Understanding Help-Seeking Behavior in Depression: A Qualitative Synthesis of Patients' Experiences.

Despite decades of evidence-based interventions, depression remains a great challenge for public health due to enormous treatment gap and lag which, at least partially, result from low professional help-seeking by people suffering from depressive symptoms. In this article, we aim to gain a better understanding of help-seeking behavior in depression, and how to intervene effectively decreasing treatment gap and delay by using a meta-ethnography approach-an interpretive technique to systematically synthesize qualitative data. It integrates views and experiences of 474 individuals with depression across 20 papers. Findings suggest several interrelated major concepts-help-seeking as a threat to identity, social networks as a conflict or support, and alternative coping strategies as the main factor for treatment delay-as well as multiple relational, structural, attitudinal, cognitive, culture-specific, or gender-specific barriers. A model of help-seeking as a threat to identity is developed and discussed in the context of existing research.