Samantha Marie Harris

• Bye, Hege Høivik; Måseidvåg, Frida Leine & Harris, Samantha Marie (2025). Men’s Help-Seeking Willingness and Disclosure of Depression: Experimental Evidence for the Role of Pluralistic Ignorance. Sex Roles. ISSN 0360-0025. 91(4). doi: 10.1007/s11199-025-01574-6. Full text in Research Archive Show summary

  When experiencing depressive symptoms, many people delay or avoid seeking professional help. We investigate whether misperceptions of other’s willingness to seek help can be a potential barrier for help-seeking by examining pluralistic ignorance (i.e., when members of a group mistakenly believe that others’ cognitions or behaviors differ systematically from their own) in men and women’s perceptions of others’ help-seeking willingness. Experiment 1 (N = 2042) demonstrated that both men and women underestimate men’s willingness to seek formal help but showed no evidence of pluralistic ignorance in women’s perceptions of “most women’s” help-seeking. For both men and women, self-rated willingness to seek help was strongly associated with the perception that other men/women would seek help. Based on these results, we proposed that a lower willingness to disclose help-seeking for depressive symptoms among men could be a source of misperceptions of men’s help-seeking willingness. Experiment 2 (N = 1528) showed that men were less willing than women to disclose help-seeking for depression to friends and colleagues, which could contribute to misperceptions of men’s help-seeking willingness. We argue that pluralistic ignorance can be a barrier for men’s mental health help-seeking and discuss implications for interventions to increase the number of men who seek help when experiencing depressive symptoms.

• Straiton, Melanie Lindsay & Harris, Samantha Marie (2025). Differences in professional help-seeking for mental health problems among migrants and non-migrants: Symptom severity, self-perceived mental health problem, and region of origin matter. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948251362562. Full text in Research Archive Show summary

  Aims: To examine differences in help-seeking for mental health problems among migrants and non-migrants in Norway and to consider the role of symptom severity, acknowledgement of a mental health problem and region of origin. Methods: We used data from a cross-sectional, online Norwegian Country Public Health Survey conducted in 2021. A total of 32,126 people, aged 18+ years, were included in the analyses, of which 8% were migrants. Around 60% of these were from countries within the European Economic Area, associated countries or the UK, USA, Canada, Australia and New Zealand (EEA+). Results: Migrants from non-EEA+ countries showed higher odds of having sought professional mental health help than non-migrants, but this difference attenuated when controlling for sociodemographic factors, psychological distress and self-reported depression. An interaction revealed that at higher, but not lower, levels of psychological distress, non-EEA+ migrants had significantly lower odds of having sought help. Moreover, a stratified analysis indicated that this applied only to those without self-reported depression. Conclusions: At high levels of psychological distress, people from non-EEA+ regions living in Norway may not be getting professional support for mental health problems to the same extent as EEA+ migrants and non-migrants. This may especially be the case for those who do not perceive their symptoms as a mental health problem. Consequently, improving the ability to recognise mental health problems may be a possible avenue for reducing the treatment gap for migrants with high symptom levels, though longitudinal studies would be required to confirm this.

• Harris, Samantha Marie; Bye, Hege Høivik & Kunst, Jonas R. (2025). The Role of Norms and Acculturation in Migrants’ Willingness to Seek Mental Health Care: Results from a Large Preregistered Study. Social Science and Medicine. ISSN 0277-9536. 384, p. 1–11. doi: 10.1016/j.socscimed.2025.118598. Full text in Research Archive
• Harris, Samantha Marie; Jørgensen, Magnus; Lowthian, Emily & Kristensen, Sara Madeleine Eriksen (2023). Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study. BMC Public Health. 23(1). doi: 10.1186/s12889-023-16952-6. Full text in Research Archive Show summary

  Background: Socioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called “alcohol harm paradox” (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more alcohol-related harm). Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible “smoking harm paradox” (SHP). We aim to fill this gap. Methods: We conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report. Results: Overall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income. Conclusions: While our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. This effect was not found for parental income, highlighting the potential influence of parental education over income as a determinant of subjective health outcomes in relation to smoking.

• Ahmed, Nafiso; Barnett, Phoebe; Greenburgh, Anna; Pemovska, Tamara; Stefanidou, Theodora & Lyons, Natasha [Show all 29 contributors for this article] (2023). Mental health in Europe during the COVID-19 pandemic: a systematic review. The Lancet Psychiatry. ISSN 2215-0374. 10(7), p. 537–556. doi: 10.1016/S2215-0366(23)00113-X. Full text in Research Archive Show summary

  The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions.

