







































Humanitas: Indonesian Psychological Journal  
Vol. 22 (1), February 2025, 31-44 

ISSN:  2598-6368(online); 1693-7236(print)                                                                 

       humanitas@psy.uad.ac.id             http://journal1.uad.ac.id/index.php/Humanitas                               10.26555/humanitas.v22i1.975 

Pathways of adolescent intention for mental health help-seeking: 

Insights from the theory of planned behavior  

Nurlaela Widyarini, Ria Wiyatfi Linsiya 

Faculty of Psychology, Universitas Muhammadiyah Jember, Jember, Indonesia 
Corresponding author: nurlaela@unmuhjember.ac.id 

 

This is an open access article under the CC BY-SA license. 

 

Introduction 

Adolescent mental health has become an increasingly urgent global health issue, driven by 
various factors such as social changes induced by the pandemic (Amran, 2022; Cooper & 
Sawaf, 1997), technological advancements  (García-Gil et al., 2022; Marciano et al., 2022), 
and increasingly complex life demands (Ortuño-Sierra et al., 2021). It encompasses the 
psychological well-being of individuals aged 10-19, integrating emotional, psychological, 
and social dimensions that influence their cognition, emotions, and behaviors. According to 
the World Health Organization (WHO), over 700,000 people die by suicide annually, making 
it the fourth leading cause of death among individuals aged 15-29 years, with 77% of cases 
occurring in low- and middle-income countries (Buli et al., 2024; Kim et al., 2020; World 
Health Organization, 2023). 

In Indonesia, adolescent mental health issues are similarly pressing. One in three 

adolescents has exhibited symptoms of mental disorders over the past 12 years, with anxiety 

being the most prevalent among those aged 10-17 years (Wahdi et al., 2023). A national 

survey by the Ministry of Women's Empowerment and Child Protection reveals alarming 

ARTICLE  INFO  

 

ABST RACT  

 

Article history 

Received: August 1, 2024 

Revised: January 3, 2025 

Accepted: January 12, 2025 

 Adolescent mental health has emerged as a critical global issue 
influenced by social changes, technological advancements, and 
complex life demands. This study, conducted in Jember, East Java, 
Indonesia, aimed to explore psychosocial factors influencing 
adolescents' mental health help-seeking intention using the Theory of 
Planned Behavior (TPB). The research comprised two phases. Phase 
1 included 72 students (mean age = 15.86 years, 87% female) from 
two junior high schools and three senior high schools. These students 
were interviewed to investigate their beliefs about mental health help-
seeking intention through open-ended questions. Phase 2 involved 
413 students (mean age = 15.3 years, 52.5% female) from three junior 
high schools and three senior high schools. This phase developed a 
model of mental health help-seeking intention based on attitudes, 
subjective norms, and perceived behavioral control. The study 
underscored the pivotal role of social support, positive attitudes, and 
accessible services in shaping adolescents’ intentions to seek mental 
health assistance. These findings imply that strengthening social 
support networks, particularly within family and community contexts, 
promoting positive attitudes and enhancing service accessibility, 
could substantially increase adolescents' intention to seek help. 

     

 
Keywords 

Adolescent Mental Health 
Help-Seeking 

Planned Behavior Theory 
Professional Help 

Psychosocial Factors 

 

 

mailto:humanitas@psy.uad.ac.id
http://journal1.uad.ac.id/index.php/Humanitas
http://doi.org/10.26555/humanitas.v22i1.975
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Nurlaela Widyarini et.al (Pathways of adolescent intention for mental health help-seeking:…) 

statistics: 21% of female adolescents who experience violence express a desire to self-harm, 

17% of those experiencing sexual violence have contemplated suicide, and eight out of 100 

have attempted it (Susilowati et al., 2021). Furthermore, while 46.3% of adolescents 

reportedly have flourishing mental health, others exhibit moderate to languishing mental 

health (Sulistiowati et al., 2019). 

