TY - JOUR
T1 - Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk
AU - Horwitz, Adam G.
AU - McGuire, Taylor
AU - Busby, Danielle R.
AU - Eisenberg, Daniel
AU - Zheng, Kai
AU - Pistorello, Jacqueline
AU - Albucher, Ronald
AU - Coryell, William
AU - King, Cheryl A.
N1 - Funding Information:
Mental health problems, including suicidal thoughts and behaviors, are increasing among college students, yet rates of MHSU remain low. Addressing this increased need for care requires a dynamic approach that targets both practical access-related barriers and internalized beliefs that reduce likelihood of help-seeking in college students. Our findings suggest that financial concerns are more prominent for women, racial/ethnic minorities, and SGM students; privacy and stigma concerns are more prominent for men and younger undergraduates; and cultural sensitivity issues continue to be barriers for SGM and racial/ethnic minority students. In order to reduce unmet needs for mental health care, approaches to increase MHSU must be tailored to address the barriers and meet the specific needs of subgroups within an increasingly diverse college student population.
Funding Information:
This research was supported by an NIH R01 (MH103244) Electronic Bridge to Mental Health (eBridge) for College Students to Cheryl A King (PI) and is registered with ClinicalTrials.gov (NCT03380117). The content of this manuscript is solely the responsibility of the authors, and does not necessarily represent the views of the funders, who had no role in the data analysis, interpretation, or preparation of this manuscript.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/6/15
Y1 - 2020/6/15
N2 - 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.
AB - 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.
KW - Barriers to care
KW - College students
KW - Service utilization
KW - Sociodemographic differences
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U2 - 10.1016/j.jad.2020.03.115
DO - 10.1016/j.jad.2020.03.115
M3 - Article
C2 - 32479307
AN - SCOPUS:85083510103
SN - 0165-0327
VL - 271
SP - 123
EP - 130
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -