Help-Seeking Among University Students: Symptom, Attitudinal, and Demographic Correlates of Formal Care Use Versus...

Despite the importance of early intervention, a substantial proportion of students experiencing psychological distress do not access professional care. This study compared the coping responses that Japanese university students without a history of psychological distress anticipate with those that students with such a history report and examined factors associated with the use of formal professional care rather than inaction among the latter group.

A cross-sectional survey was completed by 2025 undergraduates (Grades 1-4) at a large Japanese public university, representing 16.9% of the eligible undergraduate population. Students who reported no history of psychological distress described hypothetical help-seeking intentions; those with such a history reported the coping responses they had used, classified as Formal Help, Informal Help, Self-Care, or Inaction by a hierarchical priority rule. A binomial logistic regression (N = 402) examined adjusted associations with Formal Help versus Inaction.

The distribution of hypothetical intentions differed from the distribution of reported behaviour across groups (χ²(3) = 109.0, p < 0.001). Informal help accounted for 50.5% of hypothetical intentions and 30.8% of reported behaviour, whereas formal care accounted for 20.7% and 36.6%, respectively, and inaction for 7.0% and 13.0%. Higher generalized-anxiety scores were associated with formal care rather than inaction (OR = 2.51, p < 0.001); depression was not associated with the binary outcome (OR = 0.81, p = 0.434). Positive attitudes toward professional help (OR = 1.23, p < 0.001), female sex (OR = 2.06, p = 0.011), and independent living (OR = 1.82, p = 0.035) were also associated with formal care, whereas perceived stigma was not significant (p = 0.385). The model showed adequate discrimination (area under the ROC curve = 0.82).

In this cross-sectional sample, generalized anxiety, positive attitudes toward professional help, female sex, and independent living were associated with formal care relative to inaction; depression was not independently associated with the outcome. The findings support prospective evaluation of low-threshold outreach and multidimensional literacy and access interventions but do not establish causality or intervention effectiveness.