The Complexities of Mental Health Help Seeking Among Latinx College Students: Qualitative Inquiry Using the Theory of Planned Behavior

Abstract

Current Latinx college students seek mental health treatment at much lower rates compared to the general student population. This is particularly concerning, as these rates have remained stubbornly low, even as the COVID-19 pandemic exacerbated existing sources of anxiety. Thus, university officials and mental health practitioners across the country have emphasized the need for interventions encouraging these students to utilize campus mental health resources. However, additional research is needed to form a foundation of knowledge for help seeking interventions. This investigation applies the theory of planned behavior to understand Latinx students’ help-seeking perspectives. Findings revealed that Latinx students viewed campus mental health resources as lacking value for them. Additionally, cultural norms established by family members represented a barrier to help seeking. Finally, Latinx students faced steep challenges navigating US health care systems and felt that mental health resources were not designed to serve minorities. This key insight can guide mental health help-seeking interventions.

Keywords

health disparities mental health theory of planned behavior focus groups college students help seeking Gen Z

Get full access to this article

View all access options for this article.

References

Abrams

(2022). Student mental health is in crisis. Campuses are rethinking their approach. Monitor on Psychology, 53(7), 60. https://www.apa.org/monitor/2022/10/mental-health-campus-care

Ajzen

(1985). From intentions to actions: A theory of planned behavior. In Kuhl

Beckmann

(Eds.), Action control: From cognition to behavior (pp. 11–39). Springer.

Ajzen

(1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-t

American College Health Association. (2019). National college health assessment: Reference group data report. https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_US_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf

Andreasen

A. R.

(2002). Marketing social marketing in the social change marketplace. Journal of Public Policy & Marketing, 21(1), 3–13. https://www.jstor.org/stable/30000704

Bohon

L. M.

Cotter

K. A.

Kravitz

R. L.

Cello

P. C.

Jr. Fernandez

Garcia

(2016). The theory of planned behavior as it predicts potential intention to seek mental health services for depression among college students. Journal of American College Health, 64(8), 593–603. https://doi.org/10.1080/07448481.2016.1207646

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Buizza

Bazzoli

Ghilardi

(2022). Changes in college students mental health and lifestyle during the COVID-19 pandemic: A systematic review of longitudinal studies. Adolescent Research Review, 7, 537–550. https://doi.org/10.1007/s40894-022-00192-7

Cabassa

L. J.

(2007). Latino immigrant men’s perceptions of depression and attitudes toward help seeking. Hispanic Journal of Behavioral Sciences, 29(4), 492–509. https://doi.org/10.1177/0739986307307157

10.

Chandrasekara

W. S.

(2016). Help seeking attitudes and willingness to seek psychological help: Application of the theory of planned behavior. International Journal of Management, Accounting and Economics, 3(4), 233–245. http://www.ijmae.com/article_115282_1dd1c5744b78396452b4900168843690.pdf

11.

Chávez

(2017). Everyday injustice: Latino professionals and racism. Rowman & Littlefield Publishers.

12.

Christensen

M. C.

Caswell

Hernández

M. F.

(2021). Contextualizing barriers to help-seeking after sexual violence: A critical feminist study with Latinx college women. Affilia, 36(1), 97–112. https://doi.org/10.1177/0886109920906782

13.

Conde

Salomon

Civetta

Blanco

Cremonte

(2020). Time to get help? Help-seeking process in Latin American hospital patients with alcohol use disorder. International Journal of Mental Health and Addiction, 18(2), 328–335. https://doi.org/10.1007/s11469-019-00157-3

14.

Crowe

Averett

Harris

J. R. A.

Crumb

Dietz

S. S.

(2022). “The problem will pass:” Attitudes of Latinx adults toward mental illness and help seeking. International Journal for the Advancement of Counseling, 44(3), 453–468. https://doi.org/10.1007/s10447-021-09425-1

15.

Deckard

F. M.

Goosby

B. J.

Cheadle

J. E.

(2022). Debt stress, college stress: Implications for Black and Latinx students’ mental health. Race and Social Problems, 14, 238–253. https://doi.org/10.1007/s12552-021-09346-z

16.

