Professional Help-seeking Intentions Research Articles

Mental health help-seeking intentions & coping strategies of Chinese international students in the United States

Background Chinese international students (CIS) in the United States may face unique mental health challenges that are often overlooked in discussions about mainstream college student needs. Objective This study aims to investigate the predictors of mental health (MH) professional help-seeking intentions among CIS at a large public Midwestern university, as well as the obstacles that hinder their use of professional MH services. Methods The study used quantitative and qualitative approaches to gather data on CIS’ help-seeking attitudes. Quantitative analysis focused on the association between specific factors and help-seeking intentions. Qualitative coding of open-ended questions provided additional insights into obstacles and suggestions for improving mental health support. Results The study identified several factors influencing the mental health help-seeking intentions of Chinese international students. Two primary negative predictors were a preference for emotional self-control and concerns about the questionable quality of treatment. Conversely, having previous experience with professional mental health services, both in China and the United States, was found to be a positive predictor of help-seeking intentions. Additionally, qualitative analysis of open-ended responses revealed further obstacles to seeking help and provided useful suggestions for enhancing mental health support for Chinese international students in college settings. Conclusions The study identifies key factors that influence CIS’ attitudes toward seeking professional mental health services. Understanding these factors can help in developing strategies to better support the mental health of CIS in college settings. Limitations Several limitations must be acknowledged in this study. The cross-sectional design limits the ability to draw causal inferences from the data. Additionally, the sample may not be fully representative of the broader population of Chinese international students, which may affect the generalizability of the findings. Self-reported data may also introduce response biases. Future research should consider longitudinal approaches and a more diverse sample to validate and expand on these findings.

성인 계층의 정서표현 양가성이 전문적 도움추구 태도와 의도에 미치는 영향: 자기은폐와 심리적 불편감의 구조적 관계 검증

This study sought to verify the structural relationship between Self-Concealment and Psychological Distress in the impact of adult Ambivalence over Emotional Expressiveness on Professional Help-Seeking Attitudes and Intentions. This is significant in that it reveals the individual's psychological factors that affect Professional Help-Seeking and suggests a practical approach. For this study, data were collected from 472 adults aged 18 or older. Research results: First, Ambivalence over Emotional Expressiveness had a positive effect on Professional Help-Seeking intentions by mediating psychological Distress, but it also had a negative effect on the mediating variable, Professional Help-Seeking Attitudes, which also lowered Professional Help-Seeking Intentions. Second, all paths involving Professional Help-Seeking Attitudes had a negative effect on Professional Help-Seeking Intentions. Third, Self-Concealment was found to have a positive effect on the Professional Help-Seeking Intentions even though it was an avoidance factor, and Psychological Distress was found to have a negative effect on the Professional Help-Seeking Intentions even though it was an approach factor. Finally, limitations of this study and follow-up research were discussed.

The role of psychological distress, stigma and coping strategies on help-seeking intentions in a sample of Italian college students

BackgroundMental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students.MethodsThis study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions.ResultsResults showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help.ConclusionsThis study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.

Autonomy versus support: self-reliance and help-seeking for mental health problems in young people

PurposeMany young people with mental ill-health do not seek support, and developmental growth in self-reliance may be a barrier to help-seeking. Increasing autonomy is a positive developmental task for youth and a key aspect of resilience. This study examined the influence of perceived social support and resilience on the previously unexamined relationship between self-reliance and intentions to seek help from informal, professional, and self-help sources for mental health problems.MethodsAn online survey was completed by a representative Australian community sample of 5,203 young people aged 12–25 years (half female), in May–June 2020.ResultsPath analysis showed the hypothesised conceptual model did not fit the data well, but a modified model was a good fit. Higher self-reliance was associated with lower intentions to seek informal and professional help, as expected, but not with greater intentions for self-help. The relationship between self-reliance and informal help-seeking intentions was fully mediated by perceived social support, whereas the relationship between self-reliance and professional help-seeking was also direct. Perceived social support fully mediated the relationship between self-reliance and resilience. Intentions to use self-help were not influenced by variables in the study, but higher self-help intentions were associated with higher professional help-seeking intentions. Associations were consistent across age and gender groups.ConclusionThe results show the critical role of social support for combating some of the unhelpful aspects of self-reliance for mental health help-seeking in young people. Future research should explore how self-reliance can hinder or be harnessed to facilitate accessing appropriate mental health.

