Predictors of Psychological Help Seeking Intentions among the University Students in Tanzania

Worldwide, students in higher learning institutions face psycho-social challenges. Some of the challenges require to be addressed through seeking psychological help services offered by the universities. Despite the prevalence of the challenges and availability of psychological help services, studies reported that utilization of such services is very low. The existing literature provides limited information about the university students’ help seeking intentions in Tanzania. Using a cross-sectional survey, this study assessed the extent to which attitudes, subjective norms and perceived behavioural control explain the university students’ intentions to seek psychological help. A total of 740 students from two public universities in Tanzania was conveniently selected to participate in the study. Data were analysed through descriptive and inferential statistical techniques. Results showed that students’ intention to seek psychological help was higher, and varied according to sex and fields of study. Multiple regression analysis indicated that attitudes, perceived behavioural control and subjective norms predicted intention to seek psychological help among university students. Creating awareness about the benefits of psychological help services can help to increase university students’ utilization of psychological help services. The implications of the results, limitation and direction for future studies are provided.


Introduction
University life brings both exciting and challenging experiences to students. It may be exciting because getting to university provides a student with an opportunity to meet new people, create new networks, develop an autonomous personal life as well as get and develop into their chosen careers (Bayram & Bilgel, 2008). Though students may have an opportunity for personal development, university life may threaten their psycho-social well-being as a result of experiencing various stressors (Park et al., 2020;Wittenberg, 2001). The stressors that university students experience mainly emanate from aspects related to choosing courses to major on, attending classes on regular basis, meeting the deadline of the assignments provided, staying away from family members, establishing and maintaining personal relationships and engaging in romantic relationships (Arnett, 2000;Compas et al., 1986;Julal, 2013;Mahfar et al., 2007;Mindrup, 2012;Pedrelli et al., 2015). Stressors may also come from aspects related to experiencing financial difficulties, adaptation challenges brought about by the university life as well as thinking about their future employment or attempt searching for employment opportunities (Julal, 2013;Tinto, 1993). In particular, Tanzanian university students may experience stress when they fail to secure loans to sustain their life while at the university as majority of them rely on loans from the Higher Education Student Loans Board (HESLB) to pay for their university fees and cater for other university expenses (Boniface, 2008).
Alongside the experience of the stressors, university students are part of the cohort of young people who are not immune and indeed susceptible to encounter particular psychosocial problems. In the Western and Asian countries, anxiety, depression, interpersonal problems, romantic relationship difficulties, sexual harassment are part of the main psycho-social problems which most of the university students experience (Bastiani et al., 2019;Connell et al., 2007;Craggs, 2012;Mohammed et al., 2021;Pavithra et al., 2020;Pedrelli et al., 2015;Sivertsen et al., 2019). In sub-Saran Africa, the prevalence of psycho-social problems such as depression, sexual harassment cases, romantic relationship difficulties were reported among university students in Ghana, Nigeria, Uganda and Tanzania (Abe, 2012;David et al., 2014;Onditi et al., 2014).
The implication of these revelations is that the university students may not be able to address these problems on their own. Thus, universities worldwide established psychological help services to enhance students' health growth and adjustment throughout the entirety of their studies  International Association of Counseling Services [IACS], 2011;Yelpaze & Ceyhan, 2019). In particular, the University of Dar es Salaam (UDSM) and the University of Dodoma (UDOM) which were involved in this study initiated psychological counselling services with a view to addressing students' psycho-social challenges. The provision of psychological help services at both UDSM and UDOM is mainly coordinated by the dean of students' offices which work closely with the counselling units and health centres within the universities in identifying the psycho-social problems facing the students.

