A Behavioral Economic Model of Help-Seeking for Depression
Depression warps cost-benefit choices—lower the price of help to raise uptake.
01Research in Context
What this study did
Trusty and his team built a new map. They asked: why do adults with depression avoid therapy?
They used ideas from behavioral economics. These ideas show how people weigh costs and rewards.
The paper is a theory piece. It gives no new data. It shows how depression changes the math of seeking help.
What they found
Depression makes rewards feel smaller and effort feel larger.
People then stick with the status quo. They also fall for sunk-cost bias.
The model says: cut delay, cut effort, and cut social distance to boost referrals.
How this fits with other research
Yeh et al. (2025) tested a discounting model on typical adults. Their math worked. Trusty uses the same math but aims it at depressed adults who avoid care.
Gilroy et al. (2018) fixed how we measure discounting. Their new AUC tool can make Trusty’s model sharper when you test it.
Mantzalas et al. (2022) built a burnout model for autistic adults. Both papers give you checklists. One is for depression help-seeking, the other for burnout risk.
Hubert et al. (2007) and Winett et al. (1991) remind us that job loss and anxiety also block care. Trusty’s model adds the decision rules that sit on top of those stressors.
Why it matters
You can use this model today. When a client hesitates, ask what feels costly. Then shrink the cost. Offer same-day intake, telehealth, or a peer buddy. Frame therapy as the default option, not an extra step.
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02At a glance
03Original abstract
Findings from the clinical psychology literature indicate that many who experience depression do not seek treatment when needed. This may be due to help-seeking models and interventions failing to account for the behavioral characteristics of depression that affect decision making (e.g., altered sensitivity to punishment and reward). Behavioral economics can provide a framework for studying help-seeking among individuals with depression that explicitly considers such characteristics. In particular, the authors propose that depression influences help-seeking by altering sensitivity to treatment-related gains and losses and to the delays, effort, probabilities, and social distance associated with those gains and losses. Additional biases in decision making (e.g., sunk-cost bias, default bias) are also proposed to be relevant to help-seeking decisions among individuals with depression. Strengths, limitations, and future directions for research using this theoretical framework are discussed. Taken together, a behavioral economic model of help-seeking for depression could assist in identifying those who are at greatest risk of going untreated and in creating more effective help-seeking interventions.
Perspectives on Behavior Science, 2021 · doi:10.1007/s40614-021-00308-9