Research Review: Help-seeking intentions, behaviors, and barriers in college students – a systematic review and meta-analysis

Abstract

Background: The prevalence of mental health problems among college students has increased over the past decade. Even when mental health services are available, many students still struggle to access these services. This systematic review and meta-analysis aimed to identify the rates at which students actively seek or consider using formal help and to determine the main reasons for not seeking help. Methods: A comprehensive literature search was conducted on PubMed, PsycINFO, and Embase to identify studies on help-seeking behaviors, intentions, and barriers to help-seeking among college students with mental health problems. Random effect models were used to calculate the pooled proportions. Results: Of the 8,919 identified studies, 62 met the inclusion criteria and were included (n = 53 on help-seeking behaviors, n = 21 on help-seeking intentions, and n = 14 on treatment barriers). The pooled prevalence of active help-seeking behaviors was 28% (179,915/435,768 individuals; 95% CI: 23%–33%, I2 = 99.6%), and the aggregated prevalence of help-seeking intentions was 41% (62,456/80161 individuals; 95% CI: 26%–58%, I2 = 99.8%). Common barriers reported by students included a preference to address issues on their own, time constraints, insufficient knowledge of accessible resources, and a perceived lack of need for professional help. Conclusions: The findings highlight the gap between the mental health needs of the students and their actual help-seeking rates. Although personal barriers are common, systemic or contextual challenges also affect college students' help-seeking behaviors.