Cultural Differences in Psychological Help-Seeking Attitudes Among Asian and Non-Asian University Students in Malaysia

Cultural Differences in Psychological Help-Seeking Attitudes Among Asian and Non-Asian University Students in Malaysia

Kesantini Athinarayanan Rao^#, Getrude Cosmas. C. Ah. Gang^*, Carmella Ading^#

Faculty of Psychology and Social Work, Universiti Malaysia Sabah

ABSTRACT

This study investigates the impact of culture on psychological help-seeking attitudes among university students in Malaysia, focusing on Asian and Non-Asian cultural groups. A total of 200 students, selected through cluster random sampling, completed the Attitudes Toward Seeking Professional Psychological Help Scale – Short Form (ATSPPH-SF) and the Individualism versus Collectivism Scale (INDCOL). Data were analysed independent t-tests via SPSS 28.0. Findings reveal that while both Asian and Non-Asian students held positive attitudes toward the perceived value and necessity of seeking professional psychological help, both groups showed reluctance regarding openness to seeking help. Cultural differences emerged, with Asian students aligning more with collectivist values and Non-Asian students with individualist values. Significant differences were found in the perception of the value and necessity of professional help. These results suggest the need for culturally tailored interventions to improve help-seeking behaviours, with recommendations for future research exploring the specific support needs of students from different cultural backgrounds. Additionally, the study underscores the importance of developing culture-specific mental health awareness programs to address stigma and educate students on the benefits of seeking psychological help.

Keywords: Culture, Psychological Help-Seeking Attitudes, Individualism, Collectivism, University Students.

INTRODUCTION

Mental health morbidity is a significant public health concern worldwide. Epidemiological data, primarily from Non-Asian and English-speaking countries, indicate a high prevalence of mental disorders in the general population (World Health Organization [WHO], 2025). Similarly, in Malaysia, university students experience alarmingly high rates of depression (58.9%), anxiety (71.8%), and stress (53.9%) (Ismail & Kahwa, 2020). Despite these findings, only 9.6% of non-Asian students sought help from university services, while 78.6% remained unaware of the availability of professional psychological services on campus (Ismail & Kahwa, 2020). These statistics suggest that barriers to psychological help-seeking among international students may include a lack of awareness, cultural differences in mental health perceptions, and stigma associated with seeking professional assistance.

Psychological help-seeking attitudes refer to individuals’ evaluations of seeking assistance from mental health professionals (Hammer et al., 2018). Research has shown that these attitudes are influenced by factors such as acculturation and enculturation (Sun et al., 2016), gender (Nam et al., 2010), and conformity to masculine norms (Wong et al.,2017). Enculturation refers to the retention of one’s heritage cultural norms, while acculturation involves adapting to the norms of the majority culture, sometimes at the expense of one’s heritage culture (American Psychological Association, 2023). Differences in relational patterns across cultures impact the likelihood of seeking help from professionals. Collectivistic cultures, such as those in East Asia, emphasize interdependence and social harmony, viewing individuals as fundamentally connected within a larger social unit (Markus & Kitayama, 1991). In contrast, individualistic cultures, such as the United States, prioritize independence, with personal motives taking precedence over group interests (Kwan et al., 1997). These cultural differences in autonomy versus interdependence influence the appraisal of coping strategies and help-seeking behaviours. In collectivistic cultures, individuals are more likely to rely on family and close social networks for emotional support rather than seeking professional assistance. Seeking external help may be perceived as unnecessary or even shameful, as it could signal personal failure and disrupt familial harmony (Kim, 2007).

