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Author ORCID Identifier

https://orcid.org/0000-0001-5217-4051

Date Available

6-16-2026

Year of Publication

2026

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Education

Department/School/Program

Educational, School, and Counseling Psychology

Faculty

Joseph H. Hammer

Faculty

Kathleen Aspiranti

Abstract

Objective: To examine whether modifiable factors shape the extent to which help-seeking intention is translated into formal mental health service initiation among distressed adults. Method: Participants were U.S. adults (N = 777; M age = 47.21 years, SD = 16.70; 73.23% women; 77.74% White) who reported at least moderate psychological distress and were not currently receiving formal mental health treatment. At baseline, participants completed measures of help-seeking intention, focal moderators (action planning, psychological distress, and mental health steward self-identity), coping planning, cues to action, and emotion regulation as exploratory candidate moderators. At three-month follow-up, participants reported whether they had initiated formal mental health services. Latent moderated structural equation modeling tested focal moderators and exploratory candidate moderators. Results: Intention robustly predicted subsequent formal service initiation, but only 15.57% of participants initiated services during follow-up. Action planning strengthened the intention–behavior association, whereas psychological distress weakened it while also predicting (main effect) greater overall service initiation. Mental health steward self-identity did not predict behavior or moderate the intention–behavior association. No significant moderation emerged for exploratory candidate moderators. Conclusions: Among distressed adults not currently receiving care, intention was a robust but insufficient predictor of formal service initiation. Action planning may serve as a bridge process between intention and initiating care, whereas greater distress may reduce the extent to which intention distinguishes between those who follow through and those who do not.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2026.323

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