Unveiling the stigma: Exploring help-seeking attitudes among Muslim students in a school with a dual education system in Brunei Darussalam
List of Authors
  • Aziz Zulazmi Samsudin , Siti Norhedayah Abdul Latif

Keyword
  • Mental Health Help-Seeking Attitude (MHSA), Public stigma, School counselling, Self-stigma, Self-Stigma of Seeking Help (SSOSH), Well-being.

Abstract
  • The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek help. Stigma surrounding mental health services continues to be the most prevalent barrier to help-seeking behaviour. Alternative barriers have emerged that are both personal and public in nature and can have a substantial impact on students’ preferences to seek help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with a dual education system to explore both their self-stigma of seeking help (SSOSH) and mental health help-seeking attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomenon of help-seeking by students and understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favourable attitude towards counselling help. There was no significant difference in gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend in the relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendations made by students for addressing barriers to counselling and facilitating their counselling needs for the improvement of their mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped that it will serve as a guide for policymakers to consider the provision of mental health services that are more appealing to the students’ mental and academic well-being.

Reference
  • 1. Ang, R., Lim, K., Tan, A., & Yau, T. (2004). Effects of gender and sex role orientation on help-seeking attitudes. Current Psychology, 23(3), 203-214. https://doi.org/10.1007/s12144-004-1020-3 2. Arslan, G., Allen, K., & Tanhan, A. (2020). School Bullying, Mental Health, and Wellbeing in Adolescents: Mediating Impact of Positive Psychological Orientations. Child Indicators Research, 14(3), 1007-1026. https://doi.org/10.1007/s12187-020-09780-2 3. Ben-Porath, D. (2002). Stigmatization of Individuals Who Receive Psychotherapy: An Interaction Between Help-seeking Behavior and the Presence of Depression. Journal Of Social and Clinical Psychology, 21(4), 400-413. https://doi.org/10.1521/jscp.21.4.400.22594 4. Brenner, R., Engel, K., Vogel, D., Tucker, J., Yamawaki, N., & Lannin, D. (2018). Intersecting cultural identities and help-seeking attitudes: the role of religious commitment, gender, and self-stigma of seeking help. Mental Health, Religion & Culture, 21(6), 578-587. https://doi.org/10.1080/13674676.2018.1519782 5. Cage, E., Stock, M., Sharpington, A., Pitman, E., & Batchelor, R. (2018). Barriers to accessing support for mental health issues at university. Studies In Higher Education, 45(8), 1637-1649. https://doi.org/10.1080/03075079.2018.1544237 6. Cheng, H., Kwan, K., & Sevig, T. (2013). Racial and ethnic minority college students' stigma associated with seeking psychological help: Examining psychocultural correlates. Journal Of Counseling Psychology, 60(1), 98-111. https://doi.org/10.1037/a0031169 7. Cheng, H., Wang, C., McDermott, R., Kridel, M., & Rislin, J. (2018). Self-Stigma, Mental Health Literacy, and Attitudes Toward Seeking Psychological Help. Journal Of Counseling & Development, 96(1), 64-74. https://doi.org/10.1002/jcad.12178 8. Clark, L., Hudson, J., Dunstan, D., & Clark, G. (2018). Barriers and facilitating factors to help‐seeking for symptoms of clinical anxiety in adolescent males. Australian Journal of Psychology, 70(3), 225-234. https://doi.org/10.1111/ajpy.12191 9. Clough, B., Nazareth, S., Day, J., & Casey, L. (2018). A comparison of mental health literacy, attitudes, and help-seeking intentions among domestic and international tertiary students. British Journal of Guidance & Counselling, 47(1), 123-135. https://doi.org/10.1080/03069885.2018.1459473 10. Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614-625. 11. Corrigan, P., Watson, A., & Barr, L. (2006). The Self–Stigma of Mental Illness: Implications for Self–Esteem and Self–Efficacy. Journal of Social and Clinical Psychology, 25(8), 875-884. https://doi.org/10.1521/jscp.2006.25.8.875 12. Crowe, A., Mullen, P., & Littlewood, K. (2018). Self-Stigma, Mental Health Literacy, and Health Outcomes in Integrated Care. Journal Of Counseling & Development, 96(3), 267-277. https://doi.org/10.1002/jcad.12201 13. Drum, D. J., Brownson, C., Denmark, A. B., & Smith, S. E. (2009). New data on the nature of suicidal crises in college students: Shifting the paradigm. Professional Psychology: Research and Practice, 40(3), 213-222 14. Duong, M., Bruns, E., Lee, K., Cox, S., Coifman, J., Mayworm, A., & Lyon, A. (2020). Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis. Administration And Policy in Mental Health and Mental Health Services Research, 48(3), 420-439. https://doi.org/10.1007/s10488-020-01080-9 15. Fogaca, J. (2019). Combining Mental Health and Performance Interventions: Coping and Social Support for Student-Athletes. Journal Of Applied Sport Psychology, 33(1), 4-19. https://doi.org/10.1080/10413200.2019.1648326 16. Greenidge, W., & Daire, A. (2010). The Relationship Between Emotional Openness and the Attitudes Towards Seeking Professional Counseling of English-Speaking Caribbean College Students. International Journal for The Advancement of Counselling, 32(3), 191-201. https://doi.org/10.1007/s10447-010-9100-6 17. Gulliver, A., Griffiths, K., & Christensen, H. (2012). Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study. BMC Psychiatry, 12(1). https://doi.org/10.1186/1471-244x-12-157 18. Hammer, J., Parent, M., & Spiker, D. (2018). Mental Help Seeking Attitudes Scale (MHSAS): Development, reliability, validity, and comparison with the ATSPPH-SF and IASMHS-PO. Journal Of Counseling Psychology, 65(1), 74-85. https://doi.org/10.1037/cou0000248 19. Hartman, L., Michel, N., Winter, A., Young, R., Flett, G., & Goldberg, J. (2013). Self-Stigma of Mental Illness in High School Youth. Canadian Journal of School Psychology, 28(1), 28-42. https://doi.org/10.1177/0829573512468846 20. Hilliard, R., Redmond, L., & Watson, J. (2019). The Relationships Among Self-Compassion, Stigma, and Attitudes Toward Counseling in Student-Athletes. Journal Of Clinical Sport Psychology, 13(3), 374-389. https://doi.org/10.1123/jcsp.2018-0027 21. Ibrahim, N., Amit, N., Shahar, S., Wee, L., Ismail, R., & Khairuddin, R. et al. (2019). 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. BMC Public Health, 19(S4). https://doi.org/10.1186/s12889-019-6862-6 22. Johnstone, M. J. (2001). Stigma, social justice and the rights of the mentally ill: Challenging the status quo. Australian and New Zealand Journal of Mental Health Nursing, 10, 200-209. 23. Kakhnovets, R. (2011). Relationships Among Personality, Expectations About Counseling, and Help-Seeking Attitudes. Journal of Counseling & Development, 89(1), 11-19. https://doi.org/10.1002/j.1556-6678.2011.tb00056.x 24. Kim, E., Yu, J., & Kim, E. (2020). Pathways linking mental health literacy to professional help‐seeking intentions in Korean college students. Journal Of Psychiatric and Mental Health Nursing, 27(4), 393-405. https://doi.org/10.1111/jpm.12593 25. Knight, K., Gibson, K., & Cartwright, C. (2018). “It's like a refuge”: Young people's relationships with school counsellors. Counselling And Psychotherapy Research, 18(4), 377-386. https://doi.org/10.1002/capr.12186 26. Latalova, K., Kamaradova, D., & Prasko, J. (2014). Perspectives on perceived stigma and self-stigma in adult male patients with depression. Neuropsychiatric Disease and Treatment, 1399. https://doi.org/10.2147/ndt.s54081 27. Lee, H., Hwang, J., Ball, J., Lee, J., Yu, Y., & Albright, D. (2020). Mental Health Literacy Affects Mental Health Attitude: Is There a Gender Difference? American Journal of Health Behavior, 44(3), 282-291. https://doi.org/10.5993/ajhb.44.3.1 28. Low, P. (2014). Looking in from the outside: community counsellors’ opinions and attitudes to school counselling in Singapore. Pastoral Care In Education, 32(4), 295-305. https://doi.org/10.1080/02643944.2014.974663 29. Low, P. (2015). School counselling in Singapore: teachers’ thoughts and perceptions. Asia Pacific Journal of Counselling and Psychotherapy, 6(1-2), 17-27. https://doi.org/10.1080/21507686.2014.1002801 30. Low, S., Kok, J., & Lee, M. (2013). A holistic approach to school-based counselling and guidance services in Malaysia. School Psychology International, 34(2), 190-201. https://doi.org/10.1177/0143034312453398 31. Lynass, R., Pykhtina, O., & Cooper, M. (2012). A thematic analysis of young people's experience of counselling in five secondary schools in the UK. Counselling And Psychotherapy Research, 12(1), 