Mental Health Help-seeking Behavior Research Articles

Decoding Factors Influencing Mental Health Help-Seeking in Asian International Students: A Correlational Survey Study

This study investigates the effects of gender, age, perceived socioeconomic status, and attitudes toward mental health treatment, alongside the awareness and accessibility of mental health services, on the propensity of Asian international undergraduate and graduate students in U.S. colleges to seek mental health support. Utilizing an online survey, responses from a diverse group of 116 participants, aged 18 and above, from universities across the nation were examined through correlation analysis. Findings indicated no significant gender differences in attitudes toward mental health treatment. However, factors such as higher educational level, superior socioeconomic background, longer U.S. residency, and increased awareness and accessibility of mental health services positively influenced attitudes. This quantitative study extends previous qualitative research addressing similar questions, filling a gap by offering broader empirical insights into this population’s mental health service utilization. The outcome underscores the need for university counseling centers to develop targeted interventions that acknowledge the needs of Asian international students. Future research should explore the longitudinal impacts of these factors on mental health help-seeking behaviors to inform ongoing service improvement.

Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster

2020 was an unprecedented year that uncovered glaring mental health crises. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. Auto Regressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.

Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study

BackgroundMental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students.MethodsA cross-sectional study was conducted across ten Egyptian universities during the academic year 2022–2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ).ResultsAmong 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help.ConclusionThe findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

Caught between two worlds: mental health literacy and stigma among bicultural youth

ABSTRACT Purpose Bicultural youths are at higher risk of mental health problems and are less likely to utilize mental health services, yet our knowledge of their mental health literacy and help-seeking behaviours remains limited. Methods To fill this gap, the current study explored bicultural youths’ mental health literacy and stigma by conducting semi-structured interviews with 14 Canadian university students in 2021. Results Our analysis revealed that bicultural youths may be torn between two worlds: intergenerational tensions between participants assimilated into individualistic Canadian culture and their more collectivist parents meant that they had different cultural perceptions of mental health literacy and stigma. While being caught between these two worlds may be detrimental for bicultural youth, our results also suggested that a trans-cultural factor—celebrities’ mental health journeys—may promote help-seeking behaviour across participants. Furthermore, our study speaks to the ways that unprecedented events such as the COVID-19 pandemic impact mental health literacy among bicultural youth. Our findings might be used by university mental health services to encourage help-seeking among bicultural students. Conclusion The acculturation of mental health literacy, stigma, and associated intergenerational differences needs to be considered by university wellness services.

Previous mental health care and help-seeking experiences: Perspectives from sexual and gender minority survivors of near-fatal suicide attempts.

Sexual and gender minority (SGM) populations face heightened risk of suicide compared to their heterosexual and cisgender counterparts, and a previous suicide attempt is among the strongest predictors of suicide mortality. Despite this increased risk, limited research has explored mental health help-seeking behavior and previous mental health care experiences of SGM individuals among the highest risk for suicide-individuals with a recent, near-fatal suicide attempt. This study presents thematic analysis results of interviews with 22 SGM individuals who reported at least one near-fatal suicide attempt in the past 18 months. Identified themes were (a) factors that affect help-seeking for SGM individuals with a recent, near-fatal suicide attempt, including previous mental health care experiences, support systems, and structural barriers and facilitators; (b) hospitalization is not a one-size fits all solution; and (c) recommendations for improving care for this population. Findings demonstrate that anti-SGM stigma may magnify existing barriers to mental health care across all socioecological levels. Notably, participants cited a fear of loss of autonomy from inpatient hospitalization and previous discriminatory experiences when seeking mental health care as hampering help-seeking. Given increased risk for suicide mortality, this patient population is a necessary stakeholder in suicide prevention and intervention development and policy discussions affecting mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental Health Help-Seeking Behaviours in University Students: Are First-Generation Students Different?

