Individual differences in referral for help for severe emotional difficulties in adolescence

Adolescents with emotional distress may find help-seeking an extremely daunting endeavor. However, different adolescent population sectors relate differently to help-seeking for severe emotional difficulties. Gender and ethnic group are among the central factors influencing attitudes towards seeking emotional help. One of the possible mechanisms explaining these cross-group differences is self-esteem. The psychological price of seeking help could be admission of incompetence and feelings of failure, emotions that can be threatening, particularly to adolescents' self-esteem. In the present study, the psychological price of seeking help was manipulated by comparing the ease with which adolescents would self-refer for a severe emotional problem as opposed to referring another for the same problem, and the influence of gender, ethnic group differences and level of self esteem in both situations. The first hypothesis predicting greater ease of referral in the other-referral condition compared to self-referral was confirmed. The second hypothesis predicting general preference of informal help agents than the formal help agents was confirmed. The third hypothesis predicting gender differences such that girls would show higher ease of referral than boys from the different help agents was confirmed. The fourth hypothesis predicting that Jewish-Israeli adolescents would show greater ease of referral than Arab-Israeli adolescents was confirmed. An additional exploratory question examined the interaction between self-esteem and self versus other-referral on ease of referral for help. A significant interaction emerged only for help from the family. Adolescents with low self-esteem showed no differences in self versus other-referral, but adolescents with high self-esteem were more willing to refer others than themselves to seek help. These findings emphasize the importance of a sensitive needs assessment approach in designing mental health service delivery for youth.