Young Adults’ Perceptions of the Role of Self-Reliance and Trust on Help Seeking for Mental Health Problems

Abstract

Many young people are reluctant to seek support for mental health concerns, and a preference for self-reliance has been identified as a key barrier. Yet, the conceptualisation of self-reliance and its role in help seeking is not well understood. This study examines the meaning of self-reliance for young people and how they perceive it affects help seeking, with a focus on the role of trust (both in oneself and in others). Thirty Australian young people aged 18–25 years were interviewed. A reflexive approach, incorporating both inductive and deductive coding techniques, was used to construct themes about self-reliance, trust, and help seeking for young people. Participants identified that both self-reliance and help seeking exist on a continuum from insufficient self-reliance to extreme self-reliance and excessive help seeking to unwillingness to seek help. Trust was a key component of self-reliance, and a balance between trust in oneself and trust in others was deemed necessary for self-reliance to be adaptive and for appropriate help seeking to occur. To maintain this balance, young people felt that a level of self-awareness was necessary. A high level of trust in oneself was considered to increase self-reliance, whereas a high level of trust in others increases help-seeking behaviours. Understanding the role of trust in self-reliance informs developmentally appropriate ways to address self-reliance as a barrier to mental health help seeking for young people.

1. Introduction

Mental health problems are a growing concern for young people worldwide [1]. Yet, despite this age range being the most vulnerable to mental ill-health, there is strong evidence internationally showing that young people in their teens and early adult years are the least likely age groups to seek help, particularly professional help for mental health problems [2,3]. Although accessing mental healthcare is efficacious for young people, a gap remains between the need for treatment and service use, with potential negative consequences throughout adult life from not receiving effective care [4,5]. Help seeking for mental health problems is, however, a complex, non-linear process that includes problem recognition and awareness, and knowledge of, access to, and positive attitudes to using both informal and professional sources of support [6].

Key barriers to help seeking have been identified [7]. These include practical issues, like finances and distance to services; social concerns, such as fear of social stigma [8] and feelings of shame [9]; and negative perceptions of the availability of social support and effective professional services [10]. If these barriers are not overcome, efficacious treatment will fail to reduce the burden of mental ill-health for youth. It is, therefore, critical to understand the barriers that prevent young people from accessing mental health services and how to best mitigate these. A prominent psychological barrier for young people is a preference for self-reliance [2,7], whereby emerging adults prefer to deal with their emotional problems by themselves [11]. While this is a developmentally appropriate indicator of adult independence, it can act as a deterrent to seeking emotional help when needed.

1.1. Self-Reliance

Self-reliance is broadly defined as a preference for solving problems on one’s own [12]. It is considered a sign of resilience and is key to a successful transition to adulthood [13]. Self-reliance has been conceptualised in various ways and within many different frameworks. Examples include attachment theory (i.e., attachment avoidance) [14]; autonomy and emotional reliance (i.e., self-determination and willingness to receive emotional support) [15]; self-sufficiency [16]; counter-dependency in response to separation anxiety [17] or control and overly protective parenting [18]; and individualism [19]. Despite this diversity, these conceptualisations all accept that self-reliance is an important process of maturation, and adaptive self-reliance is characterised by the capacity to draw upon one’s own abilities but also seek support when required [20]. Those who demonstrate adaptive self-reliance (i.e., relying on themselves but being able to seek support when needed) can do so due to the secure attachments they can turn to for support as needs arise [21].

The foundation of autonomy is a key task of late childhood according to Erikson’s influential theory of psychosocial development; however, in adolescence and early adulthood, when identity and relationships are strongly influenced by questioning and reintegration of autonomy, independence, and increasing control over life choices, self-reliance becomes particularly salient [22]. Consequently, during adolescence, a sense of autonomy and decision making capacity grows and, importantly, becomes oriented more towards peers than the family of origin for support [2]. This developmental period can be characterised as a time of learning to balance the need for independence with the need for support. Failure to balance these needs appropriately (i.e., being insufficiently independent or insufficiently support seeking) is likely to be maladaptive [12].

