Increasing mental health issues in college students from 2016-2019: Assessing the intersections of race/ethnicity, gender, and sexual orientation

This 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. Data 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). There 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. Results 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. •Mental health indicators increased linearly from 2016 to 2019•Rates increased more so for LGBQ+ students•Rates did not increase more for any other intersectional groups•BIPOC students continue to be underserved in mental health care