Exploring Relationships among Perceived Stigma, Self-Disclosure, Social Support, & Help-Seeking Behavior in the Context of College Students’ Interpersonal Mental Health Communication: A Sequential Multi-methodological Approach



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College students in the United States experience threats to mental health and wellness at heightened rates, yet seldom seek help. Previous research identifies perceived stigma as a substantial barrier to help-seeking, but also social support as a potential a path to circumvent such stigma. Nevertheless, multi-methodological research exploring the key interpersonal communication processes that may serve to promote or constrain help-seeking behavior is limited. This research seeks to identify practical insights for promoting college students’ mental health help-seeking intention and to advance theory building in the area of interpersonal health communication by employing a sequential exploratory multi-methodological research design (Creswell & Clark, 2017). The overall goal of this exploratory research is to investigate communication processes involving the diffusion of mental health stigma, its influence on college students’ willingness to disclose mental health issues in their interpersonal networks, and the seeking of both social support as well as appropriate healthcare for mental health challenges. Study 1 utilizes data yielded from online, open-ended surveys of college students (N = 51) using the Critical Incident Technique (CIT) to identify key issues students face in communicating interpersonally about mental health. Study 2 builds upon findings from Study 1 through qualitative in-depth interviews with undergraduate and graduate students (N = 17) to develop a deeper understanding of the potential relationships among the identified critical communication constructs of perceived stigma, social support seeking, self-disclosure, and help-seeking intention. Study 3 incorporates findings from Study 2 to adapt measures for the context of college students’ interpersonal mental health communication in a quantitative survey of graduate and undergraduate students (N = 1030). Findings from Study 2 also guided hypotheses in Study 3 for relationships among operationalized constructs, including bivariate correlations as well as mediation and moderation models. Findings from each study are discussed along with practical applications, theoretical implications, methodological and conceptual limitations, as well as directions and considerations for future research.