The Relationship between Depression Stigma and Depression Literacy on Psychological Help Seeking Attitudes among University Students

The aim of this study is to investigate the relationship and influence of individual’s depression stigma and depression literacy on attitude of seeking counselling help among youth namely university students. The respondents of this study are 302 students from public universities in Malaysia namely Universiti Sains Islam Malaysia (USIM). This is a correlational study to identify the relationship and influence between variables. Data collected from the sample will be analysed using Statistical Package for Social Sciences (SPSS) version 23. Statistical analysis that will be used are descriptive and inferential analysis. Findings of the study shows that the relationship between depression stigma and psychological help seeking behaviour indicates a strong negative relationship. The relationship between depression literacy and psychological help seeking behaviour indicates a weak positive relationship. The gender difference in relation to depression stigma shows male have significantly higher negative stigma rather than female. The gender difference in relation to depression literacy demonstrate that male have significantly lower literacy on depression rather than female. The gender difference in relation to psychological help seeking behaviour shows that male have significantly lower tendency on psychological help seeking attitudes rather than female.


Introduction
Depression, a normal mental health problem, is still a big trouble among college students across the world.This includes Malaysia too.But, along with the problems of living with depression, people often have to deal with another problem such as stigma.The term 'depression as stigmatized' means bad thoughts or ideas about depression that make people understanding it less and stop them from getting the necessary help required.When discussing Malaysian university students, it is critical to understand how guilt is built around depression and awareness about it, and ideas of seeking emotional support are interconnected.
The frequency and consequences of depression among Malaysian university students' Depression is a major source of concern since it has a considerable impact on their academic performance, well-being, and overall quality of life.According to study, a large proportion of Malaysian university students suffer from depression, highlighting the need of addressing this issue (Ibrahim et al., 2019).However, the high level of depressive stigma complicates the challenges that this adolescent face.Understanding the prevalence and impact of depression in this group is crucial for developing effective stigma reduction and psychological well-being promotion strategies.
Depression is a mental health condition that presents itself through ongoing feelings of sadness and despair along with a decreased interest and enjoyment, in activities that were once enjoyable.The pursuit of future goals, social responsibilities, and academic demands can all add to stress, increasing the vulnerability of university students to depressive symptoms.It is essential to acknowledge the particular problems that this group faces in order to establish a welcoming and supportive learning environment that puts mental health and wellbeing first.
The specific challenges that university life presents can have a significant impact on students' mental health since higher education is a place where academic learning and personal development meet.Among the many mental health issues that university students encounter across the world, depression stands out as a common and sometimes silent killer.The shift from adolescent to early adulthood, along with the academic and social constraints of university life, produces a complicated setting in which mental health problems can flourish.
Depression stigma adds to university students' unwillingness to seek psychological assistance in Malaysia.Deep-seated social ideas regarding mental illness, such as depression, foster negative attitudes and fear of judgement among society.As a result, students may be hesitant to confess their difficulties to seek help.The negative repercussions of untreated depression focus on the need of addressing stigma and creating a supportive atmosphere that supports help-seeking behaviours among university students.
Eliminating the stigma associated with depression among university students in Malaysia requires raising knowledge and understanding of the disorder.By raising awareness and educating others on the causes, symptoms, and available treatment options for depression, people can clarify any misconceptions and minimise the stigma associated with the condition.Increasing students' awareness of depression's symptoms, understanding of its complexities, and ability to seek appropriate therapy will make the institution a more welcoming and inclusive place.
It is crucial to overcome the stigma associated with depression, the lack of knowledge on depression, and the attitudes of Malaysian university students towards obtaining psychiatric assistance.Reducing stigma will make it easier for young people to seek treatment, increase early intervention, and stop mental health issues from getting worse.But because of stigma, ignorance, or limited access to mental health care, a large number of individuals with depression choose not to seek help (Ibrahim et al., 2019).Raising awareness about depression and supporting mental health services is essential to guaranteeing that those who are affected get the help they need.
By raising awareness of depression, students will be able to identify mental health concerns in both themselves and their peers, creating a helpful environment on campus (Conceição et al., 2022).Addressing these traits can also aid in lowering the general risk of depression, enhancing academic achievement, and fostering holistic well-being among university students in Malaysia.In summary, understanding and resolving the relationship between psychological help-seeking attitudes, depression literacy, and stigma surrounding depression among Malaysian university students is essential to their academic success and overall well-being.This introduction aims to shed light on the signs, causes, and possible consequences of depression in college students by delving into its intricacies.
This study is motivated by the realisation that many people still encounter significant challenges when seeking to get depression treatment, even in spite of increased public awareness of mental health concerns.Through a study of the complex relationships among depression stigma, depression literacy, and help-seeking attitudes, our goal is to enable people to surpass these obstacles in order to get the necessary support.In addition to looking for trends and relationships, this study aims to offer practical advice that can influence change on both a social and a personal level.Finally, by clarifying the reasons for and barriers to psychological help-seeking, this research aims to stimulate creative solutions that promote an atmosphere of transparency, understanding, and proactive mental health care.Through these collective efforts, we aspire to create a world where seeking help for depression is seen as a courageous and empowering step towards healing and well-being.

