Navigating the Thresholds of Mental Health Help-Seeking among University Students in the Philippines: A Qualitative Interpretive Study

University students experiencing psychological distress do not always seek help, even when support is available. Less is known about how students interpret distress, disclosure, and different sources of support, particularly in the Philippine context. This qualitative interpretive study examined how university students in the Philippines made sense of psychological distress and help-seeking. Ten undergraduate students were recruited through an open online call and participated in asynchronous semi-structured written interviews conducted via email. Data were analyzed using reflexive thematic analysis. Although the written format supported private and reflective disclosure, it limited opportunities for immediate probing during participants' initial responses. Five interrelated themes were developed: (1) distress became actionable when endurance was no longer enough; (2) disclosure required permission to be vulnerable; (3) trusted relationships made help-seeking safer; (4) professional help became possible through clarity, trust, and emotional safety; and (5) silence was socially learned and continually reinforced. Across participants' accounts, self-reliance shaped whether distress was considered serious enough to warrant help; vulnerability influenced the acceptability of disclosure; trust shaped perceptions of potential sources of support; and clarity, confidentiality, and emotional safety influenced perceptions of professional care. These thematic relationships are interpreted as negotiated thresholds, referring to participants' judgments about need, disclosure, trust, and the acceptability of support rather than a temporal sequence or developmental pathway. The findings suggest that universities should complement the provision of counseling services with conditions that normalize early disclosure, strengthen trusted sources of informal support, clarify access and confidentiality procedures, and make professional care more understandable and approachable.