College students who belong to sexual minority groups are more likely to seek help for mental health problems than their straight peers, but they still face many barriers to using on-campus mental health services, according to a new RAND Corporation study.
Researchers found that students who identify themselves as lesbian, gay, bisexual, queer or questioning were more likely to use off-campus mental health services than their heterosexual peers and were more likely to report being deterred by barriers such as concerns over confidentiality and uncertainty over eligibility for on-campus services.
The findings are from one of the largest surveys ever of college students about mental health issues. More than 33,000 students from 33 public four-year and two-year colleges in California were surveyed about mental health needs during 2013. The study was published online by the Journal of Adolescent Health.
"It's encouraging that college students who identify as sexual minorities are more likely to utilize mental health services, but our findings suggest there is a need to develop campus-based mental health services tailored to this group and address barriers to using them," said Michael S. Dunbar, lead author of the study and an associate behavioral scientist at RAND, a nonprofit research organization.
The study found that 7 percent -- roughly 1 in 15 -- of the students surveyed identified as being lesbian, gay, bisexual, queer or questioning.
Compared to heterosexual students, sexual minority students had higher rates of psychological distress (26 percent versus 18 percent), were more likely to report academic impairment related to mental health problems (17 percent versus 11 percent) and reported higher overall levels of stress over the past month (63 percent versus 55 percent).
Members of sexual minority groups were nearly twice as likely to have used some type of mental health services during their time in college (31 percent versus 18 percent). Among all students, most of those who reported serious psychological distress did not use mental health services.
Among students who needed services but didn't get them on campus, sexual minority individuals were more likely than their heterosexual peers to report specific barriers to using on-campus mental health services. In particular, sexual minority students endorsed concerns over confidentiality, embarrassment over using services and uncertainty over whether they would be eligible for services as reasons they did not use on-campus services. They also were more likely to report seeking help off-campus.
"Our study underscores the need for additional actions to increase access to and use of mental health services among all students," said Dr. Bradley D. Stein, co-author of the study and a physician scientist at RAND. "It also highlights the need for efforts to ensure that campuses' mental health services are sensitive and responsive to the needs of sexual minority students, enabling all students to address their mental health needs and maximize their chances for success in college and beyond."
Previous studies have estimated that 17 percent or more of college students suffer from serious psychological distress, with risks being higher for lesbian, gay, bisexual, queer or questioning students. If unaddressed, psychological problems among college students often persist, with consequences including greater levels of substance abuse, lower academic achievement, poor graduation rates, and lower workforce participation and income.
Few studies have examined ways that sexual minority college students differ from heterosexual students on factors such as mental health status and their use of mental health services.
The RAND study analyzed information from a survey about mental health completed by students from nine University of California campuses, nine California State University campuses and 15 California community colleges. The results were weighted to help reflect the state's overall college student population.
Support for the study was provided by California Mental Health Services Authority (CalMHSA), an organization of county governments working to improve mental health outcomes for individuals, families and communities in California. Programs implemented by CalMHSA are funded by counties through Proposition 63, which provides the funding and framework needed to expand mental health prevention and early intervention services to previously underserved populations and all of California.
Other authors of the study are Lisa Sontag-Padilla, Rajeev Ramchand and Rachana Seelam.
RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.
Journal of Adolescent Health