Problem Statement
Malaysian university students are gravely concerned about the relationship between depression literacy and stigma and how these two factors affect attitudes towards psychological help-seeking.The topic of depressive stigma has been the focus of many research.Pescosolido et al (2010), for instance, emphasised in their research how society's attitudes contribute to the stigmatisation of mental health concerns, highlighting the societal side of stigma.In their investigation on the impact of public stigma on depressed individuals, Corrigan and Watson (2002) discovered that stigmatisation can result in self-stigma, which diminishes self-worth and treatment-seeking activity.Even though mental health issues are becoming more widely recognised, little empirical research has been done on how these factors interact to affect students' desire to seek out psychological care.The stigma of depression continues to be a substantial obstacle to open talks about mental health, and its influence on university students' views about obtaining psychological care is an important topic of research.Malaysia's cultural setting may develop distinct perceptions on mental health, altering the extent to which stigma impedes help-seeking behaviours.
Additionally, one important factor that can either lessen or intensify the effects of stigma is depression literacy, which includes knowledge of symptoms, causes, and readily available therapies.Gaining insight into the relationship between stigma and depression literacy may help to clarify the variables influencing college students' beliefs and choices around seeking professional mental health treatment.According to Singh et al (2019), the majority of survey participants were classified as depression illiterate, indicating a lack of understanding and awareness of depression among young people.
By examining the intricate relationships between depression stigma, depression literacy, and psychological help-seeking attitudes among Malaysian university students, this study aims to close a knowledge gap.Treatments and educational initiatives may be focused on reducing stigma, enhancing depression literacy, and other goals by acknowledging the intricate mechanisms at play.Ultimately, promote a more supportive atmosphere for students dealing with mental health issues.This can lead to improved mental health outcomes and overall well-being.

Research Objective
In general, the research objectives are to determine the relationship of depression stigma and depression literacy corresponding to psychological help seeking attitudes among university students.
1. To identify the relationship between depression stigma and psychological help seeking behaviour among students.2. To determine the relationship between depression literacy and psychological help seeking behaviour among students.3. To explore the gender differences between depression stigma, depression literacy and psychological help seeking behaviour.4. To explore the significant difference between gender and depression literacy among students.5. To investigate the significant difference between gender and psychological help seeking behaviour among students.

Research Hypothesis Hₐ1
There is a significant relationship between depression stigma and help psychological help seeking behaviour among students.

Hₐ2
There is a significant relationship between depression literacy and psychological help seeking behaviour among students.

Hₐ3
There is a significant difference between gender and depression stigma among students.Ha4 There is a significant difference between gender and depression literacy among students.Ha5 There is a significant difference between gender and psychological help seeking behaviour among students.

Significant of the Study
This study will help to contribute as many information as possible by collecting the necessary data for future counsellor or any psychological expert in innovating their approach and understanding to mental illness and stigma among youth.The results of this study can provide valuable insights to university counselling services.In addition to that, the academical aspect of this finding will help to add on to the field of knowledge focusing on the demographic background in Malaysian context.Moreover, this study aims to contribute to the development of a more supportive and inclusive campus environment.By uncovering the relationships between depression stigma, depression literacy, and help-seeking attitudes, this research can contribute to foster a culture that encourages open discussions, reducing stigma, and promotes positive mental health behaviours among university students.Last but not least, this study will enable university administrators, counsellors, and educators to gain insights into the specific areas where stigma and literacy impact help-seeking attitudes.The Ministry of Higher Education (MoHe) could consider taking a approach to addressing mental health concerns.By studying the relationship, between stigma associated with depression and seeking help researchers aim to understand the barriers that may prevent students from accessing the support for their mental wellbeing.This understanding is crucial in developing targeted interventions that aim to reduce stigma and create a environment for those seeking help.
The research focuses on exploring the connection between knowledge about depression and seeking assistance shedding light on the significance of awareness in shaping students' attitudes towards seeking support.The findings from this study can inform programs that aim to enhance students understanding of health and encourage informed decision making when it comes to addressing mental health concerns.
Additionally, the study provides insights into gender related differences by examining whether there are variations in attitudes towards seeking help perceptions of depression stigma and levels of knowledge about depression.This data is essential, for tailoring interventions that consider gender factors ensuring that support mechanisms cater to the needs of all students.Understanding the significant variations between gender and depression stigma, as well as gender and depression literacy, sheds light on the particular obstacles that male and female students have to face.This knowledge may be used to design customised educational initiatives and support systems that address gender-specific mental health challenges.
The study of gender differences in psychological help-seeking behaviour adds to our understanding of the elements that influence students' inclination to seek help.This knowledge is useful in formulating methods to increase help-seeking behaviours, particularly when addressing potential gender-specific hurdles.

