Although barriers to help-seeking for mental health issues of college students have been examined in urban universities, little is available to examine these barriers in students attending rural universities. The purpose of this exploratory descriptive study was to identify barriers to help-seeking behaviors for psychological distress among college students attending a small rural university. The aims of the study were three-fold: (1) to identify barriers to help-seeking behavior among rural college students, (2) to identify differences in attitudes toward help-seeking based on gender, race/ethnicity, family history of suicide and previous counseling experience, and (3) to describe the psychometric properties of the Help-seeking for Psychological Distress Inventory (HPDI) and each subscale.

The HPDI, a 21 item survey, was sent via campus e-mail to 1129 students with a response of 22.5% (n = 243). Scoring for each item on the HPDI was on a five point Likert scale ranging from (1) strongly disagree to (5) strongly agree with lower subscale scores indicative of barriers toward help seeking. Results suggested that stigma, self-disclosure, counseling concerns, judgment, and suicidal ideation were barriers to help-seeking. These stigma, self-disclosure, counseling concerns, judgment, and suicidal ideation were barriers to help-seeking. These findings are consistent with findings of students on urban campuses, except for judgment which was a unique barrier for students attending this rural university. Self-disclosure (p < .05) was found to be a statistically significant barrier for help-seeking based on ethnicity while suicidal ideation was a barrier to help-seeking based on a family history of suicide (p < .001). For those with a family history of counseling, barriers to help-seeking were stigma (p < .05) and suicidal ideation ( p < .05).

The HPDI was found to have a seven factor solution based on Eigenvalues and factor loadings. HPDI subscales were found to have adequate reliability with 63.5% of the variance explained for barriers to help-seeking. Cronbach's alpha values for each subscale ranged from .527 to .869. These findings suggested that additional barriers to help-seeking exist that were not measured through the HPDI.