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. 2020 Dec;10(12):e01873.
doi: 10.1002/brb3.1873. Epub 2020 Oct 7.

Pathways from health beliefs to treatment utilization for severe depression

Flavius R W Lilly  1 , Hyun-Jin Jun  2 , Patty Alvarez  3 , Jenny Owens  4 , Lauren Malloy  5 , Meghan Bruce-Bojo  1 , Carol Vidal  6
Affiliations

Pathways from health beliefs to treatment utilization for severe depression

Flavius R W Lilly et al. Brain Behav. 2020 Dec.

Abstract

Background: Untreated depression is associated with negative behavioral, psychosocial, and physical outcomes leading to socioeconomic costs, disability, and premature mortality. Research has not yet fully developed intervention models to increase the utilization of mental health treatments. The objective of the current study was to characterize the pathways linking health beliefs to treatment utilization among depressed young adults.

Methods: Data were collected in 2017 from 53,760 college students at 54 universities in the United States. Among the respondents, 5,343 screened positive for moderately severe to severe depression. Becker's Health Belief Model (HBM) was the guiding theoretical paradigm. Confirmatory factor analysis and structural equation modeling (SEM) were conducted to elucidate treatment-seeking behavior based on health beliefs (perceived severity, perceived benefit, perceived barriers, self-efficacy, and cues-to-action) while controlling for relevant sociodemographic covariates.

Results: Depression treatment utilization was significantly associated with all domains of the HBM. SEM parameter estimates indicated that higher levels of perceived severity, self-efficacy, and cues-to-action were associated with greater depression treatment utilization, whereas perceived benefits and perceived barriers were associated with lower depression treatment utilization.

Conclusions: The HBM may be useful to predict the frequency of seeking treatment by individuals for depression. However, individualized intervention strategies targeting different aspects of the HBM are needed to promote help-seeking behaviors in young adults with depression.

Keywords: depression; epidemiology; treatment.

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Conflict of interest statement

The authors declare there are no conflicts of interest.

Figures

Figure 1
Figure 1
Structural equation model of the mental health utilization. Ovals present the latent variables and rectangles present the observed variables. A dashed line with arrows indicates correlations between latent variables, and those correlation coefficients were not shown in this figure but in Table 2 for display purposes. Only significant coefficients are presented. The standardized coefficients are presented. e = errors. *p < .05, **p < .01, and ***p < .001
See this image and copyright information in PMC

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