Predictors of Help-Seeking Among College Students with Mental Health Issues: Do Attitudes about Health and Social Supports Influence Seeking Professional Treatment?

Background and Purpose: While previous studies have identified barriers to mental health help-seeking among college students, little is known about whether support received from academic supports or informal supports influence seeking help from healthcare professionals.  For students with depression and/or suicidal ideation (SI), we seek to understand a) whether seeking help from academic supports or informal supports influences seeking professional help, and b) does the perceived quality of such supports predict seeking professional help.  Furthermore, we sought to identify which key features of health beliefs, such as, stigma and perceived need, were associated with seeking help from healthcare professionals.   

Methods: This study used data from the Healthy Minds Study (2010-2013), an annual web-based survey of college students that examines mental health related issues. Depression was screened with the PHQ-9, and suicidal ideation was self-reported.  Using logistic regression, we first calculated Adjusted Odds Ratios (AOR, adjusting for demographics) perceived need, personal stigma, perceived stigma, informal support, and academic support for students who screened positive for depression and/or suicidal ideation (n= 14,893).  Thereafter, we calculated AOR’s for perceived quality of support received from informal supports, controlling for perceived need and stigma. 

Results: Important help-seeking behaviors were observed.  While only one-third of students experiencing depression or suicidal thoughts only sought help from healthcare professionals, nearly 80% of these students sought help from informal supports (peers, family, roommates, significant others, etc.), and about three-fourths of students saw a need for seeking help for their emotional distress.  Seeking help from academic supports (r = .27) and informal supports (r= .19) were positively correlated with seeking healthcare professionals, as was a presence of perceived need (r= .36); all correlations were significant (p< .001).

Perceived need was the strongest predictor of seeking help from healthcare professionals (AOR= 13.2, p< .0001) Students who sought help from academic supports as well as informal supports were more likely to seek help from healthcare professionals, (AOR 3.2 and 1.8, respectively, p< .0001).  Students experiencing personal stigma were less likely to seek help (AOR .88, p< .001); however, students with perceived stigma were more likely to seek help (AOR 1.04, p< .001) compared to their counterparts with no perceived stigma.  Lastly, while controlling for stigma and perceived need, we found that out of students who sought help from informal supports, those reporting receiving support that was helpful from friends were more likely to seek professional help (AOR 1.06).  Perceived quality of support from family was not significant.

Conclusion and Implications: Our findings highlight two themes central to prevention: campus-based education and the development of targeted tools.  Education campaigns designed to build mental health literacy to reduce stigma, and more so, education materials that will increase one’s awareness of their own mental health problems is imperative.  Lastly, our findings indicate the need for the development of interventions designed to equip the campus community with the tools they need to be able to identify one’s need for help, appropriately respond to a peer’s emotional distress, and facilitate a connection to mental health services.