Barriers and facilitators to mental health help-seeking among Indigenous university students

The transition to university is a complex developmental period associated with elevated psychological distress and low rates of mental health help-seeking. Indigenous students’ unique experiences with mental health help-seeking in post-secondary contexts, shaped by ongoing colonial legacies, remain largely unexplored. This mixed-methods study examined barriers and facilitators to mental health help-seeking among Indigenous undergraduate students, and their associations with university adjustment, internalizing psychopathology, and help-seeking intentions. Fifty Indigenous and 188 White/European undergraduates at the University of British Columbia completed self-report questionnaires, and a subset of nine Indigenous students participated in semi-structured interviews. Quantitative analyses suggested that, across demographic groups, logistical challenges and lack of time, and normalization/encouragement, were the most endorsed barriers and facilitators, respectively. Relative to White/European students, Indigenous students more strongly endorsed barriers related to concerns about healthcare providers and cultural factors. University adjustment and internalizing psychopathology were predicted by interpersonal barriers concerning the healthcare provider (e.g., fear of not being understood) and the burden of accessing care (e.g., effort required), in particular. Qualitative results highlighted the importance of culturally affirming care for Indigenous students. Findings point to systems-level opportunities to improve access to care and better support Indigenous university students.