{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:05:49Z","timestamp":1781694349857,"version":"3.54.5"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"unspecified","delay-in-days":215,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796023000641_sec1a\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>Help-seeking for mental health problems is facilitated and hindered by several factors at the individual, interpersonal and community level. The most frequently researched factors contributing to differences in help-seeking behaviour are based on classical socio-demographic variables, such as age, gender and education, but explanations for the observed differences are often absent or remain vague. The present study complements traditional approaches in help-seeking research by introducing a milieu approach, focusing on values and political attitudes as a possible explanation for differences in help-seeking for emotional mental health problems.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796023000641_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>A representative cross-sectional survey of <jats:italic>N<\/jats:italic>\u00a0=\u00a03,042 respondents in Germany was conducted through face-to-face interviews about past help-seeking for mental health problems, socio-demographic characteristics and values and political attitudes<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796023000641_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Multivariate logistic regression analyses indicated that belonging to a cosmopolitan intellectual milieu group was significantly associated with an increased likelihood of past help-seeking for mental health issues (psychotherapeutic\/psychological help-seeking [OR\u00a0=\u00a02.09, 95% CI: 1.11\u20133.93, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) and primary care (OR\u00a0=\u00a02.21, 95% CI: 1.15\u20134.24, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05]), whereas members of individualist and conservative milieu groups were less likely to report having sought help from a psychotherapist, but not from a general practitioner. Increased odds ratios were also found for a number of socio-demographic variables, such as being aged 26\u00a0years and over, a female gender and more than 12\u00a0years of formal education. Associations between socio-demographic variables remained significant, and the explained variance of the used models improved considerably when milieu variables were added.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796023000641_sec4d\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>We discuss how milieu-specific patterns were relevant for explaining differences in mental health service use in addition to socio-demographic factors. It seems promising to consider help-seeking from a milieu perspective to improve disparities in access to and the use of psychotherapy as well as to resource allocation.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796023000641","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T10:17:18Z","timestamp":1691144238000},"source":"Crossref","is-referenced-by-count":5,"title":["Do values and political attitudes affect help-seeking? Exploring reported help-seeking for mental health problems in a general population sample using a milieu framework"],"prefix":"10.1017","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-2334","authenticated-orcid":false,"given":"J.","family":"Spahlholz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2357-2138","authenticated-orcid":false,"given":"E.","family":"Baumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"M\u00fcller-Hilmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hilmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5402-6631","authenticated-orcid":false,"given":"C.","family":"Sander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1378-0053","authenticated-orcid":false,"given":"S.","family":"Schindler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9281-8461","authenticated-orcid":false,"given":"S.","family":"Speerforck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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