Traditional Asian values emphasize face concerns and self-restraint (Cogan et al., 2022), which significantly shape psychological help-seeking attitudes. Research suggests that Asians who associate mental health treatment with embarrassment are less likely to seek professional help (Xiao et al., 2024). Among young people, exposure to stigmatizing attitudes from peers further discourages professional help-seeking. Adolescents, for instance, may avoid psychiatric treatment due to fears of social ostracism, reinforcing stereotypes that equate mental illness with being “crazy” and increasing concerns about losing face (Aoki et al., 2024). Due to the avoidance, individuals from collectivistic cultures often reached out for help among their society members, as means of respecting and honoring them (Natalia & Fridari, 2022). Thus, informal support is mostly sought when encountered by mental health problems. Evidently, Malaysian university students preferred informal support from family, and friends to solve their mental health issues, and psychological help is often seen as a last resort, in instance where the issue is too sensitive to be discussed with society members (Natalia & Fridari, 2022).

Thus, informal support is mostly sought when encountered by mental health problems. Evidently, Malaysian university students preferred informal support from family, and friends to solve their mental health issues, and psychological help is often seen as a last resort, in instance where the issue is too sensitive to be discussed with society members (Natalia & Fridari, 2022).

In contrast, non-Asian cultures typically view psychological symptoms as problems to be solved. Individualism and a more open approach to mental health contribute to greater acceptance of professional psychological help in Non-Asian societies such as Western societies. Studies suggest that students studying in non-Asian countries may be more likely to seek help compared to those in Eastern societies. However, previous research has found mixed support for this hypothesis. The willingness to seek professional help in individualistic societies may be facilitated by values that emphasize personal autonomy, self-improvement, and direct problem-solving strategies (Yamawaki & Green, 2020). Additionally, the destigmatization of mental health issues through public discourse and policy in non-Asian nations contributes to more positive attitudes toward psychological services (Ahad et al., 2023).

To better understand cultural variations in psychological help-seeking attitudes, this study examines two distinct cultural perspectives: Asian collectivism and non-Asian specifically on Western individualism. By analysing these cultural dimensions, we seek to elucidate the underlying factors influencing psychological help-seeking attitudes among university students in Malaysia. This exploration will provide insights into how cultural values shape psychological help-seeking attitudes and inform interventions aimed at increasing mental health service utilization among students from diverse cultural backgrounds.

LITERATURE REVIEW

Theory of Planned Behavior

The Theory of Planned Behaviour (TPB) (Ajzen, 1991), an extension of the Theory of Reasoned Action (Ajzen & Fishbein, 2000), provides a useful framework for understanding psychological help-seeking behaviours. The TPB posits that behavioural intention is shaped by three primary factors: attitudes toward the behaviour, subjective norms (perceived social pressure to perform or avoid the behaviour), and perceived behavioural control (individuals’ confidence in their ability to perform the behaviour). In the context of help-seeking, individuals with favourable attitudes toward seeking professional assistance, who perceive social support for such behaviour, and who believe they have control over the process are more likely to intend to seek help. This intention, in turn, predicts actual help-seeking behaviour when the opportunity arises.

Collectivism and Psychological Help-Seeking

Cultural values significantly shape psychological help-seeking attitudes and behaviours. Collectivistic societies, such as many in Asia, emphasize interdependence, group harmony, and social obligations, which influence how individuals perceive mental health issues and professional psychological services (Markus & Kitayama, 1991). In these cultures, mental health struggles are often viewed as personal matters best addressed within the family unit, rather than through professional intervention (Leong et al., 2017). Seeking help outside the familial or social circle may be perceived as a failure to uphold group expectations or as a source of shame that could negatively impact the family’s reputation (Kim & Omizo, 2003).

Stigma presents a formidable barrier to psychological help-seeking in collectivistic cultures. Public stigma, which involves negative societal perceptions of mental illness, and self-stigma, which includes internalized shame, deter individuals from seeking professional help (Sue et al., 2012). Many individuals in Asian cultures may interpret psychological distress as a weakness rather than a medical condition, leading to reluctance in acknowledging mental health concerns. Consequently, alternative coping strategies, such as emotional suppression or somatization (expressing psychological distress through physical symptoms), are more prevalent in these societies (Nguyen & Benet-Martínez, 2018).

