Mental health among first-generation college students: Findings from the national Healthy Minds Study, 2018-2021

Abstract

A mounting body of evidence reveals that college mental health outcomes are worsening over time. That said, little is known about the mental health needs of the nearly eight million first-generation students in U.S. postsecondary education. The present study uses population-level data from the national Healthy Minds Study to compare prevalence of mental health symptoms and use of services for first-generation and continuing-generation students from 2018-2021. The sample includes 192,202 students at 277 campuses, with 17.3% being first-generation. Findings reveal a high prevalence of mental health symptoms among both first-generation and continuing-generation students. Controlling for symptoms, FG students had significantly lower rates of mental health service use. Just 32.8% of first-generation students with symptoms received therapy in the past year, relative to 42.8% among continuing-generation students, and this disparity widened during the COVID-19 pandemic. Findings have important implications for the design and implementation of higher education policies, mental health delivery systems, college persistence and retention initiatives, and public health efforts in school settings.

Keywords: college student populations; first-generation students; mental health; mental health treatment.

Figure 1.

Barriers to Mental Health Treatment among Students with Symptoms Figure values are weighted percentages among students with a positive screen for depression, positive screen for anxiety, and/or past-year suicidal ideation. ‘FG’ is ‘first-generation;’ ‘CG’ is ‘continuing-generation;’ ‘appt’ is ‘appointment.’