First-in-family (FiF) students experience significant barriers to university participation and are less likely to seek mental health help. This can contribute to increased dropouts when compared to non-FiF students. Using a mixed methods approach, we aimed to ascertain sources of mental health support and underlying factors for the preferences favoured by students from UK universities. Answers to the General Help Seeking Questionnaire (GHSQ) and to two open-ended questions were collected online. We found that FiF (n=194) students were more likely to seek help from friends relative to their non-FiF (n=134) peers. Trust was particularly important for FiF students, while for non-FiF students, the perceived benefit of talking to anyone about mental health was more relevant. Attitudes towards mental health discussion were influenced by background. Stigma and perceived burdensomeness negatively affected help-seeking among all students. Our findings suggest FiF students derive more benefits for their mental health concerns from friendship circles, implicating the importance of social integration programmes at university. Future work would benefit from evaluating mental health help-seeking intentions of students with more specific characteristics (e.g., race, gender), to better understand determinants influencing preferences and help institutions plan more fitting provisions to support students.

Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial

IntroductionStigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic. MethodsA randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups—the interventions aimed to reduce depression stigma. ResultsAmong the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology. ConclusionStigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.

Access and use of digital technology by patients with psychosis at a hospital in South Africa.

There is growing interest in the use of digital information and communication technology (ICT) for mental health care purposes. Information and communication technology tools may enhance mental health literacy and help-seeking behaviour. To describe the access to, use and perception of ICT in people with schizophrenia and other psychotic disorders. The study was conducted at an urban psychiatric hospital in Durban, KwaZulu-Natal (KZN) province, South Africa. Participants completed questionnaires on their socio-demographic characteristics and access to, use and perception of ICT. Multiple ordinal logistic regressions were used to test the association between socio-demographic factors and ICT use and perception. Of the 165 participants (mean age = 41 years ± 14.2), 54.5% were male, 37.6% were employed, and most (93.3%) lived in an urban area. Most participants (93%) had access to the internet in past 3 months and a smartphone (89.8%). Age (AOR 0.94, p = 0.06, CI = 0.88-1.00) and marital status (AOR = 0.26, p 0.02, CI = 1.62-253.74) were associated with internet use, while age (AOR = 0.95, p 0.03, CI = 0.9-1.00), marital status (AOR = 3.64, p = 0.05, CI = 1.03-12.90), income (AOR = 4.02, p < 0.01, CI = 1.69-9.54), employment status (AOR = 0.16, p < 0.01, CI = 0.06-0.44), and living with HIV (AOR = 5.41, p < 0.01, CI = 1.39-21.07) were associated with frequency of internet use. Older participants had lower odds of using a mental health care app (AOR = 0.93, p = 0.02, CI= 0.88-0.99). Those with higher incomes had increased odds of seeking mental health information digitally (AOR = 4.33, p = 0.03, CI = 1.13-7.54). People living with psychosis do have access to digital technology although pattern of use maybe influenced by sociodemographic factors. This study provides baseline data on digital technology use in Africa.

Research on the Effect of Personality Traits on Help-seeking Behavior and Intention

This study explores the relationship between various personality scales and traits, and the intention to seek professional help when troubling with mental distress. It aimed to identify the scales and traits that most influence help-seeking intentions and determine which had the greatest predictive strength. Using the THE HEXACO PERSONALITY INVENTORY - REVISED (HEXACO-PI-R), this study measured personality traits of 117 American participants from the CloudResearch website, all of whom were 18 years or older and received monetary compensation. The Mental Help Seeking Intention Scale was used to measure the participants willingness to seek professional mental help. The findings suggest a moderate and statistically significant positive correlation between help-seeking intention and the traits of openness to experience, conscientiousness, and emotionality. This study contributes to the understanding of how personality influences mental health help-seeking behaviors, offering potentially valuable insights for tailoring intervention strategies.

Analysis of hindering and facilitating factors of help-seeking behavior in schizophrenia based on COM-B model: a descriptive qualitative study.

Timely and systematic professional treatment is crucial in schizophrenia prognosis, but the global rate of mental health service, now, use or help-seeking behavior is low. In-depth semi-structured interviews were conducted with 13 participants with the diagnosis of schizophrenia between October to December 2021. The participants were purposively sampled from a psychiatric hospital's. Interviews were recorded and transcribed verbatim into NVivo 12.0. The findings were summarized under 3 themes and 12 subthemes: (1) capability (lack of knowledge due to insufficient mental health literacy or lack of insight, inability to access disease information due to a lack of mental health literacy, and symptoms-related barriers); (2) opportunity (lack of disease information sources, inability to balance work and study during prolonged hospitalization, accessibility and convenience of medical resources, and the acquisition and utilization of social support); and (3) motivation (awareness of the disease and professional treatment, negative experiences of disease episodes, past medical experience, confidence in tcuring the disease, and the fulfillment of daily life and self-worth). The medical help-seeking behavior of people with the diagnosis of schizophrenia is the result of the interaction of many barriers and facilitators, and challenges persist today. Interventions can be implemented with the BCW framework and our results to precisely eliminate delays in the diagnosis and treatment of mental problems.

Help-seeking during 1-year follow-up in Chinese patients diagnosed with type 2 diabetes mellitus comorbid major depressive disorder.

Previous research has revealed a bidirectional relationship between type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD). A very limited proportion of patients with T2DM comorbid MDD received adequate psychiatric intervention. This study investigated the help-seeking behaviors of patients with T2DM comorbid with MDD during one-year follow-up. At a medical center in China, a cohort of outpatients with T2DM were assessed and diagnosed for comorbid depression at baseline and after one year. The Mini International Neuropsychiatric Interview was used to diagnose MDD, while The Patient Health Questionnaire-9 (PHQ-9) and The Hamilton Depression Scale 17-item (HAMD-17) were used for depression assessment. Mental health help-seeking behaviors of patients during follow-up period were also evaluated. Out of the 203 patients with T2DM at baseline, 114 (56.2%) completed the follow-up. The prevalence of MDD in participants with T2DM was 12.8% at baseline and 22.8% at follow-up. Patients who completed the follow-up had a lower baseline PHQ-9 score (test statistic -2.068, p=0.039), HAMD-17 score (test statistic -2.285, p=0.022) than those who did not complete the follow-up. A total of 26 patients had comorbid MDD during the follow-up period, among which 8 patients (30.8%) voluntarily visited psychiatric clinics, while others did not seek assistance. The level of HbA1c at follow-up was higher in patients who sought help than in those who did not (8.1 ± 1.8% vs. 7.0 ± 0.7%), although the difference was not statistically significant. Voluntary psychiatric help-seeking for Chinese patients with comorbid T2DM and MDD is uncommon. It is crucial to increase awareness of depression among patients and healthcare professionals alike.

An Exploratory Study on Student-Athlete Mental Health: Personal and Perceived Barriers to Help-Seeking Behavior

Student-athletes are more likely to develop mental health problems than the general population. In addition to schoolwork, social networks, family ties, and financial obligations, collegiate student-athletes are required to attend practices, travel for games, attend athletic events, and perform extracurricular duties. The addition of possible injury, overtraining, burnout, scrutiny from the public and/or the media, and consistent pressure to perform results in athletes playing through both physical injuries and mental health problems. Despite the high number of athletes who report needing mental health support, fewer than half seek out mental health services. Research has identified stigma as one of the largest barriers to mental health help-seeking behavior (HSB). Help-seeking behavior has rarely been studied in relation to the larger body of work on mental health stigma in sport. The purpose of this study was to observe and describe student-athletes’ perceived stigma (e.g., what others think) and personal stigma (e.g., what the individual thinks) in relation to HSB. A sample of n = 20 athletes completed an online Qualtrics Survey, which included Link’s Perceived Discrimination and Devaluation Scale, Mental Health Literacy Scale, Self-Stigma of Seeking Help Scale, Help Seeking Questionnaire, and Student-Athlete Role Behaviors Questionnaire. Results from this study may help develop mental health interventions to improve student-athlete HSB. KEYWORDS: Mental Health; Student-Athlete; Stigma; Help-Seeking Behavior; NCAA; PDDS; MHLS; SSOSH; HSQ; SRBQ

Cultural Beliefs, Mental Health Literacy, and Help-Seeking Behaviours Among Young Sarawak Indigenous Adults

This study aimed to understand the prevailing cultural beliefs concerning mental health literacy and help-seeking behaviours among young adults within the indigenous community of Sarawak. Six participants from various indigenous communities from Sarawak, ranging from 18 to 35-year-olds, were interviewed in the qualitative study. Four main themes with fourteen (14) sub-themes were found in the interview data using thematic analysis. These comprised belief systems on mental health, mental health literacy, help-seeking behaviour, and barriers to help-seeking. The study was done among selected young adults in the Indigenous Community in Sarawak. The predominant finding of this study was the inclination of most participants to seek religious support when confronted with mental health challenges. To advance the investigation, future research should explore similar themes across different age groups and expand participant diversity, encompassing a range of socio-economic backgrounds, to provide a refined understanding of these dynamics on mental health among youths.

