High awareness but low utilization: How perceived institutional support shapes college students' mental health...

In the context of high awareness but low utilization of university counseling services, an important question is whether university mental health support may still carry psychological significance when actual service use remains limited. Drawing on social support theory and stigma theory, this study extends the understanding of university mental health support beyond a utilization-based perspective by examining whether students' perceptions of university mental health support are associated with mental health through perceived stigma. Using survey data from 642 university students in China, this study developed an analytical model examining the associations among perceived institutional support, perceived stigma, and mental health outcomes. The results showed that perceived institutional support was positively associated with mental health and negatively associated with perceived stigma. In addition, perceived stigma was negatively associated with mental health and statistically accounted for part of the observed association between perceived institutional support and mental health, suggesting an indirect association consistent with the proposed theoretical model. These findings suggest that the potential value of university mental health support may extend beyond actual counseling utilization. Rather, students' perceptions of institutional recognition, accessibility, and acceptance of psychological support may represent an important aspect of the campus mental health environment. This perspective is particularly relevant within the Chinese higher education context, where concerns about social evaluation and stigma may influence students' willingness to acknowledge psychological difficulties and seek support. This study contributes to the literature by moving beyond a utilization-based framework and highlighting the potential contextual significance of perceived institutional support in relation to stigma and mental health. Practically, the findings suggest that Chinese universities may consider not only service availability but also students' perceptions of institutional support when evaluating campus mental health environments.