Literature Review Definition of Depression Stigma
The term "depression stigma" describes the unfavourable attitudes, biases, and ideas that surround depression and individuals who experience it (Maeshima & Parent, 2020).For those who suffer from depression, this stigma may result in prejudice, discrimination, and social isolation.Additionally, people may find it difficult to ask for assistance and support because they worry that others won't understand them or judge them.The stigma associated with depression may be harmful to people who are affected because it may discourage them from getting the help and care they need.
Stigma occurs when a person labels someone based on their illness rather than who they are individually.In the context of depression stigma, it refers to negative attitudes, ideas, and stereotypes about depression which are misleading and prevent people from getting needed treatment for their mental health.Depression stigma creates a hostile environment for individuals struggling with mental health issues which fosters feelings of shame, guilt and embarrassment, leading to self-isolation and reluctance to seek support.
Depression stigma, which is based on cultural attitudes and views, is a strong obstacle to the detection and treatment of mental health diseases, particularly depression.Stigma is widely defined as a mark of shame or social disapproval that distinguishes an individual or group from others.Stigma presents itself in the context of mental health as negative preconceptions, prejudice, and discrimination aimed against persons suffering from depression.The literature gives a complete knowledge of depression stigma's multidimensional character, spanning different components that contribute to its widespread prevalence.Stigma may be categorized under a few umbrellas namely public stigma, selfstigma, perceived stigma and cultural perspective on stigma.
The general public's unfavourable views and ideas about those suffering from depression is referred to as public stigma (Maeshima & Parent, 2020).Misconceptions about the origins and effects of depression have regularly been demonstrated in studies to contribute to public stigma, producing an atmosphere in which affected persons may fear judgement and social rejection.Individuals seeking treatment may be discouraged from getting aid if they sense society disapproval, which may lead to self-stigmatization.
Self-stigma, also known as internalised stigma, arises when people suffering from depression internalise negative stereotypes and ideas about mental illness (Maeshima & Parent, 2020).This type of stigma can lower self-esteem and self-efficacy, making it more difficult to seek treatment.Understanding the mechanisms by which self-stigma functions is critical for creating therapies that target negative beliefs internalisation and promote selfacceptance.
The fear of discrimination or bad sentiments from others is referred to as perceived stigma (Maeshima & Parent, 2020).Individuals may be afraid of social implications if they disclose their depression symptoms or seek therapy.The research emphasises the significance of perceived stigma as a substantial factor affecting help-seeking decisionmaking, with implications for the design of stigma reduction initiatives.
Cultural influences are important in influencing the experience of stigma.Depression is seen differently in different civilizations according to cultural norms, beliefs, and values (Wang et al., 2019).The research investigates the intersectionality of depressive stigma, acknowledging that cultural variations can influence the presentation and repercussions of stigma, and that adapting therapies accordingly is critical.For example, those from Asian community are seen to have less depression literacy as compared to the Western community (Lynch et al., 2021).
In a nutshell, stigmatising beliefs suggest that depression is a personal weakness or a flaw in one's character, ignoring its complex medical and psychological components.As a result, people may internalise these negative views, postponing or avoiding treatment entirely.The fight against depression stereotypes is an important part of developing a culture that values and promotes mental health.

Definition of Depression Literacy
Depression literacy is defined differently in different research, but it is generally agreed that it refers to an individual's knowledge and comprehension about depression symptoms, causes, risk factors, and accessible therapies.According to Jorm (2000), depression literacy involves recognising the condition, comprehending its implications, and being aware of available resources.This conception serves as the foundation for numerous field research.
Depression literacy is to an individual's understanding and opinions regarding depression, including understanding it, handling, and avoiding it (Wang et al., 2019).It includes knowing the symptoms, causes, and therapies of depression as well as the significance of getting treatment for depression.Depression literacy has a significant role in encouraging teenagers to seek out mental health assistance.
There are various components to depression literacy.Reavley and Jorm (2012) highlighted three essential dimensions in their model: (a) the capacity to recognise distinct depressive symptoms, (b) comprehending the causes and risk factors, and (c) knowledge of successful treatment alternatives.Recognising depression literacy's multidimensional character is critical for designing thorough evaluation methods and educational treatments.
When defining depressive literacy, several researchers use a mental health literacy paradigm.Kutcher et al (2016) provided a holistic approach that involves understanding of mental health illnesses, knowing how to seek assistance, and being aware of accessible options.This larger paradigm is consistent with our growing understanding of mental health literacy and its application to depression.

Definition of Psychological Help Seeking Behaviour
Understanding psychological help-seeking behaviour is critical for dealing with mental health issues among university students.This article delves into the numerous aspects of getting help for mental health issues, highlighting the elements that impact individuals in their choices to seek help.The research on psychological help-seeking behaviour dives into the nuances of when, when, and how people seek assistance for mental health difficulties, laying the groundwork for the development of successful therapies.
Psychological help-seeking behaviour encompasses the actions individuals take to seek assistance for mental health concerns.According to Rickwood et al. (2005), it involves acknowledging a need for assistance, actively seeking resources, and engaging with formal or informal counselling.This approach emphasises the proactive nature of obtaining psychological well-being support.
There are two types of psychological help-seeking behaviour: formal and informal.Formal help-seeking involves speaking with mental health practitioners, counsellors, or healthcare professionals for professional support (Guenthner et al., 2023).In contrast, informal help-seeking comprises requesting assistance from friends, family, or other nonprofessional sources.The research emphasises the need of knowing both paths in order to design comprehensive strategies that accommodate students' different needs and preferences.
Numerous studies have found that there are challenges that prevent people from obtaining psychological care (Maeshima & Parent, 2020).Stigma, a perceived lack of social support, worries about confidentiality, and a lack of mental health knowledge are some of these hurdles.Recognising and removing these obstacles is critical to fostering a more supportive atmosphere that promotes open communication about mental health and supports prompt and appropriate help-seeking.
The literature also investigates the elements that promote psychological help-seeking behaviour.Facilitators are described as positive social support networks, understanding of accessible services, and mental health literacy.Understanding these characteristics might help shape programmes that foster a culture of help-seeking by improving individuals' abilities to recognise the need for assistance and efficiently navigate available options.
Cultural influences have a substantial impact on how people perceive and engage in help-seeking behaviour.Cultural norms, attitudes, and beliefs may affect preferences for getting assistance from certain sources, determining whether people seek aid from official or informal channels.The research emphasises the necessity of culturally competent therapies that take into account various cultural views on mental health and help-seeking.
Gender variations in psychological assistance-seeking behaviour have been studied, revealing that cultural expectations and gender norms may impact how individuals express and seek support (Staiger et al., 2020).Understanding these gender-related differences is critical for customising treatments that take into account the particular barriers that male and female students encounter when seeking mental health help.
Finally, the literature on the concept of psychological help-seeking behaviour provides a thorough examination of the elements that influence when, when, and how people seek treatment for mental health difficulties.Recognising the multidimensional nature of helpseeking behaviour is critical for designing treatments that serve the different needs of university students while also creating a campus atmosphere that promotes mental wellbeing.