University Students Avoidance of Seeking Psychological Help
Evidence from research shows that the utilization of psychological help services among the university students is very low despite the fact that they are in serious need of it (Kamunyu et al., 2016a;Raunic & Xenos, 2008;Rosenthal & Wilson, 2008;Stallman & Shochet, 2009;Yin-Fah et al., 2016). Corollary, students rarely utilize psychological help services even in circumstances where they are unable to deal and solve the problems being experienced (Serim and Cihangir-Çankaya, 2015;Topkaya et al., 2017). Most of the students do not seek psychological help from professionals unless the problem seemed crucial, and that informal sources mostly friends and parents were the primary sources of referrals for psychological help (Koydemir et al., 2010).
University students who endure psycho-social problems and unwilling to seek psychological help are more likely to have poorer relationships with their peers, poor academic performance, lower rates of completion, increased psychological distress, self-harm, suicidal behavioural tendencies and high levels of drug abuse (Anita et al., 2017;Byrd & McKinney, 2012;Drum et al., 2009;Dwyer & Cummings, 2001;Gebreegziabher et al., 2019;Pompili et al., 2012). Thus, understanding the predictors of the intention to seek psychological help among university students is vital for illuminating the insights related to their unwillingness to seek psychological help from professional help service providers. Indeed, psychological help sought from professionals act as a coping behaviour for stressful events and contributes to psychological wellbeing of university students (Mojaverian et al., 2013;Wilson & Deane, 2010).

The Concepts of Help Seeking and Help Seeking Intentions
Help seeking refers to the process of actively seeking help from other people (Rickwood et al., 2005). It can also be defined as an act of looking for a solution to fulfill a need (Cornally & Mccarthy, 2011). Such help can be sought from formal sources such as counsellors, psychologists, teachers or informal sources such as friends and family members (Rickwood et al., 2005). Help seeking intentions are defined by White et al. (2018) as "a conscious plan to exert effort to communicate about a problem, emotional pain or psychological issue, where that communication is an attempt to obtain perceived support, advice or assistance that will reduce personal distress" (p. 65). Cornally and Mccarthy (2011) asserted that help seeking comprise four components, namely; antecedents of seeking help, defining the attributes of seeking help, consequences of seeking help and finally, empirical referents of seeking help. Antecedent of seeking help refers to an individual need to recognize the existence of the problem and make decision to seek help and selection of the help source (Cornally & Mccarthy, 2011). Defining the attribute of seeking help contains three attributes, namely, problem focused, intentional action as well as interpersonal interaction. Problem focused means the presence of a problem that requires attention of a help provider; by intentional action it means seeking help is planned.
By interpersonal interaction it means two parties are involved that is the help seeker and the help giver (Cornally & Mccarthy, 2011). Seeking help has both positive and negative outcomes. This means that the problem that is presented by the help seeker can either be solved or not solved (Cornally & Mccarthy, 2011). The empirical referents of seeking help which implies the presence of multiple sources of psychological help in an area is an indication that formal help seeking behaviour takes place (Cornally & Mccarthy, 2011).

Theoretical Framework of the Study
The theory of planned behaviour (TPB) was used as the framework to understand the university students' help seeking intentions (Ajzen, 1991(Ajzen, , 2011(Ajzen, , 2020. The TPB is concerned with the prediction of intentions. In the TPB three variables namely; attitudes, subjective norms and perceived behavioural control are assumed to feed into and explain behavioural intentions (Ajzen, 2011). Attitudes entail the degree to which an individual has a favourable or unfavourable evaluation of the behaviour. Subjective norms refer to perceived social pressure to perform or not perform a particular behaviour. Perceived behavioural control involves a person's perception of the ease or difficulty of performing a particular behaviour (Ajzen, 1991). The TPB asserts that, when an individual has a positive attitude, stronger subjective norms as well as high perceived behavioural control, then he or she is more likely to have higher intentions to engage in a particular behaviour. Therefore, it was hypothesised that the university students who had positive attitudes, stronger subjective norms and high perceived behavioural control toward seeking psychological help would be more likely to form higher intentions of seeking psychological help in circumstances when they experience psycho-social problems. Previous studies have shown that this theory can successfully predict help seeking intentions (Aldalaykeh et al., 2019;Mak & Davis, 2014;Mo & Mak, 2009).