Adolescents in rural areas face particularly pronounced barriers to accessing mental 

health services, including stigma, lack of awareness of resources, and limited service 

availability (Oduola et al., 2024).  Rurality amplifies attitudinal barriers such as stoicism and 

distrust of formal systems, shaped by cultural and geographic factors (Cheesmond et al., 

2019). On the other hand, facilitators like family involvement, school-based initiatives, and 

flexible, informal support settings have shown promise in encouraging help-seeking 

behaviors (Oduola et al., 2024). Flexible and informal meeting settings may also encourage 

help-seeking behaviors (Cheesmond et al., 2020). Situated in Jember, a rural district in East 

Java, Indonesia, this study seeks to explore how adolescents in this unique socio-geographic 

context perceive and navigate the mental health resources available to them. 
Despite growing attention to adolescent mental health, significant knowledge gaps 

remain. Existing studies often focus on urban populations, overlooking the rural context 
where barriers and facilitators may differ substantially. Moreover, while individual-level 
models have been used to explain health-related behaviors, these approaches often neglect 
the broader social factors that shape such behaviors. By addressing these gaps, this study 
contributes to the literature by examining the psychosocial determinants of help-seeking 
behavior among rural adolescents and contextualizing them within the Theory of Planned 
Behavior (TPB).  

The TPB offers a comprehensive framework for understanding mental health help-
seeking intentions and behaviors, addressing limitations in other models like the Health Belief 
Model (HBM) and the Transtheoretical Mode (TTM) (Ajzen, 2012; Ajzen et al., 2009). The 
TPB has been widely applied to understand mental health help-seeking intentions and 
behaviors. It posits that behavior is determined by psychosocial aspects such as attitudes 
(assessments of benefits), subjective norms (perceptions of social support or hindrance), and 
perceived behavioral control (situational factors or resources that facilitate or impede 
behavior) (Fishbein, 2008; Fishbein & Ajzen, 2010). While attitudes and perceived 
behavioral control are consistently significant predictors of help-seeking intentions, 
subjective norms have shown more variable influence (Adams et al., 2022; Bohon et al., 2016; 
Tomczyk et al., 2020; Zorrilla et al., 2019). This study applies the TPB framework to examine 
the factors influencing adolescents' help-seeking behavior and to propose actionable 
recommendations tailored to the rural Indonesian context. 

Method 

This research was conducted in two sequential phases, guided by the structured framework 
of the Theory of Planned Behavior (TPB). The first phase focused on identifying and 
understanding the challenges that adolescents perceive as difficult or stressful and how these 
experiences influence their mental health and willingness to seek help. To achieve this, we 
identified situations that adolescents found challenging, aiming to uncover the types of 
experiences that significantly impact their mental health and help-seeking behaviors 
(Weathers et al., 2013). The participants in this study were students from two junior high 
schools and three senior high schools located across two districts in Jember Regency. 
Participants were asked whether they had personally experienced, witnessed, or learned about 
these events happening to a close family member or friend, providing valuable insights into 
the stressors that adolescents consider significant. 



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Nurlaela Widyarini et.al (Pathways of adolescent intention for mental health help-seeking:…) 

Next, we conducted a qualitative exploration of adolescents' beliefs regarding mental 
health help-seeking. Open-ended questions were used to examine the content and nature of 
these beliefs, addressing the research question, "What beliefs do adolescents hold regarding 
seeking mental health assistance, and how strong are these beliefs?" Additionally, we 
measured the strength of these beliefs to develop instruments assessing three core components 
of the TPB: attitudes, subjective norms, and perceived behavioral control (PBC). This step 
was guided by the question, "How can the strength of adolescents' beliefs about mental health 
help-seeking be measured to develop instruments for assessing attitudes, subjective norms, 
and perceived behavioral control?" 

The second phase of the study applied a regression model to examine the influence of 
these predictors—attitudes, subjective norms, and PBC—on adolescents' intentions to seek 
mental health help. This phase addressed the research questions, "How do attitudes, 
subjective norms, and perceived behavioral control influence adolescents' intentions to seek 
mental health help?" and "To what extent can a regression model based on the TPB predict 
adolescents' mental health help-seeking intentions?" By testing the regression model, we 
sought to evaluate the predictive power of the TPB framework in explaining adolescents' 
intentions to seek help in the context of mental health challenges. 