The Relationship Between Depression Stigma and Psychological Help Seeking Behaviour Among Students
Numerous research show that depression stigma has a negative impact on students' willingness to seek mental health treatment.Corrigan (2004) discovered that people who are stigmatised about their mental health are more likely to delay getting professional help because they are afraid of being judged and socially excluded.Similarly, Vogel et al (2007) discovered a negative relationship between stigma and help-seeking behaviour, highlighting the critical importance of stigma reduction in boosting mental health support-seeking.
According to research, stigma plays a substantial role in students' perceived barriers to getting mental health services.Pescosolido et al (2010) recognised public stigma as a primary barrier, as individuals expect negative society reactions to their mental health issues.Furthermore, as investigated by Vogel et al (2013), self-stigma involves internalized feelings of shame and might reduce the chance of seeking professional care.

The Relationship Between Depression Literacy and Psychological Help Seeking Behaviour Among Students
Depression literacy, defined as knowledge and comprehension of depression and related mental health disorders, has a significant impact on people's attitudes about obtaining professional psychological care.Individuals with greater levels of depression literacy are more likely to have favourable attitudes towards professional psychological help-seeking attitude, according to research (Perre et al., 2016;Wang et al., 2019;Al-Shannaq et al., 2023).Depression literacy is understanding the symptoms, causes, therapies available, and possible advantages of obtaining professional care for depression.Individuals who have accurate and complete knowledge on depression are better able to recognise the symptoms and realise the need of obtaining specialised help.
The link between depression literacy and attitudes about seeking professional mental health care is substantial and should not be underestimated.Kulwicka & Gasiorowska (2023) discovered that those with greater levels of depression literacy had more favourable views towards getting professional care for depression.This shows that education and awareness activities focused at promoting depression literacy can have a significant influence on people's attitudes towards getting treatment.We can empower individuals to overcome stigma, see the significance of getting professional care, and ultimately boost their mental health by improving depression literacy through targeted educational initiatives and distributing factual information on depression.

The Gender Differences towards Depression Stigma.
Numerous studies have found gender differences in how mental diseases, including depression, are viewed.Traditional gender norms, according to Schnittker and Pescosolido (2014), frequently result in differing social expectations and views of mental health disorders.
Females, for example, may be more accepting of admitting and seeking assistance for depression, but males may encounter higher cultural hostility.
Gender stereotypes have a big impact on how people perceive mental health concerns.Wong et al (2017) discovered that conventional masculine values, such as emotional stoicism, may contribute to male depressive stigma.Females, on the other hand, may face stigma as a result of assumptions that associate mental health issues with perceived feminine qualities.

The Gender Differences towards Depression Literacy
Understanding the gender gap in depression literacy is critical for developing mental health education and intervention programmes that are effective.According to research, there are differences between genders in the awareness and understanding of symptoms of depression.Women, according to Addis and Mahalik (2003), are better at recognising emotional and interpersonal indicators of depression, whereas males can underestimate or misinterpret these symptoms.This gender disparity in symptom detection might lead to differences in depression literacy.
Gender-related issues impact how people obtain and interpret mental health information.Females, according to Furnham and Hamid (2014), are more proactive in seeking information about mental health disorders, especially depression.This desire for informationseeking correlates to women having greater levels of depression literacy than males.Several studies have found gender disparities in attitudes towards treatment for depression alternatives.According to Oliffe et al (2016), males who are affected by conventional masculine ideals may have more unfavourable views towards professional help-seeking.Women, on the other hand, seem to have more positive views and are more eager to try new treatments.
Gender socialisation influences attitudes and understanding regarding depression.Individuals' learning and perceptions of mental health are influenced by society expectations and gender norms, according to (Barney et al., 2017).Stigma linked with mental health concerns may also play a role in gender disparities in addressing and comprehending depression, with women frequently being more receptive to obtaining knowledge.
Interventions aimed at increasing depression literacy may differ in efficacy depending on gender.According to Jorm et al (2010), while educational programmes usually promote mental health literacy, their impact may differ depending on gender.It is critical to tailor treatments to target gender-specific obstacles and preferences in order to maximise efficacy.

