Document Type : Original Research


Institute of Human Resource Advancement, University of Colombo, Sri Lanka


Stigma associated with mental illness is identified as a potential barrier for seeking psychological help for mental health disorders. The purpose of this study is to assess the perceived barriers and supporting factors and to find out the strategies to promote the help seeking behavior among university students. 16 in-depth interviews were conducted with students and students’ counselors from three state universities in Sri Lanka. Already developed and tested three questionnaires on help seeking behavior were used to develop guidelines. Barriers, supporting factors and strategies to promote counseling services were investigated. According to the findings, the most significant barrier for seeking counseling services is mental illness stigma. Males have a greater level of mental illness stigma than female. The rest of barriers are reluctance to share their problems with counselors, self-dependency, lack of trust on counselors, and lack of awareness about services availability. Most significant supporting factors are availability of free counseling services, proximity, and easy access to the counseling service. The strategies for promoting counseling services are promoting mental health education among students; making easy access to counselors; and developing a good relationship between students and counselors.


Barney, L., Griffiths, K., Christensen, H., & Jorm, A. (2009). Exploring the nature of stigmatizing beliefs about depression and help-seeking: Implications for reducing stigma. BMC Public Health , 1-11.
Bathje, G., & Pryor, J. (2011). The relationships of public and self-stigma to seeking mental health services . Journal of Mental Health Counseling , 33 (2), 161-176 .
Bewick, B., Gill, J., & Mulhern, B. (2008). Using electronic surveying to assess psychological distress within the UK university student population: A multi-site pilot investigation . E-Journal of Applied Psychology , 4, 1–5.
Cantazaro, A. (2009). Predicting help-seeking attitudes and intentions in a Latino/a sample. Retrieved 4 6, 2016, from Iowa State University Digital Repository @ Iowa State University:
Corrigan , P. (2004). How stigma interferes with mental health care. American Psychologist , 59, p.614-625.
Corrigan, W. (2005). On the Stigma of Mental Illness; Practical strategies for research and social change. Washington: American Psychological Association.
De Silva, D., & De Silva, S. (2001). A preliminary study of the impact of long-term psychotic disorder on patient’s families: A preliminary study . Ceylon Medical Journal , 46, p.121–123 .
Deane , F., & David , M. (1996). Attitudes and Intentions to Seek Professional Psychological Help for Personal Problems or Suicidal Thinking. Journal of College Student Psychotherapy , 10 (4), 45-59.
Dearing, R., Maddux, J., & Tangney, J. (2005). Predictors of psychological help seeking in clinical and counseling psychology graduate students . Professional Psychology: Research and Practice , 36 (3), 323–329 .
Dell’Osso , B., Glick , I., Baldwin , D., & Altamura , A. (2013). Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders: a conceptual framework. . Psychopathology , 14, p.14-21.
Fernando, S. (2010). Stigma and Discrimination towards people with mental illness in Sri Lanka. Wollongong: University of Wollongong.
Gulliver, A., Griffiths, K., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry Open Access .
Hagger, M., Chatzisarantis, N., Barkoukis, V., Wang, J., Hein, V., Pihu, M., et al. (2007). Cross-cultural generalizability of the theory of planned behavior among young people in a physical activity context . Journal of Sport & Exercise Psychology , 29 (1), 2–20 .
Harris, K., Collinson, C., & das Nair, R. (2012). Service-users’ experience of an early intervention in psychosis service: An interpretative phenomenological analysis . Psychology and Psychotherapy: Theory, Research and Practice , 85, 456-469 .
Hinshaw, S. (2007). The mark of shame: Stigma on mental illness and an agenda for change. New York: Oxford University Press.
Jorm, A., Korten, A., Jacomb, P., Christensen, H., Rogers, B., & Pollitt, P. (1997). Mental health literacy: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment . Medical Journal of Australia , 166, 182-186 .
