Interventions to improve mental health help-seeking attitudes, intentions and behaviors: A systematic review of recent advances

The gap between mental health conditions and care uptake remains a global challenge, despite the availability of effective and affordable treatments. This gap is driven by demand-side barriers, such as lack of mental health literacy (MHL), stigma, etc., that hinder help-seeking. In this systematic review, we critically appraise interventions aimed at promoting help-seeking for mental health conditions. The review protocol was prospectively registered with PROSPERO (registration number CRD42021273843). A systematic search was conducted across MEDLINE, PsycINFO, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Central Register of Controlled Trials (CENTRAL). Only RCTs published after 2016, testing interventions with the aim of improving help-seeking behaviors, intentions and attitudes for any mental health conditions, were included. Due to the heterogeneity of outcomes and measures used in the studies, a narrative synthesis was conducted to examine the evidence. Fifty-four studies met the inclusion criteria. Our review confirms that MHL or psychoeducation, motivational interviewing (MI) and social contact interventions effectively improve help-seeking attitudes (n = 10), intentions (n = 17) and behaviors (n = 16). Multi-component MHL and MI-based strategies enhance help-seeking behaviors, while social contact online interventions enhance intentions. MHL/psychoeducation was effective across all outcomes, particularly when combined with other strategies. Despite a rise in help-seeking research, many studies lacked standardized frameworks, making cross-intervention comparisons difficult. Future work should align with theoretical models of help-seeking and explore mechanisms of change to better understand the link between intentions, attitudes and behaviors.