Gratitude, parental support, professional help-seeking attitudes for mental health problems among adolescents

ABSTRACT

The current study aims to examine the relationship between gratitude and parental support through the mediation of perceived stress and the influence of parental support on adolescent professional help-seeking for mental health problems. 1987 participants completed the survey, including 41.4% boys and 58.6% girls aged 11–15 years. The findings indicated that (i) parental support mediated the relationship between perceived stress and professional psychological help-seeking attitudes; (ii) perceived stress mediated the effect of gratitude on parental support; (iii) gratitude predicted professional psychological help-seeking attitudes through perceived stress and parental support; and (iv) gratitude predicted positively adolescents’ academic achievement. The study highlights the potential influence of parental support on adolescents’ professional help-seeking attitudes. Mental health services should be developed to be more accessible to adolescents to facilitate more independent help-seeking. Prevention and intervention programmes for adolescents may be more effective at decreasing stress symptoms by combining gratitude interventions.

KEYWORDS:

• Adolescents
• professional help-seeking attitudes
• gratitude
• parental support
• academic achievement

Introduction

Many mental disorders occur in adolescence, and 10% − 20% of children and adolescents worldwide experience mental health issues (WHO, 2017). By the time a person is in their mid-teens, half of all mental disorders have been established (Kessler et al., 2007). In terms of mental health, adolescence is a time of high risk, vulnerability, and stress (Larsen & Luna, 2018; Rickwood et al., 2015). Some studies have discovered that mental disorders in childhood and adolescence are significantly related to mental disorders in adulthood (Himle et al., 2009; Williams et al., 2007). Therefore, potential risk and protective factors in adolescent mental health must be related to alleviating the development and influence of mental illness. Evidence proved that professional help-seeking help people reduce psychological stress and protection from mental health risks (Rickwood et al., 2005). Still, previous findings showed that adolescents disregarded seeking professional help for mental health problems (Divin et al., 2018; Mendoza et al., 2015; Pham et al., 2020; Rickwood et al., 2015). Those have been likely to often ask for help from non-professionals such as friends, family, and relatives (Burns & Rapee, 2006; Green et al., 2005; Van der Ham et al., 2011; Yap et al., 2013). Therefore, it is essential to discover the relationship between parental support, attitude towards seeking professional help, and perceived stress.

Perceived stress and parental support

Adolescence is a transitional and important period for the development of humans, as characterized by brain and body maturation, increased socialization, and the transition to independence. The increase in mental distress can compromise adolescents’ development. Understanding the association between the perceived stress scale and social support is crucial, as social support is a major psychological resource for young people to deal with negative emotional experiences (Zhang et al., 2022). Parental support is critical to an adolescent’s recovery from mental illness. Stress is a complex process that is constantly changing, a negative emotional experience accompanied by physiological, cognitive, and behavioural responses (Bakioğlu et al., 2021). A study in China reported that most adolescents perceived higher levels of stress, showing less social support from family, friends, and other’s support (Zhang et al., 2022). So, when teenagers feel more pressure, they may need more help from their families and other people to deal with the stress.

Perceived stress and help-seeking attitudes

Seeking help for mental health issues requires communicating the need for personal and psychological support to obtain assistance. Help-seeking is an adaptive approach to dealing with mental problems in which people seek help from external sources (Rickwood & Thomas, 2012). These sources involve both informal (friends, family, and teachers) and formal (health services) (Aguirre Velasco et al., 2020). However, a high risk of developing mental disorders is associated with help avoidance in adolescents experiencing general psychological distress (Jorm et al., 2007; Wilson, 2010). Adolescents have negative views of help-seeking and are more likely to find alternative resources for help (friends, teachers, and family) more useful than professional help (Coles et al., 2016; Lubman et al., 2017; Rowe et al., 2014; Singh et al., 2019).

Parental support and help-seeking attitudes

Parental support is significant to the recovery of a child from mental problems. Parents often help their teens get help from a professional when their mental health problems worsen. The role of parents is to strongly encourage children to seek professional help and find appropriate access to services and treatment to support their child’s mental problems. Maiuolo et al. (2019) examined the help-seeking process of adolescents in Australia. They found that the role of parents influenced seeking help and parental social support associated with greater intentions to seek help for mental health issues. It is well-accepted that parents have an influential role in adolescent help-seeking. This finding is especially true when students with higher social support from family were more likely to have positive attitudes towards seeking professional help (Jung et al., 2017; Koydemir-Özden, 2010; Seyfi et al., 2013). Another study observed that adolescents with lower levels of parental support predicted higher professional help-seeking intentions (Clark et al., 2020; LeCloux et al., 2016).

