INTRODUCTION:

World Health Organization (WHO) defines Psychological health is an important part of overall well-being, alongside physical and social health.^1-3 It plays crucial role in personal functioning, family dynamics, and societal development. Though very important, Psychological wellbeing remains poorly understood and even stigmatized globally, including regions like Punjab.^4-7 Cultural beliefs, myths, and misconceptions often associate mental illness with fate, moral weakness, or supernatural causes.

Such attitudes contribute to stigma, denial, and significant delays in seeking professional help. Understanding the public’s attitude toward mental health help-seeking is vital for developing effective awareness programs, reducing stigma, and improving their accessibility to services for mental health.^8-11 The present study explored mental health help-seeking attitudes among residents in urban areas of Punjab to identify existing perceptions and potential barriers to care.²People often seek medical help only after exhausting other options and when symptoms have significantly worsened, which negatively impacts treatment outcomes. Therefore, assessing community attitudes and help-seeking behaviors is essential for designing effective health promotion strategies and improving their accessibility to services for mental health, especially in developing, multi-ethnic societies.¹² Mental illness affects people globally, yet in many low-resource settings, including Ethiopia and similar regions; mental health remains under-researched.^13-16 Studies have shown that only a small fraction of people who have severe psychiatric illness in rural areas seek help professionally, with many turning to traditional healers due to cultural beliefs, stigma, and limited awareness. Misconceptions, ignorance, and lack of mental health infrastructure contribute to poor care and outcomes.^17-19 Unlike physical illnesses, public understanding of mental disorders is often vague and misinformed, leading to reluctance in seeking or offering support.^20-21 The inability to recognize symptoms in oneself or others further delays treatment, highlighting the urgent need for public education and mental health literacy. A crucial step one toward proper assessment, diagnosis, and professional intervention is, seeking help for psychological health concerns.^22-25 However, various factors influence help-seeking attitudes and behaviors. Researchers have identified multiple barriers, including technical issues such as financial constraints, lack of transportation, and limited mental health services; personal beliefs such as low perceived need or doubts about treatment effectiveness; and stigma.²⁶ Cultural norms also play an important part in building up attitudes, often linking psychiatric issues to supernatural or spiritual causes.²⁷ Stigma and negative stereotypes, including perceptions of dangerousness or unpredictability, further discourage individuals from seeking timely help.²⁸ Despite evidence supporting the benefits of early recognition and intervention, professional help is often delayed or entirely avoided. Improved mental health literacy—recognizing symptoms, understanding causes, and trusting treatment options—can promote help-seeking. However, many communities, particularly conservative and traditional ones, continue to rely on spiritual healing and maintain misconceptions about mental illness.^30-32 Public attitudes often stem from longstanding cultural beliefs and limited exposure to accurate mental health information. Treatment is sometimes perceived as ineffective, costly, or burdensome, which reinforces reluctance to seek care.^33-35

MATERIALS AND METHODS:

A descriptive research approach with a non-experimental research design was employed to assess mental health help-seeking attitudes among residents of a selected urban area in Punjab. The study was conducted in Old Rajpura, Punjab. The target population consisted of 400 residents aged 18 years and above, selected using a non-probability convenience sampling technique. Inclusion criteria specified participants who were permanent residents of Old Rajpura and available during data collection, while individuals who were unwilling to participate were excluded from the study. The study focused on two types of variables: demographic variables and the research variable. Demographic variables included age, gender, type of family, educational qualification, religion, marital status, occupation, and monthly income, source of information, family history of mental illness, experience with meditation, duration of mental illness, and duration of treatment. The key research variable was the attitude toward mental health help-seeking. To assess this variable, a standardized tool, the Mental Help Seeking Attitude Scale (MHSAS) developed by Dr. Joseph H. Hammer, was utilized. The tool was divided into two sections. Section A: collected socio-demographic data, while Section B: measured mental health help-seeking attitudes using nine items on a seven-point semantic differential scale. Each item used opposing adjectives (e.g., "useless–useful") to gauge participants' perspectives. To ensure accuracy, items 2, 5, 6, 8, and 9 were reverse-coded, as they contained negatively valenced anchors. Scores ranged from 1 (unfavourable) to 7 (favourable), with 4 indicating a neutral attitude. After reverse-coding, the mean score was calculated by summing the individual item scores and dividing by the number of items answered (a minimum of 8 out of 9 items answered was required). This allowed for a reliable assessment of participants’ attitudes toward seeking professional mental health support. The pilot study conducted aligned to the study's objectives.

RESULT:

Analysis and interpretation was done in accordance with objectives laid down for the study. Analysis of the data was done by using descriptive and inferential statistics.

