Anxiety and attitudes toward help-seeking: the mediating roles of mental health literacy and stigma in a Romanian sample

Abstract

This study investigates the relationship between anxiety and professional help-seeking attitudes, examining the mediating roles of mental health literacy (MHL) and stigma within a Romanian context. Grounded in the Theory of Planned Behavior and the ABC model of attitudes, the research explores how cognitive (MHL) and affective (stigma) components predict help-seeking propensity, psychological openness, and indifference to stigma. Data were collected from 351 Romanian participants. Correlation analyses revealed that anxiety is positively associated with psychological openness and mental health knowledge, and it is negatively linked to help-seeking skills and self-help strategies. Mediation models suggested that anxiety predicts greater psychological openness but lower help-seeking propensity, indicating that emotional distress may increase self-awareness without necessarily fostering behavioral intention. MHL demonstrated dual, opposing effects: while increased knowledge enhanced help-seeking propensity, lower perceived help-seeking skills significantly hindered it. These findings suggest that knowledge alone is insufficient to facilitate action unless accompanied by self-efficacy and skill-building. The results underscore that cognitive and affective pathways operate differently across help-seeking dimensions. This research provides culturally relevant evidence for a Romanian convenience sample, highlighting the need for interventions that go beyond traditional psychoeducation by integrating skill-building and strategies to mitigate internalized and anticipated stigma. Despite limitations regarding its cross-sectional design and convenience sampling, the study offers critical insights into the complex mechanisms shaping help-seeking intentions.