Help For Mental Health Problems Research Articles

Veterans in crisis: Describing the complexity of presentations to a mainstream UK Veterans’ mental health service

LAY SUMMARY Armed forces Veterans often delay seeking help for mental health problems until a crisis point is reached. However, the clinical presentation of UK Veterans in mental health crisis is poorly understood. This study explored the presenting demographics, mental health problems, and factors that contributed to the current mental health crisis of UK Veterans who were referred to a Veterans’ crisis service, delivered as part of the mainstream health system. It showed that Veterans in crisis were similar in age and gender to the wider population at higher risk of crisis. Veterans presented with a broad range of symptoms of mental ill health and factors that were driving their current crises. Findings suggest that crisis services that address a broad range of symptoms and factors may be best positioned to address Veterans’ needs. It also suggests that these services need to ensure they are responsive to the needs of the whole Veteran population, including younger Veterans and women.

Prevalence and patterns of mental health problems among students in a Saudi Public University: a cross-sectional study

Objective: This study aimed to measure the prevalence of mental health problems (MHPs) and their relationship with help-seeking behavior among college students at Imam Mohammad Ibn Saud Islamic University (IMSIU) in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted using an online self-completed electronic question-naire distributed to IMSIU students. The questionnaire contained items related to barriers preventing from seeking help and the Kessler Psychological Distress Scale (K6) to evaluate the distress. Results: The prevalence of MHPs among IMSIU students with severe distress, mild to moderate dis-tress, and no/less distress was 54.8%, 31.2%, and 14.0%, respectively. The prevalence of stu-dents who planned to seek help for MHPs was 53.7%. Being a female, single, smoker, with a family history of MHPs had a significantly higher mean perceived K-6 mental distress score. Conclusion: The competent authorities should develop programs that enhance students\' mental health and provide psychosocial support.

Association Between Mental Health Literacy and Stigma: A Review

People with mental illness often do not receive proper mental health services. Lack of knowledge and social stigma are factors contributing to the low prevalence of seeking help for mental health problems. In low- and middle-income countries, only around one-fifth of the population receives adequate treatment, and this situation is similar in South Asian countries. Objective: The main objective of this review is to identify research on mental health literacy and stigma in SAARC countries. Methods: Three databases (PubMed, SCOPUS, and EMBASE) were searched up to September 20, 2022. A total of 47 articles were included in the review, of which five met the inclusion criteria. Thematic analysis was conducted to review the articles. Results: The relationship between mental health literacy and stigma was found to be negative, meaning that an increase in literacy decreased stigma and vice versa. The main barriers to treatment were stigma and lack of financial means to afford care. Conclusion: Government planners and policymakers should implement mental health literacy programs to reduce stigma and encourage help-seeking behavior among individuals with mental illness. The data highlights the positive effects of anti-stigma campaigns on mental health literacy and help-seeking.

Hoarding behavior and its association with mental health and functioning in a large youth sample.

Hoarding behavior is prevalent in children and adolescents, yet clinicians do not routinely inquire about it and youth may not spontaneously report it due to stigma. It is unknown whether hoarding behavior, over and above obsessive-compulsive symptoms (OCS), is associated with major clinical factors in a general youth population. This observational study included N = 7054 youth who were not seeking help for mental health problems (ages 11-21, 54% female) and completed a structured interview that included evaluation of hoarding behavior and OCS, as a part of the Philadelphia Neurodevelopmental Cohort between November 2009 and December 2011. We employed regression models with hoarding behavior and OCS (any/none) as independent variables, and continuous (linear regression) or binary (logistic regression) mental health measures as dependent variables. All models covaried for age, sex, race, and socioeconomic status. A total of 374 participants endorsed HB (5.3%), most of which reported additional OCS (n = 317). When accounting for OCS presence, hoarding behavior was associated with greater dimensional psychopathology burden (i.e., higher P-factor) (β = 0.19, p < .001), and with poorer functioning (i.e., lower score on the child global assessment scale) (β = - 0.07, p < .001). The results were consistent when modeling psychopathology using binary variables. The results remained significant in sensitivity analyses accounting for count of endorsed OCS and excluding participants who met criteria for obsessive-compulsive disorder (n = 210). These results suggest that hoarding behavior among youth is associated with poorer mental health and functioning, independent of OCS. Brief hoarding-behavior assessments in clinical settings may prove useful given hoarding behavior's stigma and detrimental health associations.