• Harris, Samantha Marie; Binder, Per-Einar; Perez, Esperanza Diaz; Ekroll, Vebjørn & Sandal, Gro Mjeldheim (2021). General practitioners’ management of depression symptoms in Somali refugee and Norwegian patients: a film vignette experiment. BMJ Open. 11(12), p. 1–11. doi: 10.1136/bmjopen-2021-055261. Full text in Research Archive Show summary

  Objectives Refugees in comparison with non-refugee patients may face higher unmet mental healthcare needs. The mechanisms underlying these disparities are still poorly understood. The general practitioner (GP) plays a vital role in refugees’ mental health (MH), managing complaints within primary care and acting as gatekeeper to specialist services. However, GPs have reported feeling uncertain about working with refugee patients. Somalis make up one of the largest refugee groups in Norway and use primary care services more than the majority population for physical health, although not for MH. The current study examines GPs’ management of MH complaints in Somali refugee versus Norwegian vignette characters and the role of GP clinical uncertainty. Design We distributed an online experimental survey to GPs in Norway (n=133), who were randomised to watch a simulated consultation with a female Norwegian, female Somali, male Norwegian or male Somali vignette character, presenting the same symptoms of depression. GPs indicated which diagnoses, assessments and treatments they would endorse for the patient and their level of certainty. Outcome measures We calculated Simpson indices to measure inter-rater reliability and 2×2 analysis of variances as well as Bayesian estimation to examine clinical certainty based on patient background and gender. Results GPs’ clinical decisions about Somali and Norwegian vignette characters were similar, with a few exceptions. There was less consensus regarding the first prioritised diagnosis for Somali characters (Simpson index=0.129) versus Norwegian characters (Simpson index=0.208), (p=0.011, one-tailed). Somalis more frequently received diagnoses of post-traumatic stress disorder (PTSD), while Norwegians received diagnoses of feeling depressed. GPs endorsed sick leave more often for Norwegian characters and medication for physical complaints for Somali characters. There were no substantial differences in GPs’ self-reported certainty. Conclusions We found few and relatively small effects of patient background and gender on GPs’ clinical decisions. Nevertheless, the validity of certain diagnoses and prescription of sick leave need to be considered by clinicians and in future research.

• Harris, Samantha Marie; Sandal, Gro Mjeldheim; Bye, Hege Høivik; Palinkas, Lawrence A. & Binder, Per-Einar (2021). Integration Is Correlated With Mental Health Help-Seeking From the General Practitioner: Syrian Refugees' Preferences and Perceived Barriers. Frontiers in Public Health. 9(777582), p. 1–13. doi: 10.3389/fpubh.2021.777582. Full text in Research Archive Show summary

  Despite a seemingly higher need, refugees in Europe tend to underuse mental health (MH) services. To better understand this underuse, it is important to understand refugees' willingness and ability to seek help from their general practitioner (GP) when experiencing MH problems. We employed a combined vignette and survey design to explore how the GP fits into the larger context of help-seeking preferences among a sample of Syrian refugees in Norway (n = 92), and what barriers they perceive in accessing help from the GP. We also examined how indicators of integration relate to seeking help from the GP. We take an exploratory approach. Participants were presented a vignette of an individual with symptoms in line with ICD-10 and DSM-5 criteria for depression. Participants were somewhat likely to seek help from the GP; however, seeking help from one's relationship with Allah/God and one's partner was preferred. Furthermore, while the GP was rated a somewhat likely help-seeking source, most participants indicated an average of two barriers to seeking help from the GP. Finally, social ties to the majority population in the form of social integration and feelings of connectedness with the host country (psychological integration) were positively correlated with likelihood of seeking help from the GP. Taken together, these findings suggest that the GP is considered a viable source of help among Syrians with a refugee background in the current sample, but that this may be influenced by perceived barriers and social as well as psychological integration. Addressing these barriers and promoting psychosocial integration with the host country are key to facilitating access and usage amongst refugees in need of MH services.

