member might have a problem similar to those described
in the vignettes. From this perspective, they were then asked to answer questions
concerning their preferences for information, including amount of content, mode
of delivery, and whom they would likely turn to for advice concerning problems
with stress, anxiety, or depression.
A series of questions also asked for participants’ views concerning the helpful-
ness of various forms of assistance for these problems. In developing questions
about the information content that might be important to young adults, we
considered the logical sequence of events in treatment and also ndings from
qualitative research (individual interviews and focus groups) with young adults
(Ryan-Nicholls, Furer, Walker, Reynolds, & e Mobilizing Minds Research
Group, 2009). When weighing treatment options, a person might want to consider
the available treatment choices, what is involved in the treatment (what you do),
cost of treatment, eectiveness of treatment, how long it takes for treatment to
work, how long treatment continues, what happens when treatment stops, and
risks and benets of treatment.
We also included two questions about their own experience. e rst question
stated, “When thinking about your own past experiences, was there a time when
you received help from a professional (such as a counsellor, therapist, or doctor)
for problems with stress, anxiety, or depression?” A second question asked if there
was a time when they would have beneted from professional help but did not
receive it.

Table 1 shows the demographic information and characteristics of the sample.
Sixty-ve percent of the participants identied themselves as female, 32% as male,
Postsecondary Students’ Information Needs and Pathways 363
and 3% reported no gender. e apparent overrepresentation of female partici-
pants is characteristic of the proles of service utilization at the centres where
students were recruited. Overall, 73% of participants were born in Canada. On
average, respondents had completed four or more years of education after high
school and their parents had completed an average of three years after high school.
Most respondents (80%) were working toward an undergraduate degree, with the
remainder working toward graduate or professional qualications.
e majority of participants were solicited from the waiting room at the
counselling centre (85%), with a much smaller proportion (15%) obtained from
students attending the health centre. Dierential rates of participation were ob-
tained at the two sites in part because the reception sta at the counselling centre
notied students about the study during times when the research assistant was
not on site, whereas the health centre receptionists were unable to assist with this
aspect. Respondents from both locations were compared using chi-square analy-
ses to assess for dierences regarding demographic information, mental health
service use, and levels of depression, anxiety, and stress. No signicant dierences
were found between the two samples based on these variables, with the exception
of depression. Participants from the counselling centre reported signicantly
higher levels of depression symptoms than participants at the health centre.
Considering that depression is one of the major pressing issues at the counselling
centre, this result was not surprising. Because there were no other dierences
identied between the two samples, a decision was made to combine participants
from both locations into a single dataset for further analyses. As might be ex-
pected among participants from general counselling and health service settings,
levels of symptoms of distress were low to moderate. Participants’ mean levels of
depression, anxiety, and stress on the DASS-21 were higher than those reported
for nonclinical community samples, but lower than those reported for samples
of people with clinical levels of distress (Henry & Crawford, 2005). Similarly,
the average score on the K10 distress scale was consistent with levels reported in
community samples (Andrews & Slade, 2001). As might be expected with the
population we sampled, a high percentage of participants (50%) reported receiv-
ing professional help at some time for problems with stress, anxiety, or depres-
sion. Additionally, a high percentage of participants (63%) reported that there
was a time when professional help with stress, anxiety, or depression would have
been helpful, but they did not receive it.
Preferred Sources of Information
Table 2 contains information on how likely participants would be to talk
to various people if they were having a serious problem with stress, anxiety, or
depression. e largest proportion of respondents indicated that they would be
very likely to talk to a romantic partner (65%), a close friend (63%), a counsellor
at university (52%), a parent (51%), or a family doctor (51%). A lower percent-
age indicated that they would be very likely to speak to an instructor (19%) or a
phone-in counselling or health line (16%).
364 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
Table 2
Preferred Sources of Information
How likely would you be to talk to one of the following people for advice if you were having a serious
problem with stress, anxiety, or depression?
Source of advice
Not
likely (%)
Moderately
likely (%)
Very
likely (%)
Mean rating (95%
condence interval)
Parent 14 35 51 4.9 (4.52–5.31)
Brother or sister 23 35 42 4.2 (3.79–4.62)
Close friend 7 30 63 5.8 (5.44–6.07)
Romantic partner 5 30 65 5.7 (5.33–6.07)
Teacher or instructor 34 47 19 2.4 (2.02–2.69)
Counsellor at school 15 33 52 4.7 (4.27–5.03)
Phone-in counselling
or health line 39 45 16 2.4 (2.02–2.72)
Family doctor 12 37 51 4.6 (4.24–5.01)
Note. N = 187. Each source was rated on a 9-point rating scale with the anchors 0–2 (not likely), 3–5
(moderately likely), and 6–8 (very likely).
Important Information Content when Considering Help
Tables 3 and 4 summarize participants’ ratings on the importance of various
topics concerning help for mental health problems. Table 3 describes ratings of
importance regarding information about dierent aspects of the treatment proc-
ess and dierent treatment options. Information about the cost of the treatment
to the recipient was rated as more important (60% very important) than the cost
of treatment to the health care system (37% very important). More participants
thought it was highly important to receive information about counselling/psy-
chological treatment (78% very important) than medication treatments (44%
very important).
