Predictors associated with mental help seeking attitude among Malaysian college foundation students in the midst of COVID-19 pandemic: a cross sectional study / Nur Nadhirah Mesran

Introduction: Globally, the Coronavirus Disease-2019 (COVID-19) pandemic results in major psychological sequalae across age groups including adolescents. Mental illness rates are high, yet mental help seeking attitude (MHSA) among adolescents is evidently low in developed countries during the pandemic. However, data is scarce in developing countries, hence, this study aimed to determine the prevalence of psychological distressed students and the mean of MHSA total score; to compare the mean of MHSA total score between psychologically distressed and non-psychologically distressed students and to determine the predictors of MHSA during the COVID-19 pandemic.
Methods: A cross sectional study was conducted among Malaysian private college foundation students, aged 18 to 19 years old, from a private college in Klang Valley from 1st December 2021 until 30th March 2022. All college foundation students were invited, and eligible students completed self-administered online questionnaires. Data on psychological distress level, MHSA, sociodemographic, clinical factors, availability, accessibility and affordability of mental health service, mental health literacy and selfstigma of seeking help were collected. An independent T-test analysis was performed to compare the mean of MHSA total score between students who were psychologically distressed and non-psychologically distressed. Multiple linear regression analysis was done to identify predictors of MHSA.
Results: 650 students were invited to participate in the study, 409 students responded with response rate of 62.9%. In the end, 345 students completed the questionnaires and included into final analysis. The mean age was 18.7 (± 0.75) years old. More than half were female (64.3%, n=222) and a majority had no past history of mental health illness (95.1%, n=328). Almost half had personal history of COVID-19 infection (49.3%, n=170). The mean of MHSA total score was 50.98 ±10.39. The prevalence of psychologically distressed was 23.2%, (95%CI: 20.4, 26.1), in which those who were psychologically distressed students had a higher mean of MHSA total score than those who were non-psychologically distressed students (53.29 ± 10.48 vs. 50.29 ± 10.29; t (343) = -2.277 p= 0.023).The predictors of MHSA were; self-stigma of help seeking (β=-0.59 (95% CI: -0.76, -0.42) p<0.01); mental health literacy (β=0.22 (95% CI: 0.13, 0.30) p<0.01); and affordability of mental health service facility (β=3.29 (95% CI: 1.42, 5.16) p<0.01).
Conclusion: Mental help seeking attitude among Malaysian college foundation students was low during the COVID-19 pandemic, with those who were psychologically distressed had better MHSA than those who were not distressed. Low MHSA may result in lost opportunities for early diagnosis and treatment on mental health problems. Strategies to reduce self-stigma of seeking help for mental illness is vital, while educating college students about mental health and make mental health services affordable are warranted.