• Harris, Samantha Marie & Sandal, Gro Mjeldheim (2020). COVID-19 and psychological distress in Norway: The role of trust in the healthcare system. Scandinavian Journal of Public Health. ISSN 1403-4948. 49(1), p. 96–103. doi: 10.1177/1403494820971512. Full text in Research Archive Show summary

  Aim: The study aims to examine groups at risk for psychological distress in connection with the COVID-19 outbreak, and the role of trust in the healthcare system as a possible moderator. Methods: Data were collected from a large sample of the Norwegian population (n = 4008) through the Norwegian Citizen Panel (NCP). A linear regression was conducted to examine the effects of COVID-19 related risk factors on psychological distress, using the 10-item Hopkins Symptom Checklist (HSCL-10). Finally, we conducted a moderation analysis to examine the interaction of trust in the healthcare system and COVID-19 related risk factors. Results: A linear regression showed that female gender, younger age, lower level of education, being infected with COVID-19, being medically vulnerable, working in the healthcare system, being in voluntary quarantine and having an immigrant background predicted mean HSCL-10 scores. The moderation analysis revealed that people in the medically vulnerable group, those below 61, and those in quarantine reported higher psychological distress when they also had lower trust in the healthcare system. Conclusions: Findings indicate important groups to take into consideration in mental healthcare strategies and policies. However, most participants in the current study reported psychological distress levels that were below the clinical cut-off, suggesting that the majority may have coped relatively well in the early stages of the pandemic.

• Harris, Samantha; Binder, Per Einar & Sandal, Gro Mjeldheim (2020). General practitioners' experiences of clinical consultations with refugees suffering from mental health problems. Frontiers in Psychology. 11. doi: 10.3389/fpsyg.2020.00412. Full text in Research Archive Show summary

  Refugees suffer from higher rates of certain mental health problems than non-refugee migrants and the native population of their host country. General practitioners (GPs) in Norway and many other European countries are the first contact person for settled refugees in need of non-emergency medical support. This includes psychiatric support, although GPs are not typically specialists in psychiatry. The aim of this study is to investigate how GPs experience working with refugees suffering from mental health problems, with a specific focus on perceived challenges and facilitators. We conducted semi-structured interviews with 15 GPs working in Norway (7 females). Participants ages ranged from 29 to 67 (M = 41.7 years, SD = 11.1) with work experience ranging from 2 to 39 years (M = 13.6 years, SD = 12.1). Interviews were analysed thematically using the qualitative data analysis computer software package NVivo 12. The main challenges presented by GPs relate to language barriers, mismatched expectations, different understandings of health and illness, and the GP feeling unprepared to work with this patient group. The main facilitating themes related to establishing trust and finding the work meaningful. The themes presented in this study highlight areas of interest for future research, and should inform training programmes to improve health care for both clinicians and refugee patients.

• Harris, Samantha Marie; Dykxhoorn, Jennifer; Hollander, Anna-Clara; Dalman, Christina & Kirkbride, James (2019). Substance use disorders in refugee and migrant groups in Sweden: A nationwide cohort study of 1.2 million people. PLoS Medicine. ISSN 1549-1277. 16(11). doi: 10.1371/journal.pmed.1002944. Full text in Research Archive Show summary

  Background: Refugees are at higher risk of some psychiatric disorders, including post-traumatic stress disorder (PTSD) and psychosis, compared with other non-refugee migrants and the majority population. However, it is unclear whether this also applies to substance use disorders, which we investigated in a national register cohort study in Sweden. We also investigated whether risk varied by region of origin, age at migration, time in Sweden, and diagnosis of PTSD. Methods and findings: Using linked Swedish register data, we followed a cohort born between 1984 and 1997 from their 14th birthday or arrival in Sweden, if later, until an International Classification of Diseases, 10th revision (ICD-10), diagnosis of substance use disorder (codes F10.X–19.X), emigration, death, or end of follow-up (31 December 2016). Refugee and non-refugee migrants were restricted to those from regions with at least 1,000 refugees in the Swedish registers. We used Cox proportional hazards regression to estimate unadjusted and adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) in refugee and non-refugee migrants, compared with Swedish-born individuals, for all substance use disorders (F10.X–19.X), alcohol use disorders (F10.X), cannabis use disorders (F12.X), and polydrug use disorders (F19.X). In adjusted analyses, we controlled for age, sex, birth year, family income, family employment status, population density, and PTSD diagnosis. Our sample of 1,241,901 participants included 17,783 (1.4%) refugee and 104,250 (8.4%) non-refugee migrants. Refugees' regions of origin were represented in proportions ranging from 6.0% (Eastern Europe and Russia) to 41.4% (Middle East and North Africa); proportions of non-refugee migrants' regions of origin ranged from 11.8% (sub-Saharan Africa) to 33.7% (Middle East and North Africa). These groups were more economically disadvantaged at cohort entry (p < 0.001) than the Swedish-born population. Refugee (aHR: 0.52; 95% CI 0.46–0.60) and non-refugee (aHR: 0.46; 95% CI 0.43–0.49) migrants had similarly lower rates of all substance use disorders compared with Swedish-born individuals (crude incidence: 290.2 cases per 100,000 person-years; 95% CI 287.3–293.1). Rates of substance use disorders in migrants converged to the Swedish-born rate over time, indicated by both earlier age at migration and longer time in Sweden. We observed similar patterns for alcohol and polydrug use disorders, separately, although differences in cannabis use were less marked; findings did not differ substantially by migrants’ region of origin. Finally, while a PTSD diagnosis was over 5 times more common in refugees than the Swedish-born population, it was more strongly associated with increased rates of substance use disorders in the Swedish-born population (aHR: 7.36; 95% CI 6.79–7.96) than non-refugee migrants (HR: 4.88; 95% CI 3.71–6.41; likelihood ratio test [LRT]: p = 0.01). The main limitations of our study were possible non-differential or differential under-ascertainment (by migrant status) of those only seen via primary care and that our findings may not generalize to undocumented migrants, who were not part of this study. Conclusions: Our findings suggest that lower rates of substance use disorders in migrants and refugees may reflect prevalent behaviors with respect to substance use in migrants’ countries of origin, although this effect appeared to diminish over time in Sweden, with rates converging towards the substantial burden of substance use morbidity we observed in the Swedish-born population.

