Investigating institutional abuse survivors' help-seeking attitudes with the Inventory of Attitudes towards Seeking Mental Health Services

Background: Although effective treatments exist, many trauma survivors delay or avoid professional help. Attitudes towards help-seeking are associated with intentions to and actual treatment use, but were neglected in research on trauma survivors so far. Objective: This study aimed to investigate the reliability, construct validity, and predictive power of the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) and to investigate attitudes of adult institutional abuse survivors. Method: A total of 220 adult survivors of institutional abuse were interviewed using IASMHS, the PTSD Checklist for DSM-5 (PCL-5), the Childhood Trauma Questionnaire Short-Form (CTQ-SF), the Life Events Checklist (LEC-5), and the depression-subscale of the Brief Symptom Inventory (BSI-18). They were further asked about their current mental health service use. We assessed the fit of different models of IASMHS with confirmatory factor analyses and predicted current mental health service use with a binominal logistic regression model. Results: The three-factor structure of IASMHS provided the best fit. One of the three scales (help-seeking propensity), the PTSD-intrusion scale, and the depression scale significantly contributed to the prediction of current mental health service use. Single items of the psychological openness scale loaded weakly on the according factor. Our sample showed a similar IASMHS profile compared to other samples with mental health problems. Conclusion: Overall, IASMHS appears to be a useful instrument to assess attitudes towards seeking mental health services in trauma survivors. It can be used to investigate help-seeking attitudes and its correlates to better understand and facilitate survivors' treatment use.