A maladaptively high preference for self-reliance (i.e., a preference to manage all problems on one’s own) can reduce help seeking, increase mental distress, increase the risk of suicidality [14], and is associated with poorer evaluations of informal social supports [14,23]. Maladaptively high self-reliance has been described using terms such as survivalist self-reliance [24], profound self-reliance [24,25], excessive self-reliance [26], and extreme self-reliance [12,14]. Although it is most commonly known as extreme self-reliance in the growing body of literature related to this subject [10,27], terminology differences demonstrate that self-reliance is an area of research where a unified approach has yet to be achieved.

Self-reliance in seeking help for mental health concerns has been linked to several concepts in the literature, including fear of stigma [2], concerns about confidentiality [28], self-stigma [8], pride in independence [12], beliefs that problems cannot be understood by others [26], and holding masculine ideals [28]. Cultural factors affecting the perceived need for care and desire to engage with medical support have also been associated with the tendency for self-reliance [29]. Self-reliance is clearly a multidimensional construct influenced by social (e.g., support), psychological (e.g., attitudinal), and practical (e.g., availability) factors.

1.2. Trust and Self-Reliance

Self-reliance is likely to require a level of trust in oneself, whereas help seeking requires that an individual places their trust in another person, as it usually involves an interpersonal interaction [10]. Relative levels of trust (in oneself and others) should, therefore, correlate with both a tendency for self-reliance and a tendency for help seeking. Several of the factors identified as being related to self-reliance appear to be conceptually related to trust. For example, low perceptions of social support [12], poor past experiences with help seeking [30], and distrust in others following negative social interactions [26] have all been linked to extreme self-reliance. A distrust of others as a result of past experiences or a perception of poor social support indicates a belief that trust in others is not an option. For example, a qualitative study of how 23 “at-risk” young adults with multiple externalising problems and risk factors (e.g., related to delinquent behaviours) reported that the youth who exhibited “profound” self-reliance tended to endorse beliefs about trust, such as “…the only person I could trust is myself…”, and reported help-seeking attitudes, like “I know I’ll only ask for help when I’m in really, really deep trouble” [25]. These responses suggest a relationship between high levels of self-trust and simultaneously low trust in others, extreme self-reliance, and reduced help seeking, particularly amongst young people who have not experienced supportive attachments in the past.

Trust has been shown to increase help-seeking behaviours in young people. Having available and trusted health professionals facilitates increased help seeking in mental health contexts [7,31]. Trust has also been recognised as a facilitator of help seeking in informal settings, such as trust in referral suggestions from friends and family [32]. Trust in others is, therefore, likely to facilitate help seeking, but the relationships among trust, self-reliance, and help seeking need to be better understood to determine how self-reliance may operate as either a facilitator or barrier to help seeking among young people.

Research has established that self-reliance and help seeking are linked, particularly for mental health problems among young people, and that trust appears to be related to self-reliance as well as being a facilitator of seeking help. What this relationship looks like and how young adults, who are negotiating independence and need for support, conceptualise self-reliance and trust is an area in need of further research. The present study investigates the concept of self-reliance from the perspective of young adults, specifically focusing on what ways, if any, trust is related to self-reliance and how these may interact to influence help-seeking processes.

2. Materials and Methods

2.1. Participants

Thirty young people living in Australia aged 18–25 years participated. The mean age was 21.6 years (SD = 2.3); 18 were female and 12 were male; none were non-binary; and nine identified as being from a culturally and linguistically diverse background. Twelve participants indicated that they perceived they had experienced greater adversity in their lives compared to their age-matched peers (8 females, 4 males, e8 from culturally and linguistically diverse backgrounds).

