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OBJECTIVES: Mental disorders and suicidal thoughts and behaviors (STB) are common and burdensome among college students. Although available evidence suggests that only a small proportion of the students with these conditions receive treatment, broad-based data on patterns of treatment are lacking. The aim of this study is to examine the receipt of mental health treatment among college students cross-nationally. METHODS: Web-based self-report surveys were obtained from 13,984 first year students from 19 colleges in eight countries across the world as part of the World Health Organization's World Mental Health-International College Student Initiative. The survey assessed lifetime and 12-month common mental disorders/STB and treatment of these conditions. RESULTS: Lifetime and 12-month treatment rates were very low, with estimates of 25.3-36.3% for mental disorders and 29.5-36.1% for STB. Treatment was positively associated with STB severity. However, even among severe cases, lifetime and 12-month treatment rates were never higher than 60.0% and 45.1%, respectively. CONCLUSIONS: High unmet need for treatment of mental disorders and STB exists among college students. In order to resolve the problem of high unmet need, a reallocation of resources may focus on innovative, low-threshold, inexpensive, and scalable interventions. ispartof: INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH vol:28 issue:2 ispartof: location:United States status: published

Background Although mental disorders and suicidal thoughts-behaviors (suicidal thoughts and behaviors) are common among university students, the majority of students with these problems remain untreated. It is unclear what the barriers are to these students seeking treatment. Aims The aim of this study is to examine the barriers to future help-seeking and the associations of clinical characteristics with these barriers in a cross-national sample of first-year college students. Method As part of the World Mental Health International College Student (WMH-ICS) initiative, web-based self-report surveys were obtained from 13,984 first-year students in eight countries across the world. Clinical characteristics examined included screens for common mental disorders and reports about suicidal thoughts and behaviors. Multivariate regression models adjusted for socio-demographic, college-, and treatment-related variables were used to examine correlates of help-seeking intention and barriers to seeking treatment. Results Only 24.6% of students reported that they would definitely seek treatment if they had a future emotional problem. The most commonly reported reasons not to seek treatment among students who failed to report that they would definitely seek help were the preference to handle the problem alone (56.4%) and wanting to talk with friends or relatives instead (48.0%). Preference to handle the problem alone and feeling too embarrassed were also associated with significantly reduced odds of having at least some intention to seek help among students who failed to report that they would definitely seek help. Having 12-month major depression, alcohol use disorder, and suicidal thoughts and behaviors were also associated with significantly reduced reported odds of the latter outcome. Conclusions The majority of first-year college students in the WMH-ICS surveys report that they would be hesitant to seek help in case of future emotional problems. Attitudinal barriers and not structural barriers were found to be the most important reported reasons for this hesitation. Experimental research is needed to determine whether intention to seek help and, more importantly, actual help-seeking behavior could be increased with the extent to which intervention strategies need to be tailored to particular student characteristics. Given that the preference to handle problems alone and stigma and appear to be critical, there could be value in determining if internet-based psychological treatments, which can be accessed privately and are often build as self-help approaches, would be more acceptable than other types of treatments to student who report hesitation about seeking treatment., Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III-FEDER, Grant/Award Numbers: PI13/00343 and PI13/00506; Instituto de Salud Carlos III, Grant/Award Numbers: CD12/00440 and CM14/00125; Northern Ireland Public Health Agency; Bristol-Myers Squibb; GlaxoSmithKline; Ortho-McNeil Pharmaceutical; Pan American Health Organization; Fogarty International Center, Grant/Award Number: FIRCA R03-TW006481; US Public Health Service, Grant/Award Numbers: R01 DA016558, R01-MH069864 and R13-MH066849; Pfizer Foundation; John D. and Catherine T. MacArthur Foundation; Consejo Nacional de Ciencia y Tecnologia (CONACyT), Grant/Award Number: CB-2016-01-285548; Ulster University; Northern Ireland Public Health Agency (HSC R & D); European Union Regional Development Fund (ERDF) EU Sustainable Competitiveness Programme for Northern Ireland; FPU, Grant/Award Number: FPU15/05728; DIUE Generalitat de Catalunya, Grant/Award Number: 2017 SGR 452; Ministerio de Sanidad, Servicios Sociales e Igualdad, PNSD, Grant/Award Number: 2015I015; ISCIII, Grant/Award Numbers: CD12/00440 and CM14/00125; Ithemba Foundation; South African Medical Research Council; Protestants Fonds voor de Geestelijke Volksgezondheid; ZonMw, Grant/Award Number: 636110005; BARMER; Eli Lilly and Company, Grant/Award Number: IIT-H6U-BX-I002; King Baudouin Foundation United States, Grant/Award Number: 2014-J2140150-102905; Belgian Fund for Scientific Research, Grant/Award Numbers: 1114717N, 11N0514N and 11N0516N; National Institute of Mental Health (NIMH), Grant/Award Numbers: R56MH109566 and R01MH070884