Environmental constraints (e.g., access to transportation) are often left unaccounted for in investigations of the factors that influence mental health help seeking. Environmental constraints are, ideally, assessed with objective indicators (e.g., mental health provider density by county). For example, Gong and colleagues (2016) provide a systematic review of objective measurements of urban environments, and a few of these measurements may be considered environmental constraints relevant to the mental health help-seeking process (e.g., traffic volume).Likewise, Jacoby & Li (2022) examined how geographic availability of mental health care infrastructure related to help-seeking behavior.
However, there are respondent-report measures such as those administered on a survey or via an interview conversation that may partially capture the influence of environmental constraints on the help seeking process. That being said, it is important to emphasize that most people have incomplete perceptions of the true scope and nature of the environmental constraints that would shape their mental health care journey, particularly if they have not yet had personal experience seeking professional help; for more discussion of this, refer to Hammer and colleagues (2024). Therefore, self-report measures are inherently limited when it comes to measuring the true impact of environmental constraints on prospective help-seeking behavior.
There exist some self-report measures that can be used to inquire about individuals’ perceptions of the nature and impact of these environmental constraints in their lives, including how these constraints may shape their mental health care journey.
This webpage is designed to introduce readers to some of the measures of environmental constraints that exist, which professionals may leverage to answer questions about how these constraints shape people’s perceptions and behaviors related to seeking mental healthcare.
The below list of measures will be expanded and revised over time to maximize its value to those looking for measures with published evidence of reliability and validity.
- Perceived Barriers to Psychological Treatment (PBPT) (Mohr et al., 2010) (full-text download) – measures perceived potential barriers to attending weekly sessions for psychological or behavioral treatment.
As noted above, self-report measures are imperfect assessments of environmental constraints, so caution is warranted around claims about what self-report measures are truly measuring. In fact, as described on the Logistical Beliefs Measures page, it may be better to consider self-report measures, like the PBPT, to be measures of logistical beliefs that influence personal agency; beliefs are subjective by nature and understood to be necessarily imperfect and incomplete.