Race and gender are found to affect the probability
of suffering from depression, but the role of race and gender in
affecting the propensity to seek help for depression is not well-explored.
This study uses data from the 1996 round of ‘Health Behavior in
School-Aged Children’ (HBSC), USA, and explores how race and gender
affect the likelihood of depression and self-injury risk, and of
help-seeking for each condition. Results show that adolescent males
are significantly less likely to ask for help than females. Further
analysis by race shows that blacks and Asians are especially prone
not to ask for help, with the problem being particularly acute in
case of black males and Asian males. Notably, however, predicted
values show that for any gender/racial group, the likelihood of
not seeking help when suffering from depressed mood or being at
self-injury risk greatly surpasses the likelihood of seeking help.
Background: Studies investigating the correlates of adolescent
depression and suicidal tendencies have found that the probability of
such tendencies vary by race and gender. However, while there exists evidence
that most adolescents suffering from the above problems fail to seek (and
obtain) help, the role of race and gender in determining the propensity
to seek help for depression remains largely unexplored.
Aims of Study: The study uses data from the 1996 round of `Health
Behavior in School-Aged Children' (HBSC), USA, which surveys a representative
sample of more than 9000 adolescents enrolled in grades 6-10. Respondents
are asked if they suffered from persistent depressed moods (lasting two
weeks or more) over the past year, and whether they sought help while
suffering from depressed mood, and if so, from whom. Questions are also
asked about whether the respondent had self-injury ideation or actually
attempted self-injury. Demographic and other information on respondents
is also provided. The primary aim is to test whether there are significant
differences between genders, and between non-Hispanic whites, non-Hispanic
blacks, Hispanics and Asians in the likelihood of seeking help, and from
whom, when depressed. Gender and race-ethnicity differences in the likelihood
of being depressed are also explored to find if they correspond to results
in the extant literature.
Methods: Multinomial logit models are used to estimate the likelihood
of being depressed or at self-injury risk, and help-seeking behavior in
event of depressed mood. Models are estimated for the full-sample and
sub-samples who report depressed mood or are at self-injury risk. In addition
to race and gender, all models control for additional demographic characteristics
such as age, family structure, and family socio-economic status.
Results: Adolescent females are significantly more likely than
adolescent males to suffer from depressed mood. However, adolescent males
are less likely to ask for help than females (odds ratio: 0.72). All minority
groups are more likely to suffer from depressed mood compared to non-Hispanic
whites, but blacks are at lower self-injury risk. Blacks and Asians are
especially prone not to ask for help, with the problem being particularly
acute in case of black males and Asian males.
Discussion: The lower propensity of adolescent males to seek help
for depression compared to females are in keeping with previous research.
However, predicted values show that the majority of males and females
with depressed mood or at self-injury risk do not seek help from anyone.
Certain racial groups are also at greater risk for not asking for help
for depression. This may have implications regarding racial differences
in suicide rates, as well as racial differences in future life outcomes.
The study suffers from the drawback that because the survey is confined
to those enrolled in school, adolescents who are institutionalized for
mental health problems or who have dropped out of school due to problems
related to depression are not represented in it.
Implications for Health Policies: There have been efforts in the
USA to educate the population about the problems of adolescent depression.
However, the above results suggest that it may be useful to have additional
educational efforts targeted at specific population groups, to educate
them about the risks associated with depression, help overcome any stigma
associated with depression and encourage help-seeking when suffering from
Implications for Further Research: A number of directions of future
research are suggested. It would be useful to obtain information on the
outcomes of help seeking - whether it actually led to obtaining help.
It would also be useful to know the probability of an adolescent being
diagnosed with depressed mood (perhaps by a primary care physician) even
without actively seeking help. Regarding the racial differences, it would
be useful to examine the extent to which such differences arise from immigration
status, and also to have more extensive information about attitudes, familial
expectations, religiosity, community ties, confidence in the medical system
and other factors, so as to analyze further why some races are more prone
to depression and averse to seeking help for depression than others. Finally,
it would be useful to periodically revisit this topic with more contemporary
data to see whether recent efforts at awareness raising has increased
the odds of help-seeking among adolescents with depressed mood.