Mental Health Disorder Symptom Prevalence and Rates of Help-seeking Among University-Enrolled, Emerging Adults

Abstract

Objective.

Examine mental health symptom prevalence and rates of campus services utilization among Black male, White male and Black female college students.

Participants.

2500 students from an ongoing, student survey at a public university; launched in 2011.

Methods.

Measures included data for anxiety and depressive symptoms and utilization of campus health services (counseling center, health services, etc.). Descriptive analyses determined prevalence and utilization rates. Mann Whitney U tests compared prevalence. Chi-squared tests compared utilization rates.

Results.

Anxiety prevalence: greater than 60% of students from each ethnic group reported symptoms; reporting rates decreased significantly for Black men (49.6%); p<0.001. Depression prevalence: greater than 80% reported symptoms; there were significant differences in reporting between Black men and Black women (72.7% vs. 87.1%, p<0.001). Utilization: Black men utilized counseling services less than White men (20.4% vs. 37.8%, p = 0.024).

Conclusion.

Black men report depressive and anxiety symptoms but underutilize campus health resources.

Introduction

Emerging adults are at increased risk of developing poor mental health due in part, to social factors impacting the transition from adolescence to adulthood.¹ This stressful time is often correlated with high mortality rates, violence, and poor mental health, particularly among men.^1,2 Relative to young adults, emerging adults in college experience psychological distress at disproportionate rates and are at the highest risk of developing depression and anxiety.^3–5 In 2016, emerging adults in college reported the highest prevalence of mental disorders, with anxiety and depression being among the most common.^6–8 Such risk and onset has been strongly associated with stressors such as living away from home, learning to navigate campus, social environments, and dealing with academic life.⁹

Black men are at particularly high risk during this transitional period. Data indicate that Black men experience psychological distress at higher rates than White men, and suicide rates among Black men during emerging adulthood have been increasing.^10–13 This increase in risk has been attributed to several social and environmental factors, including everyday experiences with racial discrimination,^14,15 stressful life events,¹⁶ financial distress,¹⁷ poverty,¹⁸ and poor academic performance.¹⁹ For Black men who enroll in college, certain stressors, such as racial discrimination, lack of social support and belongingness, and cultural conflict, further impact their ability to succeed in higher education.^18,20,21 The compounded impact of racial stressors and college stress increases Black men’s risk of psychological distress, exacerbating depressive feelings that often correspond with suicidal ideation and behavior.¹¹ Despite being at higher risk for poor mental health, Black men, in general, seek mental health services at lower rates compared to the general population.^22,23 Help-seeking behaviors among Black men in college are often not examined; however, it is important to examine this as, on college campuses, trends in underutilization of professional mental health services persist, such that men, in general, are not seeking care even when experiencing high levels of stress and anxiety.²⁴

There is very little research examining Black men’s mental health experiences during their transition to college.^22,25 Further, there is a paucity of research examining rates of campus service utilization among student populations, much of which fails to analyze by both race and gender simultaneously.⁶ Identifying patterns of mental health prevalence among this high-risk population and ascertaining to what extent Black men in college are seeking care can offer guidance for mental health researchers and campus-based practitioners who wish to develop effective mental health prevention programs that address mental health risk and improve help-seeking behavior among Black men. As such, this study examined the prevalence of mental health symptoms, anxiety and depression, and rates of campus health services utilization among university-enrolled, Black men and compared them to prevalence rates of university-enrolled, Black women and White men.

Current literature shows that there are gender differences in not only reporting rates and mental health services utilization but also in risk between Black men and Black women.^26,27 According to literature, Black women experience higher rates.²⁸ Furthermore, though evidence is scarce and limited for Black men and their mental health experiences, there is literature to suggest that there are cultural and racial differences in mental health risk between minority and White men.²⁹ White men are shown to utilize mental health resources at higher rates compared to Black men.³⁰ Hence, it is hypothesized that Black men would report similar rates of anxiety and depressive symptoms compared to White men and Black women, as well as report lower rates of campus services utilization.