Empirical Studies on the Predictors of Help Seeking Intentions
Previous studies have provided some insights on the extent to which attitudes, subjective norms and perceived behavioural control predict the university students' intention to seek psychological help. Aldalaykeh et al. (2019) examined the efficacy of the theory of planned behaviour in predicting the intention to seek mental health services among the university students in Jordan. The results revealed that all variables significantly predicted students' help seeking intentions. Nevertheless, positive attitudes were the strongest predictor, followed by perceived behavioural control and subjective norms. Though the study by Aldalaykeh and colleagues reveal useful insights about the efficacy of the TPB in predicting help seeking intentions but the authors of the study employed the TPB to predict help seeking intentions for mental health problems particularly depression among university students and mainly in the Asian context. Furthermore, Bohon et al. (2016) examined the utility of the theory of planned behaviour in predicting help seeking intentions among college students' in the United State of America. The results revealed that positive attitudes and higher perceived behavioural control over seeking psychological help were significant predictors of the intention toward utilization of psychological help from mental health professionals. However, subjective norms regarding seeking psychological help did not significantly predict the help seeking intentions. This is contrary to previous studies which established that all TPB variables significantly predicted the intention to seek psychological help (Aldalaykeh et al., 2019;Mak & Davis, 2014). Mak and Davis (2014) reported that positive attitudes, subjective norms and perceived behavioural control significantly predicted help seeking intentions among the Chinese. Nevetheless, the sample used in the study by Mak and Davis was drawn from the general population and thus it was not clear on whether or not university students were part of the sample. Thus, the results of such study might not provide an explicit picture about the utility of the TPB in explaining help seeking intentions among the university students because of their unique sources of stressors that may or may not lead them to form help seeking intentions in contrast to the general population. Mesidor and Sly (2014) examined the mental health seeking intentions among American college students. The results indicated that perceived behavioural control strongly predicted mental health seeking intention followed by subjective norms, whereas attitudes did not contribute significantly on the intention to utilize mental health services. This is however contrary to the findings reported in previous studies that indicated that positive attitudes do significantly predict intention to seek psychological help (Aldalaykeh et al., 2019;Bohon et al., 2016;Mak & Davis, 2014). Although the authors indicated that they involved students for the study from various departments within university context but they did not reveal their specific majors or fields of study. Pheko et al. (2013) and Andoh-Arthur et al. (2015) examined the predictive role of attitudes on the intentions to seek psychological help among the university students in Botswana and Ghana respectively. The findings of both studies suggested that positive attitudes toward seeking psychological help significantly predicted the university students' help seeking intentions. These two studies widen the understanding of attitudes in explaining help seeking intentions among university students in the African context. However, both of the studies were conducted in one university and did not investigate other two components of the TPB, namely, subjective norms and perceived behavioural control in contrast to studies that have been conducted in the Western and Asian contexts. Additionally, one of the two studies involved university students from one department  while the other study did not reveal the students' majors or fields of study (Pheko et al., 2013).
Though several studies have examined the role of the TPB variables in predicting the university students' help seeking intentions, none of the studies had employed the same theory in predicting help seeking intentions among university students in Tanzania. Furthermore, the conflicting findings across studies mainly in the Western context with regard to the role of attitudes and subjective norms in predicting students' help seeking intentions calls for more studies concerning the role of such variables in predicting help seeking intentions in other contexts. Additionally, most of the studies conducted had examined intentions for mental help seeking behaviours among the university students. Notably, apart from the mental health problems, university students also face other psycho-social problems which include complications related to romantic relationships and sexual harassment among others, all of which necessitating a need for an investigation. Therefore, this study examined the predictors of the intentions to seek psychological help for psycho-social problems among university students in Tanzania. It also examined the differences in help seeking intentions focusing on the students' socio-demographic characteristics. The findings of this study would enable counsellors in Tanzanian universities and other countries who have similar system to Tanzanian universities to design ways that can increase help seeking intentions among university students. Increase in help seeking intentions may in turn see many university students utilize the established psychological help services for preventing, adjusting and coping with life stressors concerning or related with psychosocial problems during their university studies. The findings will also contribute to the body of knowledge on the extent to which students in higher learning institutions seek psychological counselling services.

Research Questions
The present study was guided by two research questions: 1. Do help seeking intentions differ by students' socio-demographic characteristics (sex, age, year of study and field of study)? 2. To what extent do attitudes, subjective norms and perceived behavioural control predict help seeking intentions among university students?

Design and Setting
We employed a cross sectional research design. Participants were obtained from two public universities in Tanzania UDOM has become one of the fast-growing universities in the sub-Saharan Africa (ibid). Both universities had the highest enrollment rate of more than 20,000 students compared to other universities, hence provided a wide range of undergraduate degree programmes. Additionally, the two universities had well established counselling services geared to help students deal with various psycho-social challenges.