Barriers and facilitators to help-seeking for mental health problems in prison: A qualitative interview study with incarcerated males in Northern Norway.

IntroductionThe prevalence of mental disorders is considerably higher among incarcerated individuals than in the general population, but this burden is not matched by a proportional use of mental health services. Studies have found that incarcerated males are reluctant to seek help for mental health problems. Gaining knowledge of factors that influence incarcerated individuals to access or avoid professional help for mental health problems is important for tailoring interventions to address the mental health needs of this population. Promoting mental health service utilization among people in prison has the potential to reduce prison suicide rates and increase institutional functioning, thereby providing safer conditions for peers and staff, promoting rehabilitation, and reducing recidivism upon release.ObjectivesThis study explores personal, interpersonal, and systemic aspects that motivate incarcerated individuals to approach or avoid seeking help for mental health problems. While prior studies have primarily focused on barriers to help-seeking, this study also sheds light on facilitators for seeking professional help for people in prison.MethodsIndividual in-depth interviews were conducted with sixteen incarcerated males from three prisons in Northern Norway. The data analysis was inspired by Grounded Theory.ResultsThe majority of participants shared positive personal perspectives related to professional help-seeking, whereas the barriers were predominantly perceived to be of an interpersonal and systemic nature. Aspects that encouraged help-seeking were: regarding mental health treatment as necessary for successful rehabilitation, sufficient knowledge of when and how to contact mental health services, support from peers, having a higher ranking in the prison hierarchy, health services that are out-reaching, and prior positive experiences with professional help. The barriers to professional help-seeking were: lack of information about when and how to access mental health services, challenges with the self-referral system, perceived unavailability of services, confidentiality issues, and a prison climate that favoured a tough appearance.ConclusionsThe participants appeared to be more positive to seeking professional help for mental health problems than reported in previous studies with incarcerated individuals. Interpersonal and systemic aspects were emphasized by the participants as barriers to accessing mental health services; some participants even perceived these services to be unavailable to them. The results are relevant for designing interventions to promote help-seeking for mental health problems among people in prison.Disclosure of InterestNone Declared

Feasibility of a video-delivered mental health course for primary care patients: a single-group prospective cohort study

BackgroundIn many health care systems, primary care is tasked with offering psychological treatment for common mental disorders. Resources are often limited, which complicates widespread dissemination of traditional psychological treatments. Stepped care models where the less resource-intensive interventions are delivered first, can be employed, but often do not eliminate the need for a thorough diagnostic assessment, which can be time-consuming, has the potential to bottleneck patient intake, and can add to waiting times. Novel low-threshold formats are needed to improve access to mental health care in the primary care setting.MethodsThis was a single-group prospective cohort study (N = 91). We assessed the feasibility of a video-delivered course as a first-line intervention for patients seeking help for mental health problems at a primary care center. The course had a transdiagnostic approach, suitable for both depression and anxiety disorders, and was based on cognitive behavioral techniques. Patients in need of psychosocial assessment, which usually entailed a four- to six-week wait, were referred by physicians or triage nurses. Study participants could start within a week, without the need for conventional diagnostic assessment, and were informed that they would be offered assessment after the course if needed. Key feasibility outcomes included participant satisfaction, attendance rates, the proportion of participants in need of additional clinical intervention after the course, and the rate of clinically significant improvement in anxiety and depression symptoms.ResultsParticipants scored a mean of 21.8 (SD = 4.0, 9–32, n = 86) on the Client Satisfaction Questionnaire-8; just below our target of 22. The mean attendance rate was 5.0/6 lectures (SD = 1.6, range: 0–6, n = 91). Forty-six percent (37/81) reported experiencing no need of further clinical intervention after the course. The rate of clinically significant improvement was 59% (27/46) for anxiety and 48% (22/46) for depression. No serious adverse event was reported.ConclusionsDelivering a low-threshold online video-delivered mental health course in primary care appears to be feasible. Adjustments to further improve patient satisfaction are warranted, such as offering the choice of participating online or face-to-face.Trial Registration(ClinicalTrials.gov NCT04522713) August 21, 2020.