This research adheres to the ethical guidelines established by the Research Ethics 
Commission of the Faculty of Psychology, Universitas Muhammadiyah Jember, as outlined 
in document No. 03/ETK/II.3.AU/FPSI/F/2024. Consent for participation in this study was 
obtained directly from the students, with prior notification provided to the principals of each 
school. Participation was entirely voluntary, and students were informed of their right to 
decline involvement or withdraw from the study at any time without any repercussions. This 
ensured that their autonomy and willingness to participate were respected throughout the 
research process 
 
Phase 1.  Identification Perceived Stressful Situation and Exploration of Beliefs in 
Mental Health Help-Seeking Intention 

Participants 

Phase 1 involved 72 students (M_ age = 15.86 years; SD = 1.43) from two junior high schools 

and three senior high schools across two districts in Jember Regency. The sample included 

63 female adolescents (87%) and nine male adolescents (13%). The data showed that only 

10% of the sample had sought professional mental health services, highlighting a low 

frequency of help-seeking behavior. The ethnic composition was predominantly Javanese 

(81%), with smaller representations of Madurese (11%) and other ethnic groups (8%). 

Data Collection and Analysis Methods for Beliefs related to Mental Health Help Seeking 

Intentions 

Participants were asked to respond to a series of open-ended questions regarding their beliefs 

about seeking mental health assistance. These questions aimed to uncover the perceived 

benefits and drawbacks, the influence of social support, and the control factors related to help-

seeking. The researchers used open-ended questions to adolescents: 1) "What are the 

advantages and disadvantages of seeking mental health assistance from professionals?" 2) 

"Who are the individuals or groups that support or obstruct in seeking mental health assistance 

from professionals?" 3) "What situational factors or resources facilitate or hinder seeking 

mental health assistance?" Based on these three open-ended questions, the researcher 

conducted a content analysis and identified the five most frequent responses (Table 2). 



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Questionnaire Development 

The purpose of developing the Belief Strength Questionnaire (BSQ) was to systematically 
quantify these beliefs and understand their strength in predicting help-seeking intentions. This 
questionnaire was crucial for identifying the specific beliefs that influence adolescents' 
decisions to seek help, thereby informing the development of interventions targeted at 
increasing help-seeking behavior. The six constructs—behavioral belief, outcome evaluation, 
normative belief, motivation to comply, control belief, and power—are derived from the 
content analysis conducted during Phase 1. Open-ended questions were analyzed to identify 
key themes and categories that represent adolescents’ perceptions and experiences related to 
seeking mental health assistance. These findings were then used to create structured items for 
the Belief Strength Questionnaire (BSQ), allowing for the systematic measurement of these 
beliefs in Phase 2. 

The BSQ is a single tool designed to measure all six constructs as part of a 
comprehensive assessment. While each construct has its own subscale, with unique items and 
response scales tailored to capture specific dimensions, they collectively form one unified 
instrument. Differences in scoring and reliability across constructs arise naturally due to the 
diversity of beliefs being measured.  

Behavioral Belief. This refers to the adolescents' beliefs about the consequences or 
outcomes of seeking mental health assistance. The construct consists of six items (α = 0.57). 
For example, one item states, "The outcome I will achieve when seeking assistance from a 
psychologist/psychiatrist in difficult situations is that my mental burden will be reduced 
because I will receive solutions to the problems I am facing." Responses are measured on a 
scale from 1 (Impossible for me to obtain) to 7 (Possible for me to obtain). 

Outcome Evaluation. This assesses adolescents' evaluations of the likely 
consequences of seeking mental health assistance. It consists of six items (α = 0.72), such as 
"Experiencing greater tranquillity due to the ability to express emotions." Responses range 
from -3 (Something of little importance/value to me) to +3 (Something important/valuable to 
me). 

Normative Belief. This measures the beliefs about the support or hindrance provided 
by individuals or groups regarding seeking mental health assistance. This construct comprises 
five items (α = 0.68), such as "The parties that determine when to seek assistance from a 
psychologist/psychiatrist when facing a difficult situation are friends, parents, relatives, 
partners, or teachers." Responses are rated on a scale from 1 (Less supportive/Less agreeable) 
to 7 (Supportive/Agreeable). 

Motivation to Comply. This refers to the tendency to follow the advice of influential 
individuals. The construct includes five items (α = 0.65), with responses ranging from -3 (I 
will not act on/follow the advice from this party) to +3 (I will act on/follow the advice from 
this party). 

