Shared Experience Versus Professional Expertise: Preferences for Features of Informal and Formal Mental Health Support Among College Students.

Informal caregiving serves vital functions in the USA, filling important gaps in formal care systems. However, informal caregiving for psychological disorders has received relatively limited research attention. In this study, we evaluated perspectives towards informal and formal caregiving in a sample of 554 college students attending a large public university in the Deep South and contrasted the relative importance of care elements in the context of informal and formal care. Results from evaluation of preferred elements of care between informal care and formal care were consistent with personal experience and professional expertise having differential importance to informal and formal care. The largest difference in relative importance identified was for psychological expertise, which was found to be more important to formal than informal care (d = 0.70). The care provider having experience working with individuals facing challenges related to living in rural areas was also seen as more desirable in the context of formal care, though the size of this effect was much smaller (d = 0.16). Three elements of care were preferred in the context of informal care, including the care provider having struggled with the same mental health concerns as oneself (d = 0.17), a shared background with the care provider (d = 0.19), and the care provider being knowledgeable about diversity and discrimination (d = 0.14). We also evaluated how rural residence status influenced the importance of experience working with clients from a rural background, finding that participants who self-reported currently residing in a rural area viewed a rural background on the part of the provider as more desirable than non-rural participants, both in the context of informal (d = 0.37) and formal care (d = 0.49). Participants were also asked to indicate whom they would look to consult prior to seeking formal psychological treatment and overwhelmingly preferred to consult family (65.5%) and friends (57.2%) over mental health professionals (28.2%), highlighting the role of informal care networks in accessing formal treatment. Findings provide insight into important attributes of informal and formal care and may inform efforts to increase treatment uptake and suggest that behavioral health clinics serving rural communities should prioritize rural cultural competence.