"I could easily get professional help if I wanted to": Professional help-seeking intentions and the Theory of planned behaviour

This study used path analysis to evaluate the ability of the Theory of planned behaviour to predict professional help-seeking intentions in an adult community sample (N = 470, 51% female, age range: 18?64 years). The results showed that perceived behavioural control was the most significant antecedent of help-seeking intentions, positive attitudes increased the likelihood to seek professional help, however, their effect was small, while subjective norms were not relevant. Past help-seeking had a small direct effect on intentions, yet equally strong as the total indirect effect via attitudes and perceived behavioural control. Psychological distress affected intentions only indirectly. Difficulties with self-disclosure were the only barrier that had a partially mediated effect on intentions through perceived behavioural control. The findings are discussed with respect to the utility of the TPB model, as well as in the wider context of professional help-seeking and interventions to encourage the utilization of mental health services.

The Association Between Problem Recognition, Race/Ethnicity, and Professional Help-Seeking Intentions Across Psychological Disorders

While 75% of mental health problems emerge by young adulthood, there is a strong reluctance during this developmental stage to seek professional help. Although limitations in mental health literacy, such as incorrect problem recognition, may hinder professional help-seeking intentions, the relationship between these variables has been understudied among young adults in the United States (U.S.) and racial/ethnic differences in help-seeking intentions for specific disorders have not been well explored. Using a vignette-based design, the current study examines the association between psychological disorder recognition and professional help-seeking intentions among 1,585 Black/African American and White/European American young adults. Correctly identifying a psychological disorder was significantly associated with intentions to seek professional help for several disorders and race/ethnicity significantly influenced intentions to seek professional help for some disorders. Implications for ways to address unmet mental health care needs, especially among racially/ethnically diverse young adults, and directions for future research are discussed.

Bridging the gap between child mental health need and professional service utilisation: Examining the influence of mothers\u2019 parental attributions on professional help-seeking intentions

There is a significant gap between the need for child mental health services and use of these services by families. Parental attributions may play a role in this. This study examined whether mothers’ attributions about their child’s problems influence professional help-seeking intentions in a general sample of community mothers. Secondary analysis re-examined this hypothesis in a subgroup of mothers of children with clinically elevated mental health symptoms. Cross-sectional survey data were collected from mothers (N = 184) of children aged between 2 and 12 years recruited from the community. Mothers completed self-report questionnaires measuring parental attributions: child-responsible attributions and parental self-efficacy; professional help-seeking intentions; and psychosocial covariates: child mental health, mothers’ anxiety and depression, child age, gender, marital status, education, and professional help-seeking experience. Hierarchical regression modelling indicated that parental attributions explained professional help-seeking intentions after controlling for covariates in both the general sample (ΔF = 6.07; p = .003) and subgroup analysis (ΔF = 10.22, p = .000). Professional help-seeking intentions were positively associated with child-responsible attributions (β = .19, p = .002) but not parental self-efficacy (β = – .01, p = .865) in the general sample, while positively associated with child-responsible attributions (β = .20, p = .009) and negatively associated with parental self-efficacy (β = – .16, p = .034) in the subgroup analysis. Findings were independent of the presence of clinically elevated symptoms, problem type, and severity. Overall, the findings support models suggesting that parental attributions have a role in professional help-seeking for child mental health problems.

Mental health stigma and professional help-seeking behaviors among Asian American and Asian international students

Objective: To examine the relationship between stigma and mental health help-seeking among Asian American and Asian international college students. Participants: Asian American college students (401 men, 858 women) and Asian international college students (384 men, 428 women). Methods: Data from the 2018–2019 Healthy Minds Study were used to assess perceived stigma, personal stigma, and help-seeking behaviors of college students. Results: Personal stigma mediated the relationship between perceived stigma and professional help-seeking intentions. The relationship between perceived stigma and personal stigma differed by international status, such that the relationship between perceived stigma and personal stigma was stronger for Asian international students. The indirect effect between perceived stigma and professional help-seeking via personal stigma also differed by international status. Conclusions: These results suggest that, consistent with prior work, stigma impacts help-seeking among Asian college students and international student status affects the strength of the key relationship between perceived stigma and personal stigma.

A randomised controlled trial of a relationship-focussed mobile phone application for improving adolescents' mental health.