Table 4 summarizes participants’ ratings of the importance of information about
the administrative and logistical aspects of treatment. e treatment provider’s
training (80% very important) and experience (81%) were seen as more important
than rationale for the recommended treatment (74%) or latency to begin treat-
ment (66%). Logistical aspects of treatment, such as information about where it
would take place (48% very important) and the time of day when appointments
were scheduled (48%) were seen as less important, even though nearly half of the
respondents thought these aspects were very important.
Helpfulness of Various Forms of Assistance
Table 5 provides a summary of opinions about the helpfulness of dierent
types of services that respondents might consider if they were having a problem
with stress, anxiety, or depression at some point in their life. e highest rating
was for an in-person meeting with a counsellor (72% very helpful). A range of
Postsecondary Students’ Information Needs and Pathways 365
Table 3
Importance of Information on Treatment Options
What information would be important to you if you were considering help (for yourself, a close
friend, or a close family member?)
Information type
Not
important
(%)
Moderately
important
(%)
Very
important
(%)
Mean rating
(95% condence
interval)
Available treatments 7 26 67 6.0 (5.75–6.30)
Available medication treatments 11 45 44 4.9 (4.56–5.17)
Available counselling or psychological
treatments
2 20 78 6.5 (6.29–6.79)
What you have to do as part of the
treatment
1 19 80 6.4 (6.16–6.67)
Cost of treatment to you 10 30 60 5.5 (5.14–5.79)
Cost of treatment to healthcare system 21 42 37 3.6 (3.18–3.95)
Eectiveness of treatment 0 10 90 7.1 (6.89–7.28)
How treatment works 1 16 83 6.9 (6.65–7.05)
Goal or outcome of treatment 0 10 90 7.2 (7.01–7.35)
How long it takes for treatment to
produce results
0 22 78 6.5 (6.27–6.69)
How long treatment continues 1 24 75 6.4 (6.14–6.58)
What happens when treatment stops 1 18 81 6.6 (6.40–6.87)
Common side eects of treatment 1 15 84 6.9 (6.69–7.11)
Uncommon but serious side eects of
treatment
3 24 73 6.4 (6.14–6.64)
Advantages and disadvantages of
treatment
0 12 88 6.9 (6.65–7.05)
Note. N = 187. Each information area was rated on a 9-point rating scale with the anchors 0–2 (not
important), 3–5 (moderately important), and 6–8 (very important).
Table 4
Importance of Information on Administrative Aspects of Treatment
What information would be important to you if you were considering help (for yourself, a close
friend, or a close family member?)
Information type
Not
important
(%)
Moderately
important
(%)
Very
important
(%)
Mean rating
(95% condence
interval)
Training of person providing treatment 1 20 80 6.7 (6.48–6.90)
Health care provider’s experience in
treating these problems
2 17 81 6.6 (6.41–6.86)
Waiting period before starting treatment 3 31 66 6.0 (65.70–6.23)
Where treatment will take place 7 45 48 5.2 (4.89–5.46)
Amount of time required to take
treatment
4 37 59 5.7 (5.49–5.99)
Time of day appointment is scheduled 11 41 48 5.1 (4.78–5.41)
Treatment option health care provider
recommends and reasons why
2 24 74 6.4 (6.13–6.59)
Note. N = 187. Each information area was rated on a 9-point rating scale with the anchors 0–2 (not
important), 3–5 (moderately important), and 6–8 (very important).
366 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
other options were considered likely to be very helpful by a smaller number of
respondents, including a recommended self-help book (47%), a recommended
self-help website (48%), medication recommended by their family doctor
(41%), and medication recommended by a psychiatrist (45%). Other service
options (e.g., Internet discussion group, educational workshop) were rated as
less helpful, with only 22–27% of respondents rating these options as likely to
be very helpful.
Table 5
Helpfulness of Various Forms of Assistance
How helpful would the following types of assistance be if you were having a problem with stress, anxiety, or
depression?
Type of assistance
Not
helpful
(%)
Moderately
helpful
(%)
Very
helpful
(%)
Mean rating
(95% condence
interval)
Recommended self-help book 11 42 47 4.6 (4.23–4.89)
Recommended self-help website 12 40 48 4.9 (4.56–5.18)
Telephone meetings with a counsellor 22 51 27 3.6 (3.24–3.88)
In-person meetings with a counsellor 5 23 72 6.2 (5.88–6.45)
Educational meeting (about 2 hours
with 20–30 people)
36 42 22 3.6 (3.25–4.01)
Educational workshop (about 6 hours
with 20–30 people)
11 41 24 3.3 (2.99–3.66)
Internet discussion group led by a
professional
31 43 26 3.3 (3.00–3.68)
Internet discussion group led by a
person who has coped with the
problem themselves
26 51 23 3.5 (3.21–3.87)
Medication recommended by your
family doctor
21 38 41 4.4 (4.04–4.71)
Medication recommended by a specialist
in psychiatry
17 38 45 4.7 (4.35–5.04)
Note. N = 187. Each source was rated on a 9-point rating scale with the anchors 0–2 (not helpful), 3–5
(moderately helpful), and 6–8 (very helpful).