The Gender Differences towards Psychological Help Seeking Behaviour
Gender appears to impact help-seeking behaviour in the setting of depressive stigma, according to research.According to Fischer and Farina (1995), females are more likely to seek professional care for mental health concerns, whereas males may be more likely to rely on informal support networks.These gender differences might be due to cultural expectations and the perceived repercussions of requesting assistance.
Gender may have a role in the association between depression stigma and help-seeking behaviour among students, according to the findings.According to Gulliver et al (2010), females feel less stigma-related hurdles and are more ready to seek psychological care than their male counterparts.Understanding gender effects can help guide focused actions.
However, there is no consistent difference between a male and a female psychological well-being.There has been proof that there is a difference between a man and a woman psychological well-being dimension.For example, women score lower in autonomy and self-acceptance as compared to men.Men on the other hand scored lower in personal growth and positive relations (Matud et al., 2019).
Nonetheless, the aim of this research is to identify the gender difference on help seeking attitudes of students.As a nation that has a strong patriarchy system, vulnerability is shown as a sign of weakness to the society.Therefore, it is substantial for future counsellors to further investigate the relation between gender and help seeking attitude especially in men.It was mentioned by Call & Shafer (2015) that men normally would seek help regarding mental health issue would not take depression as their primary issue.Thus, would not receive the necessary treatment for depression.

Research Design
This study intends to focus on the relationship between depression stigma and depression literacy towards psychological help seeking attitude among university students in Malaysia.This study applies a quantitative approach, with data being collected through a questionnaire method.The survey is distributed among university students namely among public university namely University Sains Islam Malaysia.The questionnaire will be distributed through university lecturers, ensuring a diverse representation of students across different disciplines and academic levels.In this study, researchers used a questionnaire to create a correlation design.

Population and Sample Size
The chosen university for this study is Universiti Sains Islam Malaysia (USIM) which the main campus is situated in Nilai Negeri Sembilan.The population definition of this study is undergraduate students between the age of 18-28 years old within the 6 faculties in USIM.There are a total of 6 faculties in the main campus Nilai, which are Faculty of Quran and Sunnah Studies (FPQS), Faculty of Leadership and Management (FKP)

, Faculty of Sharia and Law (FSU), Faculty of Economy and Muamalat (FEM), Faculty of Science and Technology (FST), Faculty of Main Language Studies (FPBU), Faculty of Medical and Health Science (FPSK).
It was reported, on the 3 rd October 2023, that there are 2400 registered students for 2023/2024 Academic Session Bachelor recruitment at Universiti Sains Islam Malaysia (USIM).Among those numbers, 1557 are females and 843 are males.The information is provided by USIM's e-Risalah.
Cochran Formula is a popular technique for estimating the sample size needed for a study.By applying the Cochran method to determine the sample size, one may minimise unnecessary data gathering efforts while guaranteeing the study's statistical power.The formula enables researchers to optimise time and resources by striking a compromise between precision and practicality, with a target population of 2400 undergraduate students at USIM.With a defined degree of confidence, researchers can make inferences about the traits, attitudes, or behaviours of the undergraduate population by choosing a suitable sample size based on the Cochran formula's computations.This methodical strategy to sampling improves the study's dependability and helps researchers to draw conclusions and make suggestions based on the data, which advances knowledge and comprehension among academics.
The sampling technique applied for this technique is Random Cluster Sampling technique.Splitting the target population into groups or clusters and then randomly choosing a subset of these clusters to include in the research is known as the random cluster technique, which is one of thean analytical approach to sampling.This method has a number of benefits, especially for research with sizable and widely distributed populations.The population can be grouped into categories such as neighbourhoods, schools, or even faculties, for the purpose of managing the sampling process more effectively.Since each cluster has an equal probability of being included in the sample, randomly picking clusters helps to ensure representativeness and eliminate bias.

Research Instruments
The questionnaire will be divided into four sections: Demographic, Depression Stigma, Depression Literacy, and Psychological Help Seeking Attitudes.The questions in each section will be presented using a Likert scale (e.g., strongly agree to strongly disagree) and multiplechoice questions (MCQs).This questionnaire consists of 50 items which have 3 main instruments which are; the Depression Stigma Scale (DSS) with 18 items, Depression Literacy Questionnaire (D-Lit) with 22 items and Attitudes Towards Seeking Professional Psychological Help Scale Short Form (ATSPPH-SF) with 10 items all together.

Depression Stigma Scale (DSS)
The Depression Stigma Scale (DSS) was used to examine stigma associated with depression.It comprised of 18 questions split into two subscales; personal stigma and perceived stigma.It applied the 5-point Likert scale for assessment, with the total score for each subscale ranging from 0 to 36.A higher score suggests that depression is more stigmatised.Cronbach's alpha for the ATSPPH-SF scale was 0.938 in this study.

Depression Literacy Scale (D-Lit)
The Depression Literacy Questionnaire (D-Lit), a 14-item questionnaire, was used to measure the participants' understanding of depression (Gulliver et al., 2012).The overall score varied from 0 to 14, with a higher score suggesting a better degree of depression literacy.Each item has three alternative answers: true, false, or I'm not sure.Each correct response earned one point per item; thus, the overall score is obtained by adding the number of accurate answers.Cronbach's alpha for the ATSPPH-SF scale was 0.783 in this study.

