Help-seeking preferences and barriers for mental health problems among university students in Portugal, Germany, and Sweden

Background: Mental health problems are prevalent among university students, underscoring the need to improve access to effective interventions. Mental healthcare utilization is influenced by general and country-specific factors. This study aimed to identify and compare preferences and barriers to help-seeking for mental health problems among university students in three European countries. Methods: A cross-sectional, web-based survey was conducted with a sample of 4960 university students from Portugal (n = 3399), Germany (n = 680), and Sweden (n = 881). Depressive symptoms (9-item Patient Health Questionnaire) and overall mental health (5-item Mental Health Index) were assessed. Students responded to questions regarding help-seeking preferences for and barriers to mental health problems. Results: Rates of moderate to severe depressive symptoms ranged from 37.5 to 51.0 % and were highest among German students. A majority (76.3–89.3 %) of students indicated they would talk to a friend in case of mental health problems. Readiness to seek help was particularly high among Portuguese students. Readiness to use internet-based interventions was low among all students. Up to 51 % of students reported uncertainty regarding where they could seek help. Students with depressive symptoms versus those without were less likely to speak with a friend about emotional problems but were more likely to consider taking medications. Students with depressive symptoms were also more likely to endorse several help-seeking barriers. Conclusion: Reducing structural barriers, improving awareness of treatment options and increasing acceptance of help-seeking for emotional problems may improve uptake of mental health services among students in these European countries.