The Impact of Self-Esteem and Self-Identity on Help-Seeking Intentions: An Analysis of Perceptions Toward Simulated Patients

Abstract

Mental health stigma remains a major global barrier to seeking psychological support. Psychological factors such as self-esteem and social identity are closely related to this resistance. Concerns about self-worth and perceived group belonging may influence how individuals respond to the stigma. When striving to maintain a positive self-image or avoid association with stigmatized groups, people may be less willing to seek help. This study examined the effects of self-esteem and social identity on help-seeking intention, focusing on both direct and mediating roles. A total of 190 Chinese university students participated in an experiment combining self-esteem manipulation with self-report measures. Participants completed the Contingencies of Self-Worth Scale, the Group Identification Scale, and the Attitudes Toward Seeking Professional Psychological Help scale. Results showed that neither manipulated nor measured self-esteem significantly predicted help-seeking intention. However, social identity emerged as a strong predictor and a significant mediator between self-esteem and help-seeking. Although a negative correlation between self-esteem and social identity was hypothesized, results revealed a significant positive relationship. This may indicate that among highly educated university students, those with higher self-esteem are more confident in their self-worth and possess greater awareness of mental health issues. They may view identification with mental illness groups not as self-denial but as an expression of empathy, responsibility, and social awareness. This study highlights the crucial role of social identification in shaping mental health behavior and encourages further research on how cultural contexts may moderate these mechanisms, contributing to culturally sensitive mental health education and intervention.