Materials and Methods

Data were analyzed from Spit for Science (S4S) an on-going, university-wide, longitudinal research survey at a mid-Atlantic, public university.³¹ The S4S survey began in the Fall of 2011, using surveys to assess how genetic and environmental factors influenced the emotional and behavioral health of college students.³¹ Participants for S4S were eligible to participate if 18 and older. An initial survey was completed through REDCap³² during their first semester, followed by a follow-up survey every Spring. After completing the survey, students received the option to consent to give a saliva sample, which they were compensated $10 and a S4S t-shirt. Overall, more than 12,000 students have enrolled in the Spit for Science study, consisting of 5 cohorts that average 2500 students, with approximately 68% enrollment for all incoming eligible freshmen across the first four cohorts. Data for cohort 5 was released in May 2019. The S4S study was approved by the university’s Institutional Review Board.³¹

For the current analysis, we used all available data for Black male and female students and White male students across the five cohorts. For cohorts 1 through 4, data represents individuals who entered their freshman years in the Fall of 2011, 2012, 2013 and 2014; whereas, for cohort 5, data comes from individuals who entered during Fall of 2017. Analysis focuses on the freshman year through senior year for first four cohorts and freshman and sophomore year for cohort 5. These timepoints were chosen in order to maximize sample size and ensure data analyzed is representative of the student population and their experiences.

Measures

The Spit for Science survey includes various questionnaires assessing a number of behavioral, emotional, and mental health topics. To reduce participant burden, certain surveys were abbreviated.³¹

Symptoms associated with anxiety and depression were assessed using an abbreviated version of The Symptom Checklist-90 (SCL-90).³³ SCL-90 is a widely used instrument measuring individuals’ experiences with mental health symptoms within the past 30 days. In the S4S survey, the SCL-90 includes subscales for measuring depressive and anxiety symptoms. For anxiety, four items (α = 0.85) were used, containing response options, ranging from “not at all,” “a little bit,” “moderately,” “quite a bit,” and “extremely,” to understand the degree to which students experienced: nervousness or shakiness inside; suddenly scared for no reason; feeling fearful; and spells of terror or panic.³¹ For depression, four items (α = 0.89) were used, containing the same response options to understand the degree to which students experienced: feeling blue; worrying too much about things; feeling no interest in things; and feeling hopeless about the future.³¹ Higher scores mean higher endorsement of one or more anxiety or depressive symptom.

Campus service utilization included a series of yes and no questions asking whether students used or did not use a specific campus service since attending college. The following services were assessed separately for this analysis: University Counseling Services, University Health Services, The Wellness Resource Center (The Well) and Recreational Sports. A range of services are included in this analysis to gain insight into various ways students might deal with mental health symptoms. For example, though The Wellness Resource Center does not house therapists or mental health counselors, this organization makes referrals for such services and promotes healthy behaviors among their students, offering services and resources for numerous mental health needs. Importantly, the S4S survey examines utilization of such services for every spring semester to ensure students have had the opportunity to go through at least one semester of schooling and to have used a service. A response of “yes” or “no” assesses whether a particular service was used since they’ve been at school.

Statistical Analyses

All data was analyzed using Statistical Package for Social Science (SPSS) software 26.0 version or older. Data were analyzed separately by fall (F1) and spring (S1) semesters of year 1 (freshman year) and by spring semesters for the following years (i.e. spring of sophomore (S2), junior (S3), and senior year (S4)). To determine the prevalence of depressive and anxiety symptoms among students, descriptive statistics were conducted within the sample by race and gender (i.e., Black men; White men; Black women). Sum scores were created separately for anxiety and depressive symptoms for individuals who answered at least 50% of questions asked and missing data were prorated. To assess utilization of services, descriptive analyses were conducted. Group differences in prevalence were conducted to assess differences in mental health prevalence between groups. For group differences of utilization, we examined only for individuals who reported high levels of anxiety and/or depressive symptoms. Within each group, the high-level group is operationally defined with the sample’s upper quartile as the cut-off (i.e. at or above the 75^th percentile). Group mean differences were assessed using Mann Whitney U Tests to compare prevalence rates between Black and White male students, as well as between Black male and female students. Chi squared tests were conducted to compare rates of utilization between groups.

