Barriers of mental health treatment utilization among first‐year college students: First cross‐national results from the WHO World Mental Health International College Student Initiative

Abstract

Background Although mental disorders and suicidal thoughts‐behaviors (suicidal thoughts and behaviors) are common among university students, the majority of students with these problems remain untreated. It is unclear what the barriers are to these students seeking treatment. Aims The aim of this study is to examine the barriers to future help‐seeking and the associations of clinical characteristics with these barriers in a cross‐national sample of first‐year college students. Method As part of the World Mental Health International College Student (WMH‐ICS) initiative, web‐based self‐report surveys were obtained from 13,984 first‐year students in eight countries across the world. Clinical characteristics examined included screens for common mental disorders and reports about suicidal thoughts and behaviors. Multivariate regression models adjusted for socio‐demographic, college‐, and treatment‐related variables were used to examine correlates of help‐seeking intention and barriers to seeking treatment. Results Only 24.6% of students reported that they would definitely seek treatment if they had a future emotional problem. The most commonly reported reasons not to seek treatment among students who failed to report that they would definitely seek help were the preference to handle the problem alone (56.4%) and wanting to talk with friends or relatives instead (48.0%). Preference to handle the problem alone and feeling too embarrassed were also associated with significantly reduced odds of having at least some intention to seek help among students who failed to report that they would definitely seek help. Having 12‐month major depression, alcohol use disorder, and suicidal thoughts and behaviors were also associated with significantly reduced reported odds of the latter outcome. Conclusions The majority of first‐year college students in the WMH‐ICS surveys report that they would be hesitant to seek help in case of future emotional problems. Attitudinal barriers and not structural barriers were found to be the most important reported reasons for this hesitation. Experimental research is needed to determine whether intention to seek help and, more importantly, actual help‐seeking behavior could be increased with the extent to which intervention strategies need to be tailored to particular student characteristics. Given that the preference to handle problems alone and stigma and appear to be critical, there could be value in determining if internet‐based psychological treatments, which can be accessed privately and are often build as self‐help approaches, would be more acceptable than other types of treatments to student who report hesitation about seeking treatment.

Efficacy of an unguided internet‐based self‐help intervention for social anxiety disorder in university students: A randomized controlled trial

“…Another important finding is that one third (34.5%) of the participants indicated that they would not be willing to utilize traditional available treatment formats such as face‐to‐face psychotherapy, further highlighting the potential of internet‐based treatments for reaching people who were previously not reached by the current health care system (Ebert, Van Daele, et al, ). This finding is in line with studies on barriers of treatment utilization in university students that found attitudinal barriers, such as a preference for self‐help or fear of stigma, to be more relevant than structural barriers, such as non‐availability, high costs, or long waiting times, in both university students (Ebert, Mortier, et al, ) and general population samples (Andrade et al, ).…”

Eating Disorders among College Students in France: Characteristics, Help-and Care-Seeking

“…The shame or guilt of binge-eating could be one explanation for not going to see a GP [ 41 ]. Given that the preference to handle problems alone and stigma appear to be critical, there could be a value in determining internet-based psychological treatments, which can be accessed privately and are often built as self-help approaches [ 42 ]. A meta-analysis showed a beneficial effect of internet interventions for mental health in university students on global eating disorder symptoms, weight concerns, and affective symptoms [ 43 ].…”

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“…mHealth (mobile health care), the delivery of mental health treatment using smartphones and wearables, presents an opportunity to narrow the research-practice gap by addressing barriers to treatment at the individual level. Indeed, recent research suggests that the most common reasons for not seeking mental health treatment are respondents' desire to manage their problems on their own, stigma associated with seeking psychological help, and perceptions of treatment as inconvenient or ineffective [11][12][13]. On the other hand, mobile health apps incorporate unique features that have the potential to circumvent the aforementioned barriers.…”