Attitude Towards Seeking Professional Psychological Help Scale Short Form (ATSPPH-SF)
The ATSPPH-SF (Attitudes Towards seeking Professional Psychological Help Scale Short Form) was used to measure respondents' attitudes toward obtaining professional psychological aid (Fischer & Farina, 1995).It had ten items and was scored on a four-point Likert scale.It ranged from 0 (strongly disagree) to 3 (strongly agree).The scores for items 2, 4, 8, 9, and 10 are reserved.By adding all replies to 10 items, the overall score varied from 0 to 30.A higher score suggests more favourable views towards getting psychological assistance.Cronbach's alpha for the ATSPPH-SF scale was 0.928 in this study.

Data Collection
As for the distribution and data collection procedures, the questionnaire will be administered by university lecturers during regular class sessions.The questionnaire is shared through a link that will direct the students to the questionnaire's google form.Participants will be given ample time to complete the questionnaire and will have the option to do so anonymously.Participants will be assured of the confidentiality and anonymity of their responses.Informed consent will be obtained from each participant, clearly stating the purpose of the study and how the data will be used.The study will adhere to all ethical guidelines and regulations set by the university and relevant research ethics committees.Once the data have been collected, the researchers will keyed-in the data collected into an SPSS application to be analysed.

Data Analysis
Data analysis is an important part of scientific research because it allows researchers to get relevant insights from data.To acquire a more thorough comprehension of the relationships in the dataset, three statistical approaches are used which are the Welch t-test, Pearson correlation analysis, and the Point-Biserial Correlation Coefficient.
A detailed data analysis was performed using various statistical approaches to evaluate the association between Depression Stigma and Attitudes Towards Receiving Professional Psychological Care.The Welch t-test was used to compare means between two independent groups.Furthermore, Pearson Correlation Analysis was used to assess the strength and direction of the linear relationship between continuous variables.In addition, the Point-Biserial Correlation Coefficient was used to investigate the relationship between a continuous variable (attitudes toward getting treatment) and a binary variable (presence or absence of depressive stigma).The significance level will be set at alpha = .05for all statistical tests, indicating a 5% chance of obtaining results as extreme as those observed due to random chance.
Similar to previous research objective, the Point-Biserial Correlation Coefficient will be used to assess the relationship between the binary variable Depression Literacy Questionnaire and Attitudes Towards Seeking Professional Psychological Help.The significance level will be set at alpha = .05for all statistical tests, indicating a 5% chance of obtaining results as extreme as those observed due to random chance.However, since the Depression Literacy questionnaire focus is based on true and false type of questionnaire, the chosen analyses, Welch t-test, Pearson Correlation Analysis, and Point-Biserial Correlation Coefficient, will provide comprehensive insights into the relationships and differences within the variables under investigation.
In conclusion, various statistical tools are used to solve distinct issues and concerns inside the dataset.The Welch t-test takes into account the gender imbalance in participants, Pearson correlation analysis investigates linear associations between continuous variables, and the Point-Biserial Correlation Coefficient assesses the link between a binary variable and a continuous variable.These analyses, taken together, lead to a thorough comprehension of the dataset and support evidence-based findings in the research paper.  1 shows the result of analysis of the correlation between Depression Stigma and Psychological Help Seeking Behaviour.The significance value (<0.001) which is less than α (0.01) indicates that there exists correlation between Depression Stigma and Psychological Help Seeking Attitude and the analysis is statistically significant.The negative value of Pearson Correlation Coefficient (r=-0.748)indicates a strong negative relationship between Depression Stigma and Psychological Help Seeking Attitude.When the level of stigma increase, the tendency to seek for Psychological Help will decrease and vice versa.Based on the data provided, it can be concluded that the hypothesis 1: There is a significant relationship between depression stigma and psychological help seeking behaviour among students is accepted.

Hₐ2
There is a significant relationship between depression literacy and psychological help seeking behaviour among students.2 shows the result of analysis of the correlation between Depression Literacy and Psychological Help Seeking Behaviour.The significance value (<0.001) which is less than α (0.01) indicates that there exists correlation between Depression Literacy and Psychological Help Seeking Attitude and the analysis is statistically significant.The value for the pointbiserial correlation (r=0.185)indicates a weak positive relationship between Depression Literacy and Psychological Help Seeking Attitude.As the level of literacy on depression increase, the attitude towards seeking help on psychological will also increase.Although the relationship between the two variables shows a weak positive relationship, it can be concluded that the hypothesis 2: There is a significant relationship between depression literacy and psychological help seeking behaviour among students is accepted.

Hₐ3
There is a significant difference between gender and depression stigma among students.From table 3, the value of t-statistic and p-value for Depression Stigma between male and female is 8.104 and <0.001 respectively.The p-value (<0.001) which is lower than α (0.05) indicate that we could conclude that there is statistically significant difference in the levels of Depression Stigma between male and female.The positive value of t-statistic (8.104) shows that on average, male have significantly higher negative stigma rather than female.Thus, hypothesis 4 is accepted.
Ha4 There is a significant difference between gender and depression literacy among students.From table 4, the value of Welch's t-test value and p-value for Depression Literacy between male and female is -2.090 and 0.038 respectively.The p-value (0.038) which is less than α (0.05) indicate that there is significant difference of knowledge on depression between male and female.The negative t-test value (-2.090) indicates that on average, male have significantly lower literacy on depression rather than female.Therefore, the hypothesis proposed is accepted.
Ha5 There is a significant difference between gender and psychological help seeking behaviour among students.Table 5 shows the result of Welch's t-test on Psychological Help Seeking Attitude between genders.From the table, the value of t-statistic and p-value for Psychological Help Seeking Attitude between male and female is -6.597 and <0.001 respectively.The p-value (<0.001) which is lower than α (0.05) indicate that we could conclude that there is statistically significant difference in the means of psychological help seeking attitudes between male and female.The negative value of t-statistic (-6.597) shows that on average, male have significantly lower tendency on psychological help seeking attitudes rather than female.

Discussion
Hypothesis 1: There is a significant relationship between depression stigma and help psychological help seeking behaviour among students.
Based on previous study conducted by Arnaez et al (2020), the findings suggest that the higher the internalised stigma, the stronger the barrier of seeking mental health.The study suggests that internalised stigma is closely associated to a stronger sense of barriers to mental health care, and that addressing both concerns concurrently may be important to enhance treatment-seeking behaviour.
These findings have important practical consequences, particularly in the context of mental health therapies and public health initiatives.The negative relationship identified in the study stresses the crucial need to address and reduce stigma associated with mental health concerns.Anti-stigma initiatives, education programmes, and community outreach activities that focus on destigmatizing mental health disorders are critical in creating an atmosphere in which individuals feel comfortable seeking psychological care without fear of judgement.
A study by Conceição et al (2022) discovered that prior help-seeking had a greater impact on willingness to seek treatment than on the value and need for treatment.This shows that prior help-care experiences are an important strategy for promoting literacy and helpseeking behaviours.As a result, interventions targeted at decreasing stigma and encouraging help-seeking behaviours should take into account the influence of previous help-seeking experiences.
Furthermore, the discovered association highlights the significance of personalised treatments that take into account the impact of stigma in developing individual attitudes towards mental health care.Creating a supportive social environment and tailoring interventions to address stigma-related issues may lead to a beneficial shift in attitudes, eventually encouraging a more open and welcoming approach to obtaining psychiatric care.As suggested by Maeshima & Parent (2020), there is a need to create an outreach activity on college campuses in order to remove the stigma associated with mental health.Educational programmes, workshops, and events focused at raising awareness and understanding of mental health concerns, as well as the significance of getting professional care, might be included in these efforts.
While the findings provide light on the association between depression stigma and psychological help-seeking behaviour, it is critical to recognise the changing nature of society views towards mental health.Future study should investigate these dynamics further, taking into account cultural, demographic, and environmental variables that may impact the observed connections.
Finally, the current study confirms the strong negative relationship between depression stigma and psychological help-seeking attitudes.These findings highlight the need of destigmatization initiatives and the creation of focused treatments to create a more supportive atmosphere for those seeking psychiatric help.
Hypothesis 2: There is a significant relationship between depression literacy and psychological help seeking behaviour among students.
The current study, which aims to evaluate the association between depression literacy and psychological help-seeking behaviour, fits within a larger framework of contemporary mental health research.A significant finding from the study, reflected by a point-biserial correlation coefficient (r = 0.185), reveals a weak positive link between depression literacy and attitudes towards psychological help-seeking.This means that as people become more knowledgeable about depression, their attitudes about obtaining psychological care improve.
A previous study by Wang et al (2019) demonstrated that depression literacy was connected with help-seeking behaviour for mental health services, both within and outside of the school environment.Higher levels of depression literacy, in particular, were connected to an increased chance of seeking treatment for mental health difficulties.This shows that a better awareness of depression and its symptoms may lead to a greater desire among high school students to seek psychiatric care.
Finally, the small positive link shown between depression literacy and psychological help-seeking attitudes is consistent with current findings.These findings emphasise the potential for mental health literacy interventions to favourably influence individuals' attitudes about obtaining psychological care, emphasising the necessity of continued efforts to improve mental health education and awareness.
A cross-sectional study of secondary school and university students from B40 households in Malaysia (Ibrahim et al., 2019) showed that higher self-stigma and younger age were related with unfavourable mental help-seeking attitudes among Malaysian students from low-income families.Furthermore, as compared to secondary school students, university students exhibited higher levels of depression literacy as well as lower levels of selfstigma and negative perceptions about mental illness.
Hypothesis 3: There is a significant difference between gender and depression stigma among students.
One crucial thing to consider is how society defines gender roles and expectations.The persistence of gender norms may influence how individuals perceive and respond to mental health concerns.In popular culture, men are generally seen as stoic and less likely to display vulnerability, whereas women could be considered to be emotionally open.Different attitudes towards depression may result from these assumptions influencing how stigma is viewed and expressed.
The hypothesis that there is a gendered component to the stigma associated with depression among students is supported by several empirical investigations.According to research, men may be less likely than women to seek mental health treatment because they worry about coming out as weak or unmanly.Males were associated with higher personal stigma towards depression (Yang et al., 2020).However, women may encounter other difficulties, such as being labelled as excessively sentimental or prone to mood swings.It is essential to comprehend these subtleties in order to create focused treatments that reduce stigma and promote help-seeking behaviours.
It is also important to take note the cultural influence towards the idea and concept of mental health.A cultural belief will shape a society's perception or stigma towards any mental health conditions.Thus, make it harder for people to seek help.People who come from cultures where mental illness is seen as a sign of spiritual weakness may think that depression is manageable on its own without the need for medical assistance or therapy (Yang et al., 2020).It is essential for there to be educational awareness and dialogue regarding mental health topics in society today.