Preferred Source and Amount of Information
Information about help for common mental health problems may be obtained
from a variety of sources. We asked participants how they would prefer to receive
information about various services. As described in Table 6, the preferred methods
to receive information about services were discussion with a health care provider
(67% highly preferred), information in a written form (brochure or booklet, 60%
highly preferred), and information on a recommended website accessed from
home (60% highly preferred). Less preferred methods of obtaining information
were a website accessed in a health care provider’s oce (44% highly preferred)
and video or DVD (29%).
Postsecondary Students’ Information Needs and Pathways 367
Table 6
Preferred Method for Receiving Information About Services
Preferred method
Not at all
preferred
(%)
Moderately
preferred
(%)
Highly
preferred
(%)
Mean rating
(95% condence
interval)
Written form (information sheet) 11 29 60 5.6 (5.28–5.88)
Discussion with health care provider 3 30 67 6.1 (5.85–6.36)
Video or DVD 19 52 29 3.7 (3.40–4.08)
Recommended website accessed from home 8 32 60 5.5 (5.24–5.85)
Website accessed in health-care provider’s
oce
13 43 44 4.8 (4.46–5.09)
Note. N = 187. Each method was rated on a 9-point rating scale with the anchors 0–2 (not at all
preferred), 3–5 (moderately preferred), and 6–8 (very much preferred).
Participants were also asked about the amount of information they would
prefer concerning various types of help. Table 7 shows participants’ ratings of the
amount of information they would prefer to receive (in pages) concerning medica-
tion treatment, counselling or psychological treatment, and self-help approaches.
Most participants (75–87%) indicated an interest in receiving two to six pages of
information about each of these forms of treatment.
Table 7
Preferred Amount of Information About Treatment Options
Treatment option Number of pages
Mean rating
(95% condence
interval)
0 (%) 2 (%) 4 (%) 6 (%) 8 (%) 10+ (%)
Medication treatment 2 30 37 20 3 8 2.2 (1.99–2.33)
Counselling or psychological
treatment
1 22 36 26 8 7 2.4 (2.26–2.59)
Self-help approaches 4 29 28 18 7 14 2.4 (2.15–2.57)
Note. N = 187. Amount of information area was rated on a 6-point rating scale with the anchors 0 (0
pages), 1 (2 pages), 2 (4 pages), 3 (6 pages), 4 (8 pages), and 5 (10 pages or more).

Students accessing a university counselling or health centre were surveyed to
identify their mental health information needs and pathways for help. Students
were asked, “If you were to experience a signicant problem with stress, anxiety,
or depression: Who would you likely turn to for advice? What information would
be important in considering the types of help available? What types of assistance
would you see as helpful? How would you prefer to receive information? How
much information would you prefer to receive?”
368 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
Preferred Sources of Information
e survey participants indicated that they would be likely to rst turn to
members of their personal support network when seeking advice about dealing
with common mental health problems such as stress, anxiety, and depression.
is nding about the importance of friends and family is consistent with other
research on help-seeking for mental health problems (e.g., Reavley, Yap, Wright,
& Jorm, 2011). In order to reach those who would benet from help for these
problems, it is important to reach out to students’ friends and family members to
inform them about the availability of information and help for common mental
health problems. Beyond their personal support network, students are also likely
to turn to available counselling sta and health resources such as a family doctor.
is suggests that in disseminating information to students it will be important
to ensure that high quality educational resources are available to friends and fam-
ily as well as to counselling and health professionals who are likely to come into
contact with them.
Although students overall seem less likely to use phone-in lines than friends,
family, or health care professionals as a source of advice, about 60% of our respond-
ents indicated that they would be moderately to very likely to use phone-in lines
as a source of information. ere are times when sources of information like this
may be especially helpful, such as when other sources of assistance are not available,
after regular oce hours, or in the middle of the night. Approaches such as the use
of phone lines may also have advantages in terms of cost and ease of accessibility.
In addition, other technology-based approaches could also be considered to assist
with mental health support, such as social media sites (e.g., Gowen, Deschaine,
Gruttadara, & Markey, 2012) and mobile applications that are always accessible
by students (e.g., Samson, 2014).
Important Information Content when Considering Help
Survey questions on the preferred information content revealed that par-
ticipants judged information on a wide range of topics to be highly important,
including treatment eectiveness, advantages/disadvantages of treatment, side
eects, and what happens when treatment is stopped. Previous research with
young adults suggests that information on a small number of these topics (pri-
marily descriptions of common mental health problems and the types of treat-
ment available) is accessible on the Internet and in brochure format (Walsh,
Walker, Reynolds, & the Mobilizing Minds Research Group, 2010). However,
very little information is available to the public on other topics important to
making informed choices (e.g., eectiveness of various treatments, advantages
and disadvantages of treatment, common side eects of treatments). Moreover,
where it is available, some of this information is focused on marketing specic
medications or products. As such, evidence-based information on some impor-
tant topics, such as what happens when treatment stops, is not easily accessible
to either the public or health care professionals. Developing accessible, reliable
Postsecondary Students’ Information Needs and Pathways 369
sources of such information would be very helpful for students, health care pro-
viders, and other stakeholders.
