Increasing mental health issues in college students from 2016-2019: Assessing the intersections of race/ethnicity, gender, and sexual orientation

Background: This study aimed to evaluate how trends in mental health (e.g., diagnosis/treatment of depression, anxiety, suicidal ideation) varied across intersections of gender, race/ethnicity, and sexual orientation in a large, national sample of undergraduate students. Methods: Data from the American College Health Association, and National College Health Assessment II: 2016-2019 were analyzed ( N = 228,640 undergraduate students from 442 campuses, ages 18-24; 67.8 % female, 40.4 % BIPOC, 3.0 % non -binary (trans/non-conforming), 19.4 % LGBQ +). We used logistic regression to predict each mental health indicator; covariates included year, gender, BIPOC, LGBQ + status, and their interactions, as well as other covariate controls (e.g., region, year in school). Results: There were significant and steady increases in the odds of each mental health indicator by year (ORs = 1.12-1.13), which were significantly greater in magnitude for LGBQ + students (ORs = 1.20-1.23). Increases did not vary by gender, race/ethnicity, or intersections between these groups and LGBQ + status. There were significant interactions between identity groups that aligned with intersectional and minority stress theories (which did not vary by year). Non -Hispanic White students had significantly greater odds of past -year treatment/ diagnosis of depression and anxiety compared to BIPOC students; however, BIPOC students had significantly greater odds of past -year suicidal ideation and this was pronounced for BIPOC women. Being non -binary x LGBQ + was associated with significantly greater odds of each indicator. Discussion: Results affirm the importance of promoting mental health among college students, with a particular focus on how to better serve and support BIPOC, non -binary, and LGBQ + students.