Sample for the Study
The sample size of this study was determined through following the procedures outlined by Cohen et al. (2007Cohen et al. ( , 2018, which depend on the estimated population, confidence interval and level. The estimated population of participants from the selected fields of study was 2093. According to Cohen et al. (2007Cohen et al. ( , 2018 for the population size that ranges from 2000 to 2499 with a margin error of 0.05 (5%) at 95% confidence level, the sample size should be 322. They added that, if the population is stratified into some categories, the sample size increases because the sample is drawn from each individual category of participants suggesting that the more strata (categories) the larger the sample will be. Therefore, the researchers managed to obtain 740 students from four strata (fields of study) namely; education, social science, engineering and business.

Participants
The sample comprised of 740 undergraduate students (389 females, 349 males, 2 unspecified) was conveniently selected from the fields of education, social science, engineering and business of two public universities in Tanzania. The participants had the average age of 22.6 (SD = 2.4). Majority of the participants (87%) were aged between 18 and 24 and the rest (13%) were aged between 25 and 40. UDSM had 396 students and UDOM had 344 students. The sample consisted of 339 s year students and 401 third year students. 32.2% of the students were from education, 26.2% from social science, 24.6% from business, and the remaining 17% were from engineering.

Procedures
Ethical approval to collect data at UDSM-MJKNM campus was provided by the Office of Vice Chancellor, the University of Dar es Salaam. Likewise, ethical approval to collect data at UDOM was provided by the Director of Research, Publications and Consultancy. Before data collection, the researchers informed all participants about the overall purpose and the benefits of participating in the study. Students were eligible to participate in this study if they were registered students and aged 18 years or over. Voluntary participation, confidentiality and anonymity ethical procedures were also adhered by the researchers. In particular, the participants completed the written consent form which was attached to the questionnaire. Confidentiality was ensured by telling the participants that the information they will fill in the questionnaire will be used for research purpose only. Anonymity was ensured by informing the participants not to disclose their real names and identifiers anywhere in the questionnaires. The exercise of filling in the questionnaire was done in the students' classrooms. The questionnaire was completed between 20 and 25 min.

Measures
Attitude toward psychological help seeking was measured by using 12 items which were adapted from the attitude toward seeking professional psychological help scale (ATSPPH) (Fischer & Farina, 1995). The present study used the original language versions (English) of the measures. Six items were positively worded and the other six were negatively worded. For example: "If I believed I was depressed, my first reaction would be to get counselling" and "The idea of talking about depression with a counsellor is a poor way of solving a problem". The response option ranged from 1 (strongly disagree) to 4 (strongly agree). Higher scores indicated positive attitudes toward seeking psychological help. The original scale demonstrated the acceptable reliability ranging from 0.82 to 0.84 (Fischer & Farina, 1995). Cronbach's alpha of the scale for the present study was 0.71.

Subjective Norms (SN) and Perceived Behavioural Control (PBC)
SN toward seeking psychological help was measured by using 22 items adapted from the scale by Bohon et al. (2016) after communicating with original authors. The present study used the original language versions (English) of the measures. 11 items were positively worded and the other 11 were negatively worded. For example: "My friends will be proud of me, if I spoke to a counsellor about my depression problem" and "My family will not help me to talk to a counsellor about depression". The response option ranged from 1 (strongly disagree) to 4 (strongly agree). The higher scores indicated positive subjective norms toward seeking psychological help. The original scale demonstrated the acceptable reliability (α = 0.89) (Bohon et al., 2016). Cronbach's alpha of this scale for the present study was 0.83. PBC toward seeking psychological help was measured by using 12 items adapted from the scale by Bohon et al. (2016) after communicating with original authors. The authors used the original language versions (English) of the measures. Six items were positively worded and the other six were negatively worded. For example: "It would be possible for me to get counselling for a depression problem" and "Counselling service for a depression problem is not available". The response option ranged from 1 (strongly disagree) to 4 (strongly agree). The higher scores indicated high perceived behavioural control towards seeking psychological help. The original scale had the acceptable reliability (α = 0.75) (Bohon et al., 2016). Cronbach's alpha of the scale for the present study was 0. 77.
Help seeking Intentions was measured by using 3 items which were created by the authors and piloted to a group of 60 university students from UDSM but such group did not take part in the actual study. Additionally, the authors discussed the contents validity of the items with informed academics in the area of psychological help from the Department of Educational Psychology and Curriculum Studies at the UDSM. All items were positively worded. The items were: "I would intend to seek counselling if I get depressed", "I would try to seek counselling if I face a romantic relationship difficulty" and "I would plan to seek counselling if I experience sexual harassment". The response option ranged from 1 (strongly disagree) to 4 (strongly agree). The higher scores indicated higher intention to seek psychological help. The pilot study showed that, Cronbach's alpha of the intention measure was 0.7. And for the actual study, Cronbach's alpha was 0.75. These reliability scores were within the acceptable range (Creswell & Creswell, 2018).