Helpfulness of Various Forms of Assistance
Participants indicated that in-person meetings with a counsellor were the
most highly preferred source of direct help, followed by a range of other services
including self-help books or websites and medication treatment recommended by
a family doctor or a psychiatrist. Respondents were quite positive about self-help
resources, which have advantages in terms of low cost and potentially wide avail-
ability. Self-help resources may also be integrated with other sources of help, such
as contact with a counsellor or a physician. Medication was also considered to be
a helpful form of treatment. Potentially lower-cost alternatives, such as telephone
meetings with a counsellor, educational meetings, and educational workshops,
were considered to be very helpful by a lower proportion of respondents. However,
considering both very helpful and moderately helpful ratings, almost two thirds of
respondents considered these resources to be potentially helpful. As such, these
low-cost alternatives may be methods of meeting the needs of students when one-
on-one counselling resources are limited.
Preferred Source and Amount of Information
About two thirds of the survey respondents indicated that they preferred to
receive information about mental health services through in-person discussion
with a health care provider. However, a signicant challenge for health care pro-
fessionals in providing information to students is the limited time that they have
available in each consultation. For most patients, a physician visit typically lasts
for 15 minutes or less. Visits with a counsellor are usually limited to a 50-minute
session, during which it is often necessary to accomplish a number of goals in
addition to exchanging information. ere are also limits to the availability and
accessibility of these service providers, who are only available at particular times
and at specic locations. is suggests that other methods of delivering informa-
tion would be helpful as alternatives to directly seeking out professionals for advice.
Given these issues with accessibility to information meetings with a service
provider, it is helpful to note that 60% of respondents also expressed preferences
for receiving information in written form (brochure or booklet) or through a
recommended website accessed from home. ese latter ndings are consistent
with a recent study (Cunningham et al., 2013) carried out in primary care medical
clinics, where more than 1,000 young adults from a wide range of educational
backgrounds responded to a consumer-preference modelling survey concerning
how they would like to obtain information about problems with anxiety or depres-
sion. ese researchers identied two segments of young adults—one segment
that was particularly interested in receiving information through the Internet, and
another segment interested in receiving information through more traditional
written materials such as brochures. When these ndings are considered along
with our survey results, it would seem helpful to develop resources that can be
370 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
accessed online and also downloaded in hard-copy format, as well as printed for
distribution in conventional brochure formats of two to six pages, as found in
many health service settings.
Limitations
is study has a number of limitations that should be considered when inter-
preting the results and considering their application to other samples of students
or young adults. Although the levels of symptoms and distress were fairly low, the
majority of respondents were seeking some form of help, which was corroborated
by the observation that a relatively high proportion had reportedly received help
for problems with stress, anxiety, or depression in the past. e opinions of stu-
dents who have never attended a counselling centre may be dierent, as may be
the opinions of students who did not volunteer to complete the survey. It would
be helpful in future research to obtain the opinions of students who are recruited
in other settings, such as public areas of the university campus, and from more
than one institution. In addition, the respondents had, on average, four years of
education after the completion of high school, and it would be helpful to obtain
information from young adults with lower levels of education and from families
with lower levels of parental education. Although the proportion of respondents
born outside of Canada and from dierent racial/ethnic groups suggests that
respondents came from diverse backgrounds, it is possible that young adults with
dierent characteristics (e.g., from other specic cultural groups or from lower-
income families) would have dierent opinions than participants in this survey.
Such considerations should be explored in future studies to ensure that adequately
generalizable results are obtained regarding information pathways for students
seeking help for their mental health problems.
Implications
In summary, the survey ndings indicated that students would rst turn to
people in their personal support network and then to health care providers for in-
formation, advice, and assistance with common mental health concerns. However,
given limitations on the level of mental health literacy among partners, peers, and
parents, along with limited access to counsellors and physicians, alternative sources
of information about mental health conditions and various treatment aspects are
needed. As most students have relatively easy access to the Internet and are famil-
iar with using it as a source of information, development of websites focusing on
accessible, balanced, and reliable information about their mental health-related
needs would be very helpful.
With respect to such websites, it may be especially eective to develop com-
bined sources of information that would enable students, family, friends, and
health care providers to access the required information online, which could also
be downloaded and printed as resource sheets if desired. In addition, while video
content was not highly rated as a primary method of receiving information in
the survey, such narrative information may be particularly useful in encouraging
Postsecondary Students’ Information Needs and Pathways 371
positive health behaviours (Fix et al., 2012). With broadband access now widely
available, it is not dicult to include video content on information websites.
For example, e Mobilizing Minds Research Group has recently developed
a website to specically address the documented information needs of young
adults concerning treatment choices for depression (http://depression.informed-
choices.ca), which serves to illustrate how evidence-based sites can be used to
increase mental health literacy for students and those to whom they are likely to
turn for support, such as friends and families. Professionals can also download
materials from this site, in both French and English, through its Creative Com-
mons licence.
Web-based resources are also useful as a way for student groups to enhance
mental health literacy among their peers. For example, the McMaster University
Students Union has partnered with the Canadian Mood Disorders Association
to develop the COPE: Student Mental Health Initiative (http://copex.weebly.
com/) that consists of both web-based materials and peer-led workshops to
increase awareness of depression and available treatment resources on campus.
From a faculty and sta perspective, web-based resources can also be helpful to
both increase mental health literacy and provide basic information on how to
identify and refer students at risk, such as the Mental Health Awareness Program
developed for those who work closely with students at the University of Guelph
(https://www.uoguelph.ca/counselling/awareness/).
