Trust over Self-Reliance and Stigma: Determinants of Adolescent Mental Health Help-Seeking

Abstract

Adolescent mental health is a critical global public health concern, with approximately one in seven individuals aged 10–19 years experiencing a mental disorder. In the Philippines, suicide ranks as the fourth leading cause of death among adolescents aged 15–19, yet utilization of professional mental health services remains low. This study examined perceived barriers and facilitators to mental health help-seeking among adolescents and explored differences according to age, sex, and religion. A descriptive– comparative design was employed among 263 adolescents aged 15–19 years from Laoag City and Batac City, Ilocos Norte. Proportional stratified random sampling by locality followed by simple random sampling was used. Data were collected using the Barriers to Access to Care Evaluation (BACE) and an adapted facilitators questionnaire. Both instruments underwent cultural adaptation and validation, including forward–backward translation into Iloko, expert content validation, and pilot testing. Acceptable internal consistency was demonstrated, with Cronbach’s alpha coefficients of 0.88 for the BACE and 0.91 for the facilitators scale. Attitudinal barriers exerted the strongest influence on help-seeking, particularly self-reliance, which was moderately perceived as a barrier (M = 1.84, SD = 0.99). Trust emerged as the most influential facilitator, reinforced by family and peer support (M = 1.94, SD = 1.03). A significant sex-based difference was identified in stigma-related barriers (p = .007), with male adolescents reporting higher levels of internalized stigma. These findings underscore the need to address norms of self- reliance, reduce stigma—especially among males—and strengthen trust and mental health literacy through culturally and gender-responsive interventions to improve adolescent mental health service utilization.