Female undergraduate students' experiences and barriers in accessing mental health services: an interpretative phenomenological analysis

Abstract

Female undergraduate students may experience overlapping developmental and academic stressors that contribute to psychological distress. Despite the availability of campus counseling services and a Healthy Campus program, a gap persists between students experiencing mental health difficulties and those seeking professional psychological support. This study aimed to explore female undergraduate students’ lived experiences of psychological distress, help-seeking behaviors, and perceived barriers to accessing campus psychological services at a private university in Indonesia. A qualitative study employing Interpretative Phenomenological Analysis (IPA) was conducted with four female undergraduate students purposively selected using Healthy Campus screening records and prior counseling service utilization. Data were collected through semi-structured, in-depth interviews guided by a researcher-developed interview protocol and analyzed using the six-step IPA framework. The findings were interpreted in relation to the Stuart Stress Adaptation Model. Three overarching themes emerged: (1) Clinical Manifestations of Psychological Distress, (2) Psychosocial and Behavioral Impacts, and (3) Barriers to Accessing Campus Psychological Services. Participants described interconnected cognitive, emotional, and physical manifestations of distress, alongside psychosocial and behavioral consequences. Formal help-seeking was frequently delayed until distress intensified, sometimes involving serious safety concerns or existential crises. Perceived confidentiality risks and concerns regarding overlapping academic and counseling roles further complicated service utilization. These findings highlight the importance of strengthening accessible, confidential, and independent campus psychological services. Dedicated counseling professionals without academic evaluative responsibilities and private, soundproof counseling facilities may help address perceived barriers and promote earlier help-seeking among female undergraduate students.