*5.2. Symptomatology and Help-Seeking Behavior*

Our data revealed that many students experienced moderate to severe levels of depression symptomatology, obsessive-compulsive symptomatology, and anxiety symptomatology. After completing the first screening, one-hundred-and-thirty-two students (29.07% of the total sample size) were contacted for a psychodiagnostic interview due to the high scores obtained. Of the 132 students, 24.2% students refused the interview. A

broad range of evidence identified a series of barriers to treatment such as low perceived need, the desire to handle the problem on one's own, attitudinal and structural barriers [42] and internalized and treatment stigma [43]. Considering that these students decided to participate in NoiBene, we can hypothesize that they perceived a need, but they wanted to handle the problem independently. Indeed, young people often use self-help programs, such as NoiBene, to deal with their mental health problems [24]. One hundred students accepted the interview. Of the 100 students, 64% students met the criteria for at least one mental disorder according to The Diagnostic and Statistical Manual of Mental Disorders, DSM-5 [44]. Of these students, eleven (*n* = 11) were already receiving mental health care, so they were included in the NoiBene program. In contrast, after the interview, fifty-three students (*n* = 53) were directed toward psychotherapy. Of the 53 students, about 55% of students decided to start psychotherapy, but twenty-three (*n* = 24) did not accept. This is a remarkable outcome: thanks to the individual meeting that we conducted, we had the opportunity to give personalized feedback about the individual's symptomatology and inform students about how and where to find help in the area. According to the high percentage of students that accepted psychological therapy, it seems to be an efficacious strategy [45]. Regarding students that did not accept, we had the opportunity to explore individual barriers to help-seeking during the interview. The main reasons for refusing were the low perceived need, the fear of being misunderstood by other relevant people, or the idea that talking with a psychologist would exacerbate their problems. Besides the low perceived need, the students' choices were influenced by the treatment stigma, that is, the stigma associated with treatment for mental health, and the anticipated stigma, in other words, the fear of being perceived unfairly by others [43]. Nevertheless, these students asked for access at NoiBene, suggesting that NoiBene reached people who would otherwise not ask for help. Future research should use this advantage and focus on developing a strategy to reduce the stigma among students who are reluctant to start psychotherapy.