Data Analyses
Data were coded, entered and analysed by using the SPSS for windows software package version 21.0. Descriptive statistics was used to summarize socio-demographic characteristics of the participants. The independent samples t-test was used to compare help seeking intentions mean scores by sex, age and year of study. Analysis of variance (ANOVA) was used to compare help seeking intentions mean scores across students' fields of study. The inter-correlation among the study variables was determined by using bivariate correlation. Finally, multiple regression analysis was performed to determine the best predictors (attitudes, subjective norms and perceived behavioural control) of help seeking intentions. A p-value of less than 5% was considered significant for all analyses.
ANOVA and multiple regression require that dependent variable constitutes independent measurements which are normally distributed. Another assumption for ANOVA and multiple regression is that variance is constant throughout all observations (homoscedasticity). In addition to this assumption, multiple regression requires that there is linear relationship between dependent variable and independent variable, and no multicollinearity (Pallant, 2016). We requested SPSS to check the assumptions of linearity and multicollinearity using inter-correlation matrix; normality assumption was checked using Q-Q plot, and homoscedasticity assumption was checked using scatter plot of the standardized predicted intention to seek psychological help and residuals. All of the aforementioned assumptions were met.

Differences Regarding Intentions to Seek Psychological Help by Students' Socio-Demographic Characteristics
Before determining the differences in help seeking intentions based on socio-demographic characteristics, a descriptive analysis was conducted. The results indicated that majority of students 657 (88.8%) had higher help seeking intentions related to psycho-social problems. Furthermore, the results indicated that help seeking intentions were higher for depression (94.5%), followed by sexual harassment (92.3%) and romantic relationship difficulty (90.7%). This suggests that many students would be very likely to seek psychological help in issues pertaining to psycho-social problems.
The results from the independent sample t-test (Table 1) indicated that the mean score of help seeking intentions of female students (M = 10.26, SD = 1.55) was significantly higher than that of the male students (M = 9.97, SD = 1.72 [t (736) = 2.45, p = 0.014). The magnitude of the differences in the means (mean difference = 0.297, 95% CI: -0.53 to 0.06) was very small ( 2 = 0.008). This finding suggests that female students would be slightly more likely to seek psychological help when they experience psychosocial problems compared to male students. Furthermore, there were no statistically significant differences with regard to intention toward seeking psychological help by students' age [t (726) = . -84, p = 0.39, 2 = 0.001] and year of study [t (738) = 1.33, p = 0.181, 2 = 0.002]. This means that age and year of study did not significantly account for difference in help seeking intentions among university students.
Moreover, the ANOVA results (Table 1) indicated that there were significant statistical differences with regard to intention toward seeking psychological help across the four fields of study [F (3, 736) = 6.91, p < 0.001). Despite the statistical significance, the actual difference in the mean scores between the four fields of study was quite small. The effect size calculated using eta squared ( 2 ) was 0.03. Posthoc comparisons using the Tukey HSD test indicated that the mean score for education (M = 10.35, SD = 1.62) was significantly different from engineering (M = 9.59, SD = 1.79). Social science (M = 10.27, SD = 1.58) differed significantly from engineering. Furthermore, social science and education did not differ significantly from business. The implication is that students in the field of engineering were least likely to seek psychological help should they experience psycho-social problems compared to their counterparts in education and social science fields of study.