Gratitude and parental support

A grateful disposition is a characteristic of positive psychology defined as the tendency to recognize and express gratitude for one’s positive outcomes and experiences (McCullough et al., 2002). Grateful can be defined as a positive state of mind that occurs when a person decides to do something positive to benefit someone else (Emmons, 2016). Gratitude has been hypothesized to facilitate interactions with others and promote the development of social support (Shiraki & Igarashi, 2018). Deichert et al. (2021) also suggest that gratitude may help strengthen these established relationships. Gratitude and social support have a positive relationship, showing that individuals who reported being more grateful also perceived more social support (Alfieri et al., 2018; Deichert et al., 2021; Wood et al., 2008).

Gratitude and perceived stress

Gratitude has been reviewed as an important psychological resource and a protective factor for adolescents exposed to mental health problems (Duprey et al., 2020). A grateful person will experience more positive life situations at any given time, may recover quickly from stressful life events, and will be able to recognize the contributions that others have made to their well-being (Emmons, 2007; Emmons & Mishra, 2011; Reckart et al., 2017). Several studies on adolescents (Bono & Sender, 2018) and university students (Wood et al., 2007; Yildirim & Alanazi, 2018) found that those with more gratitude perceived reduced stress.

Gratitude and academic achievement

There are relatively few studies that examined how gratitude was associated with academic achievement. According to the broaden-and-build theory (Fredrickson, 2001), grateful students are more likely to experience higher degrees of positive emotions, the broadened thoughts and actions will strengthen social bonds and friendships leading to enduring psychological and social resources over time. These resources could take the form of learning-related outcomes such as higher levels of motivation, academic engagement, and academic achievement within educational settings (King & Datu, 2018). Previous studies have demonstrated that gratitude influenced adolescents’ academic achievement, that is, adolescents with higher levels of gratitude were more likely to gain higher academic achievement (Froh et al., 2011; Ma et al., 2013). Similar to this, our study assumes that gratitude would positively predict academic achievement.

Adolescence is a particularly vulnerable time for the development of poor mental health. Adolescents, in particular, are predisposed to mental health issues but are hesitant to seek professional assistance (Hassett et al., 2018; Long et al., 2020; Maiuolo et al., 2019). Parents significantly impact the process of facilitating professional help-seeking among their children during adolescence. They are frequently the first to notice emotional problems that they suspect result from mental health issues, and they can encourage children to seek professional help. Adolescents are unlikely to self-refer to treatment and rarely seek help from formal resources without the involvement of others (Hassett et al., 2018) so more research is needed to investigate the role of parental support in adolescent professional help-seeking. Therefore, the purpose of our research is to investigate the effect of parental support on adolescent professional help-seeking attitudes for mental health issues. In addition, the present study aims to explore the relationship between gratitude and parental support through the mediation of perceived stress.

Research hypothesis

Hypothesis 1:

Parental support would mediate the relationship between the perceived stress scale and help-seeking attitudes.

Hypothesis 2:

The perceived stress would mediate the relationship between gratitude and parental support.

Hypothesis 3:

Gratitude would predict help-seeking attitudes through perceived stress and parental support.

Hypothesis 4:

Gratitude would positively predict adolescents’ academic achievement.

Materials and methods

Procedures

In this study, the data collection occurred from March 28 to 4 June 2022. We surveyed adolescent students from secondary schools in Da Nang City, Vietnam. All students in each class were invited to participate in the survey and had 20 minutes to complete the whole questionnaire. The researchers were available during the survey session to answer any questions raised by the participants. In addition, an online survey was conducted through Google Forms during the paper survey was in process. Respondents were urged to contact the research team via the specified email or phone number if they needed any explanation at any point while taking the survey. Informed consent was obtained from all the participants. Participants could withdraw at any time, and all responses were kept anonymous and confidential.

The present study adhered to the Declaration of Helsinki regarding research on human participants. The study was approved by the Ethics Committee of the Department of Science and Technology – Ho Chi Minh City University of Education.

Sample

A total of 2037 questionnaires were distributed, of which 1987 were valid. Participants were early adolescents between the ages of 11 and 15 voluntarily participated in the study. The respondents comprised 823 boys (41.4%) and 1164 girls (58.6%). Demographic information is presented in Table 1.

Table 1. Participant Demographic.

Demographic Variable	Category	Frequency (%)
Gender	Boy	823 (41.4)
	Girl	1164 (58.6)
Grade	Grade 6	362 (18.2)
	Grade 7	723 (36.4)
	Grade 8	571 (28.7)
	Grade 9	331 (16.7)

Measurement

To begin with, we translated the scales with the authors’ consent to utilize measurements in our research. The English and Vietnamese versions were translated by a native Vietnamese speaker proficient in English and vice versa. The research team examined the content accuracy and discrepancies between the original and the two versions.

Attitudes towards seeking professional psychological help scale - short form (ATSPPH)

The ATSPPH – Short Form comprises 10 items on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree), with reversed scores for items 2, 4, 8, 9, and 10 (Fischer & Turner, 1970). The ATSPPH-SF in this study was measured using the Vietnamese translation (Tran-Chi et al., 2021) to examine adolescents’ attitudes towards seeking professional psychological help. The Cronbach’s alpha for the Vietnamese version of the ATSPPH-SF was 0.837, indicating good reliability.

Perceived stress scale (PSS)

The 10-item Perceived Stress Scale (PSS-10) (reversed items 4, 5, 7 and 8) was developed by Cohen (1988) to measure the degree to which one perceives aspects of one’s life as out of control, unexpected, and overwhelming. Participants were asked to assess how frequently they have felt or thought a certain way within the previous month using a 5-point Likert scale ranging from 1 (Strongly disagree) to 5 (Strongly agree). The PSS is among the most widely used psychological instruments, has been translated into many languages, and has been used in Vietnam (Dao-Tran et al., 2017). The Cronbach’s alpha for the Vietnamese version of the PSS was 0.8, indicating good reliability.

Parental support (PS)

The Student Social Support Scale (SSSS) was developed by Malecki and Elliott (1999) to measure students’ perceptions of social support from three sources: parents, teachers and peers. The current study utilized the 15-item version of the parental support subscale to measure adolescents’ perceptions of social support from parents only. Participants were asked to rate how frequently they receive support from their parents using a 6-point Likert scale ranging from 1 (Never) to 6 (Always).

Gratitude questionnaire (GQ)

McCullough et al. (2002) developed the 6-item Gratitude Questionnaire (GQ-6) to evaluate individual differences in dispositional gratitude. The items were scored on a 7-point Likert scale, with alternatives ranging from 1 (Strongly disagree) to 7 (Strongly agree), with items 3 and 6 having reversed scores. This scale has been used in previous studies among adolescents (Tran et al., 2022). The Cronbach’s alpha for the Vietnamese version of the GQ was 0.69.

Academic achievement

Our study used the students’ grade point average (GPA) as a measure of academic achievement (AA). The GPA of each student was calculated in all subjects (Mathematics, Literature, English, Science, etc.) and was collected in the second semester, which commences after Lunar New Year and ends in June. The grading system in Vietnam uses a 10-point scale, where 10 is regarded as the highest and 0 is the lowest.

Data analysis

The Social Sciences Statistics Program (SPSS) version 25.0 was used to analyse descriptive statistics. This study used the statistical tool SmartPLS 4 to analyse the data measurement model was conducted first to check indicator reliability, construct reliability, convergent validity, and discriminant validity. The structural equation model was then evaluated via multicollinearity (variance inflation factor – VIF), standardized root means square residual (SRMR), coefficient of determination (R²), cross-validated redundancy (Q²), and the effect size (f²). The hypotheses of the current study were validated using the partial least squares structural equation modelling (PLS-SEM) performed on 1000 bootstrap samples, which was also utilized to examine the mediation hypothesis and analyse the effects of the independent variables on the dependent variables.

Results

Measurement model

Indicator reliability (outer loadings)

The outer loadings of all items were constructed in the initial and modified measurement model. According to Hair et al. (2021), the remaining items displayed acceptable loading factors ranging from 0.4 to 0.9. Except for ATSPPH2, PS14, PSS3, PSS6, PSS7, and PSS9, eliminating these indicators did not improve CR and AVE. After the removal of selected items, the model was reanalysed.

Construct reliability and convergent validity (CA; CR; AVE)

The construct’s reliability is typically examined through Cronbach’s Alpha (CA), Composite Reliability (CR) and the validity of measurements is evaluated through Average Variance Extracted (AVE) (Hair et al., 2011). The CA and CR, AVE values are presented in Table 2. The values of AVE for all scales were less than 0.5. In the case of AVE was less than 0.5 but the CR value was higher than 0.6, the convergent validity was still adequate (Fornell & Larcker, 1981). The results indicated that the reliability and validity values were satisfactory.

