Community Mental Health Journal

, Volume 55, Issue 3, pp 476–486 | Cite as

Mental Health Attitudes and Beliefs in a Community Sample on the Central Coast in Australia: Barriers to Help Seeking

  • Dominiek CoatesEmail author
  • Christine Saleeba
  • Deborah Howe
Original Paper


There continues to be call for greater community awareness actions and strategies to reduce stigma and enhance mental health literacy nationally and internationally. To identify local barriers to help-seeking and perceptions around stigma, we developed a ‘mental health attitudes and beliefs’ survey which was administered at a range of community events on the Central Coast in New South Wales, Australia. The aim was for the results of this survey to inform the development of strategies that enhance local help-seeking behaviours that are sensitive to the role of age, gender and Indigenous status. People who approached our Mental Health Information stall were invited to complete the survey and 282 individuals completed the survey. The data was analysed descriptively with a focus on comparing subgroups based on age, gender, Indigenous status, and previous service access or experience of mental illness. Cost, stigma and mental health literacy were found to be prominent barriers to help-seeking for the overall cohort; however, the ways in which or extent to which these barriers impact on help seeking varied between subgroups. A discussion of these differences and their implications for practice is the focus of this paper.


Help seeking Youth mental health Service barriers Gender in mental health service access Mental health literacy Mental health stigma 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics Approval