Healthy lifestyle promotion via digital self-help for mental health patients in primary care: a pilot study including an embedded randomized recruitment trial.

This study piloted a digital self-help intervention facilitating healthy lifestyle for patients with mental health problems in primary care. Patients with mental health problems show more unhealthy lifestyle behaviors than the general population and prior research indicates that healthy lifestyle behaviors can improve mental health. This pilot study assessed use of a self-help digital intervention for healthy lifestyle promotion and included an embedded randomized recruitment trial, where all patients were randomized to digital self-help plus treatment as usual (TAU) or to TAU only. Patients seeking help for mental health problems were recruited from two primary care clinics in Stockholm, Sweden, and offered participation in a healthy lifestyle promotion study via digital self-help. Outcome measures included use-related assessment of inclusion and follow-up rates at both clinics, participant characteristics, and intervention adherence. Secondary outcomes included depression (the Patient Health Questionnaire-9) and anxiety (the GAD-7) up to 10 weeks, and changes in alcohol and tobacco use, physical activity, and diet. The study included 152 patients. The recruitment rate, initially low, increased after involving the clinicians more and maintaining more frequent contact with the patients. The 10-week missing data rate was 33/152 (22%). Participants were 70% (106/152) women, with a mean age of 42 years (SD = 14); fewer than half (38%, n = 58/152) had one or more high-risk unhealthy behaviors at inclusion. Psychiatric symptoms were moderate at baseline and declined in both groups after 10 weeks (d = 0.57-0.75). No between-group effects over time occurred on depression (b = 0.3 [95% CI -1.6, 2.2]; d = 0.06), anxiety (b=-0.7 [-2.5, 1.2]; d = 0.13), or lifestyle behaviors (b = 0.01 [-0.3, 0,3]; d=-0.01). Recruitment routines seemed to be decisive for reaching as many patients as possible. The relatively low rate of unhealthy lifestyle behaviors and small effect sizes suggests that the intervention may only suit patients at risk. ClinicalTrials.gov NCT03691116 (01/10/2018), focusing on the embedded trial. Retrospectively registered for the first clinic and prospectively for the second clinic.

Factors Associated with Engagement in University Life, and Help Seeking Attitudes and Behaviour in First Year Undergraduate Students.

Students transitioning from secondary school to university may experience unique issues that impact their mental health. There is limited research, however, on what drives first year students to seek professional help for mental health problems. There is also a current lack of knowledge about the factors that may be associated with engagement with university life in students transitioning to university, and how engagement may be related to help seeking attitudes and behaviours in a first year university population. Data (N = 165) were drawn from two waves (Wave 1, February 2021, and Wave 4, June 2021) of a longitudinal study of Australian university students commencing study for the first time, which included measures of engagement, belonging, stigma and help seeking intentions and behaviours. The results showed that students with higher levels of depression stigma prior to commencing university at Wave 1 had less positive attitudes towards help seeking at Wave 4. Students had increased odds of seeking help for a mental health problem in Wave 4 if they had moved away for university, reported higher levels of mental health literacy or willingness to disclose, had lower levels of engagement with university life and were experiencing higher levels of general psychological distress. Students experiencing higher thwarted belongingness were also found to have lower levels of engagement with university at Wave 4. Both thwarted belongingness and stigma were found to be associated with engagement with university and help seeking behaviours and should be examined further.

Facilitating factors for seeking help for mental health problems among Norwegian adolescent males: A focus group interview study.

