Psychotherapy utilization by United States college students

Abstract

Objective: We studied current psychotherapy utilization rates among college students with mental health problems and identified characteristics associated with differential utilization. Participants: Nationwide online survey of students screening positive for at least one clinical mental health problem (N = 18,435). Methods: Rates and correlates of psychotherapy utilization were analyzed descriptively and with logistic regression. Results: Sample-wide, 19% reported receiving psychotherapy. Being male (vs. female), being Asian, Black or African American, or Multiracial (vs. White), greater financial difficulty, lower parent education, lower year in school, and attending a public (vs. private) institution were associated with lower utilization. Holding a gender minority (vs. female) identity and holding a sexual minority (vs. heterosexual) identity were associated with higher utilization. Utilization fell from Fall 2019 to Spring 2020, early during the COVID-19 pandemic, and subsequently rebounded. Conclusions: This study estimates current psychotherapy utilization among students with mental health problems and identifies possibly underserved populations.

Keywords:

• Disparities
• help-seeking
• mental health
• psychotherapy
• public health

Author contributions

Ellen E. Fitzsimmons Craft, C. Barr Taylor, Daniel Eisenberg, Denise E. Wilfley, and Michelle G. Newman designed the data collection plan and collected the data. Gavin N. Rackoff formulated the research question, analyzed data, and drafted the manuscript under Michelle G. Newman’s supervision. Ellen E. Fitzsimmons-Craft, C. Barr Taylor, Daniel Eisenberg, Denise E. Wilfley, and Michelle G. Newman provided critical revisions.

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Washington University in St. Louis Institutional Review Board.

Notes

a There were no participants between the months of June through August 2020, January through February 2021, or July through September 2021.

Additional information

Funding

This study was supported by National Institute of Mental Health grants R01MH115128 and K08MH120341. The funding agency is not responsible for any data collection, analysis, or interpretation in this manuscript. No author is being paid to write this article by a pharmaceutical company or other agency.