Table 1 Descriptive statistics among respondents regarding Mental help seeking Attitudes Scale (MHSAS)

Descriptive Statistics	MHSAS Score
Minimum – Maximum	1.67 - 7.00
Median(IQR)	7.00(6.00 - 7.00)
Mean ± SD	6.19 ± 1.43
Positive Attitude(<3.0)	315(78.7%)
Neutral/Undecided(3.0 - <6.0)	65(16.3%)
Negative Attitude(≥ 6.0)	20(5.0%)

The results of a chi-square analysis show that there was no statistically significant relationship between mental health help-seeking attitudes and various socio-demographic variables at a 0.05 level of significance. This suggests that factors such as age, gender, family type, education level, religion, marital status, occupation, monthly income, source of information, and meditation experience do not significantly influence attitudes towards seeking mental health help. Specifically, the p-values for these variables are all greater than 0.05, indicating that the differences observed across these groups are not statistically significant. For instance, age (p = 0.533), gender (p = 0.983), family type (p = 0.193), qualification (p = 0.231), religion (p = 0.188), marital status (p = 0.716), occupation (p = 0.31), monthly income (p = 0.788), source of information (p = 0.553), and meditation experience (p = 0.844) all show no significant impact on mental health help-seeking attitudes.

DISCUSSION:

Our findings are consistent with various studies that explore mental health help-seeking attitudes across different populations. For instance, a study conducted by Prince P. N. (2002)¹⁶ involved 998 university students from Sumatera and Java, aiming to assess students' attitudes toward mental health services. The results revealed that a significant majority, 91% of the students, held a positive attitude toward mental health services, while 14% showed a negative attitude. This aligns with our own findings, where a large portion of the participants demonstrated a favourable stance toward seeking professional help for mental health issues.^18-22Ibrahim et. al. (2009)²³ highlighted the importance of improving mental health literacy on campuses as a way to reduce stigma and increase the likelihood that students would seek help when facing mental health challenges.^23-27 This recommendation resonates with our results, emphasizing the role of education and awareness in shaping mental health attitudes.^29-30

Similarly, a study by Aulia et. al. (2020)³⁰ assessed mental well-being and mental health help-seeking attitudes among 364 students at the International Islamic University in Malaysia. This research used a combination of the Mental Health Help-Seeking Attitude Scale (MHSAS) and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) to explore the students' mental health and help-seeking behaviors. The study revealed that while only 7.1% of students exhibited positive mental well-being, 44.8% demonstrated a positive attitude toward seeking help for mental health issues. The lack of significant differences in mental well-being across socioeconomic status (SES) components (p > 0.05) suggests that factors such as income and family background did not substantially affect students' attitudes toward seeking help. This finding is in line with our study, which found no significant relationship between socio-demographic factors and mental health help-seeking attitudes, further supporting the idea that factors like age, gender, and education level may not be as influential as previously thought in shaping attitudes toward seeking help.^32-33

Another relevant study by Uriegas et al. (2024) focused on the mental health experiences of gender-diverse collegiate marching band artists. This cross-sectional study surveyed 78 gender-diverse individuals to examine the risk of anxiety and depression, as well as barriers and attitudes towards seeking professional help. The results showed that 78.2% of the participants were considered at risk for both state and trait anxiety and depression, yet 18% did not seek help from mental health professionals.³⁴ Despite this, the MHSAS score of 9.2 indicated a generally positive attitude toward seeking help. The study highlighted the need for more specialized mental health resources and services tailored to gender-diverse individuals, particularly those who face unique barriers to seeking help.³⁴ This finding underscores the importance of considering specific populations’ needs in the development of mental health services, a theme that complements our findings on the need for improved access to mental health support for diverse groups.³⁵

These studies collectively emphasize that while positive attitudes toward mental health help-seeking are common, there are still challenges in translating those attitudes into actual help-seeking behavior.^30-32 The studies also suggest that factors like awareness, education, and specific needs of underrepresented groups (such as gender-diverse individuals) play a significant role in whether individuals ultimately seek mental health support.^33-34 Our findings align with these observations, indicating that while a majority of participants have a positive outlook toward mental health services, there are still gaps in actual help-seeking behavior, and these gaps need to be addressed through targeted interventions and resources. Enhanced mental health literacy, more accessible services, and efforts to reduce stigma are essential for encouraging individuals to seek help when needed.³⁵

CONCLUSION:

In conclusion, our findings align with previous studies that show a generally positive attitude toward mental health help-seeking, with a majority of participants expressing willingness to seek professional help. However, there are gaps in actual help-seeking behavior, suggesting the need for improved mental health literacy, accessible services, and targeted interventions. Socio-demographic factors such as age, gender, and socioeconomic status do not significantly impact attitudes toward seeking help, emphasizing the importance of universal strategies to enhance mental health support across diverse populations.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this investigation.

ACKNOWLEDGMENTS:

The authors would like to thank Dr. Davinder Kaur, Principal Gian Sagar College of Nursing, Ramnagar, Rajpura for her guidance and kind support throughout the study.

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Received on 21.05.2025 Revised on 13.09.2025

Accepted on 24.11.2025 Published on 30.04.2026

Available online from May 02, 2026

Int. J. Nursing Education and Research. 2026;14(2):121-124.

DOI: 10.52711/2454-2660.2026.00024

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.