Suicide Prevention

When and where to look for help? Student mental health challenges in Croatia

By Lana Bojanić.

Mental health of university students has been a hot topic in the last couple of years, both in research and in public domain, and for a good reason. The fact that the usual university age coincides with the age of onset of almost two-thirds of mental health problems, makes it vital to monitor students’ mental health needs and to offer timely and efficient help. Many universities and governments in Western countries acknowledge this need through investing in student mental health services, education, and research.

However, during my Master’s degree at the University of Zagreb, Croatia, the situation was far from the ideal. Free mental health services for students were scarce and usually ran on a voluntary basis by psychology lecturers and teaching assistants. Also, there was barely any comprehensive research into student’s mental health needs. Both of these reasons prompted me and two peers to conduct an independent study on student mental health at the University of Zagreb.

The study consisted of a quantitative and qualitative part. In the qualitative part, the students were asked about their personal experience with help-seeking for mental health problems and their perceived levels of stigmatization surrounding mental health problems. Most of our participants reported confusion about when, how, and where to look for help. What they knew about available services was largely coloured by them being either too expensive (private practice psychologists) or a part of the national health system (psychiatric hospitals) which raised further questions about anonymity and how stigma of potential diagnosis could affect their life. Also, students were aware and concerned by the cultural idea that seeking help is something you do when you are “weak” or “crazy”.

The quantitative part of the study was conducted online and managed to recruit over 600 participants. Recruitment was carried out during Semester 1 exams. We have found that a third of students in our sample were experiencing mental health problems serious enough to require help. Furthermore, 20.4% reported experiencing suicidal ideation during last year and 12.5% during last week. One percent reported a suicide attempt during last year. These percentages are higher than similar research in Western countries. On the other hand, less than a quarter have sought mental health help: this percentage is lower than in similar research in Western countries. Taken together, this implies a worrisome trend: in a system with few resources, more people need, but fewer people look for help.

Subsequently, we analysed barriers toward seeking help for mental health problems. The most common barrier towards help-seeking was uncertainty about the seriousness of their mental health problem. Furthermore, this was also the most common barrier reported by the subsample of students that thought about or had attempted suicide. The preference to ‘deal with [one’s] problems alone’ was the second most common barrier, which can be ascribed to the cultural norms. Further, almost a third of participants reported being unsure about the quality of help available and whether it even works. Additionally, it was found that higher levels of personal stigmatization and being male predict negative attitudes towards help-seeking. Notably, having a higher level of distress was not predicting attitudes towards help-seeking in any way: this implies the need for education and intervention across the whole student population.

That we have touched an important topic became evident even during data collection. The response rate was very high and a lot of positive comments were left on our online questionnaire. This study conducted by students and about students was subsequently disseminated among lecturers and stakeholders. In the two years since the publication, the picture is somewhat better. There are new free mental health services being opened and the conversation about mental health problems is slowly seeping into the mainstream, mainly thanks to the English-speaking media resources. However, as it is known, fundamental change is impossible without sufficient funding and support from the government and cannot depend on the enthusiasm of individuals. Unfortunately, that kind of change is yet to happen in Croatia.

 


Lana Bojanić (@BojanicLana) has a Master’s degree in psychology and is a Research Assistant at the National Confidential Inquiry into Suicide and Safety in Mental Health, University of Manchester (lana.bojanic-2@manchester.ac.uk).

*Cover photo by Sime Jadresin on Unsplash

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