Understanding mental health literacy, stigma, and help-seeking attitudes among university students in the Maldives: a mediation analysis

Despite heightened awareness of mental health concerns among university students, considerable disparities remain in their help-seeking behaviors and use of mental health services. Previous research has highlighted the potential role of mental health literacy in shaping help-seeking attitudes and reducing stigma related to seeking mental health help, but there is a lack of empirical data from the Maldives. This study aimed to address this gap by examining the associations between mental health literacy, stigma related to seeking mental health help (self-stigma and societal stigma), and help-seeking attitudes among Maldivian university students. A quantitative cross-sectional design was employed, involving 225 university students aged 18–35 from five tertiary institutions in the Maldives. Data were collected via an online survey comprising demographic questions, the Mental Health Literacy Scale (MHLS), the Stigma Scale for Receiving Psychological Help (SSRPH), the Self-Stigma of Seeking Help Scale (SSOSH), and the Mental Help Seeking Attitudes Scale (MHSAS). Statistical analyses, including multiple linear regression and parallel mediation analysis, were conducted using SPSS. The results showed that higher mental health literacy was positively associated with more favorable help-seeking attitudes and with lower levels of self-stigma and societal stigma related to seeking help. Conversely, greater levels of self-stigma and societal stigma were associated with less favorable help-seeking attitudes. Additionally, self-stigma and societal stigma showed significant statistical mediating associations in the relationship between mental health literacy and help-seeking attitudes. These results underscore the importance of enhancing mental health literacy and addressing help-seeking stigma to support positive attitudes toward seeking help. While the cross-sectional design limits causal inference, this study provides valuable preliminary insights for developing mental health interventions and policies in the Maldives.