{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:03:49Z","timestamp":1789625029237,"version":"build-2803163510"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>In the context of high awareness but low utilization of university counseling services, an important question is whether university mental health support may still carry psychological significance when actual service use remains limited. Drawing on social support theory and stigma theory, this study extends the understanding of university mental health support beyond a utilization-based perspective by examining whether students\u2019 perceptions of university mental health support are associated with mental health through perceived stigma. Using survey data from 642 university students in China, this study developed an analytical model examining the associations among perceived institutional support, perceived stigma, and mental health outcomes. The results showed that perceived institutional support was positively associated with mental health and negatively associated with perceived stigma. In addition, perceived stigma was negatively associated with mental health and statistically accounted for part of the observed association between perceived institutional support and mental health, suggesting an indirect association consistent with the proposed theoretical model. These findings suggest that the potential value of university mental health support may extend beyond actual counseling utilization. Rather, students\u2019 perceptions of institutional recognition, accessibility, and acceptance of psychological support may represent an important aspect of the campus mental health environment. This perspective is particularly relevant within the Chinese higher education context, where concerns about social evaluation and stigma may influence students\u2019 willingness to acknowledge psychological difficulties and seek support. This study contributes to the literature by moving beyond a utilization-based framework and highlighting the potential contextual significance of perceived institutional support in relation to stigma and mental health. Practically, the findings suggest that Chinese universities may consider not only service availability but also students\u2019 perceptions of institutional support when evaluating campus mental health environments.<\/jats:p>","DOI":"10.3389\/fpsyg.2026.1897669","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:32:48Z","timestamp":1789623168000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High awareness but low utilization: How perceived institutional support shapes college students\u2019 mental health through stigma?"],"prefix":"10.3389","volume":"17","author":[{"given":"Deyun","family":"Luo","sequence":"first","affiliation":[{"name":"School of Digital Commerce, Nanjing Vocational College of Information Technology","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinchun","family":"Gu","sequence":"additional","affiliation":[{"name":"School of Trade Finance, Wuxi City College of Vocational Technology","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huizhu","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Water Pollution Control & Green Resource Recycling, School of Environment, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Economics and Management, Nanjing Agricultural University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1186\/s12888-023-04645-8","article-title":"A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students","volume":"23","author":"Ahmed","year":"2023","journal-title":"BMC Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s43045-024-00425-6","article-title":"The stigma towards seeking help among university students: a cross-sectional study in Jordan","volume":"31","author":"AlSamhori","year":"2024","journal-title":"Middle East Curr. Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1177\/0706743719839381","article-title":"Internet interventions for adults with anxiety and mood disorders: a narrative umbrella review of recent Meta-analyses","volume":"64","author":"Andersson","year":"2019","journal-title":"Can. J. Psychiatry"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1111\/pcn.12086","article-title":"Mental health stigma in Japan","volume":"67","author":"Ando","year":"2013","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1111\/j.1440-1614.2006.01741.x","article-title":"Stigma about depression and its impact on help-seeking intentions","volume":"40","author":"Barney","year":"2006","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jad.2014.10.054","article-title":"The prevalence and correlates of depression, anxiety, and stress in a sample of college students","volume":"173","author":"Beiter","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1017\/S0033291714000129","article-title":"What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies","volume":"45","author":"Clement","year":"2015","journal-title":"Psychol. Med."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1037\/0033-2909.98.2.310","article-title":"Stress, social support, and the buffering hypothesis","volume":"98","author":"Cohen","year":"1985","journal-title":"Psychol. Bull."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/0149206310388419","article-title":"Signaling theory: a review and assessment","volume":"37","author":"Connelly","year":"2011","journal-title":"J. Manag."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1002\/j.2051-5545.2009.tb00218.x","article-title":"Self-stigma and the \u201cwhy try\u201d effect: impact on life goals and evidence-based practices","volume":"8","author":"Corrigan","year":"2009","journal-title":"World Psychiatry"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1521\/jscp.2006.25.8.875","article-title":"The self-stigma of mental illness: implications for self-esteem and self-efficacy","volume":"25","author":"Corrigan","year":"2006","journal-title":"J. Soc. Clin. Psychol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1017\/S2045796018000057","article-title":"Was Eysenck right after all? A reassessment of the effects of psychotherapy for adult depression","volume":"28","author":"Cuijpers","year":"2018","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1080\/07448481.2024.2346349","article-title":"Mental health among U.S. college students: implications of COVID-19 and roles of institutional and individual characteristics","volume":"73","author":"Deng","year":"2025","journal-title":"J. Am. Coll. Heal."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"116","DOI":"10.3389\/fpsyt.2017.00116","article-title":"Prevention of mental health disorders using internet- and mobile-based interventions: a narrative review and recommendations for future research","volume":"8","author":"Ebert","year":"2017","journal-title":"Front. Psych."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1097\/MLR.0b013e31803bb4c1","article-title":"Help-seeking and access to mental health care in a college student population","volume":"45","author":"Eisenberg","year":"2007","journal-title":"Med. Care"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1037\/0021-9010.71.3.500","article-title":"Perceived organizational support","volume":"71","author":"Eisenberger","year":"1986","journal-title":"J. Appl. Psychol."},{"key":"ref21","first-page":"67","volume-title":"Report on national mental health development in China (2023\u20132024)","author":"Fang","year":"2025"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1111\/j.1467-9280.2007.01882.x","article-title":"Required sample size to detect the mediated effect","volume":"18","author":"Fritz","year":"2007","journal-title":"Psychol. Sci."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.jad.2019.11.058","article-title":"Psychological interventions for depression in Chinese college students: a systematic review and meta-analysis","volume":"262","author":"Fu","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"15897","DOI":"10.1038\/s41598-020-72998-1","article-title":"Prevalence of depression among Chinese college students: a systematic review and meta-analysis","volume":"10","author":"Gao","year":"2020","journal-title":"Sci. Rep."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"3605","DOI":"10.1080\/07448481.2024.2428408","article-title":"Perceived stigma, mental health, and campus support among Latina\/o and white college students","volume":"73","author":"Garcia","year":"2025","journal-title":"J. Am. Coll. Heal."},{"key":"ref27","volume-title":"Stigma: Notes on the Management of Spoiled Identity","author":"Goffman","year":"1963"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"113452","DOI":"10.1016\/j.psychres.2020.113452","article-title":"The role of perceived social support on depression and sleep during the COVID-19 pandemic","volume":"293","author":"Grey","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/1471-244X-10-113","article-title":"Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review","volume":"10","author":"Gulliver","year":"2010","journal-title":"BMC Psychiatry"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s10464-007-9100-9","article-title":"The relationship between self-reported received and perceived social support: a meta-analytic review","volume":"39","author":"Haber","year":"2007","journal-title":"Am. J. Community Psychol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1177\/0963721414523775","article-title":"Structural stigma and the health of lesbian, gay, and bisexual populations","volume":"23","author":"Hatzenbuehler","year":"2014","journal-title":"Curr. Dir. Psychol. Sci."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1037\/amp0000068","article-title":"Structural stigma: research evidence and implications for psychological science","volume":"71","author":"Hatzenbuehler","year":"2016","journal-title":"Am. Psychol."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1037\/a0016918","article-title":"Social support and mental health among college students","volume":"79","author":"Hefner","year":"2009","journal-title":"Am. J. Orthopsychiatry"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1126\/science.3399889","article-title":"Social relationships and health","volume":"241","author":"House","year":"1988","journal-title":"Science"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1080\/00207411.2021.1965397","article-title":"Mediating effect of stigma on the relationship between mental health literacy and help-seeking attitudes among university students in South Korea","volume":"52","author":"Kim","year":"2021","journal-title":"Int. J. Ment. Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1037\/0022-0167.47.1.138","article-title":"Emotional openness as a predictor of college students\u2019 attitudes toward seeking psychological help","volume":"47","author":"Komiya","year":"2000","journal-title":"J. Couns. Psychol."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"584","DOI":"10.3390\/healthcare10030584","article-title":"Mental health shame, caregiver identity, and self-compassion in UK education students","volume":"10","author":"Kotera","year":"2022","journal-title":"Healthcare"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1037\/cou0000108","article-title":"Does self-stigma reduce the probability of seeking mental health information?","volume":"63","author":"Lannin","year":"2016","journal-title":"J. Couns. Psychol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1080\/09540260701278903","article-title":"Stigma towards people with mental illness in developing countries in Asia","volume":"19","author":"Lauber","year":"2007","journal-title":"Int. Rev. Psychiatry"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1136\/jech.57.4.259","article-title":"Chinese SF-36 health survey: translation, cultural adaptation, validation, and normalisation","volume":"57","author":"Li","year":"2003","journal-title":"J. Epidemiol. Community Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1111\/jcpp.13585","article-title":"Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis","volume":"63","author":"Li","year":"2022","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/s40359-025-02688-y","article-title":"Prevalence of depression among college students in China: a systematic review and meta-analysis","volume":"13","author":"Lin","year":"2025","journal-title":"BMC Psychol."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1146\/annurev.soc.27.1.363","article-title":"Conceptualizing stigma","volume":"27","author":"Link","year":"2001","journal-title":"Annu. Rev. Sociol."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1176\/appi.ps.201800332","article-title":"Increased rates of mental health service utilization by U.S. college students: 10-year population-level trends (2007\u20132017)","volume":"70","author":"Lipson","year":"2019","journal-title":"Psychiatr. Serv."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1016\/j.socscimed.2010.09.030","article-title":"Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis","volume":"71","author":"Livingston","year":"2010","journal-title":"Soc. Sci. Med."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1080\/00207590444000339","article-title":"United States and Japanese college students' attitudes toward seeking professional psychological help","volume":"40","author":"Masuda","year":"2005","journal-title":"Int. J. Psychol."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s13033-022-00569-0","article-title":"College students\u2019 use of mental health services: a systematic review and meta-analysis","volume":"16","author":"Osborn","year":"2022","journal-title":"Int. J. Ment. Health Syst."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"106244","DOI":"10.1016\/j.neubiorev.2025.106244","article-title":"Prevalence of mental disorder symptoms among college students: an umbrella review","volume":"175","author":"Paiva","year":"2025","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1016\/S0895-4356(98)00104-8","article-title":"Translation and psychometric evaluation of a Chinese version of the SF-36 health survey in the United States","volume":"51","author":"Ren","year":"1998","journal-title":"J. Clin. Epidemiol."},{"key":"ref3001","doi-asserted-by":"publisher","first-page":"218","DOI":"10.5172\/jamh.4.3.218","article-title":"Young people\u2019s help-seeking for mental health problems","volume":"4","author":"Rickwood","year":"2005","journal-title":"Australian E-Journal for the Advancement of Mental Health"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.psychres.2003.08.008","article-title":"Internalized stigma of mental illness: psychometric properties of a new measure","volume":"121","author":"Ritsher","year":"2003","journal-title":"Psychiatry Res."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1037\/0022-3514.44.1.127","article-title":"Assessing social support: the social support questionnaire","volume":"44","author":"Sarason","year":"1983","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1177\/0022146510395592","article-title":"Mechanisms linking social ties and support to physical and mental health","volume":"52","author":"Thoits","year":"2011","journal-title":"J. Health Soc. Behav."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1080\/09638237.2024.2408237","article-title":"The impact of social support on college students living with mental illness: a systematic review and narrative synthesis","volume":"34","author":"Vicary","year":"2025","journal-title":"J. Ment. Health"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1037\/0022-0167.53.3.325","article-title":"Measuring the self-stigma associated with seeking psychological help","volume":"53","author":"Vogel","year":"2006","journal-title":"J. Couns. Psychol."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1037\/0022-0167.54.1.40","article-title":"Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling","volume":"54","author":"Vogel","year":"2007","journal-title":"J. Couns. Psychol."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med. Care"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/med:psych\/9780195126709.003.0004","volume-title":"Social Support Measurement and Intervention: A Guide for Health and social Scientists","author":"Wills","year":"2000"},{"key":"ref59","first-page":"98","article-title":"The theoretical basis and research application of the social support rating scale","volume":"4","author":"Xiao","year":"1994","journal-title":"J. Clin. Psychiatry"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.psychres.2017.01.008","article-title":"Challenging mental health related stigma in China: a systematic review and meta-analysis","volume":"255","author":"Xu","year":"2017","journal-title":"Psychiatry Res."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1016\/j.socscimed.2006.11.013","article-title":"Culture and stigma: adding moral experience to stigma theory","volume":"64","author":"Yang","year":"2007","journal-title":"Soc. Sci. Med."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1093\/ije\/dyu039","article-title":"Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing \u201cwhat matters most\u201d to identify culture-specific aspects of stigma","volume":"43","author":"Yang","year":"2014","journal-title":"Int. J. Epidemiol."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1897669\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:32:50Z","timestamp":1789623170000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1897669\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":57,"alternative-id":["10.3389\/fpsyg.2026.1897669"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1897669","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"1897669"}}