The Role of Campus Climate & Sense of Belonging on the Use of Behavioral Health Services By College Students: A Longitudinal Examination of Data from the Healthy Minds Study

Background: The emerging adult population, or those 18-25 years old, has grown to 36 million in the United States. College students comprise a significant subset of this population, with roughly 12.2 million enrolled at a college or university. Approximately one-third of emerging adult college students will experience some form of mental illness, while one in five will be diagnosed with a substance use disorder. Those dealing with behavioral health concerns face a myriad of challenges that include negative implications for education, relationships, long-term health, and socioeconomic status. Despite these challenges, few emerging adults receive help for their behavioral health concerns, whether on-campus or elsewhere. Attempts to understand this phenomenon have been limited, but some evidence indicates that institutional and individual-level characteristics may play a role. Given this, the purpose of this research is to examine the effects of campus climate and sense of belonging (institutional-level characteristics), as well as several individual characteristics, on the use of behavioral health services among college students.

Methods: A secondary analysis of data from the 2014-2015 and 2015-2016 Healthy Minds Study, an annual web-based survey of college students in the United States, was completed. The dependent variable is use of counseling or therapy services (yes/no) within the past 12 months.  The independent variables included measures of the campus climate and sense of belonging, drawn from the Perceived Cohesion Scale and Sense of Social and Academic Fit. Control variables include student age, gender identity, and sexual orientation.

Binomial logistic regressions were conducted with data from 39,288 undergraduate students, between the ages of 18 and 25, to test the relationship between the dependent and independent variables, and whether this relationship held after adding control variables to the model. Multiple imputation with chained equations was used to account for missing data.

Results: The logistic regression model was statistically significant, χ²(15) = 1884.02, p < .001. Both decreasing sense of belonging and decreasing campus climate scores were associated with increased odds of using counseling services. Each gender identity group had higher odds of using counseling services than men. Compared to those who identify as straight, each sexual orientation group had higher odds of using counseling services. Each age group had higher odds of using counseling services than 18 year olds, with the exception of those age 19.

Conclusions and Implications: The associations found indicate there may be a link between specific individual- and institutional-level characteristics and use of counseling services among college students. Understanding which factors impact service receipt among this population, and using this knowledge to guide policy and practice, will lead to improved behavioral health services, and likely increased use of these services, at college campuses across the country.