In addition to web resources, campus events (e.g., speakers, workshops, panel
presentations, information booths, and displays) during national campaigns
such as the Canadian Mental Health Associations Mental Health Week (http://
mentalhealthweek.cmha.ca/) provide high-prole opportunities to increase men-
tal health literacy and provide helpful information about treatment resources
available on campus. Similar programming can also be introduced at orientation
events for students and their parents. And, on an even broader scale, national
initiatives such as the Canadian Association of College & University Student
Services and Canadian Mental Health Association (2013) joint project to de-
velop a comprehensive guide for postsecondary mental health hold promise of
changing the entire landscape of mental health awareness and service delivery on
campuses across Canada.
We hope that the results of our survey of postsecondary students’ information
needs and pathways for treatment can assist in the continued development of
evidence-based resources that can be delivered online, made available in printed
format, and used to inform programming and policy development designed to
address the mental health-related issues aecting postsecondary students across
Canada.
Acknowledgements
is project was supported by a Knowledge Translation Team Grant from
the Canadian Institutes of Health Research and Mental Health Commission of
Canada (TMF 88666).
372 Stewart, Walker, Beatie, Reynolds, Hahlweg, Leonhart, Tulloch, & Mobilizing Minds
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About the Authors
Donald W. Stewart is a clinical psychologist, associate professor, and academic administrator in
Student Support at the University of Manitoba who conducts research in young adult mental health.
John R. Walker is a professor of clinical health psychology at the University of Manitoba with
interests in anxiety and mood disorders in adults and youth and knowledge translation.
Brooke Beatie is a MA student in clinical psychology at the University of Manitoba with interests
in mental health help-seeking and service utilization.
Kristin A. Reynolds is a PhD candidate in the Department of Psychology at the University of
Manitoba with research interests in the knowledge translation of health information, website
evaluation, and aging and mental health.
Ken Halhlweg is an academic family physician in the Department of Family Medicine at the
University of Manitoba with a special interest in mental health and was formerly the Director of
the University Health Service.
Mark Leonhart is currently in the MA clinical psychology program at Concordia University, focus-
ing on anxiety disorders in adults.
Alexandria Tulloch currently works as an autism senior tutor for the St. Amant Autism Program
in Winnipeg, MB.
Members of e Mobilizing Mind Research Group include the following (in alphabetical order):
Young adult partners: Chris Amini, Amanda Aziz, Meagan DeJong, Pauline Fogarty, Mark Le-
onhart, Alicia Raimundo, Kristin Reynolds, Allan Sielski, Tarannum Syed, and Alexandria Tul-
loch; community partners: Maria Luisa Contursi and Christine Garinger from mindyourmind
(mindyourmind.ca); research partners: Lynne Angus, Chuck Cunningham, John D. Eastwood,
Jack Ferrari, Patricia Furer, Madalyn Marcus, Jennifer McPhee, David Phipps, Linda Rose-Krasnor,
Kim Ryan-Nicholls, Richard Swinson, John Walker, and Henny Westra; and research associates:
Jennifer Volk and Brad Zacharias.
Address correspondence to Donald W. Stewart, Student Support, 519 University Centre, University
of Manitoba, Winnipeg, MB, R3T 2N2, Canada; e-mail <don_stewart@umanitoba.ca>
... A 2008 study of first-year students in the United States showed that over three quarters of those who reported clinically significant levels of distress had not received counseling (94). In another study, 63% of post-secondary students surveyed at a mid-sized Canadian university reported a lack of help-seeking, despite experiencing a need for mental health care (110). In a study of Canadian students' help seeking preferences, factors included: the cost of treatment, the healthcare provider's training and experience, information about where the treatment would take place, and the time of day during which appointments were scheduled (110). ...
... In another study, 63% of post-secondary students surveyed at a mid-sized Canadian university reported a lack of help-seeking, despite experiencing a need for mental health care (110). In a study of Canadian students' help seeking preferences, factors included: the cost of treatment, the healthcare provider's training and experience, information about where the treatment would take place, and the time of day during which appointments were scheduled (110). Students have also identified a number of barriers to help seeking, including: the associated stigma (111)(112)(113)(114)(115), concerns about confidentiality (116,117), lack of time (116,(118)(119)(120)(121), not believing the problem warranted professional help (87,115,116,119,121), uncertainty that professional help will be beneficial (116), as well as indicating a preference for relying on other sources of support, including family and friends (119,122,123), or managing the problem themselves (113,116,119,121,122). ...
Thesis
Background: Over the past several years, reports of excessive stress and symptoms of languishing mental health have been increasingly reported among samples of Canadian post-secondary students. Chronic stress is highly correlated with negative mental health outcomes and formal diagnoses for common mental illnesses, such as depression and anxiety, have continued to climb. The purpose of this doctoral research program was to develop a new instrument to better assess the sources of post-secondary student stress. Existing instruments in this area are imperfect for a number of reasons, including weak (or lack of) psychometric analyses, poorly focused scope, and outdatedness. Importantly, few existing tools have involved students in the process of development. Methods: The development of the Post-Secondary Student Stressors Index (PSSI) spanned two years, and involved students as collaborators and subject matter experts over the course of the project. The instrument was designed to identify stressors specific to the post-secondary setting, with the aim of providing post-secondary institutions with a tool to identify the most significant sources of stress for students on their campuses. To facilitate item pool development, students participated in online surveys and focus group discussions. The initial item pool, derived from these qualitative responses, was then refined through the use of individual cognitive interviews and an online Delphi method. Finally, an online pilot test was conducted to assess psychometric properties. Results: The PSSI is composed of 46 stressors across five domains: academics, learning environment, campus culture, interpersonal, and personal. Students were asked to rate each stressor by severity and frequency. The tool demonstrated strong psychometric properties, with four types of validation evidence collected to support its validity: content, response processes, internal construct (including test-retest reliability), and relations to other variables. Conclusion: Our exploratory sequential mixed methods research design allowed for the development of a heavily context-based tool demonstrating strong psychometric properties. The PSSI can provide Canadian post-secondary institution administrators, student wellness staff, and program developers with a valid method of identifying the sources of student stress on their campus, and facilitate better targeting of mental health promotion and mental illness prevention efforts to best support students’ needs. Full text available at: http://hdl.handle.net/1974/27421
... A 2008 study of first-year students in the United States showed that over three quarters of those who reported clinically significant levels of distress had not received counselling (Rosenthal & Wilson, 2008). In another study, 63% of post-secondary students surveyed at a mid-sized Canadian university reported that they had not sought help, despite experiencing a need for mental health care (Stewart et al., 2014). In a study of Canadian students' help-seeking preferences, factors included the cost of treatment, the healthcare provider's training and experience, information about where the treatment would take place, and the time of day during which appointments were scheduled (Stewart et al., 2014). ...
... In another study, 63% of post-secondary students surveyed at a mid-sized Canadian university reported that they had not sought help, despite experiencing a need for mental health care (Stewart et al., 2014). In a study of Canadian students' help-seeking preferences, factors included the cost of treatment, the healthcare provider's training and experience, information about where the treatment would take place, and the time of day during which appointments were scheduled (Stewart et al., 2014). Students have also identified a number of barriers to seeking help, including the associated stigma (Beatie, Stewart, & Walker, 2016;Eisenberg, Downs, Golberstein, & Zivin, 2009;Lannin, Vogel, Brenner, Abraham, & Heath, 2016;Levin, Krafft, & Levin, 2018;Salzer, Wick, & Rogers, 2008); concerns about confidentiality (Davies et al., 2000;Givens & Tjia, 2002); lack of time (Bilican, 2013;Czyz, Horwitz, Eisenberg, Kramer, & King, 2013;Davies et al., 2000;Stebleton, Soria, & Huesman, 2014;Yorgason, Linville, & Zitzman, 2008); not believing the problem warranted professional help (Arria et al., 2011;Bilican, 2013;Czyz et al., 2013;Davies et al., 2000;Salzer et al., 2008); uncertainty that professional help will be beneficial (Davies et al., 2000); as well as indicating a preference for relying on other sources of support, including family and friends (Bilican, 2013;Burlaka, Churakova, Aavik, Staller, & Delva, 2014;Cunningham et al., 2017), or managing the problem themselves (Bilican, 2013;Burlaka et al., 2014;Czyz et al., 2013;Davies et al., 2000;Levin et al., 2018). ...
Post-secondary students have been identified as an at-risk population for chronic stress and poor mental health. We conducted a scoping review of the academic literature surrounding student stress and mental well-being as the first phase of research in the development of Canada’s National Standard for the Psychological Health and Safety of Post-Secondary Students. Major thematic findings included student stress, resilience through effective coping and help-seeking, and programs or strategies to improve campus mental health. Recommendations include a call for increased mental health promotion and mental illness prevention activities that are sensitive to diverse cultures, ethnicities, religions, and sexualities.
... A 2008 study of first-year students in the United States showed that over three quarters of those who reported clinically significant levels of distress had not received counselling (Rosenthal & Wilson, 2008). In another study, 63% of post-secondary students surveyed at a mid-sized Canadian university reported that they had not sought help, despite experiencing a need for mental health care (Stewart et al., 2014). In a study of Canadian students' help-seeking preferences, factors included the cost of treatment, the healthcare provider's training and experience, information about where the treatment would take place, and the time of day during which appointments were scheduled (Stewart et al., 2014). ...
... In another study, 63% of post-secondary students surveyed at a mid-sized Canadian university reported that they had not sought help, despite experiencing a need for mental health care (Stewart et al., 2014). In a study of Canadian students' help-seeking preferences, factors included the cost of treatment, the healthcare provider's training and experience, information about where the treatment would take place, and the time of day during which appointments were scheduled (Stewart et al., 2014). Students have also identified a number of barriers to seeking help, including the associated stigma (Beatie, Stewart, & Walker, 2016;Eisenberg, Downs, Golberstein, & Zivin, 2009;Lannin, Vogel, Brenner, Abraham, & Heath, 2016;Levin, Krafft, & Levin, 2018;Salzer, Wick, & Rogers, 2008); concerns about confidentiality (Davies et al., 2000;Givens & Tjia, 2002); lack of time (Bilican, 2013;Czyz, Horwitz, Eisenberg, Kramer, & King, 2013;Davies et al., 2000;Stebleton, Soria, & Huesman, 2014;Yorgason, Linville, & Zitzman, 2008); not believing the problem warranted professional help (Arria et al., 2011;Bilican, 2013;Czyz et al., 2013;Davies et al., 2000;Salzer et al., 2008); uncertainty that professional help will be beneficial (Davies et al., 2000); as well as indicating a preference for relying on other sources of support, including family and friends (Bilican, 2013;Burlaka, Churakova, Aavik, Staller, & Delva, 2014;Cunningham et al., 2017), or managing the problem themselves (Bilican, 2013;Burlaka et al., 2014;Czyz et al., 2013;Davies et al., 2000;Levin et al., 2018). ...