Generational differences further complicate help-seeking patterns. First-generation Asian immigrants, who maintain stronger ties to traditional cultural values, exhibit lower levels of professional help-seeking compared to later generations who have greater exposure to Western mental health norms (Gates et al., 2022). Even among university students in collectivistic societies such as Malaysia, mental health literacy remains limited, and beliefs associating mental illness with supernatural causes persist (Yeoh et al., 2023). Despite increased availability of counselling services, students often prefer informal support from family and friends over professional services, highlighting the need for culturally sensitive mental health interventions (Ting & Jusoh, 2019).

Individualism and Psychological Help-Seeking

In contrast, individualistic cultures, such as those in North America and Western Europe, emphasize personal autonomy, self-expression, and self-improvement. These cultural values foster a more open approach to mental health awareness and professional help-seeking (Rickwood et al., 2015). Western societies have actively reduced stigma surrounding mental health issues, leading to greater acceptance of psychological services and more willingness to seek professional assistance (Eisenberg et al., 2007).

University students in non-Asian societies benefit from well-developed mental health resources, including counselling centres, peer support programs, and digital interventions such as teletherapy and mental health apps (Naslund et al., 2017). Gender differences persist in these settings, with females generally more willing to seek professional help than males, though stigma reduction efforts continue to encourage help-seeking across all demographics (Gulliver et al., 2010). Additionally, Western societies have integrated mental health education into public discourse, contributing to increased recognition of psychological distress and proactive engagement with mental health services (Kushner & Sher, 1991).

Cross-Cultural Comparisons Across Asian and Non-Asian Students in Malaysia

Malaysia, a multicultural society with both collectivistic and individualistic influences, presents a unique setting for understanding psychological help-seeking behaviors. Studies indicate notable differences in attitudes toward mental health services among Asian and non-Asian students in Malaysia. Self-stigma, cultural norms, and levels of acculturation significantly impact help-seeking behaviors among these student populations. A study by AthinarayananRao (2024) found that self-stigma negatively predicted psychological help-seeking attitudes among university students in Malaysia, with international students from non-Asian countries experiencing higher levels of self-stigma than local students.

Notably, male non-Asian students exhibited greater openness to seeking professional help, whereas female students placed higher value on its necessity. However, overall help-seeking attitudes remained low, underscoring the pervasive role of stigma in discouraging professional mental health service utilization.

Similarly, Kumaran et al. (2023) found ethnic differences in psychological help-seeking attitudes among Malaysian university students. Indian students exhibited higher levels of stigma and privacy concerns related to mental health services compared to Malay and other ethnic groups. These findings suggest that cultural background plays a critical role in shaping mental health perceptions and help-seeking behaviours. Furthermore, Zhang and Dixon (2003) highlighted the role of acculturation in shaping help-seeking attitudes among Asian international students. Their study found a positive correlation between acculturation levels and favourable attitudes toward professional psychological services. Higher acculturation levels were associated with greater stigma tolerance and increased confidence in mental health practitioners, indicating that exposure to Western mental health norms facilitates more positive help-seeking behaviors among Asian students (Zhang & Dixon, 2003).

Additionally, Kotera et al. (2020) conducted a cross-comparison study examining mental health among university students in the United Kingdom and Malaysia, with a particular focus on the relationship between negative mental health attitudes, self-compassion, and resilience. The study identified significant differences between the two student groups, with Malaysian students exhibiting higher levels of mental health issues and more negative attitudes toward mental health compared to their counterparts in the United Kingdom (Kotera et al., 2020). Furthermore, Kotera et al. (2020) suggested that mental health remains a stigmatized topic within Malaysian universities, which may contribute to students’ reluctance to openly discuss their mental health concerns. This disparity may be attributed to cultural differences, particularly the distinction between individualistic and collectivistic societal frameworks (Kotera et al., 2020). These findings highlight the need for culturally tailored mental health interventions to reduce stigma and promote well-being among university students in different cultural contexts.

