College Students and Depression: Their Understanding of and Willingness to Use Mental Health Resources

Background:  Depression among college students is a growing concern. Many students with depression do not seek help because of mental health stigma and lack of understanding of available resources. There are gaps in current knowledge surrounding types of mental health resources accessed. The present study aims to 1) determine what demographic characteristics among college students predict depression, 2) describe types of support students understand and are willing to use, 3) examine relationships between depression score and understanding of supports, and 4) examine types of supports college students are willing to use and their relationship to depression severity. This study contributes new knowledge about how college students understand mental health resources and how willing they are to use resources when depressed.

Methods: The study used a multisite cross-sectional survey design with data obtained from three Midwest universities (two large public and one small private) and one large, Western public university. College students in introductory undergraduate communications, biology, nursing, and psychology courses were asked to participate. The final sample size was 287 students. The survey was administered online using Catalyst WebQ.

            Measures. Demographic data were collected on age, race/ethnicity, gender, sexual orientation, year in school, and major. Depression data was collected using the Patient Health Questionnaire (PHQ-9). Depression levels were dichotomized to reflect none to minimal depression and mild depression (0-9 score) as compared to moderate to severe depression (10-27 score).

            Questions to assess understanding and willingness to access mental health resources were developed based on the theory of functional social support, which included categories of: informational support, instrumental/tangible support, and emotional/esteem/appraisal support. Participants used a Likert-scale to identify resources they would be willing to use when feeling depressed.

            Analyses. Descriptive statistics were used to describe demographic characteristics and the variables of interest including depression score, understanding of resources, and willingness to use resources. Bivariate analyses were conducted to explore relationships prior to entering the variables in multivariate models. A crosstab analysis examined the relationships between understanding available resources and willingness to use resources by depression level and a hierarchical multiple regression was used to examine relationships between understanding resources and demographic variables and depression score.

Results: 1) Multiple regression indicated that demographic variables explained almost 5% of depression score variance where Asians, freshman students, and sexual minorities reported higher depression scores. 2) Sexual minorities had a greater understanding of online, campus, and community resources than heterosexual students. Asians were less likely and Hispanics were more likely than whites to understand campus resources. 3) Higher depression scores were associated with a decrease in understanding of campus resources. 4) Willingness to seek help from friends, family, and university supports was associated with lower depression scores, whereas willingness to post on Facebook was associated with higher depression scores.

Conclusion/Implications: Findings indicate that depression scores are associated with willingness to use supports, however higher depression scores predicted a lower likelihood of accessing in-person support. Universities must consider this and provide information on types of support based on specific mental health needs of individual students.