53-62. https://doi.org/10.1080/14733145.2011.580853 32. Mackenzie, C., Knox, V., Gekoski, W., & Macaulay, H. (2004). An Adaptation and Extension of the Attitudes Toward Seeking Professional Psychological Help Scale1. Journal Of Applied Social Psychology, 34(11), 2410-2433. https://doi.org/10.1111/j.1559-1816.2004.tb01984.x 33. Martínez-Hernáez, A., DiGiacomo, S., Carceller-Maicas, N., Correa-Urquiza, M., & Martorell-Poveda, M. (2014). Non-professional-help-seeking among young people with depression: a qualitative study. BMC Psychiatry, 14(1). https://doi.org/10.1186/1471-244x-14-124 34. McKenzie, K., Murray, K., Murray, A., & Richelieu, M. (2015). The effectiveness of university counselling for students with academic issues. Counselling And Psychotherapy Research, 15(4), 284-288. https://doi.org/10.1002/capr.12034 35. Pederson, E. L., & Vogel, D. L. (2007). Male gender role conflict and willingness to seek counseling: Testing a mediation model on college-aged men. Journal of Counseling Psychology, 54(4), 373–384. https://doi.org/10.1037/0022-0167.54.4.373 36. Rickwood, D., Deane, F., Wilson, C., & Ciarrochi, J. (2005). Young people’s help-seeking for mental health problems. Australian E-Journal for The Advancement of Mental Health, 4(3), 218-251. https://doi.org/10.5172/jamh.4.3.218 37. Santor, D., Poulin, C., LeBlanc, J., & Kusumakar, V. (2006). Facilitating Help Seeking Behavior and Referrals for Mental Health Difficulties in School Aged Boys and Girls: A School-Based Intervention. Journal Of Youth and Adolescence, 36(6), 741-752. https://doi.org/10.1007/s10964-006-9092-z 38. Te Maro, B., Cuthbert, S., Sofo, M., Tasker, K., Bowden, L., Donkin, L., & Hetrick, S. (2019). Understanding the Experience and Needs of School Counsellors When Working with Young People Who Engage in Self-Harm. International Journal of Environmental Research and Public Health, 16(23), 4844. https://doi.org/10.3390/ijerph16234844 39. Vally, Z., Cody, B., Albloshi, M., & Alsheraifi, S. (2018). Public stigma and attitudes toward psychological help-seeking in the United Arab Emirates: The mediational role of self-stigma. Perspectives In Psychiatric Care, 54(4), 571-579. https://doi.org/10.1111/ppc.12282 40. Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007b). Perceived public stigma and the willingness to seek counseling: The mediating role of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54, 40–50. 41. Vogel, D., & Wester, S. (2003). To seek help or not to seek help: The risks of self-disclosure. Journal Of Counseling Psychology, 50(3), 351-361. https://doi.org/10.1037/0022-0167.50.3.351 42. Vogel, D., Bitman, R., Hammer, J., & Wade, N. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal Of Counseling Psychology, 60(2), 311-316. https://doi.org/10.1037/a0031889 43. Vogel, D., Strass, H., Heath, P., Al-Darmaki, F., Armstrong, P., & Baptista, M. et al. (2017). Stigma of Seeking Psychological Services: Examining College Students Across Ten Countries/Regions. The Counseling Psychologist, 45(2), 170-192. https://doi.org/10.1177/0011000016671411 44. Vogel, D., Wade, N., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal Of Counseling Psychology, 53(3), 325-337. https://doi.org/10.1037/0022-0167.53.3.325 45. Vogel, D., Wade, N., & Hackler, A. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal Of Counseling Psychology, 54(1), 40-50. https://doi.org/10.1037/0022-0167.54.1.40 46. Vogel, D., Wester, S., Wei, M., & Boysen, G. (2005). The Role of Outcome Expectations and Attitudes on Decisions to Seek Professional Help. Journal Of Counseling Psychology, 52(4), 459-470. https://doi.org/10.1037/0022-0167.52.4.459 47. Wei, Y., Hayden, J., Kutcher, S., Zygmunt, A., & McGrath, P. (2013). The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth. Early Intervention in Psychiatry, 7(2), 109-121. https://doi.org/10.1111/eip.12010 48. Wendt, D., & Shafer, K. (2015). Gender and Attitudes about Mental Health Help Seeking: Results from National Data. Health & Social Work, 41(1), e20-e28. https://doi.org/10.1093/hsw/hlv089 49. Yeap, R., & Low, W. Y. (2009). Mental health knowledge, attitude and help-seeking tendency: a Malaysian context. Singapore Med J, 50(12), 1169-1176. 50. Yousaf, O., Popat, A., & Hunter, M. (2015). An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. Psychology Of Men & Masculinity, 16(2), 234-237. https://doi.org/10.1037/a0036241