Young males are overrepresented in suicide statistics and underrepresented in statistics of help-seeking and receiving help from formal health services compared with young females. Few studies have examined facilitating factors for help-seeking among adolescent males with no previous experience seeking mental health help. This study aimed to explore thoughts, attitudes, and experiences regarding facilitating factors toward formal help-seeking for mental health problems among Norwegian adolescent males. Three focus group interviews were conducted, each including four adolescent males with no experience with help-seeking or receiving help from a help service for mental health problems. The interviews addressed topics such as barriers and facilitating factors for help-seeking and preferences regarding structural factors and modes of delivery of help. Data were analyzed according to the systematic text condensation method. The analysis revealed three main categories of facilitating factors: (1) transparent information and available help services, (2) proactive and outreaching help services, and (3) the possibility for discreet help-seeking. Improving help-seeking is integral to accessing care and improving mental health. Help services can be more accessible and approachable for male adolescents if they offer discretion, the possibility to remain anonymous, the option to receive help in a convenient context, and outreach services.

Help-seeking attitudes and behaviours for mental health problems in adolescents before and during the first COVID-19 school closures in Germany.

Comparing measures of psychological wellbeing and help-seeking in youths before and within the first school closures due to the coronavirus disease 2019 (COVID-19) pandemic enables a better understanding of the effects the pandemic has for those seeking professional help for mental health problems. Data were obtained from the Germany-based ProHEAD school study. Pre-lockdown and lockdown samples (n= 648) were compared regarding pupils' psychological wellbeing, help-seeking attitudes and help-seeking behaviour. Participants from the lockdown sample showed greater positive attitudes towards seeking professional help, whereas psychological wellbeing and help-seeking behaviour remained stable. Possible explanations may include an increased public discourse on mental health or self-selection bias for participation during lockdown.

A Brief Online Video-Based Intervention to Promote Mental Health Help-Seeking in the Context of Injuries for Athletes: A pilot study

In the athletic population, sports injuries are often associated with mental health decline. Despite the availability of services, athletes frequently do not seek help for mental health problems. A range of barriers to help-seeking in athletes have been proposed, including poor mental health literacy and limited help-seeking knowledge. To address this, the current study piloted a newly designed online intervention that aimed to increase help-seeking attitudes, intentions, and mental health literacy (specifically depression literacy) in an athletic population. Using a pre-test post-test design, a total of 207 athletes were recruited using online convenience sampling from across Australia. Athletes were from a range of sports and competition levels and were provided a brief online intervention comprising three short educational videos with content addressing: (1) the athlete’s response to injury; (2) help-seeking and social support; and (3) signs/symptoms of depression. Participants completed pre- and post-intervention surveys which measured attitudes and intentions towards mental health help-seeking, and depression literacy. Data were analysed using RM-MANOVA, which demonstrated significant within-group improvement from pre-to post-intervention for help-seeking intentions, particularly when seeking help from mental health professionals, F(1, 93) = 24.64, p < .001, and online/phone services, F(1, 93) = 29.75, p < .001. Two separate paired samples t-test demonstrated a significant increase from pre-to post-intervention for both help-seeking attitudes, t(206) = 9.04, p < .001, d = 0.628, and depression literacy, t(203) = 8.66, p < .001, d = 0.606. The current study shows promise for brief video-based interventions that provide information targeting help-seeking during times of injury. However, further research using a rigorous randomised controlled trial design is needed. Additionally, more work is required to explore if an improvement in attitudes or intentions corresponds with increased help-seeking behaviour.

Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public – a systematic review

BackgroundThe perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL.MethodsFour electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively.ResultsThirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public.ConclusionsThere is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole.

Families' experiences of supporting Australian veterans and emergency service first responders (ESFRs) to seek help for mental health problems.

The objective of this phenomenological study was to describe families' experiences of supporting veterans and emergency service first responders (ESFRs) (known also as public safety personnel) to seek help for a mental health problem. In-depth semi-structured open-ended interviews were undertaken with 25 family members of Australian veterans and ESFRs. Fourteen participants were family members of police officers. Data were analysed thematically. Participants described a long and difficult journey of supporting the person's help-seeking across six themes. Traumatic exposures, bullying in the workplace and lack of organisational support experienced by veterans/ESFRs caused significant family distress. Families played a vital role in help-seeking but were largely ignored by veteran/ESFR organisations. The research provides a rich understanding of distress and moral injury that is experienced not only by the service members but is transferred vicariously to their family within the mental health help-seeking journey. Veteran and ESFR organisations and mental health services need to shift from a predominant view of distress as located within an individual (intrapsychic) towards a life-course view of distress as impacting families and which is more relational, systemic, cultural and contextual.

