Methodology: Using the World Health Organization’s AAAQ framework of healthcare delivery, a survey was developed and distributed online in Spring 2020. A purposive sample was taken from Georgia college and university students who self-selected into the study (n=262, from 49 separate institutions). A two-model logistic regression analysis examined the relationship between student perception of on-campus counseling services, and factors associated with a students’ decision to utilize counseling services either on or off campus. These factors included age, race, gender identity, sexual orientation, health insurance status, disability status, employment, student status (full or part-time), caregiver status, education level, and school location (rural versus urban).
Results: Bisexual students were nearly four times more likely to utilize on-campus counseling services than heterosexual students [OR=3.89, P<.05], and over two and a half times more likely to use off-campus services [OR=2.60, P=<.05]. Additionally, students who sexually identified as other than heterosexual or bisexual were more likely to utilize counseling services off campus [OR=2.65, P=<.05]. Notably, students attending colleges and universities in rural areas were more likely to utilize on-campus services than students living in rural areas [OR=2.58, P=<.05]. Higher ratings of perceived accessibility were associated with more likely use of on-campus services [OR=1.27, P=<.05]. However, higher ratings of perceived availability of services suggested less likelihood of service utilization both on campus [OR=0.76, P=<.05] and off [OR=0.83, P=<.05]. Out-of-state students were also less likely than in-state students to use counseling services off campus [OR=0.28, p=<.05]. Finally, students who reported having a disability were more likely to use counseling services off campus than those who did not [OR=3.57, P=<.05].
Conclusion and Implications: The results of this study suggest a greater understanding is needed of how students utilize counseling services. Determining the reasons why students may not access counseling services involves deeper exploration of student perception and utilization patterns. The influence that a student’s sexuality has on their perceived rating of AAAQ can potentially inform future interventions to better meet the needs of LGBTQ+ students. If factors that influence students’ perceptions of counseling services can be identified, changes can be made to improve perception and increase student utilization of counseling services, which, in turn, may support academic success.