Kakhnovets, R. (2011). elationships among personality, expectations about counseling, and help-seeking attitudes . Journal of Counseling & Development , 89, 11-19 .
Kessler , R., Berglund, P., Demler, O., Jin , R., & Merikangas , K. (2005). Lifetime Prevalence and Age-of-onset Distributions of Dsm-Iv Disorders in the National Comorbidity Survey Replication . Archives of General Psychiatry , 62, 593–602 .
Kessler, R., Burglund, P., Bruce, M., Koch, R., Laska, E., & Leaf, P. (2001). The prevalence and correlates of untreated serious mental illness . Health Services Research , 36, 987-1007 .
Koydemir, S., Erel, O., Yumurtacı, D., & Şahin, G. (2010). Psychological help-seeking attitudes and barriers to help-seeking in young people in Turkey. International Journal for the Advancement of Counselling , 32 (4), 274-289 .
Kushner, M., & Sher, K. (1989). Fears of psychological treat- ment and its relation to mental health service avoidance. Profes- sional Psychology: Research and Practice , 20, 251–257 .
Lucas , J., & Phelan , J. (2012). Stigma and Status: The Interrelation of Two Theoretical Perspectives. Social Psychology Quarterly , 75 (4), p.310–333 .
Miles, M., & Huberman, A. (1994). Qualitative data analysis. London: Sage.
Mohr, D., Hart, S., Howard, I., Julian, L., Vella, L., Catledge, C., et al. (2006). Barriers to psychotherapy in depressed and non-depressed primary care patients. Annals of Behavioral Medicine , 32(3), p.254-258.
Pescosolido, B. (2013). The Public Stigma of Mental Illness: What Do We Think; What Do We Know; What Can We Prove? Journal of Health and Social Behavior , 54 (1), p.1.
Pettigrew, S., Donovan, R., Pescud, M., Boldy, D., & Newton , R. (2010). Mature adults’ attitudes to mental health service utilisation . Australian Psychologist , 45, 141-150 .
Rickwood , D., Deane, F., Wilson , C., & Ciarrochi , J. (2005). Young people’s help-seeking for mental health problems . Australian e-Journal for the Advancement of Mental Health , 4, pp.1-34.
Ryan, M., Shochet, I., & Stallman, H. (2010). Online resilience interventions might engage psychologically dis- tressed university students who are unlikely to seek formal help. Advances in Mental Health , 9 (1), p.73-83.
Samarasekare, N., Matthew , L., & Siribaddana , S. (2012). The Stigma of Mental Illness in Sri Lanka: The Perspectives of Community Mental Health Workers . Stigma Research and Action , 2 (2), p.93–99 .
Sartorius, N. (2007). Stigma and mental health . Lancet , 370, p. 808–810 .
Tang, Y., Sevigny, R., Mao, P., Jiang, F., & Cai, Z. (2007). Help-seeking behaviors of Chinese patients with schizophrenia admitted to a psychiatric hospital . Administration and Policy in Mental Health , 34, 101- 107 .
Tanskanen, S., Morant, N., Hinton, M., Loyd-Evans, B., Crosby, M., Killiaspy, H., et al. (2011). Service user and carers experiences of seeking help for a first episode of psychosis: A UK qualitative study. BMC Psychiatry , 11, 157-169.
Uebelacker, L., Marootian, B., Pirraglia, P., Primack, J., Tigue, P., Haggarty, R., et al. (2012). Barriers and Facilitators of treatment for depression in a Latino community: A focus group study . Community Mental Health Journal , 48, 114-126 .
Viner , R., Ozer, E., Denny , S., Marmot, M., Resnick, M., Fatusi, A., et al. (2012). Adolescence and the Social Determinants of Health. The Lancet , 379 , 1641–652 .
Wilson, C., Rickwood, D., Bushnell, J., Caputi, P., & Thomas, S. (2011). The effects of need for autonomy and preference for seeking help from informal sources on emerging adults’ intentions to access mental health services for common mental disorders and suicidal thoughts . Advances in Mental Health , 10, 29-38 .
Wright, A., Jorm, A., & Mackinnon , A. (2011). Labeling of mental disorders and stigma in young people . Social Science & Medicine , 73, p. 498-506 .
Yakunina, E., & Weigold, I. (2011). Asian International students’ intentions to seek counselling: Integrating cognitive and cultural predictors . Asian American Journal of Psychology , 2, 219-224 .
Zubrick, S., Silburn, S., Garton, A., Burton, P., Dalby, R., Carlton, J., et al. (1995). Western Australian Child Health Survey: Developing Health and Well-being in the Nineties. Western Australia: Institute for Child Health Research and ABS.