Mental disorders and help seeking in a rural impoverished population

Objective: This study examined the impact of an in-home screening and educa tional intervention on help seeking among rural impoverished individuals wi th untreated mental disorders. The effect of including a significant other in the intervention and reasons for not seeking help were explored. Method: The sample was randomly selected from households in nine rural counties in Virginia. The short form of the CIDI was used to screen 646 adult resident s. Respondents who screened positive were randomly assigned to one of three groups: 1) no intervention, 2) an educational intervention, or 3) the educ ational intervention with a significant other. A list of local sources of h ealth and mental health care was distributed. At one-month post interview, respondents were telephoned to inquire about help seeking. Results: Almost one-third (32.4%) of these respondents screened positive for at least one d isorder. Five hundred and sixty-six (87.6%) were successfully followed up, and thirty-three of the 566 (5.8%) reported that they had sought profession al help since the interview. Eighty-four subjects who screened positive and received the educational intervention reported in follow up that they had discussed the interview with a friend or family member, but only eleven (13 .1%) received encouragement to seek treatment. The predominant reason endor sed for not seeking help was "felt there was no need," even among responden ts who were informed that they had a disorder. Conclusions: A significant p roportion of this rural impoverished sample screened positive for a mental disorder. Few individuals sought professional help and significant others d id not encourage them to seek treatment. The implication of these results f or investigators and service providers is that motivating individuals to se ek mental health services is a complex process; more attention must he devo ted to the development of culturally relevant methods for facilitating help seeking.