Participants were recruited using flyers and snowball sampling. We aimed for a community sample of a diverse range of young people, including those harder to reach (i.e., not just college/tertiary students). Flyers were placed in community centres and other community meeting spaces, and participants were encouraged to pass the information on to friends (such snowball sampling is effective for recruiting harder-to-reach young people [33]). An AUD 30 e-gift voucher was provided as compensation for their time. Given the opt-in nature of participation, there were no participants who refused; none dropped out of this study, and all participants answered all questions. Recruitment initially aimed for least 12 participants in each gender group [34] but continued until we had reached inductive thematic saturation within gender groups and for young people who had experienced greater life adversity [35].

2.2. Procedure

Potential participants contacted the researchers via details on the flyer. They were provided with a Participant Information form, and informed consent was obtained prior to the interview. Interviews were conducted online via Zoom between March and April 2023 and lasted between 20 and 60 min (M = 38 min). Interviews were divided evenly between two researchers to reduce potential bias [36] and ensure that stylistic differences were minimised. Both researchers were female and final-year Master of Clinical Psychology students. They used a reflexive interview approach to acknowledge and critically examine their role and potential biases throughout this study to reduce the likelihood of leading participants and to increase confidence in interpreting participant responses. This entailed the researchers continuously reflecting on and sharing how their own perspectives, experiences, and context influenced the research process. This approach aims to enhance the credibility and depth of qualitative research by making the process more transparent and self-aware [37].

After some introductory discussion to establish rapport, the interview guide comprised 13 questions related to perceptions of self-reliance, with the questions increasing in specificity as the interview progressed. Questions asked participants to define the concept of self-reliance, indicate factors (both individual and environmental) that might affect self-reliance, whether trust in themselves and others was related to self-reliance, and consider how a preference for self-reliance might impact help seeking, particularly for mental health problems. Participants were asked to think about young people in general, rather than just their own specific thoughts and behaviours. They were also asked whether they thought and whether their friends would think that they had experienced more challenging life events than other people their age. Demographic questions included age, gender, and cultural identity.

Ethics approval was obtained from the University of Canberra Human Research Ethics Committee (202211903).

2.3. Analysis

Interviews were transcribed verbatim using the assistance of the online transcription service, Otter.ai. They were reviewed to remove identifying information (e.g., names) and correct transcription errors. Transcripts were not provided back to participants for comment [38]. QSR International NVivo 12.2 software was used for coding and analysis. Within an overall reflexive approach, thematic analysis was conducted using Braun and Clarke’s six-step data analysis process [36,39], adopting a realist approach [40]. A combined inductive (data-driven) and deductive (theory-driven) approach was taken. Researchers began by familiarising themselves with the data by reviewing each transcript thoroughly. Based on recommendations [41], six interviews (20% of the data) were selected as being representative of the sample (i.e., age, gender, adversity, cultural identity, and endorsed beliefs). These were coded individually by the two researchers. Coding and theme construction for these six interviews were then compared between researchers, and discrepancies were re-coded to increase reliability. These transcripts were then re-coded by the project supervisor for additional reliability. The remaining interviews were divided between the two researchers and coded independently using the themes constructed during initial coding but with the addition of themes as appropriate. Graphing software within NVivo was used to compare the final codes made by the two researchers. Participants did not provide feedback on the findings. Reporting of the results is guided by the consolidated criteria for the reporting qualitative research (COREQ) checklist [42].

3. Results

Four main themes comprising adaptive self-reliance continuum, trust in oneself and others, self-awareness, and help seeking as a strength, were constructed and are described below.

3.1. Adaptive Self-Reliance Continuum

Self-reliance was described as being on a continuum from insufficient self-reliance (lower end), adaptive self-reliance (middle), and extreme self-reliance (upper end). Adaptive self-reliance was described as “healthy”, “balanced”, “middle ground”, giving and taking support, asking for help when needed, and being “socially connected”. Participants agreed that some level of self-reliance was adaptive and that it was useful and important to not rely on other people, specifically noting the importance of making one’s own decisions. “I think that goes back to the healthy self-reliance and on unhealthy self-reliance. So I think people will access services when they realise that they can’t do it by themselves anymore, or they’ve exhausted all of their own support networks and then need to go and access like mental health or, you know, that kind of thing” (Participant 7). Adaptive self-reliance was described as similar to independence, with many participants not distinguishing between the two constructs.

