Abstract

BackgroundThis study aimed to evaluate how trends in mental health (e.g., diagnosis/treatment of depression, anxiety, suicidal ideation) varied across intersections of gender, race/ethnicity, and sexual orientation in a large, national sample of undergraduate students. MethodsData from the American College Health Association, and National College Health Assessment II: 2016–2019 were analyzed (N = 228,640 undergraduate students from 442 campuses, ages 18–24; 67.8 % female, 40.4 % BIPOC, 3.0 % non-binary (trans/non-conforming), 19.4 % LGBQ+). We used logistic regression to predict each mental health indicator; covariates included year, gender, BIPOC, LGBQ+ status, and their interactions, as well as other covariate controls (e.g., region, year in school). ResultsThere were significant and steady increases in the odds of each mental health indicator by year (ORs = 1.12–1.13), which were significantly greater in magnitude for LGBQ+ students (ORs = 1.20–1.23). Increases did not vary by gender, race/ethnicity, or intersections between these groups and LGBQ+ status. There were significant interactions between identity groups that aligned with intersectional and minority stress theories (which did not vary by year). Non-Hispanic White students had significantly greater odds of past-year treatment/diagnosis of depression and anxiety compared to BIPOC students; however, BIPOC students had significantly greater odds of past-year suicidal ideation and this was pronounced for BIPOC women. Being non-binary x LGBQ+ was associated with significantly greater odds of each indicator. DiscussionResults affirm the importance of promoting mental health among college students, with a particular focus on how to better serve and support BIPOC, non-binary, and LGBQ+ students.

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