Research Objectives

Despite growing research in this area, studies comparing Asian and non-Asian university students in Malaysia remain limited. Addressing this gap is crucial for developing culturally sensitive mental health interventions. The present study aims to:

• Explore the differences between Asian and non-Asian students in terms of psychological help-seeking attitudes, openness to seek professional help, and value and need in seeking professional help.
• Explore the differences between Asian and non-Asian students in terms of culture, individualism and collectivism.

By examining these factors, this study seeks to deepen understanding of the cultural influences on help-seeking behaviours and inform strategies to improve mental health service accessibility and utilization in multicultural university settings.

Research Model

This study is grounded in a theoretical framework (Figure 1) based on the Theory of Planned Behaviour (Ajzen, 1991), which suggests that an individual’s behaviour is influenced by three key factors: attitudes toward the behaviour, subjective norms, and perceived behavioural control. In collectivist cultures, such as those found in many Asian societies, cultural attitudes toward mental health often discourage help-seeking due to the stigma attached to it. Seeking psychological help may be seen as a sign of personal failure or weakness, as these cultures emphasize emotional restraint and the maintenance of social harmony (Kim & Omizo, 2003). In contrast, in individualistic cultures, such as those in many Western countries, there is a greater acceptance of seeking professional help, as these societies prioritize personal autonomy and self-expression (Rickwood et al., 2015). Subjective norms, or social pressures, also significantly influence help-seeking behaviour. In cultures with high stigma, such as many Asian societies, social norms typically discourage seeking help, as individuals may fear judgment or loss of face (Leong et al., 2017). Conversely, in non-Asian, i.e. Western societies, social norms are often more supportive of seeking help, particularly in contexts like universities, where mental health resources are actively promoted (Gulliver et al., 2010). Finally, perceived behavioural control, which reflects an individual’s belief in their ability to seek help, is also shaped by cultural factors. In collectivist cultures, individuals may perceive greater barriers to seeking help, such as a lack of culturally appropriate services or financial constraints (Gates et al., 2022). In individualistic cultures, however, with better access to mental health resources, individuals may feel more empowered to seek help due to fewer perceived obstacles (Naslund et al., 2017). Therefore, culture plays a significant role in shaping psychological help-seeking behaviours through varying attitudes, social norms, and perceptions of control across collectivist and individualistic societies.

Fig.1 Theory of Planned Behavior Model (Adapted from Rathbone,2014).

Based on the literature reviews and theoretical framework (Figure 1), the following hypotheses were formulated:

H1   : There are differences between Asian and non-Asian students in terms of psychological help-seeking attitudes, openness to seek professional help, and value and need in seeking professional help.

H2   : There are differences between Asian and non-Asian students in terms of culture, individualism and collectivism.

METHODOLOGY

Participants

This study employed a quantitative approach, utilizing a cluster random sampling method to select participants. Two clusters were formed based on cultural orientation: Individualistic and Collectivistic. The non-Asian students in Malaysia was approached for participant recruitment, and after receiving ethics approval, participants were selected according to inclusion criteria. A total of 200 university students participated in the study. Of these, 100 participants (50%) were Asian students from countries such as Malaysia, Singapore, Thailand, Brunei, Indonesia, India, China, and Korea, representing the Collectivistic culture. The remaining 100 participants (50%) were non-Asian students from countries like Australia, the United States, the United Kingdom, Poland, and Canada, representing the Individualistic culture. The majority of participants (64.5%) were aged between 18 and 22 years old. They were enrolled in various academic programs, including religious studies, literature, computer science, arts, science and technology, business, tourism management, law, humanities and social sciences, and medicine. Notably, 20.5% of participants were pursuing degrees in engineering, followed by 19.0% in religious studies.

