Help-seeking intentions, barriers and associated variables for depression and social anxiety among adolescents in Bermuda

BACKGROUND: Globally, adolescents typically display low levels of help-seeking for their mental health problems. There is limited knowledge about the help-seeking intentions and barriers among adolescents in the Caribbean. The aim of this study was to investigate help-seeking intentions, barriers and associated variables for depression and social phobia (social anxiety) among adolescents in Bermuda. METHODS: This study involved a cross-sectional survey of middle-school and high-school students aged 10–19 years in Bermuda. Online surveys conducted between November 2022 - June 2023 gathered data on age, gender and race. In response to a randomly assigned vignette describing a peer as either experiencing depression or social anxiety, the survey assessed adolescents’ mental health-related help-seeking intentions, sources of help, barriers to professional help-seeking and help-seeking preferences. RESULTS: Of 2,434 adolescents who provided valid data, less than half indicated they would seek help for the problem described in the vignette. Reporting moderate to severe depression/anxiety symptoms, older age and female gender were all associated with lower intentions to seek help. The most commonly endorsed source of help was from a parent. Stigma was the most commonly endorsed barrier to professional help-seeking. Reporting moderate to severe depression/anxiety symptoms was associated with a higher likelihood of endorsing major barriers to professional help-seeking and the help-seeking preference of trying to deal with the problem in the vignette on their own. CONCLUSIONS: This study is the first to comprehensively investigate help-seeking intentions and barriers for depression and social anxiety among adolescents in Bermuda. The low rates of help-seeking intentions among adolescents reporting moderate to severe depression/anxiety symptoms are concerning given the associated issues with delayed professional help-seeking. This study is limited in that it examined help-seeking intentions in relation to depression or social anxiety as described in a vignette. Further research is needed to understand associations with actual help-seeking behaviours for these disorders. Anti-stigma programs should be implemented for adolescents in schools to address barriers to professional help-seeking. Older adolescent females may stand the most to gain from these efforts. Early intervention and prevention programs among early adolescents are needed.