Avoiding Allostatic Load: Black Male Collegians and the Quest for Well-Being

The literature suggests that African American/Black males are less likely to seek professional assistance for mental health and other personal concerns than African American/Black females and that they are more likely to seek informal help for mental health problems than professional help. Are there circumstances where African American/Black males would seek professional help over informal help? This research updates what is currently known about African American/Black male collegians’ help-seeking behaviors and the circumstances or conditions that might influence professional help-seeking. Secondary data illustrating the help-seeking behaviors of African American/Black male collegians at an urban HBCU was examined to identify patterns or trends during the first semester of 2018 and 2019. De-identified data sheets for 103 African American/Black males were examined to identify referral sources, current mental health concerns, and past mental health concerns. African American/Black male and female collegians sought professional assistance for similar concerns: family problems, couples problems, peer interpersonal problems, depression, anxiety, and stress. Black males were more likely to self-refer for professional assistance than seek informal assistance. Implications for university counseling centers are explored.

Mental health services in the school environment-Future visions using a phenomenographic approach.

First, to describe the variation in stakeholders' perceptions related to the desirable mental health services in school environments. Second, to construct alternative future visions based on these perceptions. Finally, to describe stakeholders' perceptions about the actions needed to reach such an ideal state. The increased need for mental health care has challenged the role of schools and school health care in the area of mental health services for those of school-age. There is a need for future visions and comprehensive statements concerning the mental health services provided in the school environment. The study was undertaken in Finland, between February 2020 and February 2021. Qualitative individual interviews were conducted with 15 professional stakeholders and focus group interviews with 10 stakeholders advocating for adolescents or parents. The study was conducted with the phenomenographic approach using a visioning methodology. The study is reported following the COREQ checklist. Four alternative future visions were formulated based on the perceptions of the stakeholders. They emphasised different aspects: (1) non-medicalising the school environment, (2) early and extensive intervention by school nurses enabled by work distribution with mental health specialists, (3) a multiprofessional team providing help on overall health questions and (4) a focusing of the services on mental disorders. Necessary changes were identified at the micro-, mezzo- and macro-level. The future visions are based on opposite perceptions related to the mission and focus of school health care. One extreme emphasises overall health promotion for everyone, while the other accentuates treatment for those suffering from mental disorders. The former may lead to inadequate help for mental health problems and the latter insufficient help for other health problems. This study contributes alternative future visions, promotes strategic planning and helps to clarify the future role of school nurses.

Barriers and facilitators of help seeking among morally injured Canadian Armed Forces Veterans and service members: A qualitative analysis

LAY SUMMARY Moral injury (MI) refers to the psycho-spiritual consequences of extremely challenging events that threaten one’s moral beliefs and core values. MI is characterized by intense shame, guilt, anger, loss of trust in oneself and others, and social withdrawal — factors that may impede a person’s willingness to seek help for mental health problems. The authors analyzed interviews with 13 Canadian Armed Forces service members and Veterans struggling with MI. They identified themes representing four main barriers to help seeking (stigma, denial, no knowledge of problem or MI, negative perceptions of the military health system) and five main facilitators of help seeking (a sense of shared experience, screening, encouragement from others to seek help, purpose as motivation, alternatives to formal mental health care). The themes identified largely overlap with factors shown in previous research to be barriers to help seeking among military samples. The results of this study suggest that additional education on the mental health consequences associated with MI, and enhanced screening for this type of distress, may lead to increased support seeking among service members and Veterans struggling with MI.

125. Evaluation of an Arts-Based Educational Program to Reduce Mental-Health-Related Stigma Among Adolescents in India

Youth avoid seeking help for mental health problems due to mental-health-related stigma. Unlike high income countries, limited studies assess the impact of arts-based educational interventions on reducing such stigma among youth in low- and middle-income countries. A mixed methods, pre-post control group study was conducted (July 2016 - October 2017) to evaluate a six-week, arts-based educational program aimed to reduce mental-health-related stigma among youth in India.

