Author ORCID Identifier

https://orcid.org/0000-0002-0511-028X

Date Available

9-10-2026

Year of Publication

2024

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Nursing

Department/School/Program

Nursing

Advisor

Okoli, Chizimuzo

Abstract

Supporting the mental health of university/college students is a crucial issue facing institutions of higher learning in the U.S. A web-based survey encompassing 196 campuses in the U.S. found that rates of diagnosed mental illness among college students has significantly increased in the last decade from 21.7% in 2007 to 35.5% in 2017 (Lipson et al., 2019). Despite the availability of mental health services within universities/colleges, students with mental health problems do not often utilize these services. Recognizing the significance of assessing the mental health of nursing students is paramount, as evident from a study where 35% of 170 participants reported psychological distress (Papazisis et al., 2008). Notably, a further exploration by McKee-Lopez et al. (2019) revealed a correlation between elevated Adverse Childhood Experiences (ACEs) scores and heightened levels of depression among nursing students, underscoring the importance of addressing and supporting their mental well-being. Due to the increase in the number of university/college students who are experiencing mental health problems, it is critical to understand the factors influencing students' intentions and behaviors regarding the utilization of mental health services. Therefore, the purpose of this dissertation was to understand the barriers that hinder nursing students from seeking help for mental health issues, as well as to explore their intentions regarding the utilization of mental health services in the United States. The specific aims were to: 1) systematically review the literature to examine the barriers and facilitators influencing help-seeking for mental health services among university/college students; 2) psychometrically examine the Mental Health Help-Seeking Scale (MHHSS) that was developed based on the Theory of Planned Behavior (TPB) to explore nursing students’ intentions toward seeking mental health services in the United States; and 3) examine the frequency of Adverse Childhood Experiences (ACEs) and psychological distress among nursing students, and to determine if they moderate the relationship between attitudes, subjective norms, and perceived behavioral control and intentions to seek mental help.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2024.378

Available for download on Thursday, September 10, 2026

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