| dc.description.abstract | Making prompt contact with a health professional after the first onset of mental distress is critical for receiving appropriate treatment. However, most people with mental disorders have a six to 23 years’ delay to seek treatment. This dissertation reports results of three studies aimed at increasing college students’ intention to seek mental help. Study 1 explored the risk factors preventing individuals from seeking medical help. Based on social cognitive theory, this study analyzed the 2019 Health Information National Trends Survey (HINTS) using logistic regression models. It shows that those who are younger, male, having mental issues, low social support, experiencing poor health care, and seeking health-related information online are at risk for not seeking care. These factors also apply to the people who had more than a moderate level of mental distress.
Indeed, mental illness has been more dangerous for young adults, as they experience more severe symptoms and low help-seeking intentions. Previous research has explored the reasons for the low intentions but overlooked the influences of communicative environments, such as communication with family, clinicians, and social media. Based on the theory of planned behavior, Study 2 explores how different communicative environments affect college students’ mental help-seeking intentions using a cross-sectional survey of 428 student participants. Results showed that 71 (51.8%) of the 137 students with signs of mental distress did not intend to seek help. Students’ patient-centered communication experiences with health care providers directly affected their intentions to seek help, whereas online and family communication influenced their help-seeking intentions through changes in attitude, self-stigma, and self-efficacy.
While no intervention to date has practically improved young people’s mental health during COVID-19, Study 3 may be the first that evaluates the effectiveness of a theory-based self-persuasion intervention on increasing college students’ intention to seek mental help during the pandemic. Using a 3-arm randomized controlled design, this study used two tasks of different intensity (i.e., YouTube and the Facebook tasks) to persuade students who have mental distress to seek professional help. The results showed that the intervention significantly increased students' help-seeking intention, attitude, and efficacy at different time points. It also reduced mental help-seeking-related stigma after the first task.
Several conclusions can be drawn from the dissertation. First, a constellation of environmental contexts (e.g., clinical, social support, social media), along with personal factors (e.g., mental status), shaped people’s intention to use health care services. Within these context, patient-centered communication and quality of care played an important role in patients’ health-related help-seeking behavior. Especially for patients with mental distress, providers’ communication can improve their access to mental help, increase their knowledge on how to navigate the mental counseling system, and reduce stigma of mental illness created by mass media and society, which may motivate patients to seek help when they need it. Second, while previous research attributed college students’ intention to seek mental help to their personal attitudes, stigma, and self-efficacy to manage mental health, this study found how these attributes were associated with students’ communicative environments, such as their communication with clinicians, family, and online users. Especially, for students who felt very supported online, they tended to manage their mental health on their own. Therefore, interventions targeting college students (or young people in general) should incorporate the influences of their communicative environments, such as the Internet, family, and patient-provider communication. Third, using self-persuasion strategies, college students may be more receptive of the idea that people should seek mental help when they need it. Also, as mental health services went online because of the pandemic precautions, the service providers may need to sufficiently inform students of this change and give them guidance on how to seek mental help via online platforms. | en |