Non-adaptive self-reliance included both extreme and insufficient self-reliance. Extreme self-reliance was described as “unhealthy”, “damaging”, “selfish”, “unrealistic”, “negative”, “cynical”, and “toxic”. It was associated with outcomes such as “stress”, “burnout”, “overwhelm”, reduced safety, “avoidance”, social disconnection, and even pathology, “they might have been tackling their challenges by themselves for a really long period of time and then kind of gotten to a breaking point, it’s become extremely overwhelming and now they’ve got maybe some kind of pathology” (Participant 7).

Extreme self-reliance was associated with an unwillingness to seek help, even when it was necessitated by the situation. For some participants, this was seen to be related to pride, which was attributed to potential overconfidence in one’s abilities, “pride can kind of push self-reliance to the extreme and then create more problems” (Participant 5). However, others indicated that not seeking help when necessary may be more associated with not wanting to be a burden, “I think there’s also like another bit of self-reliance where it’s like ‘No, I don’t want to be a burden on anyone’. I wouldn’t want to be a burden on the healthcare system” (Participant 21).

The notion of insufficient self-reliance was also raised as maladaptive, characterised by “over dependence”, “co-dependency”, “anxious attachment”, always receiving support, not “growing” or “learning”, being burdensome, and “asking for help before trying”. Often, insufficient self-reliance was synonymous with excessive help seeking but also included aspects of independence, such as lack of financial or emotional independence. Participants reflected, “I don’t see it as detracting from self-reliance to want to speak to other people. But it’s bad if like you can’t cope without speaking to other people” (Participant 3) and “People that aren’t self-reliant are quite codependent and they might feel really anxious in their relationships” (Participant 7).

When considering factors that would lead to insufficient self-reliance, some participants felt that individuals who had not had the opportunity to develop age-appropriate independence would be more likely to lack self-reliance. They saw self-reliance as a blend of independent action coupled with a sense of personal ability. An over-reliance on family during early adulthood and late adolescence was frequently considered a factor that led to this, “Too much reliance on family unit that can make it difficult to have an understanding of your own personal ability to manage things” (Participant 13). There was a general consensus that young people needed to attempt to do things themselves and thereby develop confidence in their own abilities, only seeking help when they could not complete a task after having tried.

Self-reliance was considered to be both domain dependent (varying depending on context) as well as being on a continuum from insufficient to healthy to extreme. “There’s different forms of self-reliance, I guess, in those different domains. And some people can be very self-reliant in a professional domain, but sort of a little bit awkward or… I guess, lacking that calmness and self-knowledge in a social domain” (Participant 27). This sentiment was repeated throughout the interviews, with many participants describing themselves as self-reliant in some domains and not in others (e.g., financially dependent on others but emotionally self-reliant). At the same time, there was a general regard for the balance that exists between being highly self-reliant and being “un-self-reliant”. The need for maintaining this balance was put down to the usefulness of being able to achieve things on your own and, at the same time, the usefulness of utilising the resources at your disposal. Variation in self-reliance across domains reflected that the participants discussed self-reliance in a broad context, beyond just the impact on dealing with emotional problems and potentially seeking mental health help.

3.2. Trust in Oneself and Others

Both trust in oneself and trust in others were revealed as critical factors related to self-reliance. Young people with a high level of trust in themselves were perceived to be more self-reliant, more resilient, and more independent. Trust in oneself was described as the confidence that you will “rise to the occasion” when faced with adversity, and that you can “make the right decision” and overcome challenges that occur “day to day and over the long term”. Participant 18 noted, “I think that trusting… like trusting yourself is the most important part of self-reliance. Kind of in the name I guess, but you know, to rely on yourself. You need to trust that you are capable of doing the things that you rely on yourself for”.

