# Pathways to professional mental care in the Swiss young adult community: a case–control study

## TL;DR

This study explores how young adults in Switzerland seek mental health care and finds that early contact with mental health professionals improves treatment outcomes.

## Contribution

The study identifies factors influencing the first point of contact and treatment intensity in mental health care pathways for young adults.

## Key findings

- Most help-seekers contacted mental health professionals directly, but many had prior non-MH contacts.
- Non-MH pre-contacts were negatively associated with receiving the most intensive mental health treatment.
- Substance misuse and central-vegetative problems increased the likelihood of contacting mental health professionals.

## Abstract

Treatment success for mental health (MH) problems depends, among others, on the timeliness of help-seeking. Therefore, we studied the effect of symptoms and reasons for help-seeking on the point-of-contact and the most intensive professional treatment in a community sample. Participants were recruited as part of the ‘Bern Epidemiological At-Risk’ (BEAR) study on 16–40-year-old community persons of the Swiss canton Bern. Of the 2,683 participants, 615 (22.9%) reported at least one instance of help-seeking for MH problems and were selected for the presented analyses. Help-seeking behavior was assessed by a modified version of the ‘WHO pathway-to-care questionnaire’, from which the outcome ‘most intensive MH professional contact’ was generated. The effect of symptoms and reasons for help-seeking were analyzed in separate models using path analyses. Most help-seeking persons sought MH professional help (n = 405; 65.9%) with a high number of medical pre-contacts (n = 233; 37.9%). The ‘most intensive MH professional contact’ was provided after an average of 1.47 contacts. Both models showed negative associations between non-MH professional pre-contacts and the most intensive, likely most adequate MH treatment. In the symptom model, ‘substance misuse’ and ‘central-vegetative problems’ increased the general likelihood of MH professional contact. Our findings highlight the importance of the first point-of-contact in pathways to adequate MH care and, when seeking help from non-MH professional, of quick referrals to MH professionals. Awareness campaigns or training of health professionals, such as general practitioners, may support timely contact with MH professionals to improve diagnosis, prognosis, and outcome.

The online version contains supplementary material available at 10.1007/s00406-024-01757-4.