76. Determinants of Help–Seeking Behaviors for Depression among Japanese Adolescents during the COVID-19 Pandemic

The COVID-19 pandemic has negatively affected the mental health of adolescents. Help–seeking behavior for depression is important to reduce depressive symptoms. This study investigated the determinants of help–seeking behavior among adolescents during the COVID-19 pandemic. This cross-sectional study recruited 2,258 elementary and middle school-aged participants (age from 10 to 15 years old) through a stratified two-stage clustering design used to obtain a nationally representative sample of households in Japan. Help–seeking behavior was assessed using a single question answered upon reading a hypothetical scenario of a child with symptoms of poor mental health. We assessed potential determinants of help–seeking, including age, gender of adolescents, parental education and financial status, parental mental health problems, loneliness (3-items UCLA loneliness scale), and resilience. Resilience was measured using the Child and Youth Resilience Measure, a validated and internationally used questionnaire. Adolescent depression was assessed through Patient Health Questionnaire-9 modified for adolescents. Parental depression was assessed through the 6-item Kessler Psychological Distress Scale (K6). Multivariate Poisson regression was performed to identify the psychosocial determinants of help–seeking behaviors. All potential determinants were put into the model simultaneously. Study protocol was reviewed and approved by our Institutional Review Board. Written informed consent was obtained from all participants. 703 (31.1%) of adolescents reported that they would not seek help if faced with similar symptoms to that of the adolescents in the hypothetical story. Higher help–seeking behaviors were significantly associated with boys, younger age, higher resilience, lower loneliness, and lower depression in adolescents (p<0.05). However, parental socio-economic status, parental depression, and parental help–seeking behaviors were not associated with help–seeking behaviors of adolescents. Our findings suggest that reducing loneliness and enhancing resiliency should be prioritized to promote help–seeking behaviors in adolescents. Older girls may need to be targeted to promote help–seeking behaviors.