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• Harris, Samantha Marie; Bye, Hege Høivik & Kunst, Jonas R. (2025). Innvandrere er mer åpne for psykisk helsehjelp enn vi tror – og enn de tror selv. doi: https:/www.dagensmedisin.no/forskning-psykisk-helse/innvandrere-er-mer-apne-for-psykisk-helsehjelp-enn-vi-tror-og-enn-de-tror-selv/707725. Full text in Research Archive
• Harris, Samantha Marie; Binder, Per Einar; Diaz, Esperanza & Sandal, Gro Mjeldheim (2022). Hvordan møter leger flyktninger med psykiske lidelser? 142. doi: 10.4045/tidsskr.22.0165. Full text in Research Archive
• Harris, Samantha Marie (2022). Møter med det norske helsevesenet - hva går bra og hva kan forbedres? Full text in Research Archive
• Harris, Samantha Marie & Johansson, Caroline Ulvin (2022). Flyktninger med psykiske lidelser. [Internet]. Podcast. Full text in Research Archive
• Brækhus, Aurora & Harris, Samantha Marie (2022). Fastleger følte seg uforberedt på å ta imot flyktninger med psykiske plager. [Internet]. Dagens Medisin. Full text in Research Archive
• Harris, Samantha Marie (2022). Ressursprogram for fastlegers arbeid med psykisk helse blant flyktninger. Full text in Research Archive
• Harris, Samantha Marie; Dykxhoorn, Jennifer; Hollander, Anna-Clara; Dalman, Christina & Kirkbride, James B. (2022). Substance use disorders among migrant groups in Sweden. Full text in Research Archive
• Harris, Samantha Marie & Sandal, Gro Mjeldheim (2020). COVID-19 and psychological distress in Norway: the role of trust in the health-care system. Full text in Research Archive
• Harris, Samantha (2020). We are basically going to be ok. [Journal]. REPLIKK – Tidsskrift for samfunnsvitskap og humaniora. Full text in Research Archive Show summary

  An interview with Prof George Bonanno about the psychology of loss and trauma

• Harris, Samantha; Binder, Per Einar & Sandal, Gro Mjeldheim (2020). Fastlegers erfaringer i kliniske møter med flyktningspasienter som lider av psykiske problemer – hvilke barrierer oppleves og hva hjelper? Full text in Research Archive
• Harris, Samantha Marie & Sandal, Gro Mjeldheim (2020). COVID-19 and psychological distress in Norway: the role of trust in the health-care system. Full text in Research Archive
• Harris, Samantha Marie; Binder, Per-Einar & Sandal, Gro Mjeldheim (2019). Exploring GPs experiences of clinical consultations with refugees suffering from mental health problems in Norway. Full text in Research Archive
• Harris, Samantha; Binder, Per-Einar & Sandal, Gro Mjeldheim (2019). Exploring GPs’ experiences of clinical consultations with refugees suffering from mental health problems in Norway. Full text in Research Archive

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