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

Abstract

Background: Mental 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.

Methods: This 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.

Results: Results 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.

Conclusions: This 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.

Keywords: Coping strategies; Counselling; Help seeking behaviour; Psychological distress; Stigma; University students.

Fig. 1

Spearman’s correlations (on the left) and partial correlations, controlled by sex (on the right). Note. USS: University Stress Scale score; BC_Efs: Brief-COPE- Emotion focused strategies; BC_Pfs: Brief-COPE—Problem focused strategies; BC_Afs: Brief-COPE—Avoidant/dysfunctional Strategies; SSOSH: Self-Stigma of Seeking Help scale score; PSOSH: Perceived Stigma of Seeking Help scale score; GHSQ_Em: GHSQ-likelihood of seeking help from a mental health professional for: emotional or personal problems; GHSQ_St: GHSQ-likelihood of seeking help from a mental health professional for: suicide thoughts

Fig. 2

Hypothesized Structural Equation Model based on the correlation analysis. Note. The ellipses represent the latent constructs; the rectangles represent the observed variables (or indicator when related to a latent construct). Dashed lines indicate the theoretical relationships to be tested and validated by data through the Structural Equation Model approach. Based on correlation analysis results, the mutual associations (A-E) between distress, stigma, coping strategies and help seeking intentions were all plausible. A relationship mainly due to PSOSH score related with Brief-COPE Avoidance/Dysfunctional St., and to SSOSH related with Brief-COPE Problem-Focused St.; B relationship mainly due to USS score related with Brief-COPE Avoidance/Dysfunctional St.; C relationship mainly due to Brief-COPE Problem-Focused St. related with GHSQ –Seeking professional help for suicidal thoughts; D relationship mainly due to USS score related with PSOSH score; E relationship mainly due to SSOSH score related with GHSQ–Seeking professional help for suicidal thoughts and emotional/personal problems.

Fig. 3

Best-fit Structural Equation Model. Note. The small circles represent the error of the observed (endogenous) variables. The arches represent the error covariances (set to improve the fit). Standardized regression weights (or factor loading when referring to indicators of latent constructs) are reported above the arrows. All the regression weights (standardized beta coefficients) are significant at p < .001. Model fit indices:χ² = 9.62, degree of freedom = 6, p = .142; relative χ2 = 1.60, CFI = .999; TLI = .997, RSMEA = .015 [90% Confidence Interval .00 – .03], AIC = 85.6. ^***p < .001