Hypothesis 4: There is a significant difference between gender and depression literacy among students
Literacy in the context of mental health refers to the comprehension and knowledge of a specific subject.Depression literacy on the other hand refers to individual's knowledge and awareness on the symptoms and concept of depression as a whole.Furthermore, it is often known that a person's depression literacy level increases with education level (Mamun et al., 2020).Between male and female, how many are aware and approach the topic accordingly.It is noted that, compared to men, women reported being more literate about depression (Mamun et al., 2020).This ultimately supports this research finding where there is a significant difference between gender and depression literacy among students.
The educational setting is one important component that affects depression literacy.Identifying and resolving gender differences in depression literacy is essential to developing mental health therapies that work.It would be a good idea for educational institutions and mental health organisations to modify their programmes so that male and female students are more effectively reached and involved.Gender-inclusive and culturally aware methods can aid in closing the gaps in depression literacy and advance a more thorough knowledge of mental health.
In conclusion, the notion that there is a significant gap in gender and depression literacy among students raises crucial concerns about how educational, social, and individual variables contribute to these discrepancies.In order to improve depression literacy among students and eventually create a more supportive and healthy learning environment, it is important that these differences be taken seriously while developing interventions.
Hypothesis 5: There is a significant difference between gender and psychological help seeking behaviour among students.
Help-seeking behaviour may be impacted by the accessibility and availability of mental health options on college campuses.Both male and female students may be less likely to seek psychological assistance if resources are difficult to get to or if they are unaware of the services that are offered.Campuses need to work to provide a setting where mental health services are clearly marked, widely advertised, and within easy reach of every student.It is essential to acknowledge the link between gender experiences and psychological helpseeking behaviour and other dimensions of identity, includes socioeconomic background, race, and ethnicity.Understanding the particular difficulties experienced by people navigating several facets of identity is made easier with the use of an intersectional perspective.
Recognising the gender gap in students' psychological help-seeking behaviour has significant consequences for mental health support services.In order to provide a welcoming and supportive atmosphere for all students, universities and colleges should endeavour to cultivate a culture that promotes open dialogue about mental health, hence, makes resources easily available, and aggressively disputes gender-based biases.
In short, the hypothesis that there is a significant difference in the behaviour of students who seek psychological care based on their gender highlights the necessity of tailored and nuanced approaches to mental health support on campuses.Through tackling societal norms, stigma, cultural elements, and communication patterns, academic establishments may establish a setting that fosters the welfare of every student, regardless of gender.

Conclusion
Lastly, this study investigates the depression stigma and depression literacy concerning obtaining mental health care.When the factors are addressed, and being discussed further, it is clear how much the interaction between them impacts the effectiveness of guidance and counselling services.The findings offer useful insights with implications for future study, initiatives, authorities, the general public, and various interested parties.The study adds to the expanding body of information about mental health in university settings, particularly in Malaysia.The positive link between depression literacy and positive psychological help-seeking attitudes encourages further research into educational interventions and awareness campaigns that might positively affect students' attitudes toward seeking mental health care.
The recent finding of a negative connection between depressive stigma and psychological help-seeking attitudes emphasises the need of stigma-reduction programmes.Future mental health programmes may be designed to address particular elements that contribute to stigma, creating a more welcoming atmosphere for students to seek help when necessary.The survey provides university administrators with information on the mental health landscape on their campuses.This understanding is critical for the establishment of policies and resources that promote a psychologically healthy environment, meet students' individual needs, and provide accessible support networks.
The discovery of a negative relationship between depressive stigma and help-seeking attitudes highlights the widespread nature of stigma.This highlights the difficulties connected with altering society beliefs and emphasises the significance of ongoing work to de-stigmatize mental health disorders.The negative link between depressed literacy and stigma suggests that stigma continues even with improved reading.This may imply the need for more complex educational practices that actively question and modify society assumptions and attitudes in addition to conveying knowledge.
Longitudinal studies might help future study investigate the dynamic nature of these interactions over time.Understanding how attitudes, stigma, and literacy change over the course of a student's academic career can give a more complete picture.Consideration of intersectionality, including characteristics such as cultural origin, socioeconomic class, and gender, might add complexity to the study.Recognising students' varying experiences among various identity groups is critical for building more inclusive solutions.
Interventions should take a comprehensive approach, integrating standard mental health education with measures that aggressively confront stigma.Creating open discussions and debate spaces can help to change attitudes within the academic community.Collaboration between universities and mental health experts has the potential to improve support services.Integrating mental health experts into campus life makes services more available to students who are coping with mental health issues.
Authorities can use the study's findings to help build mental health regulations on college campuses.It is critical to promote a culture of well-being by making mental health services visible, accessible, and de-stigmatized.Awareness initiatives that challenge preconceptions and foster open talks about mental health can benefit the general public, including academic communities and society at large.The media, community leaders, and educational institutions may all play important roles in changing cultural beliefs.
Finally, this study establishes the groundwork for understanding the complicated relationship between depression stigma, depression literacy, and psychological help-seeking attitudes among Malaysian university students.While the findings suggest promising paths for future research and interventions, the study also emphasises the ongoing issues associated with stigma and the importance of continued efforts to promote supportive mental health settings.

Table 2
Pearson Correlation Value between Depression Literacy and Psychological Help Seeking

Table 3
Welch's t-test on Genders Depression Stigma

Table 5
Welch's t-test on Genders for Psychological Help Seeking Attitude