Perceived barriers and facilitators to professional help-seeking for depressive symptoms in a non-clinical urban Dutch adult population: A qualitative study

Introduction Barriers to professional help-seeking for depressive symptoms may arise before individuals receive a formal diagnosis or enter mental healthcare. However, previous research on such barriers has mainly focused on people with diagnosed mood disorders or prior service contact. Understanding the perceived barriers and facilitators to help-seeking within the non-clinical adult population is crucial for improving timely diagnosis of depression and thereby preventing the worsening of symptoms. This study explored how adults from a non-clinical urban Dutch study population perceive barriers and facilitators to professional help-seeking for depressive symptoms. Method We conducted semi-structured individual interviews with 18 Dutch adults from a diverse urban Dutch population who had no current or previous formal depression diagnosis. Transcripts were analysed using inductive thematic analysis. Two researchers independently coded and interpreted the transcripts, compared their analyse, and resolved differences through consensus. Results Among 18 participants (11 women; 18-86-years; 61.1% Western European), six perceived barrier themes were identified: (self-)stigma, accessibility/affordability, knowledge, systemic issues, cultural norms, and psychological barriers. Stigma was the most frequently mentioned barrier, identified in 16 of the 18 interviews. Six facilitators were identified: improving knowledge, systemic improvements, reducing stigma, professional training, peer support, and screening. Improving knowledge and awareness was the most frequently mentioned facilitators. Conclusion Although primary mental healthcare in the Netherlands is formally available and largely covered by health insurance, stigma, knowledge gaps, and perceived systemic and accessibility barriers may still discourage professional help-seeking for depressive symptoms. Mental health literacy, stigma reduction, and clearer, more accessible care pathways may help lower perceived thresholds to seeking professional help and thereby improve mental health.