This page provides information about potential help-seeking theory that can facilitate understanding of the help-seeking process, provide frameworks for our research and applied investigations into help seeking, and give us a conceptual understanding of potential targets for prevention and intervention efforts designed to close the mental health treatment gap for a given population.
As noted by Hammer and colleagues (2024), to close the mental health treatment gap (i.e., the gap between the number of people who would benefit from treatment and the number who access that treatment), it is necessary to understand why people do or do not seek help by identifying the constructs influencing access to mental healthcare. Several behavioral theories have been used to guide empirical explorations of these constructs, including the Behavioral Model of Health Services Use (Andersen et al., 2014), Common-Sense Model of Self-Regulation (Leventhal et al., 2016), Cultural Determinants of Help Seeking (Arnault, 2009), Health Belief Model (Rosenstock et al., 1988), Mental Health Literacy (Jorm et al., 1997), Network Episode Model (Pescosolido, 2010), and Transtheoretical Model (Prochaska & DiClemente, 1983). However, one of the most popular (Rickwood & Thomas, 2012; Davis et al., 2015) theoretical traditions for studying mental health help seeking is the reasoned action tradition.
The reasoned action tradition was first formalized as the Theory of Reasoned Action (TRA; Ajzen & Fishbein, 1980) and then enhanced to create the Theory of Planned Behavior (TPB; Ajzen, 1985). For resources and tutorials, visit Dr. Ajzen’s TRA and TPB resources webpage. Recently, scholars have published extensions of the reasoned action tradition, including the Integrative Model of Behavioral Prediction (IM; Fishbein & Ajzen, 2010) and the Integrated Behavioral Model (IBM; Montaño & Kasprzyk, 2015). However, the TRA, TPB, IM, and IBM are generalized theories of behavioral prediction and are not tailored to the nuances of mental health help-seeking behavior. Having spent years navigating the challenges associated with studying mental health help-seeking behavior, Dr. Hammer and his colleagues have identified several crucial adaptations to these reasoned action models to maximize their utility for the study of mental health help seeking.
Thus, Hammer and colleagues (2024) recently adapted the integrated extensions (i.e., IM and IBM) to the mental health help seeking context to create the Integrated Behavioral Model of Mental Health Help Seeking (IBM-HS). The IBM-HS is a help-seeking theory that (a) refines the positioning and dimensionality of reasoned action tradition constructs, (b) provide a mixed-method protocol for identifying primary help-seeking beliefs (i.e., the subset of salient beliefs that most distinguish those who intend to seek help from those who do not) of a population and sociodemographic groups therein, and (c) offers detailed measurement guidelines designed to guide users in the simultaneous assessment of multiple help-seeking constructs in a manner that complies with the reasoned action tradition’s principle of compatibility (Ajzen & Fishbein, 1980; Ajzen, 2020). This principle states that all help-seeking construct measures used in a given study must reference the same exact definition of help-seeking behavior.
Dr. Hammer recommends using the IBM-HS to guide the study of mental health help-seeking. To learn more about this help-seeking theoretical framework, visit the Integrated Behavioral Model of Mental Health Help Seeking (IBM-HS) page. However, all help-seeking theories have limitations, so professionals should consider the limitations of the IBM-HS versus other available theories prior to choosing a theoretical framework.
(Note: select page content excerpted from Hammer et al., 2024.)