Professional and informal help-seeking among low-income adolescents exposed to violence in the community and at school

Abstract

<p><i>Background -</i> Adolescents may seek help for many reasons beyond health needs, such as personal stress due to violence exposure. <p><i>Objective -</i>To investigate factors associated with receiving professional assistance and informal help due to violence exposure in the community and at school. <p><i>Participants and setting -</i> This study was conducted in Itaboraí, a low-income medium-size city in the State of Rio de Janeiro, Southeast Brazil, characterized by poverty, inequality and violence. It analyses data reported by 669 in-school adolescents (11–15-years, 51.7% girls). <p><i>Methods -</i> This is a cross-sectional study nested in a longitudinal study (Itaboraí Youth Study). The Itaboraí Youth Study involved a probabilistic community-based sample of 1409 6-to-15-year-olds based on a 3-stage probabilistic sampling plan that included a random selection of census units, eligible households and the target child. <p><i>Results -</i> Professional assistance was mainly received from psychologists (the Brazilian population has free access to health services). Family members were the main source of informal help. Correlates of professional assistance were having clinical emotional problems and not counting on an adult (if needing help) for community violence victims, and absent father for community and school violence victims. Correlates of informal help were female sex, maternal anxiety/depression and absent father for community violence victims, and younger age and higher maternal education for school violence victims. <p><i>Conclusions -</i> The mental health needs of violence victims, and maternal difficulties to deal with the adolescent distress resulting from violence exposure (maternal increased burden due to father absence and/or having anxiety/depression) are important influences on the help-seeking process.