Relationship between mental health help-seeking intention and prospective help-seeking behavior: A meta-analysis with moderation testing.

Intention to seek help is widely regarded as the immediate precursor to formal mental health help-seeking, yet the strength and consistency of this intention-behavior link remain unclear. This PRISMA-guided meta-analysis synthesized 15 longitudinal studies (N = 6532; 2004-2025) assessing mental health help-seeking intention and subsequent formal help-seeking behavior over follow-up intervals ranging from 3 weeks to 36 months. Searches included Academic Search Complete, ERIC, MEDLINE, PsycINFO, Web of Science, and Google Scholar. Samples were primarily adult, with two adolescent/minor samples, and included populations or contexts involving depression, general/mixed mental health concerns, alcohol-related substance use, epilepsy-related mental health needs, and veterans' mental health concerns. We estimated the pooled intention-behavior association and used mixed-effects meta-regression to test ten study-level moderators: gender composition, education level, collectivism, mental-health condition, age group, follow-up interval, intention wording, number of intention items, intention conditionality, and behavior target. The overall intention-behavior association was small to moderate (r ≈ .271), with extreme heterogeneity (I2 = 91.82%). Intention conditionality (i.e., unconditional vs. conditional) was the only moderator that was statistically significant (p = .015), although education level, number of intention items, and age group also showed descriptive explanatory value in accounting for between-study heterogeneity. Sensitivity analyses supported the stability of the overall effect, and no clear evidence of publication bias was detected. These results suggest that, in general, intention predicts help-seeking behavior to a limited but significant extent. Moreover, substantial variability across studies suggests that measurement strategies and population characteristics may shape variation in this relationship.