The relationship between clinical symptom severity and attitudes towards seeking professional psychological help in college students: exploring the serial mediating effects of self-stigma and social function

Mental health issues are increasing among college students, yet help-seeking rates remain low, especially in collectivist cultures. This study examined the relationship between clinical symptom severity and help-seeking attitudes among 198 college students, testing a serial mediation model via self-stigma and social functioning using PLS-SEM. The results revealed that clinical symptoms were significantly negatively correlated with social functioning (β = –0.70), which in turn was negatively correlated with self-stigma (β = –0.36). Self-stigma was negatively correlated with help-seeking attitudes (β = –0.66). No direct relationship was found between clinical symptoms and help-seeking attitudes, but rather this relationship was fully serially mediated by self-stigma and social functioning. Universities should implement culturally adapted interventions, such as establishing online peer-support communities and promoting localised Mental Health First Aid training, to reduce self-stigma and address the socio-psychological barriers that hinder student help-seeking in collectivist cultures.