BackgroundThis study evaluated the acceptability and effectiveness of a relationship‐focussed mobile phone application (WeClick) for improving depressive symptoms and other mental health outcomes in adolescents.MethodsA randomised controlled trial involving 193 youth (M age: 14.82, SD: 0.94, 86.5% female) from Australia was conducted. Youth were recruited via the Internet and randomly allocated to the intervention or a 4‐week wait list control condition, stratified for age and gender. The primary outcome was change in depressive symptom scores measured using the Patient Health Questionnaire for Adolescents (PHQ‐A) at baseline, 4‐week post‐test and 12‐week follow‐up. Secondary outcomes included anxiety, psychological distress, wellbeing, help‐seeking intentions for mental health, social self‐efficacy and social support. Participants in the intervention condition received access to the intervention for four weeks. Thematic analysis was utilised to identify and examine acceptability.ResultsThe change in PHQ‐A scores from baseline to 4‐week post‐test did not differ significantly (d = 0.26, p = .138) between the intervention (Mchange = −2.9, SD = 5.3) and wait list control conditions (Mchange = −1.7, SD = 4.3). However, significant between‐group improvements were observed in wellbeing (d = 0.37, p = .023), help‐seeking intentions (d = 0.36, p = .016) and professional help‐seeking intentions for mental health problems (d = 0.36, p = .008). Increases in help‐seeking intentions were sustained at follow‐up in the intervention condition. No differential effects were found for generalised anxiety, separation anxiety, social self‐efficacy or for any social support outcomes. Over 90% of participants indicated the app was enjoyable, interesting and easy to use. The app provided ‘advice and direction’ (n = 42; 46.15%), an ‘opportunity for self‐reflection’ (n = 33; 36.3%) and ‘normalised experiences’ (n = 21; 23.1%).ConclusionsThe WeClick app was found to be effective for improving wellbeing and help‐seeking intentions for mental health in adolescents. A larger, adequately powered trial is now required to establish differential effects on depressive symptoms. This trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618001982202.

Seeking professional help for suicidal ideation: A comparison between Chinese and Australian university students

Suicide is the second leading cause of death in Chinese university students and research examining their professional help-seeking is limited. This study aims to investigate: (i) professional help-seeking intentions for suicidal ideation among Chinese university students, with comparison to Australian university students, (ii) relationships between suicide literacy, social support, suicide stigma, self-reliance and help-seeking intentions, and (iii) self-recognised barriers to help-seeking. Chinese (N = 208) and Australian (N = 128) university students were recruited to complete an online cross-sectional survey assessing their intentions to seek professional help if they experienced suicidal ideation. One-third of the surveyed Chinese and Australian students expressed reluctance to seek professional help. Self-reliance was endorsed by both countries’ university students as an important barrier. Suicide literacy, suicide stigma, and social support were not found to have a significant relationship with help-seeking intentions. The high costs of mental health services (Australian university students) and informal support from family and friends (Chinese university students) were identified as critical barriers to help seeking by participants. Results from this study suggest self-reliance is a potentially important barrier to professional help-seeking, whereas, suicide literacy and suicide stigma may have limited influence on help-seeking intentions among student populations.

Development and pilot evaluation of an online psychoeducational program for suicide prevention among university students: A randomised controlled trial

IntroductionSuicide is the second leading cause of death for the university aged population globally. A significant proportion of students with suicidal ideation or behaviours do not seek professional help. Few primary suicide prevention programs have specifically targeted help seeking for suicidal ideation or behaviours among university students. MethodsThis study reported the development and pilot test of a brief, two-module online psychoeducational program (ProHelp) that aimed to encourage help seeking for suicidal ideation and behaviours among university students. The program consists of two five-minute modules that address the risk factors and warning signs of suicide, stigmatising attitudes, and perceived barriers to help seeking. 156 Chinese university students and 101 Australian university students were recruited to evaluate the effectiveness of this program at post-test and one-month follow-up. Participants were randomly assigned to the psychoeducational program or an attention control program. ResultsOf the Chinese and Australian students who were randomised into the study, around 50% completed the two­day post­test survey, and 30% completed the one-month follow­up survey. Although no significant difference was found between the control and experimental group on professional help-seeking beliefs and intentions, both groups' help-seeking attitudes increased during the study (p=0.003 for the post­test survey, and p=0.008 for the follow­up survey). The experimental group in both countries demonstrated a significant improvement in suicide literacy at the post-test survey (p=0.015) compared to control. Qualitative feedback indicated that the ProHelp program was user-friendly, clear, and helpful. ConclusionsThis study provides initial evidence that a brief online psychoeducational program could enhance university students' suicide literacy in both China and Australia. It also suggests that increasing suicide literacy might not be sufficient to improve students' help seeking, although effect sizes indicated that this low­intensity online approach shows promise in encouraging more positive beliefs towards help seeking and preparedness to help individuals with suicidal ideation among young people.