Results

As mentioned, the S4S survey includes data from over 12, 000 students; however, for this analysis, the overall analytic sample includes data from Black male students (N = 681), White male students (N = 2, 329), and Black female students (N = 1, 679) (see Table 1). Approximately 75% Black men completed the SCL-90 survey, along with 79% White men and 78% Black women. It is important to note that this sample is representative of students attending this institution.

Table 1.

SCL-90 Survey Completion and Actual Prevalence of MHD Symptoms among Groups by Year

Group	Y1F		1S		2S		3S		4S
	N	%	N	%	N	%	N	%	N	%
Anxiety
Black Men	309	60.7	286	58	127	47.6	101	54.6	69	49.6
White Men	1275	68.7	1092	69.9	575	65.7	379	67.2	300	69.1
Black Women	944	71.5	916	68.7	601	64.7	401	64.7	312	63
Depression
Black Men	424	83	414	84.5	211	79	154	83.2	101	72.7
White Men	1591	85.6	1413	90.2	779	88.9	485	85.8	385	88.5
Black Women	1195	90.2	1245	93.1	820	88.2	540	87.2	432	87.1

^*Y1F = Freshman Year Fall; 1S = Freshman Year Spring; 2S = Sophomore Year Spring; 3S = Junior Year Spring; 4S = Senior Year Spring

Anxiety Symptom Reporting

As incoming freshmen, 60.7% of Black men, 68.7% of White men, and 71.5% of Black women reported an endorsement of at least one anxiety symptom (see Table 1). In the following Spring, those numbers decreased in all groups (58% among Black men, 69.9% of White men, and 68.7% of Black women). During sophomore year, 47.6% Black men, 65.7% White men, and 64.7% Black women reported at least one anxiety symptom. However, junior year shows a slight increase for Black men (54.6%) and White men (67.2%); whereas, for Black women, 64.7% reported endorsement of at least one anxiety symptom, remaining the same. By Year 4 (senior year), we see a decline in reports among Black men (49.6 %) and an increase in reports of symptoms among White men (69.1%). Among Black women, approximately 63% of students reported at least one anxiety symptom. This may be influenced by various factors, one being that Black men are less likely to return to school, more likely to drop out, and less likely to report symptoms.^34,35

Group Differences Among All Individuals

Across incoming freshmen, anxiety symptom scores were lower for Black men (Mdn = 6) compared to Black women (Mdn = 7), U = 10506.5, p = < 0.001 (see Table 2). At the end of the spring semester, median anxiety symptom scores among Black men (Mdn = 5.5) remained lower than White men (Mdn = 7), U = 9903.5, p < 0.001, as well as compared to Black women (Mdn = 7), U = 8840, p < 0.001. During the following year, Black men’s median scores (4.5) decrease but remain low compared to White men (Mdn = 6), U = 2064.5, p < 0.001. However, compared to Black women, though median scores are similar, Black women (Mdn = 6), U = 3486 report anxiety symptoms at higher rates than their male counterparts (p = 0.001). By year 3, junior year showed anxiety symptoms were statistically significantly different between Black men (Mdn = 5.5) and White men (Mdn = 8), U = 757, p < 0.001 and Black women (Mdn = 6), U = 1981, p = 0.002. By senior year, persisting low median anxiety scores for Black men (4) remained lower compared to White men (Mdn = 7), U = 562.5, p < 0.001 and Black women (Mdn = 7), U = 792.5, p = < 0.000.

