Past help-seeking experience is commonly measured in help-seeking investigations. These measures are often referred to using synonymous phrases to “past help seeking experience”, such as “previous help seeking”, “prior help-seeking behavior”, “lifetime use”, “prior utilization”, and “prior access”.
Past help-seeking experience can be measured with objective indicators (e.g., medical records review), but is more commonly measured through respondent-report measures such as those administered on a survey or via an interview conversation. It is most common to see this construct measured with a single binary (yes/no) self-report item that asks about lifetime experience with mental health help seeking.
For example, Hammer et al., (2018) used the following binary (yes/no) item to measure past help-seeking experience: “Have you ever sought help from a mental health professional (e.g., psychologist, psychiatrist, social worker, or counselor)?
The research literature has used a variety of single-item measures that vary along the five elements of target, action, context, time, and condition. As discussed by Hammer and colleagues (2024):
- target can range from the generic “any source” to the potentially unspecified “mental health professional” to a specific kind of source (e.g., “psychologist”)
- action can range from an earlier step of a help seeking process (e.g., searching for mental health providers on the internet) to the generic (e.g., “sought help”) to the most common operationalization (i.e., “attending a first session with a professional”) to a strict interpretation (e.g., “complete a full course of psychotherapy with a mental health professional)
- context can range from unspecified (i.e., no restrictions on venue in which the professional’s help was sought) to a type of venue (e.g., in a university counseling center environment) or even a specific location (e.g., the University of Kentucky counseling center).
- time can range from the very recent (e.g., “in the last week”) to past year (e.g., “in the last 12 months”) to lifetime (e.g., “ever”).
- condition can range from unspecified (i.e., no restrictions on what kind of issue the help was sought for) to broadly specified (e.g., “for help with a mental health concern”) to narrowly specified (e.g., “for help with depression”)
Thus, single-item measures have been used which have assessed past help seeking experience as defined by various combinations of the above elements, depending on what targets, actions, context, time, and condition are of most interest to the researcher.
It should also be noted that there exist multiple-item measures of past help-seeing experience, though I am not aware of any that have gone rigorous psychometric evaluation. For example, the Actual Help Seeking Questionnaire (AHSQ) was first mentioned by name in an article by Rickwood and colleagues (2005) who said they adapted it from Rickwood and Braithwaite (1994) where it was described as “The dependent measures of help-seeking were developed specifically for this study. The two measures of help-seeking were firstly, whether or not any help had been sought for a psychological problem in the past 12 weeks and, secondly, if help had been sought, whether it was sought from the informal social network (friend or family) or from a professional source (family doctor, mental health service, educational help service). In each case a score of one indicated that help had been sought and a score of zero that help had not been sought” (p. 565). Rickwood and colleagues (2005) provides a copy of the AHSQ on page 35 which asks about the “past 2 weeks” and shows a list of 10 sources of help: partner, friend, parent, other relative, mental health professional, phone help line, family doctor, teacher, someone else not listed, I have not sought help. Each of these sources can be checked off and description of the type of problem sought help for can be written in a free text box. Here is an open access PDF copy of Actual Help Seeking Questionnaire. The AHSQ is a helpful example of the wide variety of sources of past help-seeking experience that can be asked about. Users need to be mindful of how they score and analyze such a measure to ensure they measure what they intend to measure. For example, summing or averaging scores across these sources may not be conceptually or empirically appropriately.
Lastly, as noted by Hammer and colleagues (2024), it is important to always bear in mind that measures of past help-seeking experience should not mistakenly be treated as measures of prospective help-seeking behavior that can be predicted by a set of independent variables.