Mental Health Service Use Among University Students: How Barriers and Social Support Matter

Purpose Understanding university students’ use of mental health services can help us evaluate if access to mental health services is adequate and appropriate. This study examined how depressive symptoms, perceived barriers, and social support (from family and friends) jointly associated with mental health service use (MHSU), including potential mediation and moderation effects. Methods A cross-sectional online survey was conducted with a sample of 769 undergraduate students in Singapore (18–29 years, 61.77% female). Path analyses using probit regression tested direct, mediated, and moderated associations among depressive symptoms, perceived barriers, social support (family and friends), and past-year MHSU. Results 18.60% of the sample reported using mental health services in the past 12 months. Depressive symptoms predicted an increased likelihood while barriers predicted a reduced likelihood of using mental health services. Higher social support from family and friends was associated with lower depressive symptoms, in turn predicting lower likelihood of using mental health services. Additionally, a significant interaction indicated that at high levels of depressive symptoms, greater friend support directly predicted a lower likelihood of MHSU. Gender did not moderate these associations. Conclusion Depressive symptoms, perceived barriers, and social support jointly relate to MHSU among university students. While family support consistently served as a stable informal resource, friend support became particularly important at high symptom levels, potentially substituting for formal care. Reducing access barriers and enhancing social support networks, especially family-based support, remain important strategies for promoting psychological well-being and appropriate service use in young adults.