Barriers to the utilization of primary care services for mental health problems among adolescents in a secondary school in Malaysia

  • Aida J
  • Azimah MN
  • Mohd Radzniwan AR
  • T Iryani MD
  • Ramli M
  • Khairani O


Objective: To study the barriers toward the utilization of primary care services for mental health problems among adolescentsin a secondary school in Hulu Langat, Selangor, Malaysia.

Methods: This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. Therespondents were selected using randomised cluster sampling among Form Four and Form Five students. Students weregiven self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier andbehaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal helpseeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends,parents and siblings.

Results: A total of 175 students were included in the study. None of the students admitted of using the primary health careservices for their mental health problems. Majority of the students were not aware of the services availability in the primaryhealth care (97.1%). More than half of them thought the problems were due to their own mistakes (55.4%) and the problemswere not that serious (49.1%). With regard to perception of the primary health care services, (43.2%) of the students wereworried about confidentiality, half of them were concerned about other people’s perception especially from their family members(44.6%) and friends (48.6%). Minority of them (10.8%) thought that nobody can help them. Few of them thought smoking(3.4%), alcohol (3.4%) and recreational drugs (1.1%) can solve their emotional problems.

Conclusion: One of the major barriers identified in the students’ failure to use the health care facilities was their unawarenessof the availability of the service for them in the community. Thus there is a need to promote and increase their awareness onthis issue.


The Third National Health and Morbidity Survey.

The National Health & Morbidity Survey II. Public Health Institute, Kuala Lumpur, 1996.

Child and Adolescent Mental Health Policies.

Babinski LM, Hartsough CS, Lambert NM. Childhood conduct problems, hyperactivity-impulsivity, and inattention as predictors of adult criminal activity. J Child Psychol Psychiatry. 1999;40(3):347-55.

Depression in Childhood and Adolescent. 2000.

Menna R, Ruck M. Adolescent Help-Seeking Behaviour: How Can We Encourage It? Guidance & Counselling. 2004;19(4): 176-83.

Rickwood DJ, Braithwaite VA. Social psychological factors affecting help seeking for emotional problems. Soc Sci Med. 1994;39(4):563-72.

Schonert-Reichl KA, Muller JR. Correlates of help seeking in adolescence. J Youth Adolesc. 1996;25:705-31.

Kessler RC, Brown RL, Broman CL. Sex differences in psychiatric help-seeking: evidence from four-large scale surveys. J Health Soc Behav. 1981;22(1):49-64.

Barker G. Adolescents, social support and help-seeking behaviour. WHO; 2007.

Gould MS, Munfakh JLH, Lubell K, et al. Seeking help from the internet during adolescence. J Am Acad Child Adolesc Psychiatry. 2002;41(10):1182-9.

Owens PL, Hoagwood K, Horwitz SM, et al. Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry. 2002;41(6):731-8.

Manual Latihan Prostar.

Kesihatan Remaja.

Focus on parenting and reproductive health. LPPKN Buletin; 2008.

Suicide Information and Education Centre (SIEC). Barriers to Help-Seeking. Centre for Suicide Prevention. 1999; SIEC Alert (35).

Wassef A, Ingham D, Collins ML. In search of effective programs to address student’s emotional distress and behavioural problems. Part I: Defining the problem. Adolescence. 1995;30(119):523-38.

Patel V, Flisher AJ, Hetrick S, et al. Mental health of young people: a global public-health challenge. Lancet. 2007;369(9569): 1302-13.

Rickwood D, Deane FP, Wilson CJ, et al. Young people’s helpseeking for mental health problems. Australian e-Journal for the Advancement of Mental Health. 2005;4(3):1-34.

Offer D, Howard KI, Schonert KA, et al. To whom adolescents turn for help? Differences between disturbed and non disturbed adolescents. J Am Acad Child Adolesc Psychiatry. 1991;30(4):623-30.

Rancangan Malaysia Ke-8, 2001-2005. Pengagihan Pendapatan. Pembasmian Kemiskinan Dan Penyusunan Semula Masyarakat.

How to Cite
JA., MNA., ARM. R., MDT. I., MR., & OK. (2012). Barriers to the utilization of primary care services for mental health problems among adolescents in a secondary school in Malaysia. Malaysian Family Physician, 5(1), 5. Retrieved from
Original Articles