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Background  Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated.    Methods  University and secondary school students from low-income households ( N  = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI).    Results  Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = −.258,  p  < .001), general help-seeking attitude (r = .156,  p  = .027), and age (r = .187,  p  < .001). However, the strongest predictor for mental help-seeking attitude was self-stigma on seeking help (F (2,199) = 8.207,  p  < .001 with R 2  of .076). University students had better depression literacy and lower levels of self-stigma and negative beliefs toward mental illness compared to secondary school students.    Conclusion  Higher self-stigma and younger age were associated with negative mental help-seeking attitudes among students from low-income households. As self-stigma may be a barrier to actual mental help-seeking, efforts to reduce self-stigma in this population need to be intensified.

bmc public health

Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia