J Adolesc Health. 2025 Dec 26:S1054-139X(25)00509-9. doi: 10.1016/j.jadohealth.2025.11.001. Online ahead of print.
ABSTRACT
PURPOSE: Investigate the sociodemographic disparities in mental health treatment among Canadian college students through quantifying disparities at 2 critical stages of the treatment-seeking pathway: (1) perceived need for treatment and (2) service use, conditional on perceived need.
METHODS: Survey data collected at 4 Canadian universities under the World Mental Health International College Student initiative were analyzed. Students meeting the criteria for 12-month mental disorder, substance use disorder, suicidal thoughts and behaviors, and/or non-suicidal self-injury were included in the analyses (N = 8,581). Multivariable logistic regression models were run to evaluate the associations between sociodemographic characteristics and (1) perceived need for mental health treatment and (2) service use, conditional on perceived need. Gender, sexual orientation, race and ethnicity, age, international student status, parental education, and financial stress were investigated as covariates.
RESULTS: Students meeting the criteria for a 12-month mental health condition comprised 30.4% of the total sample. Of these students, 78.7% reported a perceived need for mental health treatment and 40.2% reported service use. Gender and sexual orientation disparities appeared to predominately arise from differences in perceived need. Conversely, disparities based on age, international student status, and financial stress appeared to predominately arise from differences in structural barriers. Disparities based on race/ethnicity and parental education appeared to arise from both attitudinal and structural barriers.
DISCUSSION: Findings identify key blockage points for further investigation and highlight heterogeneity in the causes underlying sociodemographic disparities in service use, emphasizing the importance of targeted efforts to promote equitable access to mental health treatment for students.
PMID:41452305 | DOI:10.1016/j.jadohealth.2025.11.001
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