Table 2. Reliability and validity statistics.

	Cronbach’s α	Composite reliability (CR)	Average variance extracted (AVE)
ATSPPH	0.66	0.644	0.237
GQ	0.786	0.793	0.497
PS	0.928	0.927	0.483
PSS	0.736	0.711	0.202

Abbreviations: ATSPPH, attitudes towards seeking professional psychological help; GQ, gratitude questionnaire; PS, parental support; PSS, perceived stress scale.

Discriminant validity (HTMT)

Bootstrap confidence intervals can be used to test if the HTMT is significantly different from 1.0 (Henseler et al., 2015) or a lower threshold value, such as 0.9 or 0.8 (Hair et al., 2017). The HTMT ratio results showed that all the constructs were below 0.85 thresholds, which is presented in Table 3.

Table 3. Discriminant validity assessment using the HTMT criterion.

	AA	ATSPPH	GQ	PS	PSS
AA
ATSPPH	0.21
GQ	0.191	0.436
PS	0.19	0.367	0.472
PSS	0.136	0.362	0.275	0.49

Abbreviations: ATSPPH, attitudes towards seeking professional psychological help; GQ, gratitude questionnaire; PS, parental support; PSS, perceived stress scale, AA, academic achievement.

Structural model

Collinearity statistic (VIF)

The VIF value should be close to 3 and lower, resulting in the impossibility of a collinearity issue (Hair et al., 2019). The VIF values of constructs in the study were lower than 3. Therefore, the collinearity of latent variables was not a problem.

Model fit (SRMR)

A value less than 0.09 and of 0.08 are considered a good fit (Hair et al., 2018). The SRMR result in this study was less than 0.08, indicating that the model was a good fit (shown in Table 4).

Table 4. Structural model estimates.

Construct	R^2	Q^2	SRMR
AA	0.034	0.027
ATSPPH	0.261	0.104	0.076
PS	0.388	0.174
PSS	0.084	0.048

Abbreviations: ATSPPH, attitudes towards seeking professional psychological help; PS, parental support; PSS, perceived stress scale, AA, academic achievement.

Coefficient of determination (R²)

R² values of 0.75, 0.50, or 0.25 for endogenous latent variables in the structural model can be described as substantial, moderate, or weak, respectively (Hair et al., 2011). In our study, the R² value 0.261 showed that PSS and PS caused 26.1% variance in ATSPPH (referred to Table 4).

Cross-validated redundancy (Q²)

Q² greater than 0 means that the PLS-SEM model predicts the given endogenous variable. The present study showed Q² values larger than 0, indicating the predictive relevance of the present study model (Taylor & Geldenhuys, 2019) (shown in Table 4)

The effect size (f2)

The values of f² for weak, moderate and strong effect sizes are 0.02, 0.15, and 0.35, respectively (Hair et al., 2021). The effect size of f² in this study showed a relatively moderate effect of PSS on PS (0.239) and weak effects of PS on ATSPPH (0.02) and PSS on ATSPPH (0.015).

Results of PLS-SEM analysis

Figure 1 shows the final PLS model. We found that 26.1% of the variance in the ATSPPH was explained by GQ, PS, PSS, and AA. PLS showed that 38.8% of the variance in the PS could be explained by the regression on GQ, PSS, and AA, while 8.4% of the variance in the PSS and 3.4% of the variance in the AA were explained by GQ. Also, the specific indirect effects showed that most of the paths from the input variables to the output variables were significant. For example, the effect of PSS on the ATSPPH was mediated by PS.

Figure 1. A structural model.

The results from Table 5 indicate the positive effects of AA on ATSPPH (β = 0.106; t = 3.647; p < 0.001) and PS (β = 0.082; t = 3.683; p < 0.001). There were positive effects of GQ (β = 0.185; t = 7.333; p < 0.001) on AA (H4 accepted), ATSPPH (β = 0.316; t = 8.899; p < 0.001), PS (β = 0.348; t = 13.784; p < 0.001). While there was a negative effect of GQ (β = −0.290; t = 11.193; p < 0.001) on PSS. PS had a positive effect on ATSPPH (β = 0.154; t = 3.796; p < 0.001). Besides, the findings showed that PSS had negative effects on ATSPPH (β = −0.124; t = 2.450; p = 0.014) and PS (β = −0.400; t = 17.161; p < 0.001).