Inter-correlation among the Theory of Planned Behaviour Variables
Bivariate correlation analysis was conducted to determine the association amongst the study variables. The results indicated that there was a positive relationship between attitudes and subjective norms (r = 0.45, p < 0.001), attitude and perceived behavioural control (r = 0.36, p < 0.001), attitude and help seeking intentions (r = 0.47, p < 0.001). Further, there was a positive relationship between subjective norms and perceived behavioural control (r = 0.52, p < 0.001), subjective norms and help seeking intentions (r = 0.36, p < 0.001). Finally, there was a positive relationship between perceived behavioural control and help seeking intentions (r = 0.39, p < 0.001).

Regression Analysis on the Predictors of Intention to Seek Psychological Help among University Students
A multiple regression analysis was conducted to compute the best predictors of help seeking intentions. In the regression model, attitudes, subjective norms and perceived behavioural control were computed as independent variables and help seeking intentions was regarded as a dependent variable. The multiple regression results ( Table 2) revealed that the model was significant (F (3, 713) = 97.30, p < 0.001), accounting for 28.8% of the variance in the intention towards seeking psychological help ( R 2 = 0.288). All variables in the model significantly predicted help seeking intentions, all with positive effects but varying magnitudes. The strongest predictor of help seeking intentions was attitudes (β = 0.34, p < 0.001), followed by perceived behavioural control (β = 0.23, p < 0.001) and subjective norms (β = 0.08, p = 0.027). These findings imply that students who positively evaluated the idea of seeking psychological help, perceived that they will be approved by their significant others and perceived that it was easy to seek psychological help would be likely to seek psychological help if they experience psycho-social problems.

