When studying the behavior of seeking help from a mental health professional, “prospective behavior” is shorthand for “prospective seeking of mental health care help from a mental health professional.”
Prospective help-seeking behavior is one of the most under-studied constructs because it requires the use of a multiple time-point design, where potential predictor variables are measured at Time 1 and then prospective behavior is assessed at Time 2. Ideally, prospective behavior is measured objectively using non-self-report data (e.g., records review). However, this is often impractical, so most researchers ask the respondents who completed a Time 1 survey (that included self-report measures of predictor variables) to complete a second follow-up survey at Time 2, in which respondents are asked to retroactively self-report whether they sought help in the time period between the Time 1 and Time 2 surveys. This retroactive self-report is often measured with a single item, though multi-item measures are sometimes used in the help-seeking literature.
An example single-item measure is “Did you seek help from a mental health professional (e.g., psychologist, psychiatrist, social worker, therapist, counselor) in the last 3 months?” (Hammer & Spiker, 2018). Response options typically include “No” and “Yes”. For clarity purposes, we can refer to this specific single-item measure as the Prospective Mental Help Seeking Behavior Measure (PMHSBM).
In the context of mental health, the IBM-HS’s default operational definition of prospective mental health help-seeking behavior is attending a future session with a healthcare professional to acquire the professional’s assistance with addressing a mental health problem. We say “future” to reinforce the fact that prospective behavior is different than the precursor of past experiences with mental health help seeking.
We say “default” because users of the IBM-HS are encouraged to define prospective help-seeking behavior in the manner that suits their professional purpose, provided that definition is characterized by the five elements described by Ajzen & Fishbein (1980) of target, action, context, time, and condition. For example, the behavior could be attending an initial session (action) with a mental health professional (target) at the campus counseling center (context) in the next three months (time) if one was experiencing a mental health concern (condition). Regardless of how behavior is defined, the principle of compatibility (Ajzen & Fishbein, 1980) must be observed to ensure that all help-seeking items reference the same exact help-seeking action, target, context, time, and condition.
Regarding action, some users of the IBM-HS may wish to study a particular step of the mental health help-seeking process (e.g., asking their primary care physician for a referral to a mental health specialist, using an internet search engine to look up information about potential mental health providers in their area, filling out a mental health agency’s online intake form, attending a phone screening with a mental health professional, attending an initial working session with a professional).
Regarding target, some users will wish to define behavior as seeking mental health help from a professional (of any kind), a primary care physician, a mental health professional (however defined), a psychologist (specifically), or some other source.
For context, some users may care about a specific context (e.g., counseling center, emergency room) and some may wish to be inclusive across contexts.
For time, some users may be interested in shorter (e.g., in the next two weeks) or longer (e.g., in the next three months) periods of time.
For condition, some may wish to study people who are currently diagnosed as depressed, people who self-identify as having a mental health concern (however defined by the user), or people who screen above a clinical cutoff on a screening measure such as the Kessler-6 (Kessler et al., 2002). Yet others may want to sample from a mixed-distress population (some people currently distressed and some not), in which case the behavior and help-seeking measures would be best framed using conditional language (e.g., “If I had a mental health concern, I would intend to seek help…”; Hammer et al., 2018) instead of unconditional language (e.g., “I intend to seek help…”).
For an in-depth guide on defining behavior using the five elements and complying with the principle of compatibility, readers may refer to Chapter 2 of Fishbein and Ajzen (2010).
(Note: select page content excerpted from Hammer et al., 2024.)