Understanding Barriers and Pathways to Care: Gender Roles, Stigma, and Mental Health Literacy

Approximately 37% of college students report experiencing mental health challenges, yet nearly three quarters do not seek professional help. Social Learning Theory offers a framework for understanding how help-seeking attitudes are shaped by factors such as gender socialization, stigma, and mental health literacy (MHL). Messaging regarding help-seeking varies by gender, with women often socialized toward social connection and men toward self-reliance, contributing to differences in help-seeking behavior. Mental health stigma, including both public beliefs and their internalization, is socially transmitted and affects the likelihood of seeking help. In contrast, MHL, defined as the knowledge and beliefs about mental disorders which aid their recognition, management, and prevention, promotes help-seeking by enhancing perceived controllability and social support. While these factors have been examined individually, fewer studies have evaluated them simultaneously. The present study examined the influence of femininity, masculinity, public stigma, internalized stigma, and MHL on help-seeking intentions among undergraduates (N = 267). Participants completed the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form, the Mental Health Literacy Scale, Traditional Masculinity-Femininity scale, Perceived Devaluation-Discrimination Scale, the Self-Stigma of Seeking Help scale. Hierarchical regression and mediation analyses indicated that internalized stigma emerged as the strongest negative predictor, statistically accounting for 49% of the association between femininity and help-seeking, and 62% for masculinity. Results highlight the importance of increasing MHL and challenging internalized stigma for improving help-seeking in college students.