Table 2:

Comparison of MHD Symptomology of Black Men to White Men and Black Women by Year

Year	Black Men (Mdn)	White Men (Mdn)	U	Z	P-value	Black Women (Mdn)	U	Z	P-value
Anxiety
1F	6	6	23923	−0.368	0.713	7	10506.5	−4.003	<0.001
1S	5.5	7	9903.5	−5.305	<0.001	7	8840	−4.9	<0.001
2S	4.5	6	2064.5	−4.931	<0.001	6	3486	−3.193	0.001
3S	5.5	8	757	−5.645	<0.001	6	1981	−3.148	0.002
4S	4	7	562.5	−3.819	<0.001	7	792.5	−3.941	<0.001
Depression
1F	9	9	25003	−0.346	0.729	10	14458.5	−2.476	0.013
1S	9	11	10359	−7.717	<0.001	11	9327	−7.45	<0.001
2S	9	11	2946	−6.037	<0.001	11	3015	−5.837	<0.001
3S	9	11	2946	−6.037	<0.001	11	3015	−5.837	<0.001
4S	9	10	1318.5	−1.42	0.156	11.5	913	−3.585	<0.001

Depressive Symptom Reporting

Overall, reports of depressive symptoms were high among all groups. 83% of Black men, 85.6% of White men, and 90.2% of Black women reported experiencing at least one depressive symptom during fall of their incoming year. During the spring, reports of at least one depressive symptom increased slightly for Black men (84.5%). Among White men (90.2%), there was approximately a 5% increase and a little less of an increase for Black women (93.1%). In the following year, year 2, reports of anxiety symptoms decreased for all groups—Black men (79%), White men (88.9%), Black women (88.2%) (see table 1). Junior year, 83.2% Black men, 85.8% White men, and 87.2% Black women reported experiences with at least one depressive symptom. During their senior year, there was a decrease in reporting for Black men (72.7 %) but not for Black women (87.1%) and White men (88.5%).

Group Differences Among All Individuals

During Fall of year 1, Black men (Mdn = 9) reported statistically significantly lower median depressive symptom scores compared to Black women (Mdn = 10), U = 14458.5, p = < 0.013 (see Table 2). The following semester showed statistically significant differences in reports of depressive symptoms between Black men (Mdn = 9) and White men (Mdn = 11), U = 10359, p < 0.001 as well as compared to Black women (Mdn = 11), U = 9327, p <0.001. Junior year presents a similar trend showing median depressive symptoms scores significantly lower for Black men (9) compared to White men (11), U = 2946, p < 0.001, and Black women (11, U = 3015, p < 0.001). During spring semester of junior year, Black men (9) showed lower median depressive symptom scores than White men (11), U = 2946, p < 0.001 and Black women (11), U = 3015, p < 0.001). In Year 4, depressive symptom scores were only statistically significantly different between Black men (9) and women (11.5), U = 913, p = < 0.001.

Service Utilization

Group comparisons were conducted between Black men and White men, as well as between Black men and women. Chi Square Tests (see Table 3) were conducted to assess differences in utilization between groups. Only individuals from high-level groups (i.e. endorsement of symptoms at or above 75th percentile) were compared.

Table 3:

Comparison of Service Utilization for Groups by Mental Health Symptom and Year

Anxiety
YR	Group/N *	UCS		USHS		The Well		Rec Sports
		%	Chi-Sq/P	N	Chi-Sq/P	N	Chi-Sq/P	N	Chi-Sq/P
1S	Black Men (49)	20.4		57.1		24.5		63.3
	White Men (186)	37.76	x2 (1) = 5.12, p= 0.02	58.1	x2 (1) = 0.01, p= 0.90	22.0	x2 (1) = 0.13, p= 0.71	32.3	x2 (1) = 15.71, p= <0.001
	Black Women (164)	20.10	x2 (1) = 0.002, p= 0.96	58.5	x2 (1) = 0.03, p= 0.86	17.1	x2 (1) =1.361, p = 0.243	42.7	x2 (1) = 6.41, p. = 0.01
2S	Black Men (19)	21.1		52.6		10.5		57.9
	White Men (105)	27.6	x2 (1) = 0.35, p= 0.55	65.7	x2 (1) = 1.19, p= 0.27	26.7	x2 (1) = 2.50, p = 0.15	48.6	x2 (1) = 0.55, p= 0.45
	Black Women (118)	22	x2 (1) = 0.009, p= 1.000	72.0	x2 (1) = 2.89, p= 0.08	33.1	x2 (1) = 3.95, p = 0.04	48.3	x2 (1) = 0.60, p= 0.43
3S	Black Men (45)	28.9		60		33.3		62.2
	White Men (107)	43.0	x2 (1) = 2.65, p= 0.10	68.2	x2 (1) = 0.95, p= 0.32	31.8	x2 (1) = 0.03, p = 0.85	51.4	x2 (1) = 1.49, p= 0.22
	Black Women (144)	32.6	x2 (1) = 0.22, p= 0.63	81.9	x2 (1) = 9.24, p= 0.002	40.3	x2 (1) = 0.69, p= 0.40	54.9	x2 (1) = 0.75, p= 0.384
4S	Black Men (27)	37		66.7		40.7		74.1
	White Men (61)	41	x2 (1) = 0.12, p= 0.72	72.1	x2 (1) = 0.26, p= 0.60	32.8	x2 (1) = 0.51, p = 0.47	50.8	x2 (1) = 4.15, p= 0.04
	Black Women (81)	42.0	x2 (1) = 0.20,p= 0.65	86.4	x2 (1) = 5.23, p= 0.02	38.3	x2 (1) = 0.05, p = 0.82	61.7	x2 (1) = 1.35, p= 0.24
Depression
1S	Black Men (60)	30		61.7		25		63.3
	White Men (189)	34.40	x2 (1) = 0.39, p= 0.53	55	x2 (1) = 0.81, p= 0.36	21.2	x2 (1) = 0.38, p = 0.53	37.6	x2 (1) = 12.28, p = <0.001
	Black Women (173)	22	x2 (1) = 1.57, p= 0.20	54.9	x2 (1) = 0.82, p= 0.36	15	x2 (1) = 3.05, p = 0.08	34.1	x2 (1) = 15.66, p< 0.001
2S	Black Men (30)	16.7		63.3		26.7		63.3
	White Men (128)	25	x2 (1) = 0.94, p= 0.33	60.2	x2 (1) = 0.10, p= 0.74	25	x2 (1) = 0.03, p = 0.85	48.4	x2 (1) = 2.15, p= 0.14
	Black Women (99)	25.3	x2 (1) = 0.95, p= 0.32	70.7	x2 (1) = 0.58, p= 0.44	34.3	x2 (1) = 0.61, p = 0.43	47.5	x2 (1) = 2.31, p= 0.12
3S	Black Men (27)	33.3		59.3		29.6		55.6
	White Men (100)	36	x2 (1) =.06, p= .79	71	x2 (1) =1.35, p= 0.24	22	x2 (1) = 0.68, p = 0.40	45	x2 (1) = 0.95, p= 0.33
	Black Women (105)	32.4	x2 (1) =.009, p= 0.92	79.0	x2 (1) = 4.48, p = 0.03	45.7	x2 (1) = 2.27, p = 0.13	55.2	x2 (1) = 0.01, p= 0.97
4S	Black Men (7)	36.8		68.4		42.1		68.4
	White Men (76)	39.5	x2 (1) = 0.04, p= 0.83	67.1	x2 (1) =.012, p= 0.91	31.6	x2 (1) = 0.75, p = 0.38	52.6	x2 (1) = 1.53, p= 0.215
	Black Women (69)	42.0	x2 (1) = 0.16, p= 0.68	92.8	x2 (1) = 8.06, p= 0.01	40.6	x2 (1) = 0.01, p = 0.90	58.0	x2 (1) = 0.67, p= 0.410

^*Sample size reflects those who are in the “high” level group for anxiety and depressive symptom endorsement

