June 27, 2008

EITHNE DONNELLAN, Health Correspondent

SEVERAL FACTORS, including concerns about confidentiality and a lack of understanding about the nature of depression, make many Irish teenage boys unlikely to seek professional help for mental health problems, a new study has found.

The study, which was conducted during focus group discussions with boys aged 15 to 18 years at two Dublin second-level schools, found stigma around psychiatric hospitals also increased their doubts about seeking help.

The boys also indicated they would be reluctant to confront a friend if they thought there was something amiss. Furthermore, the students said they would be reluctant to share emotional or psychological problems in case their peers reacted badly.

In addition, they expressed the belief that if a man was to show all his emotions, that people would laugh at him. Some showed a lack of knowledge about mental illness, describing conditions like Downs syndrome as a mental condition while not recognising depression as an illness.

Many said they would be reluctant to disclose sensitive information about their mental health to a GP or counsellor in case confidentiality was breached, and they thought speaking to somebody over the phone would be much easier.

The authors of the study, published in the Irish Journal of Psychological Medicine, state that the results indicate an urgent need for education in schools about mental illness and mental health services, as well as basic information about how mental health professionals can be contacted.

"As depression is the most common form of mental illness, this education should also explain how being depressed differs from general feelings of sadness. This information is crucial if young people are to recognise problems in themselves or others," they added.

They also say the study shows young men are unlikely to come forward if they are having problems. "It is for this reason that friends must be encouraged to ask them what is wrong, should they notice a change. Such an intervention might prove crucial in preventing a suicide".

With just 18 students taking part in the study and all of them from a higher socio-economic grouping, the authors of the study, who included leading psychiatrist Prof Patrick McKeon, point out that it is not representative of all teenage boys, some of whom leave school early.

Nonetheless, they say the study provides some "important insights" and its findings are useful for anyone involved in promoting mental health education in schools "and should be used to inform such educational initiatives". But they warn that young people's reluctance to use mental health services is not an issue that can be solved solely within schools.

Wider society, they say, needs to examine how it stigmatises mental illness and how this in turn affects the behaviour of those seeking help. They add that it is also the responsibility of parents to become informed about mental illness so that they can discuss it openly with their children.

Students' attitudes: in their words

On opening up to friends about emotional or psychological problems:
"It's just hard to open up to someone . . . How will I feel afterwards or how will they feel or will they still be my friend or whatever?"

On how men should behave:
"There's more like a stigma to men, like if a man was to show all his emotions people would laugh at him, but if a woman would do it, they'd say 'That's what women do'."

"Men like to sort things out themselves. They don't like to be helped unless they feel they have to be . . ."

On psychiatric hospitals:
". . . you can't leave, its almost like a prison. I know this is wrong but you automatically think of straitjackets and padded cells".

On accessing health service providers for help:
GPs – "I don't think they're trained to give that sort of advice.

"Also, you have to book an appointment and stuff and it might be a bit awkward, maybe a bit embarrassing to go to your GP".

Counsellors – ". . . they'll say to you obviously it's confidential . . . you still have it in your head that they're going to look at you completely differently. . ."

On medication for treating mental illness:
"You kind of associate medication with physical illness . . . I'm not too sure about mental illness and medication".