Openness to Discussing Mental Health is Negatively Associated with Suicidal Ideation among South Korean College Students

Background: College students are particularly vulnerable to mental health challenges, including depression, anxiety, and suicidal ideation. This study aims to (1) examine the prevalence of suicidal ideation and describe perceived barriers to mental health service utilization among South Korean college students, and (2) identify factors associated with suicidal ideation. Methods: A total of 572 undergraduate students completed an online survey assessing depression and generalized anxiety, which were measured using the International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ). Suicidal ideation was assessed using items determining the lifetime experience and recency of serious thoughts of taking one’s own life. Openness to discussing mental health difficulties and perceived barriers to accessing mental health services were also measured. Logistic regression analyses were conducted to identify factors associated with suicidal ideation. Results: Regarding suicidal ideation, 8.4% of students reported experiencing it in the past month, while 15.7% reported experiencing it within the past year. The prevalence of depression was 4.7% and anxiety was 5.4%, with 2.8% of participants meeting criteria for both depression and anxiety. The most commonly cited barriers to mental health service utilization were high costs (69.2%), uncertainty about where to seek help (63.5%), and concerns about disclosure of personal information (57.3%). After controlling for sex, satisfaction with current economic status, and depression and generalized anxiety symptom severity, lower ease of discussing mental health difficulties was significantly associated with suicidal ideation. Conclusion: These findings highlight that openness to discussing mental health plays a protective role in suicidal ideation among South Korean college students. Clinical trial number: Not applicable.