A theory-based examination of the predictors of mental health help-seeking in young men

ABSTRACT Objective The present research seeks to understand young men’s willingness to engage in both informal (social) and formal (professional) mental health support using the lens of the Prototype Willingness Model (PWM). Method The main study (N = 171) examined the constructs of attitude (positive or negative appraisal of the target behaviour), subjective norm (perceived social influence related to behavioural performance), prototype similarity (degree to which the individual feels similar to the typical person who perform the behaviour) and prototype favourability (degree to which the individual identifies the typical performer as being favourable), in addition to self-stigma and emotional expressivity. Hierarchical multiple regressions assessed these constructs in predicting young men’s willingness to engage in mental health support. Results Results indicated attitudes, prototype similarity, self-stigma and emotional expressivity explained a significant proportion of variance for willingness to engage in both informal support and formal help-seeking. Self-stigma was significantly associated with formal help-seeking, while emotional expressivity was significantly associated with informal and formal help-seeking. Conclusions The current research supports the value of the PWM in understanding males’ mental health help-seeking behaviour. The study enhances awareness of key factors which may inform young men’s willingness to engage in support services for their mental health.

Mental health problems and help-seeking behaviours of Syrian refugee adolescents: mediating role of self-stigma.

Although common mental health problems have been widely studied with self-stigma, few studies have focused on the mediating effect of self-stigma in the relationship between mental health problems and help-seeking behaviours of refugee adolescents. Therefore, the purpose of the present study was to examine whether self-stigma mitigates the adverse effects of stress, anxiety, and depression symptoms on the help-seeking behaviours of Syrian adolescents living in Turkey. The participants of this study included 488 Syrian refugee adolescents (boys, 63.73%; girls, 3627%) living in Turkey. Participants completed the Depression Anxiety Stress Scale and General Help-Seeking Scale and Self-Stigma of Seeking Psychology Help Scale. The findings revealed that stress (β = 0.19, p < 0.01), anxiety (β = 0.12, p < 0.05), and depression (β = 0.17, p < 0.01) had significant and positive predictive effects on self-stigma, but not on help-seeking behaviours. Also, self-stigma (β = -0.12, p < 0.01) had a significant negative predictive effect on help-seeking behaviours. With regard to the indirect effects, the findings showed that self-stigma fully mediated the associations between stress - help-seeking [effect = -0.05, 95% confidence interval (CI) -0.11 to -0.01], anxiety - help-seeking (effect = -0.04, 95% CI -0.09 to -0.01)], and depression - help-seeking (effect = -0.05, 95% CI -0.12 to -0.01). Our findings highlight the potential negative effects of self-stigma on the help-seeking behaviours of Syrian refugee adolescents, both directly and indirectly. These results can be used to develop and implement effective and efficient interventions to address the unmet mental health needs of refugee adolescents.

An App to Support Fathers' Mental Health and Well-Being: User-Centered Development Study.

Numerous studies describe the popularity and usefulness of parenting programs. In particular, parenting programs are generally viewed as effective for supporting parents' mental well-being during key transition periods. However, the evidence base for fathers is limited owing to their lack of involvement in parenting programs and scarcity of tailored support. This paper aimed to describe the co-design process for a universal digital intervention for fathers (fatherli) and the outline of a logic model with its expected outcomes. Following established guidelines for co-designing and developing complex interventions, we conducted a nonsystematic review of the available literature to gather key information, developed market surveys to assess fathers' needs and interests, consulted with key stakeholders to obtain expert opinions, and engaged in a rapid iterative prototyping process with app developers. Each step was summarized, and the information was collated and integrated to inform a logic model and the features of the resulting intervention. The steps in the co-design process confirmed a need for and interest in a digital intervention for fathers. In response to this finding, fatherli was developed, consisting of 5 key features: a discussion forum for anyone to post information about various topics (the forum), a socializing platform for fathers to create and engage with others in small groups about topics or points of shared interest (dad hub), a tool for fathers to find other fathers with shared interests or within the same geographic location (dad finder), a resource for fathers to access up-to-date information about topics that interest them (dad wiki), and a portal to book sessions with coaches who specialize in different topics (dad coaching space). The evidence-based logic model proposes that if fatherli is successfully implemented, important outcomes such as increased parental efficacy and mental health help-seeking behaviors may be observed. We documented the co-design and development process of fatherli, which confirmed that it is possible to use input from end users and experts, integrated with theory and research evidence, to create suitable digital well-being interventions for fathers. In general, the key findings suggest that an app that facilitates connection, communication, and psychoeducation may appeal to fathers. Further studies will now focus on acceptability, feasibility, and effectiveness. Feedback gathered during pilot-testing will inform any further developments in the app to increase its applicability to fathers and its usability.