Factors Influencing Professional Help-Seeking for Suicidality.

Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. To systematically evaluate the factors that influence professional help-seeking for suicidality. Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.

Professional Help-Seeking for Adolescent Dating Violence in the Rural South: The Role of Social Support and Informal Help-Seeking.

Structural equation modeling with three waves of data was used to assess a mediation model investigating the relationship between perceived social support, informal help-seeking intentions, and professional help-seeking intentions in the context of adolescent dating violence. The sample included 589 adolescents from a rural, southern county who participated in a longitudinal study of teen dating violence victimization and perpetration. Results suggest that informal help-seeking intentions are an important link between perceived social support and professional help-seeking intentions. Findings highlight the importance of informal help-seeking and informal help-giving in fostering professional help-seeking for adolescent victims and perpetrators of dating violence.

Patterns of help-seeking in a national sample of student veterans: a matched control group investigation.

This study examined patterns of professional and nontraditional help-seeking in a national sample of veterans from 57 colleges/universities and demographically matched students from the same institutions who had not served in the US Armed Forces. In total, 945 veterans and 2835 demographically matched nonveteran students from the same 4-year institutions completed assessments of help-seeking intentions and behaviors from professional, religious and informal sources in the Healthy Minds Study between 2011 and 2015. Drawing on bivariate and multivariate logistic regression models, equal ratios of these samples (2:1) did not endorse professional help-seeking intentions or behaviors. When compared to nonveteran students, veterans had greater intentions for religious help-seeking but were less likely to seek help from family/friends. Nearly half of depressed veterans who had not utilized services had also not sought help from any religious or informal sources. Unmet mental health needs might interfere with the success of a sizeable contingent of veterans pursuing new vocational goals. Community-based programs that can educate and/or equip nontraditional sources of support in veterans' naturally occurring relationships might offset these concerns.

Persuading People with Depression to Seek Help: Respect the Boomerang

People with depression are likely to process information with a negative bias when confronted with self-relevant information. Accordingly, we feared exposing depressed people to a public service announcement (PSA) addressing the stigma of depression would possibly boomerang and result in less intention to seek help and in increased self-stigma. College students (N = 271; Mage = 22.51, SD = 4.71; 63.1% female; 37.3% White, 31.9% Hispanic, 12.9% Asian, 6.8% multiethnic, 3.4% Black, 7.6% other) were randomly assigned to receive a print ad focused on depression or a nonrelevant comparison ad. A paper-and-pencil survey consisting of the Beck Depression Inventory–II, Self-Stigma of Seeking Help scale, help-seeking intentions, and demographics followed. Regression analysis indicated that viewing a depression ad caused people with greater depressive symptoms to experience greater levels of self-stigma than depressed people exposed to a nonrelevant comparison ad. Bootstrap mediation analysis showed that for individuals who viewed a depression PSA, self-stigma mediated the relationship between depressive symptoms and professional help-seeking intentions. While this current study offers no direct evidence in regard to the utility of current and past depression campaigns, results indicate a definite need for caution when developing materials targeting people with depression to seek help.

The Distress Disclosure Index: A research review and multitrait–multimethod examination.

The Distress Disclosure Index (DDI; J. H. Kahn & R. M. Hessling, 2001) is a brief self-report measure of one's tendency to disclose personally distressing information. The purpose of this article was to summarize what is known about the DDI, present new validity evidence, and make recommendations for use of the DDI. This article reviews research on the DDI from the past decade that indicates that distress disclosure is associated with well-being, professional help-seeking attitudes and intentions, and success in brief psychotherapy. On the basis of the reviewed literature, the authors report a reliability generalization study of DDI scores that strongly supports the internal consistency and test-retest reliability of DDI scores, and they review criterion-related and construct validity evidence. Next, the authors present a new multitrait-multimethod validity study of the DDI. Participants (N = 153) and peer informants (N = 153)--one per participant--completed paper-and-pencil questionnaire packets. Convergent validity of self-reported DDI scores was supported by a strong association with self-reports of emotional self-disclosure in response to a specific, unpleasant event, and self- and peer reports on the DDI were moderately correlated. DDI scores were not strongly associated with cognitive reappraisal and ambivalence over emotional expression, thus supporting discriminant validity. DDI scores were strongly associated with expressive suppression, and correlations between DDI scores and affect, depression symptoms, coping, and emotional expressivity were similar to those found with expressive suppression. The authors offer possible hypotheses explaining the overlap between distress disclosure and expressive suppression and present recommendations for future use of the DDI.