“Confidence” was the word most frequently used to refer to trust in oneself, but another related theme was that of “resilience”. Participants felt that individuals who had demonstrated greater resilience (i.e., the ability to “bounce back”) would subsequently have a greater trust in themselves because of this competency. Confidence and resilience have in common that they can refer to both how an individual handles challenging life events (e.g., significant stressors in early childhood) and how they cope with responsibilities of daily living (e.g., paying rent, grocery shopping).

Trust in others was associated with social support and the availability of trusted personal relationships that were characterised by safety and strong attachment. “It is important that you know, trust the outside world, that you trust the people that you’re close with, trust the people. I think it is important that trust is important for self-reliance because you need people around you, to encourage you and you need to feel safe around them” (Participant 2).

Trust in others was considered to be a key component of healthy self-reliance, although was itself dependent on life experiences. Participants identified that experiences that reduced trust in others could lead to an increase in self-reliance and potentially be associated with extreme self-reliance and an unwillingness to seek help in the future. “I think, a lack of trust in others or being hurt in previous experiences where you’ve been vulnerable… feeling like you have no really like true friends or no support, I think can kind of make you think, well, actually, we’re all alone in this world and we should just be able to cope with things ourselves” (Participant 3).

In general, there was consensus that trust in others is necessary for human survival, with participants recognising that humans are social creatures and that individuals are not able to do everything alone. The importance of “social connection” underpinned trust in others. Sometimes, this connection with others was identified as an explicit reason for cultivating trust in others (i.e., to increase connection), and other times, it was seen as a byproduct of needing others. Regardless, it was a positive outcome of having trust in others. “I just don’t think that anyone can live by themselves. Like you need support. Like you can be self-reliant to the point where like, you’re not always looking for help, like, you know, you’re taking accountability for like your own life and taking responsibility for whatever you need to do, and mistakes you make, but I don’t think that you can kind of live happily without relying on other people” (Participant 21).

Trust in oneself and trust in others were not seen as mutually exclusive; a high level of both was the most desirable and most likely to result in adaptive self-reliance. One way this was described by participants was in terms of “open mindedness”. Open-minded individuals may have a high level of trust in themselves, but they take into consideration the perspectives of others. “If you don’t rely on other people, you will create a situation where you are only thinking with yourself and that can create a funny little echo chamber of one person which is not good for your own thinking. Also, you don’t know everything, you can never know everything, other people might know things that will help you” (Participant 17). In this quote, there is recognition that consulting others increases one’s trust in oneself. There is also the understanding that a high level of trust in oneself without trust in others can lead to cognitive biases and mistakes that are otherwise avoidable. Trust in oneself needs to be balanced and supported by trust in others.

A high level of trust in others and low trust in oneself was associated with insufficient self-reliance. Participants felt that these individuals had low confidence in their own abilities to problem solve, often because of insufficient opportunities to do so in the past (e.g., being “mollycoddled”) and, therefore, were more likely to have confidence in others than in themselves. Conversely, high trust in oneself and low trust in others was typically associated with extreme self-reliance. It was felt that these individuals would be less help seeking, potentially due to insufficient or inadequate help in the past and would hold the belief that it is better to cope with challenges on one’s own than expose yourself to others. Low trust in oneself and low trust in others was not a combination that was described in any of the interviews.