Instruments

The Attitudes Toward Seeking Professional Psychological Help Scale – Short Form (ATSPPH-SF) which developed by Fischer and Farina (1995) is widely used across diverse cultural settings, with strong psychometric properties supporting its socio-cultural appropriateness. The scale consists of ten items assessing individuals’ openness to seeking psychological help and their perceived value of doing so. Participants respond on a four-point Likert scale, with reverse scoring applied to specific items. Higher scores indicate more positive attitudes, with a score of 20 or higher suggesting a generally favourable attitude. The scale measures two main constructs: openness to seeking help (items 1, 3, 5, 6, and 7) and the perceived value of seeking help (items 2, 4, 8, 9, and 10). These constructs have been validated across various cultures, with strong Cronbach’s alpha values. For example, Palmer (2009) found a Cronbach’s alpha of 0.87 among Jamaican Americans, and studies with Asian-American groups have reported similar reliability. Research in Malaysia further supports the scale’s validity, showing that cultural stigma can impact attitudes toward seeking psychological help (Nizam & Nen, 2022; Picco et al., 2016). In conclusion, the ATSPPH-SF remains a reliable and valid tool for studying help-seeking attitudes across diverse cultural contexts.

The Individualism Versus Collectivism Scale (INDCOL), developed by Triandis and Gelfand (1998), measures four dimensions, i.e., vertical collectivism, vertical individualism, horizontal collectivism, and horizontal individualism. In this study, individualism includes vertical and horizontal individualism, while collectivism includes vertical and horizontal collectivism. The scale consists of 16 items, with eight items for each category, answered on a nine-point scale. The INDCOL scale distinguishes between different cultural dimensions: vertical individualism (achievement, status, competition) and horizontal individualism (self-reliance, uniqueness). Similarly, vertical collectivism (group integrity, personal sacrifice) and horizontal collectivism (interdependence, equality) are also measured. Studies have confirmed the scale’s reliability and validity across various cultures, with high internal consistency coefficients for each dimension (e.g., HI α = 0.81, VI α = 0.82). The scale has been widely adopted, including studies in Malaysia. Research has shown that Malaysians exhibit a dual orientation toward individualism and collectivism (Nair et al., 2021). The scale has proven valuable in studying cultural influences on psychological outcomes, with studies showing strong internal consistency (e.g., Mohan et al., 2016).

RESULTS

Table 1  Differences between Asian and Non-asian students in Terms of Psychological Help-Seeking Attitudes, Openness to Seek Professional Help and Value and Need in Seeking Professional Help

Table 1 shows significant differences in terms of psychological help-seeking attitudes (t (198) = 4.22,p < 0.05) in the scores with mean score for Asian students (M = 14.95, SD = 7.78) was lower than non-Asian students (M = 19.19, SD = 6.31). The magnitude of the differences in the means (mean difference = 4.24, 95% CI : 2.26 to 6.22) was significant. Additionally, no significant differences (t (198) = -0.13, p > 0.05) were reported among Asian students (M = 8.48, SD = 3.44) and non-Asian students (M = 8.53, SD = 3.58). However, the value and need in seeking professional help are significantly different (t(198)= 7.85, p <0.05) among Asian students (M = 6.39, SD = 4.39) and non-Asian students (M=10.71, SD = 3.25). The magnitude of the differences in the means (mean difference = 4.31, 95% CI : 3.23 to 5.39) was significant. Hence, H1 is supported.

Table 2 Cultural Differences among Asian and Non-asian University Students

In terms of cultural differences, both Asian and non-Asian students in this study were investigated through independent t-test analysis. Results in Table 2 depict significant cultural differences (t(198) = 5.00, p <0.00) were found between Asian students (M = 74.18, SD = 8.63) and non-Asian students (M = 80.0, SD = 7.78). The magnitude of the differences in the means (mean difference = 5.83, 95% CI : 3.53 to 8.13) was significant. non-Asian students (M= 55.22, SD= 9.31) scored higher on the individualism construct compared to the Asian students (M= 15.6, SD= 6.26). The magnitude of the differences in the means of the individualism construct (mean difference = – 39.56, 95% CI : -41.79 to -37.33) was significant, indicating non-Asian students holding more individualistic traits. Contrastingly, Asian students (M= 4.36, SD= 5.88) held more collectivistic traits compared to non-Asian students (M= 18.96, SD= 9.54), with the magnitude of the differences in the means (mean difference = 45.39, 95% CI : 43.17 to 47.62) appearing significant. Hence, H2 is supported.

DISCUSSION

Differences Between Asian and Non-Asian Students in Psychological Help-Seeking Attitudes, Openness to Seek Professional Help and Value and Need in Seeking Professional Help.

This study found significant differences in psychological help-seeking attitudes between Asian and non-Asian university students in Malaysia. These differences suggest that, despite sharing the same academic environment, students from different cultural backgrounds exhibit varying levels of help-seeking behaviour. Participants in the Asian group represented countries such as Malaysia, Singapore, Thailand, Brunei, Indonesia, India, China, and Korea, while non-Asian participants came from Australia, the United States, the United Kingdom, Poland, and Canada. Many Asian cultures, including those represented in the study—such as Malaysia, Singapore, Thailand, Brunei, Indonesia, India, China, and Korea—prioritize group cohesion, social harmony, and family reputation (Hofstede, 1980). In these societies, seeking psychological help may be perceived as a sign of personal weakness or an issue that could bring shame to one’s family (Hofstede, 1980). This cultural stigma may discourage individuals from openly addressing their mental health struggles, leading to lower rates of help-seeking behaviour. Conversely, non-Asian cultures, represented in the study by participants from Australia, the United States, the United Kingdom, Poland, and Canada, tend to be more individualistic, emphasizing personal autonomy, self-expression, and emotional openness (Triandis, 1995). As a result, students from these backgrounds may feel more comfortable seeking professional psychological support without fear of social repercussions (Triandis, 1995).

In line with this, this study found that non-Asian students scored higher on psychological help-seeking attitudes compared to their Asian counterparts, which may be attributed to their cultural inclination toward seeking assistance as a beneficial rather than burdensome action. Cultural values influence help-seeking behaviour through enculturation (retaining one’s heritage cultural norms) and acculturation (adapting to the dominant culture’s norms) (Mojaverian et al., 2013). Asian students in this study may have adopted a passive positive attitude toward psychological help due to enculturation within a social environment that discourages help-seeking (Mojaverian et al., 2013). Despite these differences, this study found no significant disparities between Asian and non-Asian students in terms of openness to seeking professional help. Both groups exhibited similar reluctance, possibly due to self-stigma, as identified by Arifin et al. (2022), where many Malaysian students hesitate to seek counselling due to internalized cultural stereotypes (Pheng et al., 2019). Self-stigma leads individuals to adopt negative beliefs about mental illness and help-seeking (Topkaya, 2014). Cultural values such as masculinity and femininity in collectivist societies and self-reliance in individualist societies further reinforce this reluctance (Cheng et al., 2020). Masculinity in collectivist cultures often dictates that men should appear strong and self-sufficient, making help-seeking seem like a sign of weakness. Conversely, individualist cultures emphasize personal responsibility, which may lead individuals to handle their own problems rather than seek professional assistance (Cheng et al., 2020).

However, both groups recognized the value of psychological help, with cultural values influencing their perceptions of necessity. The characteristics of Generation Z, such as digital proficiency, values-driven decision-making, and a focus on work-life balance, may also shape their approach to mental health (Kanste et al., 2025). Given their tech-savviness, students may prefer self-coping mechanisms over professional counselling (Kanste et al., 2025). A report by the International Youth Research (IYRES, 2024) found that Malaysian youth demonstrate problem-solving abilities, yet they receive only moderate support from their social circles. This could mean that even if they recognize the value of psychological help, they may not have adequate encouragement from peers, family, or institutions to seek professional assistance. This aligns with previous findings that self-stigma and cultural expectations influence help-seeking behavior, leading many students to hesitate in reaching out for support despite acknowledging its benefits (Arifin et al., 2022; Pheng et al., 2019).

