Students in U.S. medical schools experience a high occurrence of psychological distress which can impact their health, professional behavior, and ability to succeed academically (Dyrbye et al, 2005). Despite the growing attention to this topic and the increased provision of mental health services available to medical students, many obstacles still remain for the achievement of student well-being (Givens & Tija, 2002). In addition, little research has been reported on medical students’ views on the help-seeking process; thus the aim of this study is to explore the attitudes of medical students regarding the process of seeking help for issues of distress encountered during medical school.

For the purposes of this study, in-depth interviews of medical students were used to examine the individual, interpersonal, sociocultural, and institutional factors that distressed medical students cite as reasons for their help-seeking decisions. The interview data and subsequent analysis provided the following key findings: (1) help-seeking behavior is a result of not only deliberate, reasoned decision-making but also of spontaneous, reactive decision-making, (2) a positive help-seeking attitude and prototype increase willingness to get help, (3) the stages of the help-seeking process can be experienced non-linearly, (4) external and internal factors can cause delays at any stage of the help-seeking process, and (5) the way in which each student defines his or her own distress impacts his or her help-seeking behavior.

This study introduced the Integrated Model of Help-Seeking Behavior (IMHSB), which combined existing models to depict the help-seeking process as an intersecting array of circumstances, various systems, and personal and social meaning, all of which interact within the four distinct stages of help seeking. The findings support this revised model as a suitable framework for viewing help-seeking behavior and also as a flexible model for future research. The IMHSB provides an integrated approach which can assist educators and policy-makers in considering all the possible barriers and drivers that influence students’ help-seeking behavior when planning strategies for supporting the mental health of medical students.