Understanding the utility of "Talk-to-Me" an online suicide prevention program for Australian university students.

Australian university students are at risk of experiencing poor mental health, being vulnerable to self-harm and suicidal ideation. "Talk-to-Me" is a suicide ideation prevention Massive open online course (MOOC) previously showing it can support Western Australian university students' knowledge of identifying and responding to suicide ideation in themselves and others. A multi-site one-group pre-test/post-test design with a 12-week follow-up explored the efficacy of "Talk-to-Me" for university students Australia-wide, evaluating the influence of COVID-19 and location. Overall, 217 students (55% female; mage  = 24.93 years [18, 60]) enrolled in this study from 2020 to 2021. Participants' responses to suicidal statements, mental health literacy, generalized self-efficacy, help-seeking behavior, and overall utility of the program were collected at baseline, post-MOOC (10 weeks from baseline) and 12-week follow-up. The effect of time and location interaction was explored using a random-effects regression model. Findings indicated significant improvement in participants' knowledge of positive mental health support strategies (ES = 0.42, p < 0.001) and recognizing appropriate responses to suicidal statements (ES = 0.37, p < 0.001) at 10-weeks, with further improvement at 12 weeks follow-up (ES = 0.47 and 0.46, p < 0.001). Students reported higher generalized self-efficacy at the 12-week follow-up compared to baseline (ES = 0.19, p = 0.03) and an increased tendency to seek professional help for mental health issues (ES = 0.22, p = 0.02). These findings provide preliminary evidence of the efficacy of the "Talk-to-Me" program in supporting ‎university students across Australia to increase their suicide-related knowledge and skills, ‎general self-efficacy, and overall mental fitness.

Evaluating the mental health status, help-seeking behaviors, and coping strategies of Canadian essential workers versus non-essential workers during COVID-19: a longitudinal study

ABSTRACT Objective This study examined mental health symptoms, help-seeking, and coping differences between Canadian essential workers (EWs) versus non-EWs, as well as common COVID-related concerns and longitudinal predictors of mental health symptoms among EWs only. Design An online, longitudinal survey (N = 1260; response rate (RR) =  78.5%) assessing mental health and psychosocial domains amongst Canadian adults was administered during the first wave of COVID-19 with a six-month follow-up (N = 821; RR = 53.7%). Methods Cross tabulations and chi-square analyses examined sociodemographic, mental health, and coping differences between EWs and non-EWs. Frequencies evaluated common COVID-related concerns. Linear regression analyses examined associations between baseline measures with mental health symptoms six months later amongst EWs. Results EWs reported fewer mental health symptoms and avoidance coping than non-EWs, and were most concerned with transmitting COVID-19. Both groups reported similar patterns of help-seeking. Longitudinal correlates of anxiety and perceived stress symptoms among EWs included age, marital status, household income, accessing a psychologist, avoidant coping, and higher COVID-19-related distress. Conclusions COVID-19 has had a substantial impact on the mental health of Canadian EWs. This research identifies which EWs are at greater risk of developing mental disorders, and may further guide the development of pandemic-related interventions for these workers.

Translation, Adaptation, and Validation of the Malay Version of the Barriers to Access to Care Questionnaire for Assessing the Barriers to Seeking Mental Health Care Among the Health Workforce in the East Coast Region of Peninsular Malaysia.

