CoChat
Sign Up
Cited by 108Mental Health Treatment and AccessSuicide and Self-Harm StudiesGender Roles and Identity Studies

Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk

Open access
Horwitz, Adam G., McGuire, Taylor, Busby, Danielle R., Eisenberg, Daniel, Zheng, Kai, Pistorello, Jacqueline, Albucher, Ronald, Coryell, William +1 more·2020·Journal of Affective Disorders
DOI 10.1016/j.jad.2020.03.115PMC PMC7266827
Open this paper in CoChat — free account

Abstract

Background College student mental health (MH) problems and suicide risk have steadily increased over the past decade and a significant number of students with MH problems do not seek treatment. While some barriers to mental health care service utilization (MHSU) have been identified, very little is known regarding how these barriers differ among sociodemographic subgroups of students. Method Participants were 3,358 college students from four US universities who screened positive for elevated suicide risk (defined as 2 or more of: depression, alcohol misuse, suicidal ideation, suicide attempt) and were not actively receiving MH services. Reported barriers to MHSU were categorized into: Low perceived need, privacy/stigma concerns, questioning helpfulness of treatment, logistics, time constraints, finances, and cultural issues. Results Adjusted odds ratios indicated that finances were a greater barrier for women, sexual and gender minority students, and Black and Hispanic students. Privacy/stigma concerns were more prominent for men and young undergraduate students. White students and older undergraduate and graduate students were more likely to report a lack of time, and cultural sensitivity issues were significant barriers for sexual and gender minority, and racial/ethnic minority, students. Limitations Participating sites were not nationally representative. The barriers assessment did not examine the degree to which a specific barrier contributed to lack of MHSU relative to others. Conclusions In light of the significant variation in barriers based on age, gender identity, race/ethnicity, and sexual orientation, efforts to increase MHSU should be tailored to meet the unique needs of specific sociodemographic student subgroups.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jad.2020.03.115

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Extreme prolonged psychological distress is linked to increased drug and alcohol coping, increased cardiovascular illness risk, and higher suicide rates.

    “extreme prolonged psychological distress has been linked to an increased tendency to turn to drugs and alcohol as a coping mechanism, an increased risk of cardiovascular illness, and higher rates of suicide”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Horwitz et al., 2020

    The Introduction links stressful life events to suicide risk among college students, supporting the suicide-related part in a narrower population. It does not address prolonged psychological distress, drug or alcohol use as a coping mechanism, or cardiovascular illness; the Results report heavy alcohol use but do not link it to coping with distress. Page numbers are not available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Cost is a recurring and often one of the most prevalent barriers to mental health service use.

    “This seems to be a recurring theme in many studies and often one of the most prevalent barriers”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Horwitz et al., 2020

    The Discussion reports that nearly half of the surveyed college students at elevated suicide risk cited finances as a barrier, and lists finances among frequently reported barriers. It does not establish that cost is one of the most prevalent barriers across many studies; that broader, recurring pattern is not supported by this paper. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Mental health services can be difficult to navigate and wait-lists are lengthy, preventing students from being proactive in seeking help.

    “students also report that mental health services can be difficult to navigate and wait-lists for mental health services tend to be quite lengthy, preventing students from being proactive in seeking help”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Horwitz et al., 2020

    The Discussion (page not available) says rising demand has led some college counseling centers to have longer waitlists. The Methods and Results also identify logistical barriers to students’ use of services. Our copy does not say that students reported services were difficult to navigate or that waitlists prevented them from proactively seeking help. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Cultural sensitivity issues are a barrier for minority students, who are less likely to seek mental health services in times of need.

    “cultural sensitivity issues as a barrier for minority students, as they were less likely to seek mental health services in times of need.”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Horwitz et al., 2020

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Horwitz, A. G., McGuire, T., Busby, D. R., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R., Coryell, W., & King, C. A.
Affiliations
  • University of Michigan (US)
  • University of California, Irvine (US)
  • University of Nevada, Reno (US)
  • Stanford University (US)
  • University of Iowa (US)
Corresponding author
Horwitz, Adam G.
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2020-06
Volume
271
Pages
123-130
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2020.03.115
PMC
PMC7266827
OpenAlex
W3017208978
Cited by
107
References
43
Citations by year
2026: 18 · 2025: 13 · 2024: 21 · 2023: 22 · 2022: 24 · 2021: 7 · 2020: 2
FWCI
15.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institute of Mental Health
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Gender Studies › Gender Roles and Identity Studies
Keywords
barriers to mental health care, university students, suicide risk, help-seeking, sociodemographic differences, financial barriers, stigma, privacy concerns, sexual and gender minority students, racial and ethnic minority students, gender differences, age differences, cultural sensitivity, depression, suicidal ideation, alcohol abuse
MeSH terms
Ethnicity, Female, Gender Identity, Humans, Male, Mental Health, Minority Groups, Students, Universities

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review