Preprint
BACKGROUND: In 2018, Bell Canada, the Rossy Family Foundation, and the Royal Bank of Canada announced their intent to fund the development of a National Standard for the Psychological Health and Safety of Post-Secondary Students (“the Standard”). This manuscript details a scoping review of the academic literature conducted as the first phase of research in the development of the Standard. OBJECTIVES: The goal of this study was to explore the state of research relative to the discussion around post-secondary student mental health. A detailed, international scoping review of the academic literature was conducted to map existing knowledge. METHODS: Six diverse academic databases were searched for published, academic literature, restricted by English language and a publication date range between 2000-2018. A screening process was undertaken by two reviewers filtering articles by title and abstract, with a third party available to break ties in the event of reviewer disagreement. A total of 177 records were included in the scoping review. RESULTS: Findings revealed a substantial self-reported prevalence of stress, mental distress, and diagnosed mental disorders among the post-secondary student population in Canada and elsewhere. Major thematic findings in the literature included: stress and stressors; resiliency through effective coping and help seeking; and programs, interventions, and strategies to improve post-secondary students’ mental health. CONCLUSIONS: Post-secondary students represent an at-risk group for increased stress and negative mental health outcomes, and many are ill-equipped to cope. While students have become more willing to seek help in recent years, post-secondary institutions are struggling to manage the volume of students in need. Therefore, rather than increased investment in treatment for mental illnesses, a call for increased mental health promotion (i.e., stress reduction) and mental illness prevention (i.e., development of healthy coping skills) that is sensitive to diverse cultures, ethnicities, religions, sexualities, and sexes is warranted.
... However, in evaluating this item raters did not consider how many treatments were discussed in each website, and this number varied widely. Most of the websites included at least adequate information on psychological treatment, self-help treatment, and the patient's role in treatment, which fortuitously are topics that consumers of anxiety, depression, and stress information are very interested in [4,[31][32][33]. Very few websites included information on the cost of the treatment to the healthcare system, however consumers report little interest in seeking this information [31]. ...
Article
Objectives and Methods: A wealth of online anxiety information exists but much of it is not evidence-based or well-balanced. This study evaluated anxiety websites (N=20) on readability, quality, usability, visual design, and content. Results Overall, websites were of reasonable quality but only half were considered understandable according to the PEMAT usability scale (70% cutoff value). The average reading level across websites was 11.2 (SMOG), which is higher than NIH recommended grade 6-7 level. Websites had variable design features and a trending association suggested websites with better design come up earlier in search results. The number of topics covered varied across websites and most did not adequately cover all topics of interest. Most websites included information about psychological and self-help treatments, how treatment works, and what treatment entails. The Top 5 websites were: (1) Anxiety BC, (2) ADAA, (3) Mind, (4) Beyond Blue, and (5) Web MD. Conclusions This is the first study to evaluate existing anxiety information websites based on the dimensions described above and their relationship to Google search results. Practice Implications This study highlights the importance of considering several dimensions in developing mental health resources and provides direction for strategies to improve existing websites and/or develop new resources.
... However, in evaluating this item raters did not consider how many treatments were discussed in each website, and this number varied widely. Most of the websites included at least adequate information on psychological treatment, self-help treatment, and the patient's role in treatment, which fortuitously are topics that consumers of anxiety, depression, and stress information are very interested in [4,[31][32][33]. Very few websites included information on the cost of the treatment to the healthcare system, however consumers report little interest in seeking this information [31]. ...
Preprint
BACKGROUND There are several treatments available for anxiety, which can make treatment decisions difficult. Resources are often produced with limited knowledge of what is of interest to consumers. This is a problem because there is a limited understanding of what people want to know when considering help for anxiety. OBJECTIVE This study examined the information needs and preferences concerning treatment options for anxiety. The aims were: (a) what information do people consider to be important when they are considering treatment options for anxiety; (b) what information have people received on psychological and medication treatment in the past; (c) how did they receive this information in the past; and (d) are there any differences in information needs between specific samples and demographic groups. METHODS Using a web-based survey, we recruited participants from a peer-support association website (n = 288) and from clinic samples (psychology n = 113, psychiatry n = 64). RESULTS Overall, participants in all samples wanted information on a broad range of topics pertaining to anxiety treatments. However, they reported not receiving the amount of information they desired. Participants in the clinic samples rated the importance of information topics higher than did the self-help sample. When considering anxiety treatment information received in the past, the highest proportion of respondents indicated receiving information from informational websites, family doctors, and mental health practitioners. In terms of what respondents want to learn about, high ratings of importance were given to topics concerning treatment effectiveness, how it works, advantages/disadvantages, what happens when it stops, and common side effects. CONCLUSIONS It is challenging for individuals to obtain anxiety-related information on the range of topics they desire through currently available information sources. It is also difficult to provide comprehensive information in a typical clinical visit. Providing evidence-based information online and in brochure format would help consumers make informed choices and would support advice provided by health professionals.
