The Hidden Majority: Dual-Factor Mental Health Profiles Among Help-Avoidant University Students

Many university students experience mental health difficulties, yet a large proportion do not seek professional psychological support. Although prior research has linked mental health status to help-seeking behavior, it remains unclear whether all help-avoidant students require professional support and how their mental health profiles compare with those of help-seeking students. To address this gap, this study employed a dual-factor model, which integrates subjective well-being and psychopathology to map mental health profiles, and explored demographic predictors of profile membership. Additionally, profiles of help-avoidant students were also compared with those of students currently seeking help or who had sought help previously. The sample included 8,679 university students from seven Dutch universities (M_age = 21.76, SD = 3.31; 69.3% female), including 2,023 students who experienced mental health difficulties but did not seek help (M_age = 21.43, SD = 3.21; 71.7% female). Most of these help-avoidant participants were bachelor's students (69.1%), freshmen (55.4%), and of Dutch origin (53.8%). Results supported the dual-factor model, identifying four distinct profiles: (1) "Complete mental health" (31.0%), characterized by high well-being and low psychopathology; (2) "Symptomatic but Content" (23.7%), with high-average psychopathology and relatively high well-being; (3) "Vulnerable" (27.7%), with low-to-average well-being and moderately low psychopathology; and (4) "Troubled" (17.6%), with low well-being and high psychopathology. Profile structures among help-avoidant students differed from those of current and past help-seeking group. Students in the "Complete Mental Health" Profile were more likely to be younger, female, domestic, master's students, and non-freshman. Furthermore, insomnia severity increased progressively from the "Complete Mental Health" profile to the "Troubled" profile. These findings highlight the heterogeneity of mental health profiles among help-avoidant students, underscoring the importance of comprehensive screening, which may provide insights for targeted intervention strategies.