Ethics approval for this study was received through the Hunter New England Human Research Ethics Committee and the Central Coast Local Health District Research Office. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. Australian Bureau of Statistics. (2008). National survey of mental health and well-being. Summary of results Cat No 4364.0. Canberra: Australian Bureau of Statistics.Google Scholar
  2. Australian Bureau of Statistics. (2012). 2011 census of population and housing, basic community profile (catalogue number 2001.0): Central Coast. Retrieved from
  3. Australian Bureau of Statistics. (2014–2015). National Health Survey Australia—First Results. Canberra: Australian Bureau of StatisticsGoogle Scholar
  4. Australian Institute of Health and Welfare. (2016). Mental health services—In brief 2016. Cat. no. HSE 180. Canberra: Australian Institute of Health and WelfareGoogle Scholar
  5. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., … Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11–27.CrossRefGoogle Scholar
  6. Coates, D. (2016). Client and parent feedback on a Youth Mental Health Service: The importance of family inclusive practice and working with client preferences. International Journal of Mental Health Nursing, 25, 526–535.CrossRefGoogle Scholar
  7. Coates, D., & Howe, D. (2014). The importance and benefits of youth participation in mental health settings from the perspective of the headspace Gosford Youth Alliance in Australia. Children and Youth Services Review, 46, 294–299. Scholar
  8. Commonwealth of Australia. (2007). NSW aboriginal mental health and well being policy 2006–2010. Canberra: Commonwealth of AustraliaGoogle Scholar
  9. Commonwealth of Australia. (2009a). Cultural respect & communication guide: A NSW aboriginal sexual health resource. Canberra: Commonwealth of AustraliaGoogle Scholar
  10. Commonwealth of Australia. (2009b). Fourth national mental health plan: An agenda for collaborative government action in mental health 2009–2014. Canberra: Commonwealth of Australia.Google Scholar
  11. Commonwealth of Australia. (2012). Work wanted: Mental health and workforce participation. Canberra: Commonwealth of Australia.Google Scholar
  12. Conwell, Y., Van Orden, K., & Caine, E. D. (2011). Suicide in older adults. Psychiatric Clinics of North America, 34(2), 451–468.CrossRefGoogle Scholar
  13. Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614–625.CrossRefGoogle Scholar
  14. Department of Health and Ageing. (2013). National aboriginal and Torres Strait Islander Health Plan 2013–2023. Canberra: Australian Government.Google Scholar
  15. Farnbach, S., Eades, A., Fernando, J. K., Gwynn, J. D., Glozier, N., & Hackett, M. L. (2017). The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: A systematic review. Public Health Research and Practice, 27(4), e27341700.CrossRefGoogle Scholar
  16. Gibb, S. J., Fergusson, D. M., & Horwood, L. J. (2010). Burden of psychiatric disorder in young adulthood and life outcomes at age 30. The British Journal of Psychiatry, 197, 122–127.CrossRefGoogle Scholar
  17. Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 2010(10), 113.CrossRefGoogle Scholar
  18. Gulliver, A., Griffiths, K. M., Christensen, H., & Brewer, J. L. (2012). A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry, 12, 81.CrossRefGoogle Scholar
  19. Harding, C., & Fox, C. (2015). It’s not about “Freudian couches and personality changing drugs”: An investigation into men’s mental health help-seeking enablers. American Journal of Men’s Health, 9(6), 451–463.CrossRefGoogle Scholar
  20. Hom, M. A., Stanley, I. H., & Joiner, T. E. Jr. (2015). Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: A review of the literature. Clinical Psychology Review, 40, 28–39.CrossRefGoogle Scholar
  21. Howe, D., Batchelor, S., Coates, D., & Cashman, E. (2013). Nine key principles to guide Youth Mental Health: Development of Service Models in New South Wales. Early Intervention in Psychiatry, 8(2), 190–197. Scholar
  22. Isaacs, A. N., Pyett, P., Oakley-Browne, m, Gruis, H., & Waples-Crowe, P. (2010). Barriers and facilitators to the utilisation of adult menta; health services by Australia’s Indigenous people: Seeking a way forwward. International Journal of Mental Health Nursing, 19, 75–82.CrossRefGoogle Scholar
  23. Jorm, A. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231–243.CrossRefGoogle Scholar
  24. Jorm, A., Bourchier, S. J., Cvetkovski, S., & Stewart, G. (2012). Mental health of indigenous Australians: A review of findings from community surveys. The Medical Journal of Australia, 196, 118–121.CrossRefGoogle Scholar
  25. Jorm, A., & Kitchener, B. A. (2011). Noting a landmark achievement: Mental health first aid training reaches 1% of Australian adults. Australian and New Zealand Journal of Psychiatry, 45, 808–813.CrossRefGoogle Scholar
  26. Kantor, V., Knefel, M., & Lueger-Schuster, B. (2017). Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: A systematic review. Clinical Psychology Review, 52, 52–68.CrossRefGoogle Scholar
  27. Kessler, R. C., Avenevoli, S., Costello, J. E., Georgiades, K., Green, J. G., Gruber, M. J.,.. . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey replication adolescent supplement. Archives of General Psychiatry, 69(4), 372–380.CrossRefGoogle Scholar
  28. Leavey, G., Rothi, D., & Rini, P. (2011). Trust, autonomy and relationships: The help-seeking preferences of young people in secondary level schools in London (UK). Journal of Adolescence, 34, 685–693.CrossRefGoogle Scholar
  29. Marcus, M. A., Westra, H. A., Eastwood, J. D., & Barnes, K. L. (2012). What are young people saying about mental health? An analysis of internet blogs. Journal of Medical Internet Research, 14(1), e17.CrossRefGoogle Scholar
