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Ritika Rastogi, PhD

Job Title

Postdoctoral Researcher

Academic Rank

Fellow or Postdoc


Pediatric Newborn Medicine


Ritika Rastogi, G. Alice Woolverton, Courtney Stevens, Justin A. Chen, Cindy H. Liu

Principal Investigator

Ritika Rastogi/Cindy Liu



Suicidality predicts decreased help-seeking attitudes in college students: A “foot-in-the-door” effect of past service utilization?

Scientific Abstract

Suicide is a leading cause of death in college-aged youth, yet only half of all students report engaging in professional mental health help-seeking (e.g., psychotherapy, medication). We examined aspects of young adults’ suicidality as predictors of their openness to pursue professional mental health care(i.e., “future help-seeking intentions”), reasoning intentions may be a key precursor to behaviors. Multilevel binary logistic regression analyses were conducted among a sample of 24,548 U.S. college undergraduates with lifetime suicidality (i.e., indicating suicidal ideation at any point in their past). Past-year suicidal ideation and self-reported likelihood of a future suicide attempt each predicted decreased odds of future help-seeking intentions, while past mental health service utilization predicted increased odds. Past service utilization also significantly moderated the effect of suicide disclosure: young adults who had previously disclosed suicide once and who also previously utilized professional mental health services reported 33% greater odds of future help-seeking intentions relative to those who had disclosed suicidality but never utilized professional services. Results suggest a “foot-in-the-door” effect, wherein previous exposure to help-seeking processes in and of itself begets future help-seeking. Increasing uptake of mental health services is critical to mitigating the mental health crisis in youth populations and across the lifespan.

Lay Abstract

Suicide is a leading cause of death in college-aged youth, but only half of all college students in the US have received professional mental health care (e.g., therapy, medication). We therefore aimed to understand what aspects of the experience of suicidality might improve young adults’ attitudes toward, and interest in, professional mental health care in the future. We tested these questions among a sample of almost 25,000 U.S. college undergraduates who reported struggling with suicidality at any point in their past. We found that young adults with recent suicidal thoughts had negative attitudes toward future professional care. Young adults who envisioned themselves attempting suicide in their future also had negative attitudes. More promising was that young adults who had previously received professional mental health care reported positive attitudes toward future care. We found that this was especially true for young adults who had previously opened up about their suicidal thoughts to others. Our findings suggest a “foot-in-the-door” effect: people with prior familiarity with the process of receiving professional care had the best attitudes toward receiving such care in the future. Providers should focus on getting students “in the door” once they start college, as this might positively impact health long-term.

Clinical Implications

Suicide in young adults constitutes an urgent public health crisis; efforts to increase help-seeking behaviors are critical. We show past service utilization is the strongest predictor of future help-seeking intentions; broadening access to care is necessary (screening days, peer counseling).