Understanding the intention and behavior of psychological help-seeking among Chinese college students using theory of planned behavior: a three-month follow-up study

Underutilization of mental health services is common and associated with substantial suffering, mental disorders and death. The present study aimed to explore factors significantly affecting the professional psychological help-seeking behavior based on the Theory of Planned Behavior (TPB). A sample of 597 Chinese college students recruited online completed the questionnaires, which measured four constructs of TPB including help-seeking intention, attitude, subjective norm and perceived behavioral control in December 2020. Help-seeking behaviors were evaluated three months later in March 2021. A two-step structural equation modeling procedure was used to test the TPB model. Findings show that partially consistent with TPB, more positive attitudes about seeking professional help (Beta = .258, p = .001) and higher perceived behavioral control (Beta = .504, p < .001) directly predicted higher intention to seek mental health services, and perceived behavioral control (Beta = .230, p = .006) directly predicted help-seeking behavior. However, behavioral intention (Beta = -.017, p = .830) did not statistically significantly predict help-seeking behavior, while subjective norm (Beta = .047, p = .356) did not predict help-seeking intention as well. The model accounted for 49.9% of the variance modeling help-seeking intention and 12.4% of the variance modeling help-seeking behavior. The results revealed the importance of attitude and perceived behavioral control in predicting help-seeking intention and behavior among Chinese college students and indicated that there existed a gap between intention and actual help-seeking behavior.