Table 5. Hypothesis testing.

Path	β coefficient	t-value	95% confidence intervals	95% BC confidence intervals
Direct effect
AA ➔ ATSPPH	0.106	3.647***	[0.045; 0.158]	[0.046; 0.158]
AA ➔ PS	0.082	3.683***	[0.039; 0.127]	[0.036; 0.124]
GQ ➔ AA	0.185	7.333***	[0.135; 0.235]	[0.139; 0.236]
GQ ➔ ATSPPH	0.316	8.899***	[0.249; 0.388]	[0.248; 0.384]
GQ ➔ PS	0.348	13.784***	[0.299; 0.395]	[0.303; 0.397]
GQ ➔ PSS	−0.290	11.193***	[−0.346; −0.244]	[−0.341; −0.237]
PS ➔ ATSPPH	0.154	3.796***	[0.079; 0.234]	[0.080; 0.234]
PSS ➔ ATSPPH	−0.124	2.450**	[−0.227; −0.025]	[−0.212; −0.012]
PSS ➔ PS	−0.400	17.161***	[−0.449; −0.356]	[−0.441; −0.350]
Indirect effect
GQ ➔ PSS ➔ PS	0.116	10.366***	[0.098; 0.140]	[0.096; 0.138]
PSS ➔ PS ➔ ATSPPH	−0.062	3.715***	[−0.095; −0.032]	[−0.095; −0.032]
GQ ➔ PSS ➔ PS ➔ ATSPPH	0.018	3.622***	[0.009; 0.028]	[0.009; 0.028]

***p < 0.001, **p < 0.05.

Abbreviations: ATSPPH, attitudes towards seeking professional psychological help; GQ, gratitude questionnaire; PS, parental support; PSS, perceived stress scale, AA, academic achievement.

The results also showed that the indirect effect of PSS between the relationship GQ and PS was positive and statistically significant (β = 0.116, t = 10.366, p < 0.001) (H2 accepted). Another finding showed that the indirect effect of PS between the relationship PSS and ATSPPH was negative and statistically significant (β = −0.062, t = 3.715, p < 0.001) (H1 accepted). The present study indicated that the indirect effect of GQ on ATSPPH (β = 0.018, t = 3.622, p < 0.001) through PSS and PS (H3 accepted).

Discussion

This study aimed to explore the influence of parental support on the association between perceived stress and attitude towards professional help-seeking among adolescents. In addition, the study illuminated the relationship between gratitude and parental support through the mediated model of perceived stress.

One finding suggested that parental support partially mediated the relationship between perceived stress and professional psychological help-seeking attitudes among adolescents. The partial mediation indicated that parental support played a dual role, acting both directly and indirectly in professional help-seeking attitudes. This result is consistent with the findings of previous studies that adolescents with mental health needs tend to access fewer professional services for their problems (Rickwood et al., 2007; Zhang et al., 2022). This finding might be explained by the fact that these early adolescents have difficulty accessing mental health services and recognizing a need for professional help (Barker et al., 2005; Wilson, 2010). These adolescents believe it is inappropriate to discuss private issues with professionals (Rickwood et al., 2007; Wilson et al., 2011). Therefore, parents might play a potential role in adolescents’ professional help-seeking attitudes (Rickwood et al., 2007). This finding showed that parents recognize their children’s mental health problems, can find the appropriate sources of help, and then encourage their children to seek professional help.

Additionally, perceived stress mediated the effect of gratitude on parental support. The results indicate that gratitude leads to lower perceived stress, which affects parental support for adolescents. The current findings are consistent with previous results showing that gratitude positively affects social support, and individuals with gratitude receive more social support (Alfieri et al., 2018; Deichert et al., 2021; Wood et al., 2008). Moreover, gratitude is crucial in protecting adolescents from mental health problems (Duprey et al., 2020). Several studies suggest that adolescents with more gratitude express less stress (Bono & Sender, 2018; Wood et al., 2007; Yildirim & Alanazi, 2018).

The results are directly in line with previous findings claiming that adolescents with higher stress levels show less social support from family, friends, and other sources (Zhang et al., 2022). Family plays a crucial role in adolescent development (Huston & Bentley, 2010). The level of parental support for daily challenges and difficulties can affect adolescents’ psychological well-being (Luthar & Sexton, 2007; Pfefferbaum et al., 2014).