3.3. Self-Awareness

To be adaptively self-reliant, participants perceived that self-awareness was essential. Self-awareness describes an individual’s knowledge of their emotions, capabilities, resources, boundaries, and limitations. High self-awareness was associated with adaptive self-reliance, whereas low self-awareness was associated with both insufficient and extreme self-reliance. Participants indicated that self-aware individuals could identify when they needed help, how much help, and what kind of help they needed. “If you have this healthy level, maybe it’s like, based off past experience … They might be more in tune with themselves and like past experiences in terms of just like ‘Okay, now I know I need help, or I know I know I can do this by myself because I’ve done this before type thing’” (Participant 10). Self-aware individuals could understand their personal capacity to manage difficulties based on knowledge of their strengths and weaknesses, intellectual capabilities, and their ability to self-reflect, receive feedback, and set realistic goals. An important characteristic of self-awareness was understanding personal limits, boundaries, and the assessment of their own needs rather than relying on others to do so (e.g., “you need help”). Participant 27 noted, “I guess that’s self-knowledge to know what you’re capable of doing or not doing. So, you know, if you have to get from A to B, but you know, you can’t read a map. You bring someone who can read a map”.

Participants felt that self-aware individuals were able to act in their own best interests, although, interestingly, some felt that they did not always have this quality themselves, “I guess knowing yourself well and what you need at any time, if you need to reach out or if you can deal, is something I need to work on a lot–it changes with what’s happening” (Participant 3).

3.4. Help Seeking as a Strength (When Required)

Participants considered self-awareness and knowledge to be a deciding factor in help seeking; they felt that if an individual could accurately and consciously reflect on their abilities in context, they would seek help or not as required. Help seeking was generally understood by participants as the process of identifying the need for support and taking steps to obtain this support through intentional and interpersonal interaction, as defined in the literature [6]. Importantly, all participants acknowledged the need for help seeking in some contexts, and many regarded help-seeking behaviours as a character strength. When asked what they thought of others who asked for help, responses included “I think it takes a lot of strength to ask for help. Especially if it’s something personal that you’re asking for help about. Because a lot of times it’s a lot easier to just try to do it on your own. So yeah, I think it takes a lot of courage to ask for help” (Participant 6). Participants also tended to agree that help seeking could be a vulnerable and difficult process that may be perceived as a weakness by others, but mostly reflected non-judgementally on it and felt that to seek help was a sign of strength and a quality to be admired.

There was also recognition of the need for balance between neither being excessively help seeking nor unwilling to seek help. Excessive help seeking was associated with insufficient self-reliance and an unwillingness or inability to problem solve on one’s own. It was also associated with high trust in others and low trust in oneself. Unwillingness to seek help was associated with extreme self-reliance, discussed in relation to insufficient trust in others and high levels of trust in oneself.

Many participants acknowledged that they themselves did not seek help as often as they would like to or perhaps should. While there was a social stigma associated with being extremely self-reliant and unwilling to seek help, there was also a clearly expressed dislike towards the appearance of being insufficiently self-reliant and excessively help seeking. When asked “What do you think of people who ask for help?” participants responded “Fine. As long as it’s not like everything. But yeah, I think that goes back to the people that like, too much on the ‘not self-reliant’ like spectrum” (Participant 8); and “Everyone has asked for help throughout their life, so I feel like it is that middle ground where you’re able to be both self-reliant and ask for help” (Participant 15).

When asked what self-reliant help seeking might look like, one participant described “Um, like let’s say you’re making dinner and you’ve prepped pretty much everything, but you can’t reach the wine glasses on the very top shelf and you don’t have a stool or a chair around and you merely are just too short to grab it. You can ask for help. That doesn’t mean you’re not self-reliant on anything, just means you can’t physically reach it” (Participant 19).

There was some disagreement about whether a given action could be both self-reliant and help seeking, with some participants identifying help seeking as a means of self-reliance (i.e., I seek help so that I am able to be self-reliant) and others feeling that individual actions were either help seeking or self-reliant but not both. Generally, however, it was conceded that an individual could be overall self-reliant and still seek help when necessary.

Figure 1 summarises the continua of the dimensions and how they are likely to co-occur. On the left there is insufficient self-reliance with low trust in oneself and high trust in others and excessive help seeking; in the middle, there is healthy adaptive self-reliance with balanced trust in oneself and others and help seeking when needed, which was supported by self-awareness; and on the right, there is extreme self-reliance with high trust in oneself low trust in others and insufficient help seeking.