Control Belief. This assesses the perceived availability of resources or situations that 
facilitate or obstruct help-seeking. It consists of five items (α = 0.84), such as "Easily 
accessible information regarding the availability of psychologists/psychiatrists, costs, and 
service hours provided." Responses are measured on a scale from 1 (Not available/Not 
possessed) to 7 (Available/Possessed). 

Power. This refers to the perceived strength of the factors that enable or impede seeking 
mental health assistance. It includes five items (α = 0.89), with responses ranging from -3 
(Hindering) to +3 (Facilitating). 

 
 
 
 



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Data Analysis 

Data from Phase 1 were analyzed using content analysis to identify key themes from the open-
ended questions, followed by descriptive analysis of the BSQ data to assess the strength and 
impact of each belief on help-seeking intentions 
 

Phase 2: Regression Model of Adolescent Mental Health Help-Seeking Intention 

Participants.  

 

Phase 2 involved 413 students (M_age = 15.3 years; SD = 1.66) from three junior high schools 

and three senior high schools across three districts in Jember Regency. The sample included 

196 males (47.5%) and 217 females (52.5%), with an ethnic composition predominantly 

Javanese (80%), followed by Madurese (12%) and other ethnic groups (8%).   

Data Collection  

The instruments used in Phase 2 were developed based on the constructs (Attitude, Subjective 

Norms and PBC) identified in Phase 1. The instruments are four separate scales, each 

designed to measure a distinct variable within the context of the Theory of Planned Behavior 

(TPB): attitude towards mental health help-seeking intentions, subjective norms, perceived 

behavioral control, and mental health help-seeking intentions. Each scale operates 

independently, as these variables are analyzed separately to explore their individual 

contributions to adolescents' help-seeking behavior. These instruments included: 

Attitude Towards Mental Health Help-Seeking Intention Scale (Three items, α= 

0.79). This scale assesses adolescents' overall disposition towards seeking mental health 

assistance, encompassing both positive and negative evaluations of potential outcomes. 

Subjective Norm Scale (Four items, α = 0.68). This scale measures the influence of 

social norms on adolescents' help-seeking intentions, categorized into vertical (injunctive 

norms) and horizontal (descriptive norms) relationships. 

Perceived Behavioral Control Scale (Four items, α = 0.73). This scale evaluates 

adolescents' perceptions of the ease or difficulty of seeking mental health assistance, 

influenced by factors such as accessibility of information, communication resources, and 

logistical concerns. 

Mental Health Help-Seeking Intention Scale (Five items, α = 0.66). This scale 

measures the adolescents' willingness to seek mental health assistance, reflected in behaviors 

such as researching services, contacting a psychologist, and attending appointments. 

The number of items in each scale is intentionally limited to ensure the instruments 

remain concise and focused, reducing the response burden on adolescent participants. 

However, we acknowledge that the relatively small number of items can contribute to 

moderate reliability scores, such as α = 0.66 for the Mental Health Help-Seeking Intention 

Scale. This is a limitation of the study, and future research should consider expanding the 

number of items in each scale to improve internal consistency and reliability. 

Despite this limitation, the reliability scores obtained are acceptable for exploratory 

research and provide meaningful insights into the relationships between these variables. The 

findings contribute to understanding adolescents' help-seeking behaviors and offer a 

foundation for refining these instruments in subsequent studies to enhance their robustness 

and reliability. 

 

 



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Data Analysis 

Data from Phase 2 were analyzed using regression analysis, conducted with JAMOVI 

software version 1.6.18.0, to determine the model fit and identify the most significant 

predictors of mental health help-seeking intention. 

Results 

Table 1 illustrates the various challenging events and situations that adolescents reported as 

impacting their lives, their families, or others around them. Bullying emerged as a common 

issue, affecting individuals, families, and others equally. Conflicts with friends and teachers 

were primarily personal struggles, with some impact extending to others but rarely involving 

family members. Similarly, conflicts with romantic partners and siblings were mostly 

personal matters, with less effect on the broader family or community. Transportation 

accidents and natural disasters had a more widespread impact, affecting not just the 

individuals involved but also their families and others in their community. On the other hand, 

feelings of inadequacy in academic tasks and fear of future failure were mainly internal 

challenges faced by the adolescents themselves, with little to no reported impact on their 

families or others. This overview highlights how certain stressful events are more likely to 

affect only the individual, while others have broader implications for families and 

communities. 

