A study on the influencing factors of Chinese vocational high school students' attitudes towards seeking psychological help - an empirical analysis based on mixed research methods

In China, vocational high school students frequently encounter mental health challenges; however, they often exhibit largely unfavourable attitudes towards seeking psychological help, a situation demanding urgent attention. Our study aimed to comprehensively investigate the key factors influencing these students' psychological help-seeking attitudes and their complex interrelationships. We adopted a mixed-methods approach, commencing with in-depth interviews involving 28 vocational high school students. Drawing on grounded theory principles informed by the interview data and relevant literature, we identified crucial factors and constructed a hypothetical model. Subsequently, questionnaires were administered to 465 vocational high school students across six schools, yielding 417 valid responses. Thematic analysis using grounded theory indicated that self-stigma, public stigma, mental health literacy, and perceived social support emerged as significant variables predicting psychological help-seeking attitudes. Questionnaire results further confirmed that vocational high school students generally hold reserved attitudes towards seeking psychological health support. Structural equation modelling revealed that self-stigma and public stigma had a significant negative impact on help-seeking attitudes, whilst mental health literacy and perceived social support exerted a positive influence. Notably, perceived social support demonstrated the strongest positive effect, and public stigma the most negative. Furthermore, self-stigma was found to play a mediating role between mental health literacy and attitudes towards seeking psychological help. Both self-stigma and public stigma also mediated the relationship between perceived social support and attitudes towards seeking psychological help. To foster more positive psychological help-seeking attitudes among students, it is crucial to enhance the quality of mental health education in vocational high schools and strengthen emotional support from significant others.