Between data and touch: how nurses and patients negotiate the human boundary under data-driven surveillance in chronic care.

Mental disorders remain in the top 10 leading causes of burden worldwide, with recent data showing a prevalence of 12% of people experiencing a mental disorder globally []. Nearly half of Australian adults will experience a mental disorder during their lifetime; 21.5% during any 12-month period []. Anxiety disorders (17.2%) and major depressive episodes (4.9%) are the most commonly experienced mental disorders in a single year []. Worldwide, working-aged adults experience the greatest rates of mental disorders, with 80.6% of the burden of disease from mental disorders occurring in working-aged adults (16‐65 y) []. In Australia, the prevalence of mental disorders is highest in young adults aged 16 to 24 years (38.8%) and 25 to 34 years (26.3%), with those aged 55 to 64 years experiencing a lower, although still high, 17.9% prevalence of mental disorders in a year []. Despite the high rates of all mental disorders, fewer than half of Australian adults experiencing symptoms seek help from a health professional []. Typically, even when people do seek help, many have experienced symptoms over a long period before seeing a health professional [,], with delays in treatment reported to be 6 to 8 years for depression and 9 to 23 years for anxiety disorders. A lack of appropriate professional support may affect the person’s ability to recover, resulting in poorer outcomes for mental health, lower quality of life, increased issues within social and family networks, and potentially issues at work such as functional impairment and productivity loss [-]. Effective treatment also has benefits for general health. For example, recent data suggest that in those with depressive symptoms, use of antidepressants was associated with an increase in disability-free survival of 2.95 years (95% CI 2.12‐3.04) []. These gaps in service use are driven by a range of barriers []. Some are impacted by structural factors such as cost, poor service accessibility, waiting lists, transport, childcare [], or digital poverty []. Sociocultural barriers include the experience of generational trauma, poor past help seeking experiences, historical medical mistreatment, or a lack of culturally appropriate, trauma-informed services, and masculine gender norms [-]. However, there are also personal and attitudinal factors that can impact a person’s likelihood to seek help when needed, including stigmatizing attitudes toward mental ill-health and help seeking [], self-stigma [], a lack of knowledge about help seeking and mental health in general, termed “mental health literacy,” and a preference to manage mental health symptoms on their own [,]. Attitudinal barriers are thought to be particularly problematic for help seeking in mild-to-moderate mental health issues []. People who have experienced early childhood trauma or neglect are also more likely to have disrupted attachments and consequent difficulties with trust and help seeking [].