Psychological Medicine

Original Articles

Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour

G. Schomerusa1 c1, H. Matschingera2 and M. C. Angermeyera3

a1 Department of Psychiatry and Psychotherapy, University of Greifswald, Germany

a2 Department of Psychiatry, Leipzig University, Germany

a3 Centre for Public Mental Health, Gösing am Wagram, Austria


Background Many people suffering from mental disorders do not seek appropriate help. We have examined attitudes that further or hinder help-seeking for depression with an established socio-psychological model, the Theory of Planned Behaviour (TPB), comparing models for respondents with and without depressive symptoms.

Method A qualitative preparatory study (n=29) elicited salient behavioural (BB), normative (NB) and control beliefs (CB) that were later included in the TPB questionnaire. Telephone interviews with a representative population sample in Germany (n=2303) started with a labelled vignette describing symptoms of a major depression, followed by items covering the components of the TPB. Intention to see a psychiatrist for the problem described was elicited at the beginning and at the end of the interview. We screened participants for current depressive symptoms using the mood subscale of the Patient Health Questionnaire (PHQ-9).

Results In non-depressed respondents (n=2167), a TPB path model predicted 42% of the variance for the first and 51% for the second question on intention. In an analogous model for depressed respondents (n=136), these values increased to 50% and 61% respectively. Path coefficients in both models were similar. In both depressed and non-depressed persons, attitude towards the behaviour was more important than the subjective norm, whereas perceived behavioural control was of minor influence.

Conclusions Willingness to seek psychiatric help for depression can largely be explained by a set of attitudes and beliefs as conceptualized by the TPB. Our findings suggest that changing attitudes in the general population are likely to effect help-seeking when people experience depressive symptoms.

(Received May 28 2008)

(Revised February 13 2009)

(Accepted March 18 2009)

(Online publication April 20 2009)


c1 Address for correspondence: Dr. med. G. Schomerus, Department of Psychiatry and Psychotherapy, University of Greifswald, Rostocker Chaussee 70, 18437 Stralsund, Germany. (Email: