Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education

Tugce Ertem-Eray; Eyun-Jung Ki; Yezi He; Katelin Aspre Mueller

doi:10.66815/ajqr/18488

Tugce Ertem-Eray ¹ ^* , Eyun-Jung Ki ², Yezi He ³, Katelin Aspre Mueller ⁴

More Detail

AM J QUALITATIVE RES, Volume 10, Issue 3, pp. 126-147

https://doi.org/10.66815/ajqr/18488

OPEN ACCESS 6 Views 1 Downloads

Download Full Text (PDF)

Abstract

Guided by intersectionality theory, this study conducted in-depth interviews to examine mental health challenges among underrepresented college students and to determine how they access care in U.S. higher education. Findings indicated that the challenges faced by underrepresented college students during the COVID-19 era continue to influence the higher education landscape. Underrepresented college students face mental health challenges not only as individuals but as members of overlapping identity groups. These challenges are shaped by the stigma and discrimination associated with their social identities. Recognizing and addressing these challenges is essential to addressing mental health issues effectively. Thus, colleges must respond by making targeted adjustments to better support these students and choose an approach to mental health in U.S. higher education that accounts for how multiple social identities and systems of oppression intersect. This study suggests that colleges should develop counseling and support systems that explicitly consider these intersections and promote coping strategies tailored to the needs of diverse student populations.

Keywords: mental health problems, counseling centers, underrepresented college students, intersectionality

References

Abrams, Z. (2020, July 11). A crunch at college counseling centers. Monitor on Psychology, 51(6). https://www.apa.org/monitor/2020/09/crunch-college-counseling
Abrams, Z. (2022, October 12). Student mental health is in crisis. Campuses are rethinking their approach. Monitor on Psychology, 53(7). https://www.apa.org/monitor/2022/10/mental-health-campus-care
ADAA. (2023, May 11). Prevention & warning signs. https://adaa.org/understanding-anxiety/suicide/prevention-warning-signs
American Psychiatric Association (2022). Anxiety disorders. In Diagnostic and statistical manual of mental disorders (pp. 215-231). 5th ed. Text Revision. American Psychiatric Association.
American College Health Association-National College Health Assessment II. (2019). https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_UNDERGRADUATE_REFERENCE%20_GROUP_EXECUTIVE_SUMMARY.pdf
Bradesko, L., & Mladenic, D. (2012). A Survey of chatbot systems through a Loebner prize competition. Ljubljana. In Proceedings of Slovenian Language Technologies Society Eighth Conference of Language Technologies. https://nl.ijs.si/isjt12/proceedings/isjt2012_06.pdf
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912–920. https://doi.org/10.1016/S0140-6736(20)30460-8
Bryant, J., & Welding, L. (2023, February 15). College student mental health statistics. Best Colleges. https://www.bestcolleges.com/research/college-student-mental-health-statistics/
Chad, S. P., & Arif, H. (2023). Depression. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430847/
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Sage.
Collins, P. H., & Bilge, S. (2020). Intersectionality. Polity.
Corbin, J., & Strauss, A. (2008). Basics of qualitative research. Sage.
Crenshaw, K. W. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1(8), 139-167. http://chicagounbound.uchicago.edu/uclf/vol1989/iss1/8
Cuijpers, P., Cristea, I. A., Ebert, D. D., Koot, H. M., Auerbach, R. P., Bruffaerts, R., & Kessler, R. C. (2016). Psychological treatment of depression in college students: A metaanalysis. Depression and Anxiety, 33(5), 400-414. https://doi.org/10.1002/da.22461
Davis, C. S., & Lachlan, K. A. (2017). Straight talk about communication research methods. Kendall Hunt.
Dennon, A. (2022, January 21). Update on the college student mental health crisis. Best Colleges. https://shorturl.at/hvyB7
Denzin, N. K., & Lincoln, Y. S. (2005). The Sage handbook of qualitative research. Sage.
Duggan, M., Koczela, S., Hanhan, T., Humphrey, D., Malpiede, M., Cogan, D., Eisenberg, D.,… (2022, January). Peer counseling in college mental health. https://drive.google.com/file/d/1bpb2KJdNAtLGoUJpHtZaS9JvovOHWI1w/view
Edelman, J. (2023, March 14). More students are having mental health problems, but more are asking for help. Diverse Issues in Higher Education. https://www.diverseeducation.com/reports-data/article/15352465/more-students-are-having-mental-health-problems-but-more-are-asking-for-help#:~:text=The%20HMS%20did%20find%20differences,health%20stigma%20in%20different%20cultures.
Eisenberg, D., Golberstein, E., & Hunt, J. B. (2009). Mental health and academic success in college. The B.E. Journal of Economic Analysis & Policy, 9(1). Article 40.
Elmer, T., Mepham, K., Stadtfeld, C., & Capraro, V. (2020). Students under lockdown: Comparisons of students’ social networks and mental health before and during the COVID-19 crisis in Switzerland. PLoS One, 15(7), e0236337. https://doi.org/10.1371/journal.pone.0236337
Fiani, C. N. (2018). Beyond the binary: Gender identity and mental health among transgender and gender non-conforming adults. [Doctoral dissertation, City University of New York].
Finn, C. (2018). Examining the relationship between the nontraditional learner and sense of connectedness in an online learning environment at a for-profit college (Doctoral dissertation). Northcentral University. Ann Arbor, MI: ProQuest Dissertations Publishing.
Frost, D. M., & Meyer, I. H. (2023). Minority stress theory: Application, critique, and continued relevance. Current Opinion in Psychology, 51, 101579. https://doi.org/10.1016/j.copsyc.2023.101579
Gaffney, H., & Mansell, W., & Tai, S. (2019). Conversational agents in the treatment of mental health problems: Mixed-method systematic review. JMIR Mental Health, 6(10). https://doi.org/10.2196/14166
Harmer, B., Lee, S., Duong, T. V. H., Saadabadi, A. (2023). Suicidal ideation. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/33351435/
Harris, P. (2023, February 10). ‘Survival mode’: Worsening post-COVID-19 quarantine student behavior contributes to classroom issues. Alligator. https://www.alligator.org/article/2023/02/worsening-student-behavior
Hingwe, S. (2021). Mental health considerations for black, indigenous, and people of color: trends, barriers, and recommendations for collegiate mental health. In Riba, M. B. and Menon, M. (Eds.) College Psychiatry. Psychiatry Update, vol 1. Springer, Cham. https://doi.org/10.1007/978-3-030-69468-5_6
Hook, J. N., Davis, D., Owen J., & DeBlare, C. (2017). Cultural humility. Engaging diverse identities in therapy. American Psychological Association.
Ingram, L., & Wallace, B. (2019). “It creates fear and divides us:” Minority college students’ experiences of stress from racism, coping responses, and recommendations for colleges. Journal of Health Disparities Research and Practice, 12(1), 80-112. http://digitalscholarship.unlv.edu/jhdrp/
Kaplan, S. (2024, January 12). Dr. Jodi Halpern on why AI isn’t a magic bullet for mental health. Berkeley Public Health. Retrieved from https://publichealth.berkeley.edu/news-media/research-highlights/why-ai-isnt-a-magic-bullet-for-mental-health
Kirsch, D. J., Doerfler, L. A., & Truong, D. (2015). Mental health issues among college students: Who gets referred for psychopharmacology evaluation? Journal of American College Health, 63(1), 50-56. https://doi.org/10.1080/07448481.2014.960423
Kitzrow, M. A. (2009). The mental health needs of today’s college students: Challenges and recommendations. NASPA Journal, 46(4), 647-660. https://doi-org.prox.lib.ncsu.edu/10.2202/1949-6605.5037
Ko, N. J. (2024, April 10). Virtual therapy vs. in-person therapy. https://www.psychology.org/resources/virtual-therapy-vs-in-person/
Kognito. (2015). Benefits of investing in students’ mental health. White Paper. https://ocde.us/EducationalServices/SLACI/SchoolClimate/Documents/Landing%20Page/Return_On_Investment_Mental%20Health%20Kognito_WhitePaper.pdf
Kuhail, M. A., Alturki, N., Thomas, J., & Alkhalifa, A. K. (2024). Human vs. AI counseling: College students’ perspectives. Computers in Human Behavior Reports, 16, 100534. https://doi.org/10.1016/j.chbr.2024.100534
Kumpf, E. (2020). I’m fine. A student perspective on suicide and mental health on college campuses. New Degree Press.
Lee, J., Solomon, M., Stead, T., Kwon, B., & Ganti, L. (2021). Impact of COVID-19 on the mental health of US college students. BMC Psychology, 9, Article number 95 https://doi.org/10.1186/s40359-021-00598-3
Lefevor, G. T., Park, S., & Pedersen, T. (2018). The impact of minority stress on the mental health of sexual and religious minorities. Journal of Gay & Lesbian Mental Health, 22, 90–104. https://doi.org/10.1080/19359705.2017.1418696
Lefevor, G. T., Smacka, A. C. P., & Giwab, S. (2020). Religiousness, support, distal stressors, and psychological distress among black sexual minority college students. Journal of GLBT Family Studies, 16(2), 148-162. https://doi.org/10.1080/1550428X.2020.1723369
Li, Y., Zhao, J., Ma, Z., McReynolds, L. S., Lin, D., Chen, Z., Wang, T., Wang, D., Zhang, Y., Zhang, J., Fan, F., Liu, X. (2021). Mental health among college students during the COVID-19 pandemic in China: A 2-wave longitudinal survey. Journal of Affective Disorders, 281, 597-604. https://doi.org/10.1016/j.jad.2020.11.109
Lindlof, T. R., & Taylor, B. C. (2011). Qualitative communication research methods. Sage.
Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities among college students of color. Journal of Adolescent Health, 63(3), 348-356. https://doi.org/10.1016/j.jadohealth.2018.04.014
Lipson, S. K., Zhou, S., Abelson, S., Heinze, J., Jirsa, M., Morigney, J., Patterson, A., Singh, M., Eisenberg, D. (2022). Trends in college student mental health and help-seeking by race/ethnicity: Findings from the National Healthy Minds Study, 2013-2021. Journal of Affective Disorders, 306, 138-147. https://doi.org/10.1016/j.jad.2022.03.038
Liu, X. Q., Guo, Y. X., Zhang, W. J., & Gao, W. J. (2022). Influencing factors, prediction and prevention of depression in college students: A literature review. World Journal of Psychiatry, 12(7), 860-873. https://doi.org/10.5498/wjp.v12.i7.860
Liu, X. Q., Guo, Y. X., Xu, Y. (2023). Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives. World Journal of Clinical Cases, 11(7), 1442-1457. https://doi.org/10.12998/wjcc.v11.i7.1442.
McKenzie, K., Murray, K. R., Murray, A. L., & Richelieu, M. (2015). The effectiveness of university counseling for students with academic issues. Counselling & Psychotherapy Research, 15(4)., 284-288. https://doi.org/10.1002/capr.12034
Meilman, P. W., & Hall, T. M. (2006). Aftermath of tragic events: The development and use of community support meetings on a university campus. Journal of American College Health, 54(6), 382–384. https://doi.org/10.3200/JACH.54.6.382-384
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychology Bulletin, 129, 674–697. https://doi.org/10.1037/0033-2909.129.5.674
Meyer, I. H., Dietrich, J., & Schwartz, S. (2008). Lifetime prevalence of mental disorders and suicide attempts in diverse lesbian, gay, and bisexual populations. American Journal of Public Health, 98(6), 1004–1006. https://doi.org/10.2105/AJPH.2006.096826
Nakkeeran, N., & Nakkeeran, B. (2018). Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference. Health Research Policy and Systems, 16(1), 9-29. https://doi.org/10.1186/s12961-018-0366-1
Nam, J. (2023, March 31). Diversity in Higher Education: Facts and Statistics. Best Colleges. https://www.bestcolleges.com/research/diversity-in-higher-education-facts-statistics/
National College Health Assessment (NCHA). https://www.acha.org/NCHA/NCHA_Home
National Institute of Mental Health. (n.d.). Anxiety disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders
Nomura, K., Minamizono, S., Maeda, E., Kim, R., Iwata, T., Hirayama, J., Ono, K., Fushimi, M., Goto, T., Mishima, K., Yamamoto, F. (2021). Cross-sectional survey of depressive symptoms and suicide-related ideation at a Japanese national university during the COVID-19 stay-home order. Environmental Health and Preventive Medicine, 26(30). https://doi.org/10.1186/s12199-021-00953-1
PaperClip Communications. (2022). 10 student mental health & well-being workshops. https://cdn.shopify.com/s/files/1/0595/5171/1405/files/10_Student_Mental_Health_and_Well-Being_Workshops_SAMPLE.pdf?v=1639603418
Pedrelli, P., Nyer, M., Yeung, A., Zulauf, C., & Wilens, T. (2015). College students: Mental health problems and treatment considerations. Academic Psychiatry, 39, 503–511. https://doi.org/10.1007/s40596-014-0205-9
Pompper, D. (2014). Practical and theoretical implications of successfully doing difference in organizations. Emerald.
Prince, J. P. (2015). University student counseling and mental health in the United States: Trends and challenges. Mental Health & Prevention, 3(1–2), 5-10. https://doi.org/10.1016/j.mhp.2015.03.001
Quinn, H. (2024, February 26). Marginalized high school students are avoiding college for mental health reasons. Technical.ly. https://technical.ly/diversity-equity-inclusion/mental-health-college-marginalized-students-eab-report/
Schwitzer, A. M., Moss, C. B., Pribesh, S. L., St. John, D. J., Burnett, D. D., Thompson, L. H., & Foss, J. J. (2018). Students With Mental Health Needs: College Counseling Experiences and Academic Success. Journal of College Student Development, 59(1), 3-20. https://doi.org/10.1353/csd.2018.0001
Schmitz, R. M., Robinson, B. A., Tabler, J., Welch, B., & Rafaqut, S. (2019). LGBTQ+ Latino/a young people’s interpretations of stigma and mental health: An intersectional minority stress perspective. Society and Mental Health, 10(2), 163-179. https://doi.org/10.1177/2156869319847248 (Original work published 2020)
Shea, M., & Wong, Y. J. (2022). A two-way street: Immigrants’ mental health challenges, resilience, and contributions. One Earth, 5(8), 845-848. https://doi.org/10.1016/j.oneear.2022.07.010
Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on college students’ mental health in the United States: Interview survey study. Journal of Medical Internet Research, 22(9), e21279. https://doi.org/10.2196/21279
Stearns, P. N. (2022, September 1). A ‘crisis’ of student anxiety? The Chronicle of Higher Education. https://www.chronicle.com/article/a-crisis-of-student-anxiety
Stewart-Rozema, J., & Pratts, C. (2023, April 3). International student enrollment statistics. Best Colleges. https://www.bestcolleges.com/research/international-student-enrollment-statistics/
The Trevor Project. (2020, October 6). All Black Lives Matter: Mental health of Black LGBTQ youth. https://www.thetrevorproject.org/research-briefs/all-black-lives-matter-mental-health-of-black-lgbtq-youth/
The Healthy Mind Study. (n.d.). Student survey. https://healthymindsnetwork.org/hms/
The Healthy Minds Study. (2020). Fall 2020 data report. https://healthymindsnetwork.org/wp-content/uploads/2021/02/HMS-Fall-2020-National-Data-Report.pdf
The Healthy Minds Study. (2023). 2021-2022 data report. https://healthymindsnetwork.org/wp-content/uploads/2023/03/HMS_national_print-6-1.pdf
Venable, M. A., & Pietrucha, M. E. (2022). College student mental health report. Awareness and perception of college student mental health and support systems. Best Colleges. https://www.bestcolleges.com/wp-content/uploads/2023/06/Mental-Health_Report.pdf
Vescovelli, F., Melani, P., Ruini, C., Bitti, P. E. R., & Monti, F. (2017). University counseling service for improving students’ mental health. Psychological Services, 14(4), 470-480. http://dx.doi.org/10.1037/ser0000166
Volken, T., Zysset, A., Amendola, S., Klein, S. A., Huber, M., von Wyl, A., Dratva, J. (2021). Depressive symptoms in Swiss University students during the COVID-19 pandemic and its correlates. International Journal of Environmental Research and Public Health, 18(4), 1458. https://doi.org/10.3390/ijerph18041458
Wang, X., Hegde, S., Son, C., Keller, B., Smith, A., Sasangohar, F. (2020). Investigating mental health of US college students during the COVID-19 pandemic: Cross-sectional survey study. Journal of Medical Internet Research, 22(9), e22817. https://doi.org/10.2196/22817
Warren, C. A. B., & Karner, T. X. (2015). Discovering qualitative methods. Ethnography, interviews, documents, and images. Oxford University Press.
Waymer, D., Brown, K. A., & Jackson, J. (2023). Researcher responsibility to diversity and inclusion in public relations and social scientific research: A call for more inclusive research and researcher participation. Journal of Public Relations Research, 35(5-6). 287-306. https://doi.org/10.1080/1062726X.2023.2195185
Weissman, S. (2021, August 4). New mental health investments, ongoing uncertainties. Inside Higher Ed. https://www.insidehighered.com/news/2021/08/05/colleges-expand-mental-health-offerings-ahead-fall-semester
Wilfong, S. (2022, May 16). What does campus mental health services do? Best Colleges. https://www.bestcolleges.com/blog/what-mental-health-services-do/#:~:text=College%20counseling%20services%20can%20help,%2C%20virtual%2C%20and%20hybrid%20options.
Williams, D. R., Gonzalez, H. M., Neighbors, H., Nesse, R., Abelson, J. M., Sweetman, J., & Jackson, J. S. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: Results from the National Survey of American Life. Archives of General Psychiatry, 64(3), 305–315. https://doi.org/10.1001/archpsyc.64.3.305
World Health Organization. (2023, March 31). Depressive disorder (depression). https://www.who.int/news-room/fact-sheets/detail/depression#:~:text=Depressive%20disorder%20(also%20known%20as,and%20feelings%20about%20everyday%20life
Yasui, M., Pottick, K.J. & Chen, Y. (2017). Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families. Clinical Child and Family Psychology Review, 20, 250–332. https://doi.org/10.1007/s10567-017-0229-2
Zhang, J., & Goodson, P. (2011). Predictors of international students’ psychosocial adjustment to life in the United States: A systematic review. International Journal of Intercultural Relations, 35(2), 139–162.

Citation

Ertem-Eray, T., Ki, E.-J., He, Y., & Mueller, K. A. (2026). Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education. American Journal of Qualitative Research, 10(3), 126-147. https://doi.org/10.66815/ajqr/18488

Ertem-Eray, T., Ki, E.-J., He, Y., and Mueller, K. A. (2026). Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education. American Journal of Qualitative Research, 10(3), pp. 126-147. https://doi.org/10.66815/ajqr/18488

Ertem-Eray T, Ki EJ, He Y, Mueller KA. Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education. AM J QUALITATIVE RES. 2026;10(3), 126-147. https://doi.org/10.66815/ajqr/18488

Ertem-Eray, Tugce, Eyun-Jung Ki, Yezi He, and Katelin Aspre Mueller. "Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education". American Journal of Qualitative Research 2026 10 no. 3 (2026): 126-147. https://doi.org/10.66815/ajqr/18488

Ertem-Eray, Tugce et al. "Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education". American Journal of Qualitative Research, vol. 10, no. 3, 2026, pp. 126-147. https://doi.org/10.66815/ajqr/18488

Ertem-Eray T, Ki EJ, He Y, Mueller KA. Mental Health Perceptions of Underrepresented College Students in U.S. Higher Education. AM J QUALITATIVE RES. 2026;10(3):126-47. https://doi.org/10.66815/ajqr/18488