 

Table 1  

Frequency of Adolescent-Reported Events and Situations Affecting Individuals, Families, and 

Others 

Event or Situation 

Number of Responds 

Happened 

to Me  

Happened to 

My Family 

Happened 

to Other 

Bullying (physical, verbal, and psychological) 7 7 7 

Conflict with friends 12 1 3 

Conflict with parents 7 5 2 

Conflict with teachers 12 0 4 

Conflict with a romantic partner 6 5 1 

Conflict with siblings 8 2 0 

Transportation accidents (e.g., car accident, shipwreck, train 

accident, plane crash) 

4 5 3 

Natural disasters (floods, earthquakes, landslides, disease 

outbreaks, etc.) 

9 0 7 

Feeling inadequate in academic tasks 3 0 2 

Fear of future failure 3 0 0 

Phase 1 

The study explored the various factors influencing adolescents' mental health help-seeking 
intentions by examining attitudes, subjective norms, and perceived behavioral control. The 
findings are summarized in Table 2, which outlines the relationships between specific beliefs, 
evaluations, and the resulting components of intention. Column 1 in Table 2 contains the most 
frequent responses from participants to the open-ended questions asked by the researchers: 1) 
"What are the advantages and disadvantages of seeking mental health assistance from 
professionals?" 2) "Who are the individuals or groups that support or obstruct in seeking 
mental health assistance from professionals?" 3) "What situational factors or resources 
facilitate or hinder seeking mental health assistance?" Based on these three open-ended 



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Nurlaela Widyarini et.al (Pathways of adolescent intention for mental health help-seeking:…) 

questions, the researchers conducted a content analysis and identified the five most frequent 
responses. 

The study explored the various factors influencing adolescents' mental health help-
seeking intentions by examining attitudes, subjective norms, and perceived behavioral 
control. The findings are summarized in Table 2, which outlines the relationships between 
specific beliefs, evaluations, and the resulting components of intention. Column 1 in Table 2 
contains the most frequent responses from participants to the open-ended questions asked by 
the researchers: 1) "What are the advantages and disadvantages of seeking mental health 
assistance from professionals?" 2) "Who are the individuals or groups that support or obstruct 
in seeking mental health assistance from professionals?" 3) "What situational factors or 
resources facilitate or hinder seeking mental health assistance?" Based on these three open-
ended questions, the researchers conducted a content analysis and identified the five most 
frequent responses. 

The content analysis employed in this study involved transforming qualitative 
responses into quantitative data to facilitate statistical analysis. Participants' responses to 
questions about their beliefs, evaluations, and motivations were coded using a Likert scale 
(e.g., 1 = strongly disagree to 5 = strongly agree). The mean values calculated represent the 
average response across all participants, providing an overview of the trends and relative 
strength of each factor. This approach allowed us to quantify subjective perceptions, such as 
the strength of behavioral beliefs and the importance of specific outcomes, ensuring that the 
findings were both systematic and interpretable. 

In line with the Theory of Planned Behavior (TPB), the study multiplied belief strength 
by outcome evaluation (b × e) to calculate attitudes, normative belief by motivation to comply 
(n × m) to determine subjective norms, and control belief by power (c × p) to assess perceived 
behavioral control. This multiplication reflects the interactive nature of these constructs, 
where both components must be considered together to capture their combined effect. For 
instance, a strong belief about the benefits of seeking help would contribute less to attitudes 
if the associated outcome were deemed unimportant. Similarly, the influence of social 
expectations depends not only on the perceived strength of those expectations but also on the 
individual’s willingness to comply. By employing this approach, the study aligns with the 
TPB framework to evaluate the predictors of help-seeking intentions comprehensively and 
meaningfully. 

Based on the findings from Phase 1 (Table 2), adolescents' attitudes towards seeking 
psychological help reveals that the most significant factor influencing a positive attitude is 
enhanced calmness through attentive listening, with the highest attitude score (mean = 9.85), 
supported by strong behavioral belief (mean = 4.9) and high outcome evaluation (mean = 
1.46). Additionally, emotional expression that leads to calmness also contributes significantly 
to a positive attitude (mean = 8.40). The belief that psychological help can alleviate mental 
burden is viewed positively as well (mean = 6.93), though slightly less so. On the other hand, 
the financial cost is the most substantial deterrent, resulting in a low attitude score (mean = 
0.26), followed by significant time investment (mean = 3.53) and feelings of awkwardness or 
discomfort (mean = 3.18), which have a more moderate impact.  