Background Mental health problems among the health workforce are a significant concern worldwide, including in Malaysia. Unfortunately, some health workforce may perceive various barriers or challenges that prevent them from seeking help. Identifying and addressing these barriers is crucial for enhancing mental health services and support. The Barriers to Access to Care Evaluation (BACE-3) questionnaire is a valuable tool that can be used for assessing these barriers among health workers. However, a validated Malay version is needed. Therefore, this study aims to translate, adapt, and validate the original version of Barriers to Access to Care Evaluation (BACE-3) into the Malay version (MBACE). Methods A rigorous process of translation and adaptation was followed to develop the Malay version of the BACE-3 questionnaire (MBACE). A cross-sectional study was conducted to assess the psychometric properties of the questionnaire, with purposive sampling employed to recruit 188 participants from various job categories, including doctors, nurses, pharmacists, and non-clinical staff, such as health assistants and clerks. The analysis was conducted using the R software version 4.2.2 (R Foundation, Vienna, Austria). Construct validity was determined using confirmatory factor analysis (CFA). To assess the convergent validity, internal consistency, and reliability of the instrument, measures such as the average variance extracted (AVE), composite reliability (CR), and Cronbach's alpha values were calculated. Results During the CFA process, two items with a factor loading less than 0.5 (items 15 and 16) were removed to improve the convergent validity and model fit. The CFA results revealed that the 2-factor model MBACE had good construct validity (root mean square error of approximation (RMSEA) = 0.053; comparative fit index (CFI) = 0.939; Tucker-Lewis fit index (TLI) = 0.934). The internal consistency was supported by Cronbach's alpha values ranging from 0.92 to 0.94 for the stigma factor and non-stigma factor. The average variance extracted (AVE) and composite reliability (CR) values further supported the questionnaire's reliability and convergent validity. Conclusion The translated and adapted 28-item MBACE questionnaire is a valid and reliable tool for assessing the barrier to seeking professional mental health care among the Malaysian health workforce. This instrument has the potential to aid in the development of targeted interventions to promote mental health help-seeking behavior and enhance the well-being of the Malaysian health workforce.

Culturally Adapting a Digital Intervention to Reduce Suicidal Ideation for Syrian Asylum Seekers and Refugees in the United Kingdom: Protocol for a Qualitative Study.

The conflict in Syria has produced the largest forced displacement crisis since the Second World War. As a result, Syrians have experienced various stressors across the migratory process, putting them at an increased risk of developing mental health issues, including, crucially, suicidal ideation (SI). Despite their high rates of SI across Europe, there remain various barriers to accessing treatment. One way to increase access is the use of culturally adapted digital interventions, which have already shown potential for other minority populations. To culturally adapt the intervention, further research is needed to better understand Syrian asylum seekers' and refugees' cultural conceptualizations, coping strategies, and help-seeking behavior for SI. To do so, this study will use a unique cultural adaptation framework to intervene at points of lived experience with the migratory process where Syrian culture and signs of psychopathology converge. Likewise, co-design events will be used to adapt points of experience with the intervention where Syrian culture and the intervention conflict. As the first cultural adaption of a digital SI intervention for Syrian asylum seekers and refugees, this study will hopefully encourage further development of culturally sensitive interventions for the largest refugee population in the United Kingdom and the world. The objective of the study is to increase access to mental health treatment for Syrian asylum seekers and refugees in the United Kingdom by culturally adapting a digital intervention to reduce SI. The study will use experience-based co-design, an action research method, to culturally adapt a digital intervention to reduce SI for Syrian asylum seekers and refugees in the United Kingdom. This will involve conducting 20-30 interviews to understand their lived experiences with the migratory process, cultural conceptualizations of mental health and SI, coping strategies, mental health help-seeking behavior, and perceptions of digital mental health interventions. In addition, 3 co-design events with 6 participants in each will be held to collaboratively adapt the intervention. Touchpoints and themes extracted from each phase will be prioritized by a community panel before adapting the intervention. The study began in November 2022 and will continue until the last co-design event in August 2023. The results of the study will then be published by December 2023. Access to treatment for some of the most severe mental health issues is still limited for Syrian asylum seekers and refugees in the United Kingdom. Cultural adaptations of digital interventions developed for general populations have the potential to increase access to treatment for this population. Specifically, adapting the intervention for Syrian asylum seekers' and refugees' experiences with SI in relation to their lived experience with the migratory process may enable greater recruitment and adherence for users of various cultural and ethnic subgroups and levels of SI. DERR1-10.2196/47627.