Whose Judgment Counts? Anticipated Family Cost, Perceived Public Stigma and Help-Seeking Intentions among Vietnamese University Students

Stigma is among the reasons young people give most often for not seeking help with mental health problems, yet perceived public stigma, measured as what "most people" think, rarely predicts help-seeking in Western samples. This study asked whether, for Vietnamese university students, the stigma that matters is the cost they expect their family to bear if their problem became known. Students at four universities in northern Vietnam completed an anonymous online survey (582 submissions; 308 after registered data-quality exclusions). After reading a depression vignette, they rated how likely they would be to seek help from family, peers, professionals, or no one. Anticipated family cost was associated with lower intentions to seek help from family (ρ = −.18) and higher intentions to seek help from no one (ρ = .22), but it was not a stronger predictor than perceived public stigma on any outcome. Perceived public stigma was associated with help from family at least as strongly (ρ = −.22), while the association for personal stigma was close to zero. Studies in Western population have usually found the opposite, but the result matches an earlier finding on help from family and friends. Family cost and anticipated peer rejection could not be separated empirically, moderation by living with family or depending on it financially was inconclusive, and students who expected a clinician to tell their family were more willing to seek professional help. In this sample, help from family was more closely tied to what students believed most people think than to their own attitudes.