The influence of significant others on adolescents' intentions to seek mental health help 
shows that parents have the strongest impact, with the highest subjective norm score (mean 
= 6.56), driven by a significant normative belief (mean = 4.06) and motivation to comply 
(mean = 1.04). This highlights the crucial role of parental expectations in encouraging help-
seeking behavior. Teachers and school counselors also exert considerable influence, with a 
subjective norm score of 4.36, underscoring their authority in guiding adolescents towards 
seeking help. Friends and siblings have a moderate influence, with mean of subjective norm 
are 2.68 and 3.14, respectively, indicating that while their opinions matter, they are less 
impactful compared to parents and teachers. Interestingly, the influence of a partner or close 
friend is relatively low, with a subjective norm score of 1.69 and even a negative motivation 



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to comply (mean = -0.25), suggesting that some adolescents may not prioritize the opinions 
of close friends when deciding to seek psychological help. These findings demonstrate that 
parental and teacher expectations are the most influential factors, while peer influence is more 
moderate.  

The results of Phase 1 also explore perceived behavioral control reveals that the 
availability of online mental health services is the most influential factor, with a high 
perceived behavioral control (mean = 3.49), indicating that adolescents find online resources 
highly accessible and motivating for seeking help. School-issued permission, while notable, 
has a moderate impact (mean = 2.25), suggesting that obtaining school permission plays a 
role but is not a major barrier. The proximity of services to home presents a lower influence 
(mean = 0.89), indicating that geographical distance may be a barrier, though less significant 
than online accessibility. Lastly, the availability of information about services shows the least 
influence (mean = 0.42), suggesting that while information is accessible, it is not a strong 
motivator for adolescents to seek help. These findings highlight that online accessibility is 
the most empowering factor, while geographical proximity and information availability are 
less influential in adolescents' help-seeking behavior. 

Table 2  
Attitude, Subjective Norm and Perceived Behavioral Control Based on Beliefs 

Attitude Based on Behavioral Belief and 

Outcome Evaluation 

Behavioral Belief 

Strength 

(b) 

Outcome 

Evaluation 

(e) 

Attitude 

(bxe) 

mean mean mean 

Alleviated mental burden 4.35 1.18 6.93 

Enhanced calmness through emotional 

expression 

4.89 1.19 8.40 

Enhanced calmness from attentive 

listening 

4.86 1.46 9.85 

High financial cost 3.44 -0.43 0.26 

Significant time investment 4.07 0.49 3.53 

Experiencing awkwardness, 

embarrassment, or discomfort 

4.32 0.15 3.18 

Subjective Norm Based on Normative 

Belief and Motivation to Comply 

Normative 

Belief (n) 

Motivation 

to Comply (m) 

Subjective Norm 

(nxm) 

mean mean mean 

Friends 4.58 0.21 2.68 

Parents 4.06 1.04 6.56 

Siblings 3.94 0.24 3.14 

Partner/close friend 3.85 -0.25 1.69 

Teachers/School Counselors 4.07 0.44 4.36 

Perceived Behavioral Control Based on 

Control Belief and Power 

Control Belief (c) Power 

(p) 

Perceived 

Behavioral 

Control 

(c x p) 

mean mean mean 

Readily accessible information 2.79 -0.15 0.42 

Comprehensive information on obtaining 

services 

2.90  0.26 2.17 

Proximity of services to the home 2.81 -0.26 0.89 

Availability of online mental health 

services 

3.68   0.60 3.49 

School-issued permission 3.29  0.19 2.25 

 