Findings obtained from the serial mediation analyses showed that gratitude predicted professional psychological help-seeking attitudes through perceived stress and parental support. According to our findings, the effects of perceived stress and parental support on the relationship between gratitude and attitude towards seeking professional assistance are significant. These findings are consistent with previous studies, which find that gratitude has a negative influence on perceived stress (Bono & Sender, 2018) and a positive influence on seeking professional help (Siegel & Thomson, 2017), and that parental support has a positive influence on attitude towards seeking professional help (Jung et al., 2017; Koydemir-Özden, 2010; Seyfi et al., 2013). The findings inform the current study of a recent study by Hill et al. (2013), which discovered that grateful people have better psychological health, were more likely to engage in healthy activities, and were more willing to seek help when needed.

The current study also found that adolescents with higher levels of gratitude were more likely to attain higher academic achievement, which is familiar with the details presented in previous studies (Froh et al., 2011; Ma et al., 2013; Wu et al., 2020). Gratitude has a positive role in academic engagement, leading to successful academic achievement (Zhen et al., 2021).

Limitation

There are some limitations in the present study that should be considered. The data are cross-sectional, which would not illustrate the influence of parental support on the relationship between perceived stress and attitude towards seeking professional help among participants. Future research should design longitudinal studies and experimental research to clarify the causality of those factors. The current research only examines the relationship between parental factors and attitude towards seeking professional help, gratitude with parental support. In terms of the potential benefits of gratitude to adolescents, future research should apply gratitude to adolescents’ relations with peers and teachers. Adolescents will build trust with people who are attempting to assist them if they feel respected and can focus on those that they appreciate. Thus, it is recommended that future research examine the role of peers and teacher support in facilitating help-seeking for mental health problems. Before doing the survey, students should be given academic information about professional help to ensure they fully understand it.

Implication

Despite the limitations mentioned above, the current study provides novel findings on the role of parental support, one of the sources of social support, in facilitating the attitude towards seeking professional help among adolescents in Vietnam who have mental health problems. Our results have several possible implications for prevention science and clinical practice. These results, however, are preliminary. More basic and applied research are needed to assess how parental support, gratitude, and stress affect adolescent attitude towards seeking professional help. The findings highlight the critical role of social support in adolescent help-seeking attitudes, indicating that parental support was associated with higher levels of adolescent professional help-seeking attitudes. Parental support may promote positive attitudes towards seeking professional help, providing evidence that requires more experimental research. Increasing students’ social networks and social support systems can help them feel more open to getting help from professionals. Parents should be provided more information about mental health and professional help services to get their kids professional help when needed. The study’s results have clinical practice implications for those who work with adolescents and their families. The findings emphasize the significance of the role of adults in adolescent help-seeking attitudes and the difficulty which adolescents encounter when looking for assistance without the influence of others. Our study may be used to inform the development of gratitude interventions that target Vietnamese adolescents. The current study showed that being grateful was linked to adolescents experiencing less stress. Prevention and intervention programmes for adolescents may be more effective at decreasing stress symptoms by combining gratitude interventions.

The present findings highlight that most adolescents with mental health issues experience negative seeking help attitude from professional services. It is essential that developing methods to make adolescent mental health services more accessible to young people is crucial for facilitating more independent help-seeking. Providing information about mental health services in an easily accessible online format and developing appropriate information for adolescents on how to seek help, especially for those who do not have an adult to confide in. It is possible that the provision of support within schools could be utilized further to facilitate this. Stress literacy-based interventions should focus on some areas, such as (i) teaching adolescents about the symptoms and signs of stress so they can identify it in the early stages; (ii) increasing their understanding of the potential benefits; (iii) raising their awareness of the roles and responsibilities of mental health professionals; (iv) ensuring school counsellors receive adequate training to serve as competent mental health literacy advocates; (v) enhancing adolescents’ mental illness understanding to prevent the development of stigma.

Conclusion

Parental supports were found to have a highly influential role in seeking professional help attitudes, particularly those highly accessible to their children. Once adolescents received their parents’ support, they could frequently find it easier to seek further assistance independently. The findings have implications for clinical practices, emphasizing that mental health services should be established more accessible to encourage more self-directed help-seeking. More information about mental health and professional help services should be made available to parents to get adolescents help when needed. Future research should consider informal support as a powerful resource for improving adolescents’ mental health.

Acknowledgments

The authors are grateful to the students for their support in the data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).