Determinants of mental health help-seeking in Europe: a systematic review based on the behavioural model of health services use

Help-seeking behaviours for mental health are critical for timely intervention, yet vary widely across populations due to multiple influencing factors. These include demographics, psychological attitudes, sociocultural norms, stigma, and healthcare systems. This review aims to identify factor associated with help-seeking behaviours related to mental health across European countries, guided by Andersen’s Behavioural Model of Health Services Use. This systematic review followed PRISMA guidelines, examining quantitative research published between January 2000 and October 2024 across PubMed, PsycINFO, and Web of Science. Studies were eligible if they included only adult participants residing in European countries who reported mental health symptoms or diagnoses. Data extraction and synthesis focused on identifying key barriers, facilitators, and factors associated with help-seeking behaviour. Seventeen studies, primarily cross-sectional, met the inclusion criteria. Despite a high prevalence of mental disorders, these studies revealed a low perceived need for care. It was found that personal stigma significantly reduces help-seeking, while positive attitudes towards mental healthcare, higher psychological distress, longer symptom duration, and stronger internal locus of control increased help-seeking likelihood. Men, individuals with lower levels of education, and those from conservative social contexts were less likely to seek support. Structural barriers included inadequate social support and geographic disparities. This review highlights modifiable factors, particularly stigma, mental health literacy and service accessibility. Addressing these through targeted interventions, such as educational campaigns, community-based programs, and early detection strategies, may improve mental health service utilisation across Europe. Future research should focus on longitudinal, intersectional, and culturally-sensitive studies to further refine effective mental health policies and interventions.