  30. McGorry, P., Purcell, R., Goldstone, S., & Amminger, G. (2011). Age of onset and timing of treatment for mental and substance use disorders: Implications for preventive intervention strategies and models of care. Current Opinion in Psychiatry, 24(4), 301–306.CrossRefGoogle Scholar
  31. McIntyre, C., Harris, M. G., Baxter, A. J., Leske, S., Diminic, S., Gone, J. P., … Whiteford, H. (2017). Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States: A rapid review of population surveys. Health Research Policy and Systems, 15, 67.CrossRefGoogle Scholar
  32. Muir-Cochrane, E., O’Kane, D., Barkway, P., Oster, C., & Fuller, J. (2014). Service provision for older poeple with mental health problems in a rural area of Australia. Aging and Mental Health, 18(6), 759–766.CrossRefGoogle Scholar
  33. Oliffe, J. L., Orgodniczuk, J. S., Gordon, S. J., Creighton, G., Kelly, M. T., Black, N., & Mackenzie, C. (2016). Stigma in male depression and suicide: A Canadian sex comparison study. Community Mental Health Journal, 52, 302–310.CrossRefGoogle Scholar
  34. Patulny, R., Muir, K., Powell, A., Flaxman, S., & Oprea, I. (2013). Are we reaching them yet? Service access patterns among attendees at the headspace youth mental health initiative. Child and Adolescent Mental Health, 18(2), 95–102.CrossRefGoogle Scholar
  35. Plaistow, J., Masson, K., Koch, D., Wilson, J., Stark, R., Jones, P., & Lennox, B. (2014). Young Poeple’s views of UK mental health services. Early Intervention in Psychiatry, 8, 12–23.CrossRefGoogle Scholar
  36. Povey, J., Mills, P. P. J. R., Dingwall, K. M., Lowell, A., Singer, J., Rotumah, D., … Nagel, T. (2016). Acceptability of mental health apps for aboriginal and Torre Strait Islander Australians: A qualitative study. Journal of Medical Internet Research, 18(3), e65.Google Scholar
  37. Reavley, N., Cvetkovski, S., Jorm, A., & Lubman, D. I. (2010). Help seeking for substance use, anxiety and affective disorders among young people: Results from the 2007. Australian National Survey of Mental Health and Wellbeing, 44, 729–735.Google Scholar
  38. Reavley, N., & Jorm, A. (2011). Stigmatizing attitudes towards people with mental disorders: Findings from an Australian National Survey of Mental Health Literacy and Stigma. Australian and New Zealand Journal of Psychiatry, 45, 1086–1093.CrossRefGoogle Scholar
  39. Rickwood, D., Deane, F. P., & Wilson, C. (2007). When and how do young people seek professional help for mental health problems? Medical Journal of Australia, 187, S35-S39.Google Scholar
  40. Rickwood, D., Deane, F. P., Wilson, C., & Ciarrochi, J. (2005). Young people’s help-seeking for mental health problems. Australian e-Journal for the Advancement of Mental Health (AeJAMH), 4(3), 1–34.Google Scholar
  41. Ross, A. M., Hart, L. M., Jorm, A. F., Kelly, C. M., & Kitchener, B. A. (2012). Development of key messages for adolescents on providing basic mental health first aid to peers: A Delphi consensus study. Early Intervention in Psychiatry, 6, 229–238.CrossRefGoogle Scholar
  42. Sane Australia. (2013). A life without stigma. South Melbourne, VIC: Sane AustraliaGoogle Scholar
  43. Sherwood, E., & Edwards, T. (2006). Decolonisation: A critical step for improving Aboriginal health. Contemporary Nurse, 22(2), 178–190.CrossRefGoogle Scholar
  44. Siu, B., Chow, K., Lam, L., Chan, W., Tang, V., & Chiu, W. (2012). A questionnaire survey on attitudes and understanding towards mental disorders. East Asian Arch Psychiatry, 22, 18–24.Google Scholar
  45. Smith, C. (2012). Mental health and help-seeking in adolescence. Australasian Epidemologist, 19(1), 5–8.Google Scholar
  46. South Australia Deptartment of Health. (2010). Aboriginal health care plan 2010–2016. South Australia: Dept. of Health, Statewide Service Strategy Division.Google Scholar
  47. Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60(2), 311–316.CrossRefGoogle Scholar
  48. Wahl, O., Susin, J., Lax, A., Kaplan, L., & Zatina, D. (2012). Knowledge and attitudes about mental illness: A survey of middle school students. Psychiatric Services, 63(7), 649–654CrossRefGoogle Scholar
  49. Westerman, T. G. (2010). Engaging Australian aboriginal youth in mental health Services. Australian Psychologist, 45(3), 212–222.CrossRefGoogle Scholar
  50. Williamson, A. B., Raphael, R., Redman, S., Daniels, J., Eades, S. J., & Mayers, N. (2010). Emerging themes in Aboriginal child and adolescent mental health: Findings from a qualitative study in Sydney, New South Wales. Medical Journal of Australia, 192(10), 603.Google Scholar
  51. World Health Organisation. (2014). Preventing suicide: A global imperative. Geneva: World Health Organisation.Google Scholar
  52. Wright, A., McGorry, P., Harris, M., Jorm, A., & Pennell, K. (2006). Development and evaluation of a youth mental health community awareness campaign—The compass strategy. BMC Public Health, 6, 215.CrossRefGoogle Scholar
  53. Yap, M. B., & Jorm, A. (2012). Young people’s mental health first aid intentions and beliefs propectively predict their actions: Findings from an Australian National Survey of Youth. Psychiatry Research, 196, 315–319.CrossRefGoogle Scholar
  54. Yap, M. B., Reavley, N., & Jorm, A. (2012). Australian youth still have limited awareness of headspace: Results from a national survey. Australian & New Zealand Journal of Psychiatry, 46(1), 28–34.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculty of HealthUniversity of Technology SydneyUltimoAustralia
  2. 2.Central Coast Mental Health ServiceCentral Coast Local Health DistrictGosfordAustralia
  3. 3.Department of Biomedical Sciences, Faculty of Medicine and Health SciencesMacquarie UniversitySydneyAustralia

Personalised recommendations