4. Discussion

This study examined young people’s views about self-reliance, a recognised barrier to seeking help for mental health problems [6,7]. Encouraging young people to seek both informal and professional help for mental health problems is argued to be essential to reducing the prevalence and burden of mental health problems for these vulnerable age groups [27]. Despite self-reliance being indicated as a barrier to seeking help in the literature, young people in this study described a much more nuanced understanding of self-reliance. They described self-reliance as an adaptive quality but one that exists on a continuum from insufficient to adaptive to extreme self-reliance. Healthy, adaptive self-reliance was at the centre of this continuum and comprised the optimal state. They also recognised that self-reliance is domain dependent and varies in different areas of life at different times, including but not only for mental health support. They considered help seeking to be directly related to self-reliance and as also being on a continuum from overdependence to a lack of needed social connection and support. Adaptively self-reliant individuals sought help when needed but were expected to deal with their issues when able to do so. Unwillingness to seek help was associated with extreme self-reliance, and excessive help seeking was associated with insufficient self-reliance. Extreme self-reliance, not self-reliance per se, was considered the barrier to help seeking [7,9,10].

Both extreme self-reliance and insufficient self-reliance were regarded as undesirable and maladaptive. Future research could develop our understanding of the relative undesirability of each and whether the social perceptions of this undesirability impact help-seeking behaviour. Individuals who are extremely self-reliant may be this way in part because they do not want to be perceived by themselves or others as insufficiently self-reliant. This would accord with previous research about self-stigmatisation (both oneself and others) and the impact of this on help seeking [7,8].

Novel to this study was the exploration of the theme of trust and the relevance of both trust in oneself and trust in others. Participants felt that those who were extremely self-reliant would have a low level of trust in others, a high trust in themselves, and a general unwillingness to seek help. The converse was also proposed, whereby those with insufficient self-reliance would have low trust in themselves, high trust in others, and be excessive in their help-seeking behaviours. Trust is a key outcome of secure attachment, which supports both self-confidence and the belief that other people are safe and supportive, which in turn supports seeking help in times of personal challenge [43,44]. It is surprising that this construct has not been more fully explored in the research on seeking help. Our participants felt that there was a balance along the dimensions of self-reliance, trust, help seeking, and self-awareness that was optimal for young people’s adaptive coping with mental health problems and other life stresses. Many of these factors reflect the notion of mental health literacy, which is an acknowledged facilitator of mental-health-related help seeking [27].

The themes were generally congruent with previous research that has identified life experiences (e.g., different stress domains), social connectedness, perceptions of help seeking [9,24], and confidence and optimism [45] as being key to how individuals develop and express self-reliance. Underpinning notions of resilience were also apparent, as well as pride and fears of being a burden. Participants tended to regard resilience as a component of trust in themselves (i.e., a resilient person has greater confidence in their own abilities). Fears of being a burden and excessive pride in independence were associated with extreme self-reliance. Pride in one’s ability to look after oneself was not always considered negative, but excessive pride (identifying as wholly independent) was considered to be negative as it did not allow for trust in others and adaptive self-reliance.

Importantly, for young people’s help seeking, previous research has identified stigma as a key driver of self-reliant behaviours in relation to mental health support [46]. Although participants in this study identified that help-seeking stigma was held by some people, none of them personally endorsed stigmatising attitudes towards seeking help. Instead, participants used words such as “selfish”, “toxic”, and “cynical” to describe individuals who were extremely self-reliant and did not seek help for their mental health and relied solely on themselves. This observation was not anticipated and could indicate a self-perpetuating cycle whereby those who do not seek help then find it harder to connect with support due to increasing levels of social disconnection and self-stigmatisation which then negate seeking help [47]. Social connection and safety were a key motivating factor associated with seeking help and were repeatedly referenced as a positive outcome of help seeking, above and beyond the benefit of accessing the required support. This could explain the links between self-reliance, perceptions of social support, and intentions to seek help observed in other research [10].

