Document Type : Original Research


School of Public Administration, Huazhong University of Science & Technology, China / Institute of Human Resource Advancement, University of Colombo, Sri Lanka


Though there is a high level of mental health related difficulties among university students, only one third of them seek psychological help despite the evidence-based treatments for mental health problems. Therefore, this paper examines the help seeking attitudes towards psychological help services and willingness to seek psychological help based on the Theory of Planned Behavior (TPB). Attitudes, subjective norms, and behavioral control were measured using the Inventory of Attitudes toward Seeking Mental Health Services (IASMHS). Barriers for seeking psychological help were measured using Mental Health Service Utilization Questions (MHSUQ) whereas intention to seek psychological help was measured using the General Help Seeking Questionnaire – Vignette Version (GHSQ-V). 600 students were interviewed from three Sri Lankan state universities from January 2015 to March 2015. Results suggested that positive attitudes towards psychological help service positively associate with greater willingness to seek psychological help. Further, female students show a greater attitude seeking psychological help than male students. The most common barrier reported by students was that the fear of what relatives, friends might think. In contrast, students who follow psychology as a subject have a significantly higher level of positive attitude towards seeking psychological help than the students who do not follow. Findings suggest that mental health campaigns are required to focus their attention to change the negative attitudes towards mental health services among university students. Further, it highlights the importance of changing the public attitudes towards mental illnesses.


Ajzen, I. (1985). From intentions to actions: A theory of planned behavior . In I. J. Beckmann, Action Control: From Cognition to Behavior (pp. p.11-39 ). Berlin, Germany: Springer-Verlag.
Ajzen, I. (2011). he theory of planned behavior: a bibliography. Amherst: MA: Department of Psychology, University of Massachusetts.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human . Decision Processes , 50, 179-211.
Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. NewJersey: NewJersey.
Armitage, C., & Conner, M. (2001). Efficacy of the theory of planned behaviour: A meta-analytic review. British Journal of Social Psychology , 40, 471–499.
Aromaa, E., Tolvanen, A., Tuulari, J., & Wahlbeck, K. (2011). Predictors of stigmatizing attitudes towards people with mental disorders in a general population in Finland. Nordic Journal of Psychiatry , 65, 125–132.
Boonstra , N., Klaassen , R., Sytema, S., Marshall , M., De Haan , L., Wunderink , L., et al. (2012). Duration of untreated psychosis and negative symptoms: a systematic review and meta-analysis of individual patient data . Schizophrenia Research , 142, p.12-19.
Clay, R. (2012). Beyond psychotherapy . Monitor on Psychology , 43, p.46-50.
Conner, M., Black, K., & Stratton, P. (1998). Understanding drug compliance in a psychiatric population: an application of the Theory of Planned Behaviour. Psychology, Health & Medicine , 3, 337–344.
Cornally, N., & McCarthy, G. (2011). Help-seeking behavior: A concept analysis . International Journal of Nursing Practice , 17, p.280-288.
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.
Fife-Schaw, C., Sheeran, P., & Norman, P. (2007). Simulating behaviour change interventions based on the theory of planned behaviour: Impacts on intention and action. British Journal of Social Psychology , 46, 43-68 .
Fishbein, M., & Ajzen, I. (2009). Predicting and changing behaviour: The Reasoned Action Approach. Hove: Psychology Press.
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., & Biddle, S. (2002). A meta-analytic review of the theories of reasoned action and planned behaviour in physical activity: Predictive validity and the contribution of additional variables . ournal of Sport and Exercise Psychology , 24 (1), 3–32.
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 .
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 .
Kessler, R., Foster, C., Saunders, W., & Stan, P. (1995). Social consequences of psychiatric disorders: Educational attainment. . American Journal of Psychiatry , 152, 1026-1032.
Kosky, R., & Hardy, J. (1992). Mental health: Is early intervention the key? . Medical Journal of Australia , 256, 147- 148 .
Mackenzie, C., Knox, V., Gekoski, W., & Macaulay, H. (2004). An adaptation and extension of the Attitudes Toward Seeking Professional Psychological Help Scale. Journal of Applied Social Psychology , 34, p.2410-2435.
McCarthy, J., Pfohl, A., & Bruno, M. (2010). Help seeking among counseling trainees: An exploratory study . Journal of Counseling Research and Practice , 1 (1), 53-63 .
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.
Moller-Leimkuhler, A. (2002). Barriers to help-seeking by men: A review of sociocultural and clinical literature with particular refer- ence to depression . Journal of Affective Disorders , 71, 1-9.
O’Loughlin , R., Duberstein, P., Veazie, P., Bell, R., Rochlen, A., Fernandez , Y., et al. (2011). Role of gender-linked norm of toughness in the decision to engage in treatment for depression . Psychiatric Services , 62, 740–746.
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.
Riska, E., & Ettore , E. (1999). Mental distress: Gender aspects of symptoms and coping. Acta Oncolology , 38, 757–761 .
Robertson, S. (2003). Men managing health . Men’ s Health Journal , 2, 111–13 .
Sanders-Thompson, V., Brazile, A., & Akbar, M. (2004). African American’s perceptions of psychotherapy and psychotherapists . Professional Psychology: Research and Practice , 35 (1), 19-26.
Stefl, M., & Prosperi, D. (1985). Barriers to mental health service utilization . Community Mental Health Journal, 21(3), 167-178. , 21(3), p.167-178.
Ten , H., de Graaf, R., Ormel, J., Vilagut, G., Kovess, V., & Alonso, J. (2010). Investigators. Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders. Social Psychiatry and Psychiatric Epidemiology , 45, 153-163.
Thornicroft , G. (2007). Most people with mental illness are not treated . Lancet , 370, p.807-808.
Trafimow, D., Sheeran, P., Conner, M., & Finlay, K. (2002). Is perceived behavioural control a multidimensional construct? Perceived difficulty and perceived control . British Journal of Social Psychology , 41, 101–121.
U.S. Department of Health and Human Services . (1999). Mental Health: A Report ofthe Surgeon General. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
Vogel, D., Wester, S., & Larson, L. (2007). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of Counseling and Development , 85, p.410-422.
Wilson, C., Bushnell, J., & Caputi, P. (2011). Early access and help seeking: Practice implications and new initiatives. Early Intervention in Psychiatry , 5 (1), P.34-39.
Wittchen , H., & Jacobi . (2005). Size and burden of mental disorders in Europe: a critical review and appraisal of 27 studies. . European Neuropsychopharmacology 15, 357–376. , 15, p.375-376.
Wright, A., Jorm, A., & Mackinnon , A. (2011). Labeling of mental disorders and stigma in young people . Social Science & Medicine , 73, p. 498-506 .
Yoshioka, K., & Misawa, R. (2013). Causal attribution of depression and the social distance caused by the stigma. The Japanese Journal of Health Psychology , 25, p.93–103.
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.