DuBay

D. A.

Ivankova

Herby

Wynn

T. A.

Kohler

Berry

Foushee

Carson

A. P.

Redden

D. T.

Holt

Siminoff

Fouad

Martin

M. Y.

(2014). African American organ donor registration: A mixed methods design using the theory of planned behavior. Progress in Transplantation, 24(3), 273–283. https://doi.org/10.7182/pit2014936

17.

Firth

Siddiqi

Koyanagi

Siskind

Rosenbaum

Galletly

Allan

Caneo

Carney

Carvalho

A. F.

Chatterton

M. L.

Correll

C. U.

Curtis

Gaughran

Heald

Hoare

Jackson

S. E.

Kisely

Lovell

, . . .Stubbs

(2019). The Lancet Psychiatry Commission: A blueprint for protecting physical health in people with mental illness. The Lancet Psychiatry, 6(8), 675–712. https://doi.org/10.1016/s2215-0366(19)30132-4

18.

Fleming

M. L.

Bapat

S. S.

Varisco

T. J.

(2019). Using the theory of planned behavior to investigate community pharmacists’ beliefs regarding engaging patients about prescription drug misuse. Research in Social and Administrative Pharmacy, 15(8), 992–999. https://doi.org/10.1016/j.sapharm.2018.10.027

19.

Gearing

R. E.

Washburn

Brewer

K. B.

Bjugstad

Torres

L. R.

(2023). Predictors of help-seeking for mental health treatment among Latinos. Journal of Racial and Ethnic Health Disparities, 10, 1869–1877. https://doi.org/10.1007/s40615-022-01370-y

20.

Geegan

S. A.

Parker

K. A.

Ivanov

(2022a). “Other people need it more than me”: Using the theory of planned behavior to understand mental health help-seeking among Gen Z college students [Research Paper presentation]. National Communication Association National Conference, New Orleans, LA, United States.

21.

Geegan

S. A.

Parker

K. A.

Ivanov

(2022b). Gender differences in mental health: A theory of planned behavior approach to understand help seeking among Gen Z college students [Research Paper presentation]. International Conference on Health, Wellness, and Society, Johannesburg, South Africa.

22.

Gonzales

Przedworski

Henning-Smith

(2016). Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States: Results from the National Health Interview Survey. JAMA Internal Medicine, 176(9), 1344–1351. https://doi.org/10.1001/jamainternmed.2016.3432

23.

Gorman

Bruns

Chin

Fitzpatrick

Przedworski

Koenig

LeViness

Sokolowski

(2021). Annual Survey: 2021. Association for University and College Counseling Directors. https://www.aucccd.org/assets/2020-21%20Annual%20Survey%20Report%20Public%20Survey.pdf

24.

Hagger

M. S.

Cheung

M. W.

Ajzen

Hamilton

(2022). Perceived behavioral control moderating effects in the theory of planned behavior: A meta-analysis. Health Psychology, 41(2), 155–167. https://doi.org/10.1037/hea0001153

25.

Harris

B. R.

Maher

B. M.

Wentworth

(2022). Optimizing efforts to promote mental health on College and university campuses: Recommendations to facilitate usage of services, resources, and supports. The Journal of Behavioral Health Services & Research, 49(2), 252–258. https://doi.org/10.1007/s11414-021-09780-2

26.

Horwitz

A. G.

McGuire

Busby

D. R.

Eisenberg

Zheng

Pistorello

Albucher

Coryell

King

C. A.

(2020). Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk. Journal of Affective Disorders, 271, 123–130. https://doi.org/10.1016/j.jad.2020.03.115

27.

House

L. A.

Neal

Kolb

(2020). Supporting the mental health needs of first generation college students. Journal of College Student Psychotherapy, 34(2), 157–167. https://doi.org/10.1080/87568225.2019.1578940

28.

Kakol

Upson

Sood

(2021). Susceptibility of southwestern American Indian tribes to Coronavirus Disease 2019 (COVID-19). The Journal of Rural Health, 37(1), 197–199. https://doi.org/10.1111/jrh.12451

29.

Kessler

R. C.

Heeringa

Lakoma

M. D.

Petukhova

Rupp

A. E.

Schoenbaum

Wang

P. S.

Zaslavsky

A. M.

(2008). Individual and societal effects of mental disorders on earnings in the United States: Results from the national comorbidity survey replication. The American Journal of Psychiatry, 165(6), 703–711. https://doi.org/10.1176/appi.ajp.2008.08010126

30.

