Mental health malleability beliefs and help-seeking intentions among Chinese college students: the mediating role of help-seeking self-stigma and the moderating role of depression

Introduction: College years represent a critical period for mental health; however, despite the high prevalence of depression among them, Chinese college students show low utilization of on-campus mental health services. This study examined the associations between beliefs about the malleability of mental health, help-seeking self-stigma, depression level, and intentions to seek mental health services on campus among Chinese college students. Method: A sample of 2,258 Chinese undergraduates (589 males and 1,669 females, aged between 18 and 25 years old; M_age = 19.59, SD = 1.23) completed questionnaires measuring the core variables, including Implicit Theories of Mental Health Scale, Help-Seeking Self-Stigma Scale, Intentions to Seek Mental Health Services on Campus, and Patient Health Questionnaire. A moderated mediation model was developed to analyze the beliefs about the malleability of mental health, help-seeking self-stigma, depression level, and intentions to seek mental health services on campus. Results: This study showed that (1) beliefs about the malleability of mental health were positively associated with intentions to seek on-campus services (b = 0.44, p < 0.001, 95% CI [0.22, 0.66]); (2) help-seeking self-stigma partially mediated this association between beliefs about the malleability of mental health and intentions to seek on-campus services, with an indirect effect value of 0.19, 95% CI [0.15, 0.25] and accounting for 30.51% of the total effect; (3) depression level marginally significantly moderated the first stage of the mediating pathway(interaction term b = 0.01, p < 0.05, 95% CI [0.0004, 0.02]). Specifically, the negative association between beliefs about the malleability of mental health and self-stigma was weaker among students with higher depression levels. Discussion: This findings showed that beliefs about the malleability of mental health were positively associated with Chinese college students’ intentions to seek on-campus mental health services by reducing help-seeking self-stigma, and this mediating effect is weakened among students with higher depression levels. These findings provide insights into factors facilitating the utilization of on-campus mental health services and inform targeted interventions to reduce help-seeking self-stigma.