Discussion
The purpose of this study was to examine the predictors of the intentions toward seeking psychological help among the university students. The results have revealed that majority of the students had higher intentions toward seeking psychological help for psycho-social problems. This means that they would be more likely to seek psychological services should they experience psycho-social problems. The findings of the present study are also consistent with those in previous studies whose majority of participants reported higher help seeking intentions (Boyd et al., 2011;Oliver et al., 2005;Yu et al., 2015). However, the findings from the present study contradicts those in previous studies which reported weak intentions toward seeking psychological help (Aldalaykeh et al., 2019;Mesidor & Sly, 2014) and moderate intentions toward seeking psychological help Pheko et al., 2013). Students' higher intentions to seek psychological help could be explained by their previous positive help seeking experience, competence and qualification of the service providers (Boyd et al., 2011;Yelpaze & Ceyhan, 2019), presence of established social relationships built on understanding and trust (Rickwood et al., 2005), assurance of confidentiality and awareness of the existence of the service (Setiawan, 2006). The study also revealed significant statistical differences in help seeking intentions by students' gender. However, this difference was small. Arguably, this finding suggests that female students were slightly more likely to seek psychological help than their male counterparts. The finding of this study is consistent with previous studies (Boldero & Fallon, 1995;Chandrasekara, 2016;Greenley & Mechanic, 1976) that showed that female students were more likely to seek psychological help than male students. Slightly higher help seeking intentions among females could possibly be attributed to the fact that females are considered to be more encouraged to seek psychological help and are more likely to know people who sought help compared to males (Vogel et al., 2007). In addition, gender variation in help seeking intentions could be attributed to males' beliefs that they are strong enough to deal with their problems without necessary looking for external help (Chandrasekara, 2016;Kamunyu et al., 2016b).
However, the present study has contradicted previous studies by Andoh-Arthur et al. (2015) and Alemu (2014) which revealed a lack of significant differences in help seeking intentions between males and females. A lack of statistical significant gender differences in some studies could be explained by the shifting gender roles which homogenize gender with regard to some values and practices . The present study is also in contrast with previous studies by Boyd et al. (2011) and Ratnayake and Hyde (2019) which reported that males are significantly more likely to seek psychological help for personal and emotional problems than their female counterparts.
Furthermore, there were significant statistical differences in help seeking intentions by students' fields of study where by education and social science students were slightly more likely to seek psychological help than students from the field of engineering. However, the difference in help seeking intentions between the four fields of study was small. One of the possible explanations for the differences in help seeking intentions across the aforementioned fields of study could be that education and social science students had more favourable attitudes toward seeking psychological help that may have contributed to their higher help seeking intentions compared to engineering students (Cebi, 2009). And in our study, we also found that education and social science students had slightly more favourable attitudes toward seeking psychological help compared to engineering students. Another possible explanation for the existing variation in help seeking intentions across the fields of study could be the familiarity with mental health services among education and social science students compared to engineering students (Cebi, 2009). We argue that, such familiarity might had helped education and social science students to be well informed about the benefits of psychological help that in turn lead them to form slightly higher help seeking intentions than engineering students.
Moreover, the regression analysis results revealed that all predictor variables namely attitudes, subjective norms and perceived behavioural control significantly predicted students' intention toward seeking psychological help. This concurs with the TPB that advances that an individual needs to have positive attitudes, positive subjective norms and high perceived behavioural control toward the behaviour for him or her to form higher intentions to engage into the behaviour in question (Ajzen, 2002). The findings of this study are also consistent with the findings of the previous studies that indicated that the TPB variables can successfully predict mental help seeking intentions (Aldalaykeh et al., 2019;Mak & Davis, 2014;Mo & Mak, 2009;Schomerus et al., 2009). Contrary to other studies, the present study has established that the TPB is also useful in explaining help seeking intentions for psycho-social problems.
The regression analysis model indicated that positive attitudes were the strongest predictor of help seeking intentions. Basically, this finding suggests that positive evaluation of seeking psychological help significantly predict university students' intention to seek psychological help when they face psycho-social problems. This is consistent with previous studies that have also indicated that positive attitudes are the strongest predictor of help seeking intentions (Aldalaykeh et al., 2019;Bohon et al., 2016;Mo & Mak, 2009;Schomerus et al., 2009). However, the present study contradicts a study by Mesidor and Sly (2014) that found that positive attitudes do not significantly predict help seeking intentions. Furthermore, the findings of this study are also different from the study by Mak and Davis (2014) that found that positive attitudes significantly predict help seeking intentions but they were not a strongest predictor of help seeking intentions. Mak and Davis added that attitude not being a strongest predictor might be that its influence may have been overshadowed by the powerful effect of perceived behavioural control and subjective norms.
Furthermore, perceived behavioural control was the strong predictor of help seeking intentions. Generally, this finding implies that perceived ease of seeking psychological help significantly predicted students' intention to seek psychological help for psycho-social problems. The results of this study are consistent with those of previous studies that found that perceived behavioural control was a significant predictor of help seeking intentions (Aldalaykeh et al., 2019;Bohon et al., 2016;Mak & Davis, 2014;Mesidor & Sly, 2014;Mo & Mak, 2009;Schomerus et al., 2009). Nonetheless, the results are in contrast with those by Woods (2013) who found that perceived behavioural control does not significantly predict help seeking intentions. Perceived behavioural control is affected by various factors such as knowledge about psychological help services, affordability of service, social support from significant others and availability of psychological help services (Mak & Davis, 2014;Mesidor & Sly, 2014).
Finally, subjective norm was the weak but a significant predictor of help seeking intentions. The finding of this study suggests that perceived approval from significant others with regard to help seeking played a significant role in predicting students' help seeking intentions. This is consistent with previous studies that revealed that subjective norm significantly predict help seeking intentions (Aldalaykeh et al., 2019;Mak & Davis, 2014;Mesidor & Sly, 2014;Mo & Mak, 2009;Schomerus et al., 2009). However, the findings of the present study contradicts a study by Bohon et al. (2016) that found that subjective norm was not a significant predictor of the intention to seek psychological help among college students in the US. Bohon and colleagues provided a possible explanation for the differences in the results between their study and other studies on the aspect of subjective norm, in which they argued that, the American university sample used in their study was going through specific life circumstances and problems, which made them qualitatively different from the samples used in other studies. Thus, the differences in findings show the importance of undertaking research using samples from population of interest instead of simply assuming that the generalization of findings across samples are accurate (Bohon et al., 2016).

