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Functioning mediates help-seeking for mental problems in the general population

  • Chantal Michel (a1) (a2), Nina Schnyder (a1), Stefanie J. Schmidt (a1), Nicola Groth (a1), Benno G. Schimmelmann (a1) (a3) and Frauke Schultze-Lutter (a1) (a4)...



Absent or delayed help-seeking is considered to aggravate the immense personal and societal burden caused by mental disorders. Therefore, we cross-sectionally examined rates and clinical and sociodemographic moderators of early help-seeking for current clinician-assessed non-psychotic mental problems/disorders in the community.


Altogether, 2683 individuals of the Swiss Canton Bern (16–40 years old, response rate 63.4%) were interviewed by telephone for current axis-I problems/disorders using the Mini-International Neuropsychiatric Interview, for psychosocial functioning using the Social and Occupational Functioning Assessment Scale, and for help-seeking for mental problems.


In total, 1122 (41.8%) reported mental problems. Of these, 769 (68.5%) affirmed any one screening question and 353 (31.5%) fulfilled criteria for any current axis-I disorder, and 396 (35.3%) reported any lifetime help-seeking (28.3% sought help in the past and 7.0% were in current treatment). In path analyses, current help-seeking was associated mainly by type and number of mental problems/disorders mediated by functional impairment, in addition to older age, no current partner, and past treatment.


Our cross-sectional data indicate a gap in help-seeking for mental problems/disorders. The relationship between number of mental problems/disorders and help-seeking mediated by functional impairment confirm that individuals commonly do not seek help until problems are severe enough to cause problems in occupational and psychosocial functioning, driving the already immense costs of mental disorders. Thus, campaigns promoting early help-seeking, including early diagnostic clarification of and support for subthreshold mental problems in terms of an indicated prevention, should focus on psychosocial functioning, aside from signs of mental illness.

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Corresponding author

*Corresponding author at: University Hospital of Child and Adolescent Psychiatry and Psychotherapy, Bolligenstrasse 111, Haus A, CH-3000 Bern 60, Switzerland. E-mail address: (C. Michel).


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Functioning mediates help-seeking for mental problems in the general population

  • Chantal Michel (a1) (a2), Nina Schnyder (a1), Stefanie J. Schmidt (a1), Nicola Groth (a1), Benno G. Schimmelmann (a1) (a3) and Frauke Schultze-Lutter (a1) (a4)...


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Functioning mediates help-seeking for mental problems in the general population

  • Chantal Michel (a1) (a2), Nina Schnyder (a1), Stefanie J. Schmidt (a1), Nicola Groth (a1), Benno G. Schimmelmann (a1) (a3) and Frauke Schultze-Lutter (a1) (a4)...
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