The role of norms and acculturation in migrants’ willingness to seek mental health care: results from a large preregistered study

ENAims: This study investigated the role of perceived social norms and acculturation orientations in shaping mi grants’ willingness to seek mental health care. Specifically, we examined perceptions of help-seeking norms, presumed approval by family and friends, and the moderating role of migrants’ acculturation orientations. Methods: The study used a preregistered design with a sample of 2768 people with a migrant background from six countries (Afghanistan, Eritrea, Lithuania, Poland, Syria, and Ukraine). Participants completed a web-based survey assessing their willingness to seek help, perceived approval by family and friends, perceived help- seeking norms among people from their own group (same country of origin and gender) and among Norwe gian majority members, and acculturation orientations. We used multilevel regression models to test our predictions. Results: Participants perceived their own group as less willing to seek help than themselves; in the Ukrainian sample, this tendency was attenuated among women. All perceived norms had a significant and positive asso ciation with own willingness to seek help, but family and friends’ approval had the strongest association. Exploratory analyses showed that participants rated the majority group as more willing to seek help than both participants themselves and members of their own group. Critically, acculturation orientations moderated the associations.Conclusions: Our results suggest that participants may show more willingness to seek help than they believe others in their own group do. This misperception of norms may contribute to hindering help-seeking. While all group norms played a role in own willingness to seek help, presumed approval from family and friends may play a more pivotal role. The role of own group and majority group norms depends on individuals’ acculturation orientations. Tailored interventions should consider these factors when aiming to facilitate access to mental health services among diverse migrant populations. Keywords: help-seeking; norms; migrants; misperceptions; pluralistic ignorance; treatment gap; acculturation; mental health.