Implications of the Findings to Counsellors in Tanzania and Other Similar Country Contexts
The findings from the present study point to a number of implications. First, positive attitudes toward psychological help were a strongest predictor of help seeking intentions. Therefore, planners and implementers particularly counsellors in Tanzanian universities and other countries with similar university contexts need to mainly target attitude in their education and promotion campaigns that focus on creating awareness about the usefulness of psychological help among university students. Specifically, the focus needs to be on developing positive attitudes toward seeking psychological help among the same students. Additionally, enhancing confidentiality about problems shared by students as well as eliminating the stigma associated with seeking psychological help could form part of the strategies that could be used by universities in Tanzania and other similar country contexts to promote positive help seeking attitudes among university students. In these ways, positive attitudes towards psychological help could result to higher help seeking intentions among university students.
Second, perceived behavioural control was a strong predictor of help seeking intentions. Thus, government policies, university counselling policies and psychological help service providers in Tanzania and other similar country contexts could target perceived behavioural control through increasing publicity about the availability of psychological help, reducing or removing the fees so that the services become affordable to many and establish psychological help centres in every school and/or college to increase accessibility. Other recommended strategies include educating significant others (friends and families) about psychological help since perceived social support may either act as a facilitator or barrier in seeking psychological help, and creating more knowledge about the effectiveness of psychological help and the nature of problems that can be resolved through psychological help. In these ways, high perceived behavioural control could lead to higher intention to seek psychological help among university students.
Third, subjective norm also predicted help seeking intentions. However, it contributed the least in predicting help seeking intentions. Therefore, to increase help seeking intentions among university students, the families and friends as important figures in students' university life need to be consistently made aware about the benefits of psychological help by psychological help service providers. This is important because programs that aim to change students' attitudes toward psychological help may not be as effective as they should be in circumstances where the significant others do not see the true value of psychological help and therefore do not encourage students to seek such help.
Fourth, male students reported slightly lower mean scores in intention to seek psychological help than female students. Gender role socialization might have played an important part in this variation such that males may have been socialized to believe that they are strong and seeking external help when in need of it may be a sign of weakness. On that basis, the government policies and psychological help service providers in Tanzania and other similar country contexts should aim to challenge such barriers through educating the community about the advantages of psychological help for everyone and reaching out for help when faced by problems is not a sign of weakness. This might in turn lead the community to encourage everyone to seek psychological help and consequently improve help seeking intentions amongst them.
Fifth, engineering students had the lower mean score in intention to seek psychological help. Unlike students from other disciplines such as education and social science, engineering students might not be familiar with the mental health professions since they have no courses that are either directly or indirectly related to psychology. Thus, awareness programs about psychological help should be put in place by help service providers in Tanzanian universities and in other similar country contexts so as to improve engineering students' help seeking intentions.

Limitations of the Study and Directions of Future Research
The study was constrained by mainly four limitations. First, the use of convenience sampling in recruiting the participants may limit generalizations to a broader population of the university students. Thus, the results from the study can only be generalized to the population that has similar characteristics with the one used in the current study. Second, the study used the cross-sectional design; hence the causeeffect relationship could not be established. An experimental design can establish a high degree of confidence that a person attitudes, subjective norms and perceived behavioural control are the factors that directly lead to intention to seek psychological help. Third, the study was limited to help seeking from a formal source (counsellors) only. This drawback limits the scope of generalization to other sources of help seeking such as informal sources. This suggests a need for future research to examine students' help seeking intentions from other sources such as friends and family members. Fourth, the study involved the participants from only four fields of study. Therefore, it remains unclear whether the results can be applied to other fields of study. Future research may explore help seeking intentions by involving students from other fields of study such as law, information technology, and agriculture. Despite these limitations, the current study has contributed to the existing body of knowledge on the intention to seek psychological help since it has highlighted the important elements of help seeking intentions in a new cultural context.

Conclusion
The present study has contributed towards broadening an understanding of the university students' help seeking intentions in the Tanzanian context. The research problem explored in this study was yet to be researched. As such, there existed no published research evidence on the phenomenon. The study has also extended the application of TPB theory in sub-Saharan Africa, particularly on predictors of help seeking intentions. The findings indicated that attitudes, subjective norms and perceived behavioural control significantly predict the intention to seek psychological help. Thus, these constructs should be considered in designing appropriate psychological interventions in Tanzanian universities and other countries who have similar system to Tanzanian universities. Additionally, these constructs should also be considered in the design of studies seeking to understand intentions to seek psychological help services among university students in Tanzania and other similar country contexts.