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Phase 2 

The overall intention to seek mental health assistance integrates the key predictors: attitude, 
subjective norm, and perceived behavioral control (F(4.41) = 44.7; p<0.01). The analysis 
revealed that these three factors significantly influence adolescents' mental health help-
seeking intentions, with a determination coefficient (R² = 0.30; p < 0.01). This indicates that 
30.4% of the variance in mental health help-seeking intention can be explained by the 
combination of these predictors. Attitudes toward seeking assistance demonstrated a 
significant positive influence (β = 0.24; p<0.01), indicating that adolescents with more 
favorable views of mental health services are more inclined to seek help when required. 
Subjective norm demonstrated the most significant influence (β = 0.44; p<0.01), indicating 
that the social expectations and pressures from significant others, such as parents and peers, 
play a crucial role in shaping adolescents' intentions to seek help. Perceived behavioral 
control also played a significant role (β = 0.25; p<0.01), reflecting that adolescents' 
confidence in their ability to access mental health services—considering factors like the 
availability of services and perceived ease of access—strongly impacts their intention to seek 
help. Interestingly, gender did not significantly influence the intention to seek help in this 
regression model (β = -1.19; p>0.05), suggesting that, within this context, gender differences 
do not play a crucial role in determining help-seeking intentions. 

Discussion 

This study explored the psychosocial factors influencing adolescents' mental health help-

seeking intentions using the Theory of Planned Behavior (TPB) framework. By examining 

attitudes, subjective norms, and perceived behavioral control, Phase 1 and Phase 2 provided 

comprehensive and sequential insights into these factors and their interconnections, 

demonstrating the importance of this dual-phase approach in yielding significant findings. 

Phase 1 focused on identifying and understanding adolescents’ beliefs and perceptions 

regarding mental health help-seeking. The qualitative exploration revealed that positive 

attitudes toward seeking psychological help were primarily influenced by benefits such as 

enhanced calmness and reduced mental burden (Aras & Peker, 2024). However, financial 

costs, time investment, and embarrassment were notable deterrents. Subjective norms, 

especially parental and teacher influence, emerged as significant motivators for help-seeking 

intentions (Digal & Gagnon, 2020; Hassett et al., 2018), while peer influence played a 

moderate role (Sears & MacIntyre, 2023). Perceived behavioral control highlighted the 

availability of online mental health services as a critical enabler, with geographical proximity 

and information accessibility being less influential (Sweeney et al., 2019). These findings 

provided a foundation for developing the instruments used in Phase 2, underscoring the 

sequential nature of this research. 

Phase 2 built upon these foundational insights by analyzing how attitudes, subjective 

norms, and perceived behavioral control predicted adolescents' intentions to seek help. These 

results affirm the importance of social expectations and the perceived ease of accessing 

services in shaping help-seeking intentions. Interestingly, gender did not significantly impact 

help-seeking intentions, suggesting that cultural or societal norms within the study context 

may encourage equitable perceptions of mental health services. This phase confirmed the 

interconnectedness of the findings from both phases and reinforced the predictive power of 

the TPB model (Fishbein, 2008; Fishbein & Ajzen, 2010). 



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This study shares similarities with prior research, such as the consistent finding that 

subjective norms significantly influence mental health help-seeking intentions (Bohon et al., 

2016; Kam et al., 2022). Like these studies, the present research highlights the critical role 

of social support systems, particularly from parents and teachers, in motivating adolescents 

to seek help. Similarly, the emphasis on perceived behavioral control aligns with existing 

literature, underscoring the importance of adolescents’ confidence in their ability to access 

mental health services and navigate logistical barriers (Adams et al., 2022). 

However, differences were also observed. Unlike some studies that reported 

significant gender differences in help-seeking behaviors (Syakarofath & Widyasari, 2023), 

this research found no such disparities. This discrepancy may be attributed to cultural or 

societal norms in the study’s context, which appear to promote more equitable attitudes 

toward mental health services across genders. Additionally, while earlier studies emphasized 

the challenges posed by stigma and confidentiality concerns (Boyd et al., 2011; Cramer, 

2016), this research identified online mental health services as a particularly empowering 

factor, reflecting a shift toward digital solutions in adolescent health behavior. 

The findings also extend prior research by integrating a sequential mixed-methods 

approach, combining qualitative insights with quantitative validation. This design enabled a 

deeper understanding of the interplay between attitudes, subjective norms, and perceived 

behavioral control, offering a more nuanced perspective than studies that relied solely on 

one methodological approach. The study’s integration of qualitative and quantitative 

approaches provides a robust understanding of adolescent mental health help-seeking 

behaviors. By adopting a sequential design, the research effectively bridged the gap between 

exploratory and confirmatory analyses, enabling a deeper examination of the predictors of 

help-seeking intentions. The findings underscore the relevance of the TPB framework in 

predicting health-related intentions (Bohon et al., 2016; Tomczyk et al., 2020). 