Mental Health Problems among Young People-A Scoping Review of Help-Seeking.

Young people’s mental health is a public health priority, particularly as mental health problems in this group seem to be increasing. Even in countries with supposedly good access to healthcare, few young people seek support for mental health problems. The aim of this study was twofold, firstly to map the published literature on young people’s experiences of seeking help for mental health problems and secondly to validate whether the Lost in Space model was adaptable as a theoretical model of the help-seeking process described in the included articles in this scoping review. A scoping review was conducted in which we searched for literature on mental health help-seeking with a user perspective published between 2010 and 2020 in different databases. From the 2905 studies identified, we selected 12 articles for inclusion. The review showed how young people experience unfamiliarity and insecurity with regard to issues related to mental health and help-seeking. A strong wish for self-reliance and to safe-guard one’s own health were consistent among young people. Support structures were often regarded as inaccessible and unresponsive. There was a high level of conformity between the model on help-seeking and the analysed articles, reinforcing that help-seeking is a dynamic and psychosocial process.

Youths' Perceived Impact of Invalidation and Validation on Their Mental Health Treatment Journeys.

Youths' experiences in seeking and accessing help for mental health problems can have pervasive and lasting effects on personal and interpersonal functioning. In particular, youth who experience validating experiences presumably persevere in seeking help and generally have positive treatment outcomes, whereas youth who experience invalidation are also likely to experience, at least in the short term, ruptures in therapeutic relationships, shame, and reluctance to seek services. The goal of the current study was to expand on previous research assessing youths' interactions with mental health providers, allied professionals, family members, and peers, with a focus on subjective experiences of validation and invalidation. The current study investigated both validating and invalidating experiences in seeking, accessing, and maintaining professional services among 31 Canadian youth (n = 20 girls, n = 11 boys; 12 to 21years old [M = 16.97, SD = 2.01]) who were diagnosed or self-identified with at least one of five conditions: depression (n = 26), anxiety (n = 22), eating disorders (n = 9), autism spectrum disorder (n = 2), or conduct disorder or oppositional defiant disorder (n = 2). Youth were recruited using convenience (e.g., posted advertisements in mental health clinics) and snowball sampling methods. Journey mapping methodology (i.e., participants created visual representations of milestones of their mental health journeys) was employed accompanied by semi-structured interviews to prompt youth to expand on their experiences (e.g., "Could you describe what was happening in your life when you first felt you would need support for your mental health?"). Four themes emerged using inductive thematic analysis, marked by the presence (validation) or lack (invalidation) of: feeling heard, feeling seen, feeling understood, and receiving helpful actions. Participants also reported key consequences of validation and invalidation. Findings broaden a conceptualization of validation across supportive relationships and an understanding of factors that enhance or impede the formation or maintenance of therapeutic relationships with youth. Clinical implications and limitations are discussed.

Description of Anxiety Levels of Midwifery Students : Literature Review

Midwifery study programs around the world operate with the aim of training and producing competent midwives. To improve the quality of special attention needs and a good learning process so that learning objectives can be achieved. Midwifery is considered as one of the educational programs that require high academic scores so that it takes a lot of time and effort. Such high demands and pressures can trigger anxiety and anxiety. This study aims to describe the level of anxiety of midwifery students which is useful as an effort to assess student welfare in learning determined by a Midwifery Education Institution in dealing with what is experienced by students. Literature review through searching scientific publications in the period 2016-2021 using several databases, namely Pubmed, Science Direct and Google Scholar. A total of 8 articles are in accordance with the objects discussed in the literature review by considering the inclusion and exclusion criteria. Literature results are N=113, Pubmed N=53, Direct Science N=49, Google Scholar N=11. Can unlock that the students are on average at very pleasant scores which can be overcome with the support of providing psychoeducation and stress management by midwifery students. A student counseling center with adequate facilities and qualified staff should be established on campus as students seek appropriate help for mental health problems.