Differences Between Asian and Non-Asian Students in Cultural Orientation.

This study also found significant cultural differences between Asian and non-Asian university students, with Asian students scoring higher on collectivism constructs and non-Asian students scoring higher on individualism constructs. Despite globalization and modernization, these findings suggest that cultural roots continue to shape individuals’ thought processes and decision-making behaviours (Yates & De Olieveira, 2016). Non-Asian students’ higher mean scores in psychological help-seeking attitudes align with the characteristics of individualistic cultures, which emphasize independence, personal goals, and self-expression (Triandis & Gelfand, 1998). In individualistic societies, seeking psychological help is viewed as a necessity rather than a burden, reinforcing its importance in personal well-being (Dahlberg, 2024). Conversely, collectivist cultures emphasize group identity, shared responsibilities, and social cohesion (Hui, 1988; Triandis, 1996). In these societies, individuals are more likely to seek informal support from family and close friends rather than professional help. The reluctance to seek professional psychological help may stem from cultural values such as “loss of face,” which refers to the fear of bringing shame to oneself or one’s community by discussing personal issues with an outsider (Ho, 1976). Since one’s identity in collectivist cultures is closely tied to the group, disclosing personal struggles to a professional may be perceived as dishonourable (Su-Kubricht et al., 2024). Oyserman and Coon (2002) further differentiate individualistic and collectivist orientations, stating that personal achievement, happiness, and control are central to well-being in individualistic cultures, whereas fulfilling social obligations and maintaining group harmony are paramount in collectivist cultures. Previous research (Diener et al., 1995) also suggests that these cultural orientations significantly impact well-being and life satisfaction. Therefore, cultural differences should be considered when developing culturally appropriate mental health interventions.

CONCLUSION

This study investigated the cultural differences in psychological help-seeking attitudes among 200 Asian and non-Asian university students in Malaysia, selected through a cluster random sampling method. Using the Attitudes Toward Seeking Professional Psychological Help (ATSPPH-SF) and Individualism versus Collectivism Scale (INDCOL), data were analysed through independent t-test analyses in SPSS 28.0. Findings revealed that both Asian and non-Asian students held positive attitudes toward psychological help-seeking, particularly regarding the perceived value and necessity of professional assistance. However, both groups demonstrated reluctance in terms of openness to seeking help. Culture was a significant predictor of psychological help-seeking attitudes, with Asian students aligning with collectivist values and non-Asian students with individualist values. Significant differences emerged in the perception of value and necessity for professional help between the two cultural groups, underscoring the continued influence of culture on mental health attitudes. As attitudes shape behaviour through intention (Armitage & Conner, 2001), psychological service providers should implement culturally tailored intervention programs to improve help-seeking behaviours (Gulliver et al., 2012; Hammer & Vogel, 2017). Future research could explore the specific types of support students from different cultural backgrounds require for mental health assistance. Additionally, university management should develop culture-specific programs, such as raising awareness of cultural stigma for collectivists and educating individualists on recognizing signs of mental health issues.

Methodological Contributions

This study makes several key methodological contributions. Firstly, it employs a robust cluster random sampling method to select participants, ensuring that the sample represents both Asian and non-Asian university students in Malaysia. This approach enhances the generalizability of the findings to diverse student populations (Fink, 2017). The use of well-established scales—the Attitudes Toward Seeking Professional Psychological Help Scale – Short Form (ATSPPH-SF) and the Individualism versus Collectivism Scale (INDCOL)—ensures that the measures are both reliable and valid for assessing cultural influences on psychological help-seeking attitudes (Fischer & Farina, 1995; Rickwood et al., 2015; Singelis et al., 1995). Additionally, the study uses quantitative data analysis techniques such as regression and independent t-tests in SPSS 28.0, providing a thorough statistical approach to understand the relationships between cultural dimensions and help-seeking behaviours.

Social Contributions

This study offers valuable insights into the cultural impact on psychological help-seeking attitudes, particularly in a multicultural context like Malaysia. The findings highlight how cultural values, such as collectivism in Asian students and individualism in non-Asian students, influence their perceptions of the value and necessity of seeking professional psychological help (Hofstede, 2001; Heppner et al., 2006). By identifying these cultural differences, the study emphasizes the importance of culturally tailored interventions for mental health services. It suggests that mental health professionals should consider cultural factors when designing programs to improve help-seeking behaviours, ensuring that students from both collectivist and individualist cultures feel supported in accessing psychological help (Kim-Goh et al., 2014). Moreover, the study contributes to raising awareness of cultural stigma surrounding mental health, particularly among collectivist cultures (Kim-Goh et al., 2014; Lau et al., 2022). This insight can guide university management in developing culture-specific programs that address cultural stigma and promote mental health awareness (Cho et al., 2024). By emphasizing the need to educate individualistic cultures about recognizing mental health issues, the study suggests potential strategies for fostering a more inclusive and supportive environment for students seeking mental health assistance. Future research can build on these findings to further explore how different cultural backgrounds shape the type of support students need in mental health contexts, enhancing the effectiveness of psychological services across diverse student populations (Gates et al., 2022; Zhou et al., 2022).

Limitations

While this study includes both Asian and non-Asian university students in Malaysia, the sample may not fully represent all cultural or ethnic groups within these broader categories. For example, the Asian student group predominantly includes students from specific countries such as Malaysia, Singapore, China, and India, which may not capture the diversity within Asia as a whole. This limits the generalizability of the findings to all Asian or non-Asian student populations. Furthermore, this study uses a cross-sectional design, which provides a snapshot of attitudes at a single point in time. This limits the ability to draw conclusions about how attitudes toward psychological help-seeking may change over time or in response to specific interventions. Longitudinal studies would provide more insight into how these attitudes evolve. Additionally, this study heavily relied on self-reported data, which is prone to social desirability bias. Participants may have overreported their willingness to seek psychological help to conform to societal expectations (Latkin et al., 2017). This bias could distort the accuracy of the findings, especially given the sensitive nature of mental health topics. To reduce the impact of social desirability bias, this study employed screening procedures to clarify the research objectives and obtain informed consent, which improved the quality of responses and reduced the likelihood of inaccurate or biased answers.

RECOMMENDATIONS

Future studies should include a more diverse range of cultural groups to enhance the generalizability of the findings. Including students from African, Latin American, and other non-Asian backgrounds would provide a more comprehensive understanding of how cultural values influence help-seeking attitudes across different global contexts (Bhui et al., 2007). Additionally, to better understand how attitudes toward psychological help-seeking evolve over time, it would be beneficial to conduct longitudinal studies. This would allow researchers to track changes in students’ perceptions of mental health services, helping to identify trends or shifts in attitudes and behaviour, especially in response to interventions or changing cultural dynamics (Bonabi et al., 2016). Besides, incorporating qualitative research methods such as interviews or focus groups could offer deeper insights into the personal, emotional, and social factors that influence students’ willingness to seek help. This would complement the quantitative findings by offering deeper insights into cultural nuances and individual experiences with mental health, thereby enhancing both the credibility and the overall robustness of the research findings, while also helping to reduce self-reported bias by triangulating data from multiple sources (Moustakas, 1994; Creswell, 2014).

ACKNOWLEDGEMENT

We would like to express our gratitude to the participating university and the participants.

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