Professional help seeking for suicidal ideation among Chinese and Australian university students
Date
2017
Authors
Han, Jin
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Abstract
Introduction: Suicide is a leading cause of death among the
university-aged population. Alarmingly, a large proportion of
students with suicidal ideation or behaviour do not seek help
from health services. This thesis aims to identify the factors
associated with professional help seeking for suicidal ideation
among Chinese and Australian university students and to develop a
trial online program to facilitate help seeking.
Methods: A systematic review was conducted to identify factors
that may influence professional help seeking for suicidal
ideation and behaviour. Two hundred and eight Chinese university
students and 128 Australian university students were subsequently
recruited to complete an online cross-sectional survey to further
test the influence of the identified factors on professional help
seeking for suicidal ideation. The results of this survey were
then used to guide the development of a two-module online
psychoeducational program (ProHelp). The effectiveness of this
program was evaluated through a pilot randomised controlled study
of 156 Chinese university students and 101 Australian university
students.
Results: Low perceived need for treatment, great self-reliance,
low suicide literacy, and stigmatising attitudes were identified
as important barriers to professional help seeking in both the
systematic review and the cross-sectional surveys. In particular,
greater self-reliance was significantly associated with negative
help-seeking attitudes for suicidal ideation in both China and
Australia. Attribution of suicidal individuals to isolation (p =
.035) was negatively associated with help-seeking attitudes in
China, while glorification (p = .008) and stigmatising attitudes
(p = .025) of suicidal individuals were negatively associated
with help-seeking beliefs and attitudes respectively in
Australia. Limited suicide prevention knowledge (p = .042) in
China and less supportive family relationship (p = .006) in
Australia were associated with lower help-seeking beliefs. Two
self-recognised barriers, “I prefer to deal with issues on my
own” and “I question how serious my needs are” were
identified in both China and Australia. Self-reliance, suicide
literacy, suicide attitudes and social support were found to
influence help-seeking and thus formed the basis of the ProHelp
intervention. Although no significant effect of the intervention
on professional help-seeking beliefs or intentions was found,
both groups’ help-seeking attitudes increased during the study
(p = .003 for the post-test survey, and p = .008 for the
follow-up survey). The experimental group in both countries
demonstrated a significant improvement in suicide literacy at the
post-test survey (p = .015). Qualitative feedback indicated that
the ProHelp program was generally user-friendly, clear, and
helpful.
Conclusion: The current thesis identified and tested the impact
of self-reliance, suicide literacy, suicide attitudes, and social
support on professional help-seeking for suicidal ideation among
university students. It also provided initial evidence that a
brief online psychoeducational program could enhance university
students’ suicide literacy in both China and Australia.
Although increasing suicide literacy was not sufficient to
improve students’ help seeking, effect sizes indicated that
this low-intensity online approach showed promise in encouraging
more positive beliefs towards help seeking among young people.
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Keywords
Suicide, help seeking, university students
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Thesis (PhD)
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