TITLE:
Breaking the Silence: The Interplay of Literacy, Attitudes, and Mental Health Access among Malaysian Adolescents
AUTHORS:
Logeswary Krisnan, Mohd Pilus Abdullah, Norli Abdul Jabbar, Nurashikin Ibrahim
KEYWORDS:
Barriers, Facilitators, Mental Health Services, Help-Seeking Behaviour, Adolescents, Malaysia
JOURNAL NAME:
Health,
Vol.18 No.9,
September
21,
2026
ABSTRACT: Purpose: This study aimed to explore the interplay between mental health knowledge, attitudes, perceived barriers, and facilitating factors regarding access to mental health services among Malaysian government secondary school students. Methods: A total of 6735 adolescents (mean age 14.91 ± 1.36 years) across six states completed a validated, self-administered online questionnaire. Data were analyzed using descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlations, and multiple linear regression to identify predictors of perceived barriers to care. Results: Participants demonstrated relatively high mental health knowledge and positive attitudes, yet reported substantial internal and sociocultural barriers to accessing care. Female and urban students exhibited significantly higher knowledge and more positive attitudes than their male and rural counterparts. Notably, perceived barriers remained uniformly high across all geographic locations. Correlation analysis revealed that while knowledge positively correlated with attitudes and facilitators (P Discussion: High mental health literacy and positive attitudes do not inherently diminish the systemic and cultural obstacles Malaysian adolescents face when seeking professional help. Enhancing service utilization requires moving beyond awareness campaigns to implement culturally sensitive, school-based interventions that foster professional trust and reduce internal stigma.