Factors Related to Psychological Help-Seeking Behavior among First-Year College Students

Introduction: Psychological Help-Seeking Behavior is an action taken in seeking psychological help from others to solve the problem at hand. Objectives: This study aims to determine factors related to psychological help-seeking behavior among first-year college students. Methods: This study is a descriptive-correlation study with an approach cross-sectional. The sample was taken using proportionate stratified random sampling, with 144 participants based on the G-Power calculation. The instruments used are General Help-Seeking Questionnaire (GHSQ) and Actual Help Seeking Questionnaire (AHSQ), data analysis using univariate and bivariate (chi-square). Results: In this research, there is a relationship between age factor and gender factor with psychological help-seeking behavior with a p-value (< 0.05). Discussions: Most of the first-year students perform psychological help-seeking behavior in the future and currently, while other factors in this research did not have a significant relationship both in the future, past and present. This can happen due to the unbalanced number of sample proportions.


INTRODUCTION
Psychological Help-Seeking Behavior is an action taken in seeking psychological help from others to solve the problem at hand.According to Yin et al. (2019), the first psychological assistance sought by adolescents was 58.4% of informal sources of assistance.In Salim (2010) research, the majority of students sought informal assistance as much as 80.7%.Informal helpseeking and the existence of social support can potentially reduce mental health problems in adolescents (Heerde & Hemphill, 2018).This is supported by Shi and Hall (2020) that more than 30% of students choose not to seek psychological help.In line with Salim (2010) research only 6% of students psychological help-seeking from formal sources.Psychological help-seeking from informal sources is not a problem when the problems they face can still be handled by informal sources of assistance.However, this will be a problem when the handling of the problem is not appropriate so it is necessary to seek formal assistance sources.
Seeking appropriate psychological help is protective and has the potential to reduce psychological distress and improve mental health (Rickwood et al., 2005).Student counseling services are also available at the Faculty of Nursing, Universitas Padjadjaran.
Nursing students were the sample in this study because, according to Ramadan and Mohamed (2019) Nursing students had higher stress levels than the Faculty of Pharmacy and Medicine.According to Prasetio et al. (2019), firstyear students are more susceptible to emotional problems due to the transition period from senior high school to college.The positive impact that is felt in psychological help-seeking can be used as a strategy that refers to the behavior of psychological help-seeking, as in Vidourek et al (2014) research, it was found that students have a perception of the perceived benefits when seeking help including improved mental health, stress is reduced, one problem solved.The benefits of this research as a source of knowledge and information for nursing students as well as the development of knowledge about factors related to the psychological help-seeking behavior assistance in first-year students in the future, especially in the field of psychiatric nursing and useful for mental nurses in providing interventions related to psychological help-seeking behavior.
Psychological Help-Seeking Behavior is a behavior related to other people through formal and informally communication to get advice, information, understanding, care, and support in dealing with complex situations or problems (Rickwood et al., 2005).Informal sources of help come from informal social relationships, such as partners, friends, parents, family, and self-help through information and websites.Formal sources of assistance come from professional assistance sources who have a recognized role and appropriate training in providing assistance and advice, such as psychologists, psychiatrists, general practitioners, psychiatric nurses, lecturers, teachers, and clergy/religious leaders (Rickwood et al., 2005).According to Ross et al (2008) in the context of students, the types of problems or stressors are divided into 4, namely, interpersonal, intrapersonal, academic, and environmental.The psychological help-seeking behavior, according to Rickwood's theory, can be seen from 3 times, namely the future (there is no definite time), the past (more than three weeks ago), and the current period (from the previous three weeks to the present) with different items for the three periods, the psychological help-seeking behavior may changes over time, so it is necessary to identify from the three periods.Research that examines the factors related to the psychological help-seeking behavior is mostly carried out in other countries, but this research is still rarely studied in Indonesia, so the researcher aims to determine factors related to psychological help-seeking behavior among first-year college student.

Research Design
This research is a descriptive-correlation study with a cross-sectional approach and the independent variable in this research is the psychological help-seeking behavior with future, current, and past sub-variables, and the dependent variable, namely the factors.

Population and Sample
The population of this research is the firstyear students of the Faculty of Nursing, Universitas Padjadjaran, with as many as 191 students as the population.The sample size was obtained through calculations using G-power with a test family x² test then effect size 0.3, alpha error 0.1, power error 0.90, and Degree of freedom (Df) 4 so that with these calculations obtained a sample of 144.The sampling technique used is proportionate stratified random sampling, the reason for taking the proportionate stratified random sampling technique is because the number of campus areas is not proportional.

Instrument
The instrument used is the General Help Seeking Questionnaire (GHSQ) which is used to see the psychological help-seeking behavior in the future with a total of 12 questions and 7 items in the past, and the Actual Help Seeking Questionnaire (AHSQ) is used to observe the psychological help-seeking behavior in the current period, this question with a total of 13 items.The GHSQ and AHSQ measuring tools were proposed by (Rickwood et al., 2005).This researcher uses the GHSQ and AHSQ instruments, which have been changed in the Indonesian version (Pratiwi 2013).In the research of Pratiwi (2013) and Rickwood et al. (2005) the use of the GHSQ instrument uses a scale from 1 "very unlikely" to 7 "very likely" by calculating the number of scores, where the higher the score, the higher the likelihood of help-seeking, in Pratiwi (2013) after calculating the score, the cutoff point was first seen to see the mean/median value, and it was divided into 2 categories "looking for help and not helpseeking".Meanwhile, the AHSQ respondents were asked to indicate whether they had sought assistance or not by answering "Yes" and "No" to each of the available sources of assistance.The GHSQ and AHSQ instruments have been tested for validity, both the original version and the Indonesian version by Pratiwi (2013), and the results are declared valid.The reliability of the original version of the AHSQ instrument obtained Cronbach's coefficient alpha of 0.86 while the Indonesian version carried out by Pratiwi (2013) obtained Cronbach's coefficient of alpha of 0.827.

Research Procedure
The research was conducted from April 22, 2021, to May 16, 2021, which was conducted online via Google Form.

Data Analysis
Data analysis in this study used univariate analysis presented in the form of distribution and frequency tables as well as percentages and bivariate analysis using the chi-square test.The data analysis process used the IBM SPSS 22 application.

Ethical Approval
This research has received ethical approval from the Research Ethics Commission of Universitas Padjadjaran with the number: 284/UN6.KEP/EC/2021

RESULT
The demographic characteristics of the majority of respondents are female, Muslim, and the majority live with their parents.The largest number of respondents is from the Jatinangor campus area.The age of the respondents starts from 18 to 20 years, which is in the late teens.
In Tables 1 and 2, seen from the distribution and frequency, most will seek psychological help in the future when they have problems.Unlike in the past, the psychological help-seeking behavior is still many who do not help-seeking.In the table, there is a p-value (< 0.05), where there is a relationship between the age factor and psychological help-seeking behavior, but on other factors, it shows that there is no significant relationship with the psychological help-seeking behavior.In tables 3 and 4, seen from the distribution and frequency of most of the sources of assistance that have been sought, namely friends, but in the Pangandaran campus area the source of assistance that has been sought is mother, psychological helpseeking from formal sources is still low, but some students seek psychological assistance from formal sources with the most sought-after sources of assistance being mental health workers and lecturers.when students have intrapersonal problems the source of help sought is the mother, while friends are more sought after when students have problems caused by interpersonal and environmental problems, and lecturers become the most sought-after source of help when students experience problems or difficulties in academic matters.When viewed from the p-value, gender and age factors have a significant relationship with the behavior of seeking psychological help from both informal and formal sources.