The study’s strengths lie in its dual-phase design and emphasis on cultural and social 

contexts, which offer valuable insights for tailored interventions. One of the primary 

strengths of this study lies in its mixed-method approach, which allowed for a nuanced 

exploration of the psychosocial factors influencing mental health help-seeking intentions. 

The sequential design effectively combined qualitative findings from Phase 1 with 

quantitative validation in Phase 2, providing a comprehensive understanding of the 

predictors of help-seeking behavior. The application of the TPB framework further added a 

structured lens for analyzing these intentions, with findings aligning closely with established 

literature (Guo et al., 2024). Moreover, the study's emphasis on cultural and social contexts 

enriched its relevance, highlighting how societal norms and support systems influence 

adolescents' behaviors (Kam et al., 2022; Tomczyk et al., 2020). 

However, certain limitations should be noted. First, the sample predominantly 

consisted of adolescents from a rural area, which may limit the applicability of the findings 

to urban or more diverse demographic contexts, so it may limit the generalizability of the 

findings to urban populations. Second, while Phase 1 provided rich qualitative data, the 

reliance on self-reported measures, while practical, introduces the possibility of response 

biases, particularly in a study focusing on sensitive issues like mental health (Boyd et al., 

2011; Cramer, 2016). These limitations underscore the need for future research to include a 

broader range of participants and to consider alternative data collection methods to mitigate 

potential biases. 



Humanitas: Indonesian Psychological Journal 41 
 

Nurlaela Widyarini et.al (Pathways of adolescent intention for mental health help-seeking:…) 

Conclusion 

This study highlights the critical roles of attitudes, subjective norms, and perceived behavioral 

control in shaping adolescents' mental health help-seeking intentions. Positive attitudes 

toward mental health services, significant social influences from parents and teachers, and 

confidence in accessing services emerged as key factors. The sequential design of Phase 1 

and Phase 2 demonstrated the importance of understanding both qualitative beliefs and 

quantitative predictors, reinforcing the utility of the TPB framework in this context. The 

findings suggest that interventions should focus on fostering positive attitudes, strengthening 

supportive social norms, and enhancing perceived control over accessing mental health 

resources. Addressing barriers such as stigma and financial costs while leveraging facilitators 

like online mental health services is essential for improving help-seeking behaviors. Future 

research should consider diverse cultural and urban contexts to further validate these findings 

and develop targeted intervention strategies. 

 

Acknowledgment 

We extend our deepest gratitude to the Majelis Pendidikan Tinggi Penelitian dan 

Pengembangan (Diktilitbang) Pimpinan Pusat Muhammadiyah for their generous funding 

that made this research possible. We are also profoundly thankful to the Lembaga Penelitian 

dan Pengabdian kepada Masyarakat Universitas Muhammadiyah Jember for their invaluable 

technical support throughout this study. Furthermore, we appreciate the cooperation and 

permissions granted by the Pimpinan Daerah Muhammadiyah Kabupaten Jember, as well as 

the school principals within their jurisdiction. Their assistance was crucial for the successful 

implementation of this research. Lastly, we wish to express our sincere thanks to the study 

participants for their willingness to contribute their time and insights, which were essential 

to the completion and success of this study. 

Declarations 

Author contribution. Author 1 was the principal investigator, responsible for leading the 
research project, including the development of the research design, overseeing data 
collection, and conducting the analysis. Author 2 contributed as a co-investigator, supporting 
the data collection process, assisting with the analysis, and helping interpret the findings. Both 
authors were actively involved in the drafting and critical revision of the manuscript, 
contributing to its intellectual content and ensuring the integrity of the study. 
Funding statement. This research was funded by the National Muhammadiyah Research 
Grant, Batch VII, 2024 [Grant Number: 0258.168/I.3/D/2024] 
Conflict of interest. The authors declare no conflict of interest. 
Additional information. No additional information is available for this paper. 
 
 
 
 
 
 
 
 
 
 



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