... One study did look at the mental health information needs and preferences of Canadian postsecondary students with stress, anxiety, and depression. However, this study did not include a focus on perinatal anxiety (Stewart et al. 2014). A further potential limitation is that although the DISCERN examines website quality, it does not evaluate whether the website contains accurate and evidence-based information. ...
Article
Full-text available
The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.
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This research explored parents' mental health literacy (MHL) skills (i.e., recognizing symptoms and identifying effective help‐seeking strategies) for child attention‐deficit/hyperactivity disorder (ADHD) and anxiety, factors associated with their MHL, and preferences for receiving information about each disorder. N = 128 parents were recruited from community organizations to participate in an online survey. Parents were randomly assigned to read one vignette depicting a child with symptoms of ADHD or anxiety. They were asked to identify the depicted problem and rate the helpfulness of potential help‐seeking strategies (i.e., different health professionals and medications). They also completed measures of parental self‐efficacy and parenting stress and indicated information preferences for learning about symptoms and treatment. Parents scored just above the mid‐range on a measure of their MHL skills, with no significant difference between parents responding to the ADHD and anxiety vignettes. Stronger MHL was associated with being a mother, having personal, family, or friend‐related mental health experience, and stronger parental self‐efficacy. Parents were interested in receiving more information about child ADHD and anxiety via health provider or written format. Results are valuable for informing future MHL intervention efforts to educate parents about symptoms and treatment for common child mental health problems such as ADHD and anxiety.
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A small minority of older adults seek psychological help when they need it. Barriers to mental health service use among older adults include low mental health literacy and reduced opportunities for shared decision-making in health care. There is a gap in the literature examining the mental health information preferences of older adults. The objectives of this study were to describe the information preferences and predictors of preferences among older adults. In total, 229 adults aged 50 years and older in central Canada responded to a questionnaire investigating socio-demographic, psycho-social and health-related characteristics, as well as mental health information preferences. Descriptive analysis quantified participants’ ratings of information preferences and hierarchical linear regression analysis determined predictors of their preferences. Older adults rated all mental health content items as very important. Most participants preferred detailed information (two to six pages) on all treatment options (psychological, pharmacological, combined and self-help). Older adults significantly preferred discussion with a heath-care provider and written information, in comparison to other formats. Older adults also significantly preferred to consult family, friends and heath-care professionals over other sources. Socio-demographic and psycho-social characteristics accounted for some of the variance in predicting older adults’ information preferences. Findings highlight older adults’ desire to be involved in decisions concerning mental health supports. Providing balanced information concerning mental health treatment may increase empowerment in mental health help-seeking.
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Little is known about how factors related to the post-secondary academic setting impact Canadian students’ self-reported anxiety. Using a socio-ecological framework, we examined lifetime prevalence and correlates of self-reported student anxiety. Data were collected from 593 university students (422 of whom were undergraduates) from a university in central Canada through an online survey. Descriptive statistics and a series of regression models were used to examine the study’s objectives. Most students reported having experienced anxiety that had impacted their lives. Findings provide support for a socio-ecological explanation of anxiety: socio-demographic, relationship, and academic factors predicted self-reported student anxiety. The results highlight the need to ensure that campus services and supports are well equipped to address the mental health problems of students. Theoretical, practice, and research implications are noted. On sait peu de choses sur la façon dont les facteurs liés au milieu de l’éducation postsecondaire influencent le degré d’anxiété rapporté par les étudiants canadiens. Grâce à un cadre socio-écologique, nous avons examiné leur prévalence au cours de la vie et leurs corrélations avec l’anxiété rapportée par les étudiants. Les données furent recueillies par un sondage en ligne auprès de 593 étudiantes et étudiants universitaires (dont 422 de premier cycle) fréquentant une université du centre du Canada. Pour examiner les objectifs de l’étude, on a eu recours à des statistiques descriptives et à une série de modèles de régression. La plupart des étudiantes et étudiants ont rapporté avoir vécu une anxiété qui a eu des répercussions sur leur vie. Les résultats vont dans le sens d’une explication socio-écologique de l’anxiété : des facteurs relatifs à la sociodémographie, aux relations et aux études semblaient en lien direct avec les degrés d’anxiété rapportés par les étudiantes et les étudiants. Les résultats mettent en lumière la nécessité de s’assurer que les services aux étudiants et les services d’aide sur les campus sont en mesure de prendre en charge les problèmes de santé mentale. On y souligne des implications sur le plan de la théorie, de la pratique et de la recherche.
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This study examined the mediating effects of the self-stigma associated with seeking counseling and attitudes toward seeking counseling on the link between perceived public stigma and willingness to seek counseling for psychological and interpersonal concerns. Structural equation modeling of data from 676 undergraduates indicated that the link between perceived public stigma and willingness to seek counseling was fully mediated by self-stigma and attitudes. Perceptions of public stigma contributed to the experience of self-stigma, which, in turn, influenced help-seeking attitudes and eventually help-seeking willingness. Furthermore, 57% of the variance in attitudes toward counseling and 34% of the variance in willingness to seek counseling for psychological and interpersonal concerns were accounted for in the proposed model.
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