DISCUSSION
Psychological help-seeking behavior in the future or the same as the intention to seek psychological help in the future, based on the results of research, more than half of the first-year students of the Faculty of Nursing, Universitas Padjadjaran will seek psychological help in the future, this may be because at this time students are more aware of this mental health issues so that in the future it is possible to seek psychological help.This is in line with Pratiwi's research that students from the health cluster seek psychological assistance more than those from other disciplines.The psychological help-seeking behavior in the past can be said to be an experience in seeking psychological help, but in the past, the sources of help were only focused on formal sources of assistance.The results of the research that has been carried out are that most of the first-year students of the Faculty of Nursing, Universitas Padjadjaran, have never sought psychological help, could have happened because in the past the issue of mental health literacy was still not familiar, as in Syafitri and Wijayanti (2017) which researched the general public with the results that most people do not know about mental health or mental health literacy can be said to be still low, and the respondents in the study were the majority of high school students, while the sample in this study was junior high school students where in the past they were a student Senior High School.That way, the number of students who did not seek psychological help in the past may be due to a lack of knowledge about mental health so that it becomes an obstacle in seeking help, as in the study of Handayani, Ayubi and Anshari (2020) which states that someone with high mental health literacy tends to utilize mental health services compared to those with low mental health literacy.
The results of psychological help-seeking behavior at this time, overall this first-year student of the Faculty of Nursing, Universitas Padjadjaran is seeking psychological help from both informal and formal sources.most students have sought psychological help from friends and mothers (informal sources of help), this is in line with research by Ebert et al (2018) conducted on firstyear students with the results that students prefer relatives or close friends as a source of help.Supported by research by Pratiwi (2013) that students prefer friends as a source of help because they feel more comfortable.When viewed from the source of formal assistance, the more sought-after sources are mental health workers and lecturers, someone who visits mental health workers there is a possibility that the person is aware of the problem so that he decides to come to mental health workers, as in the research of Liang et al (2020) that awareness of mental health affects the behavior of seeking psychological help, to seek psychological help 3.61 times higher in students who have awareness of their mental condition.Then lecturers are more sought after as a source of assistance usually related to academic problems such as lecture problems, assignments that are not understood, academic consultations, and so on related to academics, this is also in line with Pratiwi (2013) research that the most sought-after sources of formal assistance are a lecturer.In the results of research by Pratiwi (2013) and Ebert et al (2018) and this study, although there are differences in country, location, time, and characteristics, it can be found that there are similarities in the results regarding this psychological help-seeking behavior.As long as they are still seeking psychological help, both from informal and formal sources, this will not be a problem as long as the problem can be resolved, but this will become a serious problem if these informal sources of assistance cannot overcome the existing problems, thus requiring assistance from other sources.formal assistance such as mental health workers where they have expertise competence in their field.
From this research, it can be found that the factors related to psychological help-seeking behavior are gender and age.This is in line with research Yin et al (2019) in which there are gender differences in psychological help-seeking, due to differences in socializing between women and men so that women are more likely to help-seek by seeking social support than men, and the results of research by Yin et al (2019) that psychological help-seeking is more likely to be done by women compared to men.When women tend to find it easier to psychological help-seeking, so a special approach is needed, especially for men who will encourage them to psychological help-seeking, where according to Wimer and Levant (2011) men have an attitude of masculinity, the higher the masculinity of a man.Men are less likely psychological help-seeking.
Seen from the age factor, the age of the students in this study were in their late teens, and students at that age tended to psychological helpseeking.This is supported by research by Rickwood et al (2005) and Pratiwi (2013) that these late teens tend to seek psychological help, supported by research by Yin et al (2019) that this psychological help-seeking behavior is lower in the elderly.
While other factors in this study there is no significant relationship both in the future, past, and present.The results of this study are contrary to research of Upadhyaya et al (2019) states that the reason someone uses a religious teacher/spiritual teacher as a source of help is because of the easy accessibility and belief in their respective religions or beliefs.The majority of students living with their parents live with their parents, students who live with their parents choose to seeking psychological assistance, this is because when living with their parents the sources of assistance are more accessible, for example, mothers whom we can meet when seeking psychological assistance, supported by Maba et al (2020) stated that during the COVID-19 pandemic, the first source of assistance sought was parents, especially mothers and fathers because these sources were easily accessible.Meanwhile, students who live in a boarding house tend not to seek psychological help in the future, this can be a concern where students with a boarding house status when they have problems need regular monitoring to prevent things that are not desirable.Most of the Jatinangor and Pangandaran campus areas will seek psychological help, this may be due to the research of Thompson, Sugg and Runkle (2018) that there are differences in seeking psychological assistance between rural and urban areas, wherein rural areas the level of seeking assistance is low.While the Jatinangor and Pangandaran campus areas are included in urban areas, even though the location of the two areas is different, now the times have begun to develop and technology has advanced so that wherever and whenever you can seek psychological assistance by using online-based access because currently there are many onlinebased counseling services, as in the research of Liang et al (2020) with the COVID-19 pandemic, mental problems in students increased so that the ministry of education and social institutions had provided online-based psychological service resources, and with the COVID-19 pandemic, most of the students in the campus area Jatinangor and Pangandaran conduct online learning so that most of them live with their parents or other family members who can be used as a source of assistance, in such a case the difference in area or location does not become an obstacle in seeking psychological assistance.
This study factors consisted of gender, age, religion, residence status, and campus area, although there were still several other factors related to behavior seeking psychological help.Another example, the researcher did not look at the socioeconomic perspective, because in this study the sample was students where the economic level could not be ascertained, besides that these students could take advantage of the counseling services that were available both at the faculty and university level or by looking for sources of help from friends.and lecturers who do not require fees, so the economy here is not a major factor in seeking psychological assistance.Other factors, according to Manumba and Hamid (2020) who analyzed 14 articles, found several factors related to behavior seeking psychological help, including stigma, demographic characteristics, social environment, knowledge, and beliefs as well as accessibility and health services.In this study, based on demographic data, the proportion of the sample was not balanced so that when the bivariate analysis was carried out, no significant p-value was obtained.

CONCLUSION
The conclusion of this study, most of the first-year students conduct psychological helpseeking behavior in the future and currently, with the most sought-after sources of help, namely friends and mothers (informal sources) and mental health workers and lecturers (formal sources).While viewed from 3 periods, the factors related to the psychological help-seeking behavior are gender and age factors in the past and present, while other factors in this study have no significant relationship either in the future, the past, and the current period, this can happen because based on demographic data the number of sample proportions is not balanced