The prevalence and predictors of mental health diagnoses and suicide among U.S. college students: Implications for addressing disparities in service use
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BACKGROUND: The college years represent a period of increased vulnerability for a wide range of mental health (MH) challenges. The onset of common psychiatric conditions occurs during this period of development. Increases in depression, anxiety, and suicidality among U.S. college students have been observed. This study identified prevalence and correlates of MH diagnoses and suicidality in a recent sample of U.S. college students. METHODS: The Spring 2015 American College Health Association-National College Health Assessment (ACHA-NCHA) survey assessed MH diagnoses and suicidality from U.S. undergraduate students (n = 67,308) across 108 institutions. RESULTS: Stress was strongly associated with a greater likelihood of suicide attempts and MH diagnoses, even among students reporting 1-2 stressful events (OR [odds ratio] range 1.6-2.6, CI [confidence interval] = 1.2-3.2). Bisexual students were more likely to report MH diagnoses and suicidality, compared to heterosexual and gay/lesbian students (OR range 1.5-3.9, CI = 1.8-4.3), with over half engaging in suicidal ideation and self-harm, and over a quarter reporting suicide attempts. Transgender students reported a higher rate of MH diagnoses and suicidality relative to females (OR range 1.9-2.4, CI = 1.1-3.4). Racial/ethnic minority students were generally less likely to report MH diagnoses relative to Whites, although the likelihood for suicidality was mixed. CONCLUSIONS: The high rate of multiple stress exposures among the U.S. college population and the high impacts of stress on MH and suicidality point to an urgent need for service utilization strategies, especially among racial/ethnic, sexual, or gender minorities. Campuses must consider student experiences to mitigate stress during this developmental period.
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Counselling services face the challenge of serving a widely diverse range of psychological difficulties such as depression, suicidality, self-harm, substance abuse, and eating disorders.
“In addition, counselling services face the challenge of serving a widely diverse range of psychological difficulties such as depression, suicidality, self-harm, substance abuse, and eating disorders (Liu et al., 2019).”
From A randomised controlled trial of brief web-based acceptance and commitment Therapy on the general mental health, depression, anxiety and stress of college Students (2022) · cites this paper as Liu et al., 2019
Depression and anxiety symptoms are two of the most common mental health complaints among students.
“Additionally, depression and anxiety symptoms are two of the most common mental health complaints among students [29, 30]”
From Procrastination, depression and anxiety symptoms in university students: a three-wave longitudinal study on the mediating role of perceived stress (2024) · cites this paper as [30]
During the first year of university, students face multiple challenges that can lead to psychological stress and mental health problems.
“During this time, they must cope with multiple challenges that can lead them to experience psychological stress and mental health problems, such as increasing responsibility, financial demands, pressure to succeed, and changes in their support network (Liu et al., 2019; Ross et al., 1999).”
From Feasibility of a Brief Online Mindfulness and Compassion-Based Intervention to Promote Mental Health Among University Students During the COVID-19 Pandemic (2021) · cites this paper as Liu et al., 2019
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- Authors
- Liu, C. H., Stevens, C., Wong, S. H. M., Yasui, M., & Chen, J. A.
- Affiliations
- Brigham and Women's Hospital (US)
- Willamette University (US)
- Beth Israel Deaconess Medical Center (US)
- University of Chicago (US)
- Harvard University (US)
- Corresponding author
- Liu, Cindy H.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2018-09-06
- Volume
- 36
- Issue
- 1
- Pages
- 8-17
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC6628691
- OpenAlex
- W2891801059
- Cited by
- 603
- References
- 64
- Citations by year
- 2026: 43 · 2025: 83 · 2024: 89 · 2023: 83 · 2022: 89 · 2021: 142 · 2020: 55 · 2019: 18 · 2018: 1
- FWCI
- 63.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (K23 MH 107714-01 A1)
- Tynan Faculty Research Fellowship
- Massachusetts Department of Mental Health (SCDMH82101008006)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Keywords
- university students, mental health diagnoses, suicidality, suicide attempts, suicidal ideation, self-harm, stress, sexual minority students, bisexual students, transgender students, racial and ethnic minority students, mental health service utilization, disparity, depression, anxiety
- MeSH terms
- Adolescent, Adult, Anxiety, Mental Disorders, Depression, Ethnicity, Female, Health Surveys, Humans, Male, Mental Health, Minority Groups, Stress, Psychological, Students, Suicide, Attempted, United States, Universities, Prevalence, Odds Ratio, Self-Injurious Behavior, Sexuality, Racial Groups, Healthcare Disparities, Young Adult, Suicidal Ideation
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