An implication of this study is that a measure of self-reliance is needed that incorporates both adaptive and maladaptive dimensions. Currently, there are no established standardised measures that apply in the mental health help-seeking context [16,23]. Studies have used single-item measures (e.g., “I prefer to solve problems on my own” [12,48]), borrowed items from help-seeking measures, or used items that relate to self-reliance but are too generic (e.g., “I know how to help myself” [46]). We need to develop a more robust construct and measure that can be used to unify future research efforts.

Our results align with observations reported by Quick et al. [17] that informed the development of their self-reliance measure specific to anxiety. Self-reliance is a multidimensional construct influenced by developmental (i.e., attachment styles and adverse experiences), social (e.g., stigma, social support), and structural (e.g., accessibility of support) factors. These factors were associated with the shaping of key features of self-reliance (i.e., independence, autonomy, ability to cope, confidence/trust in self, and self-awareness).

Importantly, a measure of self-reliance needs to incorporate trust in oneself and others. For instance, an item such as “I do not trust myself to make decisions” could be used to assess insufficient self-reliance, while an item such as “I do not trust others to be there for me” may assess extreme self-reliance. Notably, future researchers should avoid using items that contain help-seeking references; a self-reliance measure is needed that can predict help seeking rather than be confounded with it. For instance, an item related to self-awareness, such as “When I realise I need it, I get help”, would measure self-awareness but would also measure help seeking. This type of tautology is evident in many of the measures used in the extant research demonstrating that a better, unconfounded, measure of self-reliance is needed.

The main practical implication of this study is that self-reliance needs to be considered in a more detailed way as a potential barrier to young people’s help seeking. Adaptive self-reliance was valued and seen as a strength and sign of maturity by our participants; it was not viewed as a barrier to seeking help. In contrast, both extreme and insufficient self-reliance were deemed maladaptive; the first suppressing seeking help when required and the latter resulting in overdependence—neither of which were thought to demonstrate appropriate maturity for emerging adults. Trust in oneself and others, along with self-awareness, were seen to be key personal strengths that underpinned adaptive self-reliance and facilitated seeking mental health support when needed. Programs aiming to improve mental health and help-seeking behaviour, such as those focused on mental health literacy, may benefit from incorporating a discussion of self-reliance, trust, and self-awareness, thereby more fully unpacking the effects of this important aspect of young people’s development.

A key strength of the current study is that it directly obtained the views of 30 young Australians from diverse backgrounds in terms of gender, cultural background, and experience of adversity. The qualitative nature of our approach ensured that their viewpoints were considered in depth and allowed themes to be constructed inductively, enabling new insights. Our specific focus was on self-reliance and the role of trust as a potential influence, as suggested by the literature [31], but other themes were also constructed from participant responses. Many of these were congruent with findings from the literature [49], although they revealed that a much more nuanced and comprehensive conceptualisation of self-reliance and its impact on help seeking was required.

The results must be considered in light of this study’s limitations. These include that the views of these young people do not comprise a representative sample, and other young people may have different perspectives. It was also challenging to ask questions in the interviews that probed our interest areas without somewhat priming these issues. It is clear that the impact and expression of self-reliance as young people attain adult status is an area requiring further research.

5. Conclusions

This study confirms that self-reliance is relevant to young people’s help seeking, in general, and for mental health problems specifically, but that a more comprehensive and dimensional approach to its conceptualisation is required. Trust in oneself and others are important aspects of self-reliance and impact whether or not an individual will engage in help seeking. Both insufficient and extreme self-reliance were seen to be maladaptive, but through self-awareness and balancing trust in oneself with trust in others, adaptive self-reliance, which included both independence and seeking help when needed, could be achieved. These findings may inform future interventions for young people who are unwilling to seek help even when their own capacities have been exceeded.