Kim

K. M.

(2015). Clinical experiences as related to standard precautions compliance among nursing students: A focus group interview based on the theory of planned behavior. Asian Nursing Research, 9(2), 109–114. https://doi.org/10.1016/j.anr.2015.01.002

31.

Klaic

McDermott

Haines

(2019). Does the theory of planned behavior explain allied health professionals’ evidence-based practice behaviors? A focus group study. Journal of Allied Health, 48(1), 43–51. https://www.ingentaconnect.com/content/asahp/jah/2019/00000048/00000001/art00022

32.

Kreuter

M. W.

McClure

S. M.

(2004). The role of culture in health communication. Annual Review of Public Health, 25, 439–455. https://doi.org/10.1146/annurev.publhealth.25.101802.123000

33.

Kuo

B. C. H.

Roldan-Bau

Lowinger

(2015). Psychological help-seeking among Latin American immigrants in Canada: Testing a culturally-expanded model of the theory of reasoned action using path analysis. International Journal for the Advancement of Counseling, 37(2), 179–197. https://doi.org/10.1007/s10447-015-9236-5

34.

Lee

Jeong

H. J.

Kim

(2021). Stress, anxiety, and depression among undergraduate students during the COVID-19 pandemic and their use of mental health services. Innovative Higher Education, 46, 519–538. https://doi.org/10.1007/s10755-021-09552-y

35.

Lindlof

T. R.

Taylor

B. C.

(2002). Qualitative communication research methods (2nd ed.). Sage Publications.

36.

Lipson

S. K.

Kern

Eisenberg

Breland-Noble

A. M.

(2018). Mental health disparities among college students of color. Journal of Adolescent Health, 63(3), 348–356. https://doi.org/10.1016/j.jadohealth.2018.04.014

37.

Lipson

S. K.

Zhou

Abelson

Heinze

Jirsa

Morigney

Patterson

Singh

Eisenberg

(2022). Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013–2021. Journal of Affective Disorders, 306, 138–147. https://doi.org/10.1016/j.jad.2022.03.038

38.

Lopez

M. H.

Gonzalez-Barrera

Arditi

(2021, November 4). Majority of Latinos say skin color impacts opportunity in America and shapes daily life. Pew Research Center. https://www.pewresearch.org/hispanic/wp-content/uploads/sites/5/2021/11/RE_2021.11.04_Latinos-Race-Identity_FINAL.pdf

39.

MacQueen

K. M.

McLellan

Kay

Milstein

(1998). Codebook development for team-based qualitative analysis. Cultural Anthropology Methods, 10, 31–36. https://doi.org/10.1177/1525822x980100020301

40.

McCarthy

E. J.

(1964). Basic marketing: A managerial approach. Richard D. Irwin.

41.

McDermott

M. S.

Oliver

Svenson

Simnadis

Beck

E. J.

Coltman

Iverson

Caputi

Sharma

(2015). The theory of planned behaviour and discrete food choices: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 162. https://doi.org/10.1186/s12966-015-0324-z

42.

McEachan

R. R. C.

Conner

Taylor

N. J.

Lawton

R. J.

(2011). Prospective prediction of health-related behaviours with the theory of planned behaviour: A meta-analysis. Health Psychology Review, 5(2), 97–144. https://doi.org/10.1080/17437199.2010.521684

43.

McKnight-Eily

L. R.

Okoro

C. A.

Strine

T. W.

Verlenden

Hollis

N. D.

Njai

Mitchell

E. W.

Board

Puddy

Thomas

(2021). Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the COVID-19 pandemic—United States, April and May 2020. Center for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/70/wr/mm7005a3.htm

44.

Menendez

Franco

Davari

Gnilka

P. B.

Ashby

J. S.

(2020). Barriers and facilitators to Latinx college students seeking counseling. Journal of College Student Psychotherapy, 34(4), 302–315. https://doi.org/10.1080/87568225.2019.1600093

45.

Miller

(2002). On being persuaded: Some basic distinctions. In Dillard

J. P.

Pfau

(Eds.), The Persuasion handbook: Developments in theory and practice (pp. 3–16). Sage Publications, Inc.

46.

Morgan

D. L.

(2019). Basic and advanced focus groups. Sage.

47.

