Graduation Year


Document Type




Degree Granting Department


Major Professor

Marc S. Karver, Ph.D.

Committee Member

Jennifer Bosson, Ph.D.

Committee Member

Ellis Gesten, Ph.D.

Committee Member

Krista Kutash, Ph.D.

Committee Member

Vicky Phares, Ph.D.


Gatekeeper, Depression, Prevention, Mental Health, Help-Seeking


The role of peer gatekeepers is crucial in connecting individuals at risk for suicide

related behaviors to mental health service providers. However, limited research has

focused on the role of peers as potential helpers for those at-risk. The current study

utilized a mixed experimental and correlational design to examine predictors of female

college students’ referral intentions following hypothetical interactions with peers at-risk

for suicide related behavior. More specifically, the current project examined the utility of

an extended Theory of Planned Behavior (TPB) model of peer-referral intentions. In

addition to the original TPB constructs of attitudes, subjective norms, and perceived

behavioral control associated with referring a peer to a mental health professional,

attitudes towards seeking professional help, perceived stigma associated with receiving

professional psychological help, emotional competence, and symptom severity were

incorporated into an extended TPB model. The sample included 284 female college

students. Participants completed computer-based questionnaires both before and after the

presentation of a theoretically and empirically informed vignette describing a peer who

was characterized as low, moderate, or high risk for suicide related behavior. The results

of this study suggest the utility of applying an extended TPB model to intentions to refer

at-risk peers for mental health services. The final trimmed model, which included all of

the aforementioned constructs except symptom severity, accounted for 78.9% of the

variance in referral intentions. The findings indicate that, in particular, preventative

interventions would likely benefit from emphasizing the role of attitudes towards

receiving mental health services, attitudes towards peer referral, and subjective norms

regarding peer referral, in order to maximize the role of peers as gatekeepers for college

students in distress. Incorporating the findings from this study with findings from future

research will hopefully lead to more informed, empirically-based interventions for

enhancing peer referrals.