Barriers and facilitators to formal mental health help-seeking in individuals living with inflammatory bowel disease: A systematic review.
James Overs, Eliza Matas, Pragalathan Apputhurai et al.
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In 30 seconds
This systematic review synthesised evidence on factors influencing formal mental health help-seeking among people living with inflammatory bowel disease (IBD). It included 19 studies involving 6,285 participants and used narrative synthesis across help-seeking orientation, intention and actual engagement. Engagement rates ranged from 21%-64% (weighted average: 37.15%). Health-related quality of life, IBD-related concerns, anxiety and depression were the psychosocial factors consistently and positively associated with help-seeking domains. Reported barriers covered sociodemographic, clinical, psychosocial, structural, systemic and treatment-related factors.
Key findings
- Across 19 studies (N = 6285), formal mental health service engagement ranged from 21%-64% (weighted average: 37.15%).
- Health-related quality of life, IBD-related concerns, anxiety and depression were consistently and positively associated with help-seeking domains.
- Barriers included low perceived need, cost, lack of IBD-specific therapists, busy lifestyles, disease duration and stigma.
Why it matters
The review suggests that low uptake of mental health services in IBD may reflect a broad mix of personal, clinical and service-level obstacles, rather than a single barrier. Recognising this range can help inform research and the development of approaches to support access, while the review’s assessment of a fragmented evidence base cautions against assuming which factors are most influential.
What to keep in mind
The authors report significant methodological limitations and a fragmented, underdeveloped evidence base; included studies were assessed as having overall moderate quality.