National Alliance on Mental Illness. (2021, March). Mental health by the numbers. https://www.nami.org/mhstats

48.

National Center for Education Statistics. (2022). College enrollment rates. https://nces.ed.gov/programs/coe/indicator/cpb

49.

Noe-Bustamante

Gonzalez-Barrera

Edwards

Mora

Lopez

M. H.

(2021, November 4). Half of U.S. Latinos experienced some form of discrimination during the first year of the pandemic. Pew Research Center. https://www.pewresearch.org/hispanic/2021/11/04/half-of-u-s-latinos-experienced-some-form-of-discrimination-during-the-first-year-of-the-pandemic/

50.

Quirkos 2.4.2 [Computer Software]. (2021). https://www.quirkos.com

51.

Record

R. A.

Harrington

N. G.

Helme

D. W.

Savage

M. W.

(2018). Using the theory of planned behavior to guide focus group development of messages aimed at increasing compliance with a tobacco-free policy. American Journal of Health Promotion, 32(1), 143–152. https://doi.org/10.1177/0890117116687467

52.

Rue

(2018). Make way, Millennials, here comes Gen Z. About Campus, 23(3), 5–12. https://doi.org/10.1177/1086482218804251

53.

Santabárbara

Lasheras

Lipnicki

D. M.

Bueno-Notivol

Pérez-Moreno

López-Antón

De la Cámara

Lobo

Gracia-García

(2021). Prevalence of anxiety in the COVID-19 pandemic: An updated meta-analysis of community-based studies. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 109, 110207. https://doi.org/10.1016/j.pnpbp.2020.110207

54.

Shi

Kim

H. K.

(2020). Integrating risk perception attitude framework and the theory of planned behavior to predict mental health promotion behaviors among young adults. Health Communication, 35(5), 597–606. https://doi.org/10.1080/10410236.2019.1573298

55.

Silva

A. P.

Figueiredo

Hogg

Sottomayor

(2014). Young adults and wine consumption a qualitative application of the theory of planned behavior. British Food Journal, 116(5), 832–848. https://doi.org/10.1108/BFJ-05-2012-0114

56.

Stiff

J. B.

Mongeau

P. A.

(2016). Persuasive communication. Guilford Publications.

57.

Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf

58.

Substance Abuse and Mental Health Services Administration. (2022). 2020 national survey on drug use and health. US Department of Health & Human Services. https://www.samhsa.gov/data/report/2020-nsduh-detailed-tables

59.

Thomeer

M. B.

Moody

M. D.

Yahirun

(2023). Racial and ethnic disparities in mental health and mental health care during the COVID-19 pandemic. Journal of Racial and Ethnic Health Disparities, 10, 961–976. https://doi.org/10.1007/s40615-022-01284-9

60.

Twenge

J. M.

(2017). iGen: Why today’s super-connected kids are growing up less rebellious, more tolerant, less happy—and completely unprepared for adulthood—and what that means for the rest of us. Simon and Schuster.

61.

U.S. Census Bureau. (2017). 2017 national population projections tables. https://www.census.gov/data/tables/2017/demo/popproj/2017-summary-tables.html

62.

U.S. Census Bureau. (2021). Decennial census P.L. 94-171 redistricting data. https://www.census.gov/programs-surveys/decennial-census/about/rdo/summary-files.html

63.

Wang

Barlis

K. A.

Chen

Alami

(2020). Barriers to mental health help seeking at school for Asian- and Latinx-American adolescents. School Mental Health, 12(1), 182–194. https://doi.org/10.1007/s12310-019-09344-y

64.

World Health Organization. (2022). Mental health. https://www.who.int/health-topics/mental-health

65.

Zhou

Kyeong

Cheung

C. S.

Michalska

K. J.

(2022). Shared cultural values influence mental health help-seeking behaviors in Asian and Latinx college students. Journal of Racial and Ethnic Health Disparities, 9, 1325–1334. https://doi.org/10.1007/s40615-021-01073-w

66.

Zoellner

Krzeski

Harden

Cook

Allen

Estabrooks

P. A.

(2012). Qualitative application of the theory of planned behavior to understand beverage behaviors among adults. Journal of the Academy of Nutrition and Dietetics, 112(11), 1774–1784. https://doi.org/10.1016/j.jand.2012.06.268