Utilization for those with High Level Anxiety Symptoms

During spring semester of freshman year, the percentage of Black men (20.4%) utilizing counseling services were lower compared to White men (37.76%), p = 0.024. Similarly, White men (N = 60) utilized recreational sports at higher rates compared to Black men (N = 31), p < 0.001. Of the 164 Black women who reported high levels of anxiety, only 42.7% reported utilization of recreational sports which is lower than that of Black men (63.3%), p = 0.011. During their sophomore year, there were differences in utilization of services of The Well where Black women’s (33.1%) rates were higher than Black men (10.5%), p = 0.047. During junior year, there were significant differences in utilization of health services between Black men (27%) and Black women (81.9%), p = 0.002. By senior year, similar results show that the percentage of Black women (86.4%) utilizing used health services were higher compared to Black men (66.7%), p = 0.022. Black men (74.1%) also show higher rate of recreational sports utilization compared to White men (50.8%), p = 0.042.

Utilization for those with High Level Depressive Symptoms

Freshman year showed significant differences between Black men (63.3%) who used recreational sports and White men (37.6%), p < 0.001, as well as compared to Black women (34.1%), p < 0.001. Assessment of campus services utilization showed higher rates for Black women (79%) compared to Black men (59,3%), p = 0.034, during junior year. During senior year, Black men (68.4%) reported lower utilization of health services compared to Black women (92.8%), p = 0.011.

Discussion

This study is one of the first to examine the prevalence of anxiety and depressive symptoms longitudinally and by sex and race simultaneously among college students. The aim was specifically to ascertain prevalence rates and rates of campus services utilization among university-enrolled, Black men and compare these rates to university-enrolled, Black women and White men. Among those who completed the surveys, results showed reporting rates of anxiety symptoms greater than 60% for Black men, White men, and Black women during their Freshman year. By their senior year, this rate remained higher than 60% for Black women and White men but dropped below 50% for Black male students. These findings somewhat align with the current literature base.³⁶

Firstly, it is difficult to ascertain if the differences in rates between Black men and women are due to underreporting or lack of reporting. In the mental health literature, it is shown that Black men may be experiencing mental health symptoms at similar rates to their counterparts;³⁷ however, it is uncertain how many Black men are actually suffering from mental health symptoms as they often underutilize services.^38–40 In addition, based on recent studies, this difference in rates may be due to educational disparities, such as low enrollment and retention and high drop-out among Black men.⁴¹ With enrollment rates and drop-out rates remaining high among Black men,^42,43 further research is needed to ascertain whether mental health prevalence rates on a college campus are impacted by these educational disparities or whether Black men’s endorsement of such symptoms contributes to their inability to continue in higher education.⁴⁴ Both avenues would provide valuable information for campus practitioners and public health professional who wish to address poor mental health among Black men the gap in higher education enrollment.

Overall, reporting of endorsement of at least one depressive symptom is concerningly high among all groups. During freshman year, we see even higher rates where approximately 80% of individuals from all groups are reporting experiences with at least one symptom. As students approach the end of their senior years, reports of experiences with depressive symptoms decrease significantly for Black men but remain high and steady for their White male and Black female counterparts. From the literature, it is evident that depression is common among students on college campuses.^45,46 According to Eskin and colleagues (2016), approximately 18–30% of emerging adults in university settings will suffer from depression.⁴⁷ Emerging adults on a college campus are at increased risk of developing psychological distress due to various stressors that increase their risk of developing poor mental health.⁴⁸ Interestingly, however, anxiety is typically more common, in general, according to recent statistical evidence.⁴⁹ It may be beneficial for future research to examine and understand why depression is more common on a college campus like this one. Similarly, further research is needed to ascertain prevalence rates of depression and anxiety among college students and determine what about the college experience may make depression more commonplace than anxiety.

Comparisons regarding rates of utilization showed that Black men, though reporting high levels of symptoms, still utilized counseling services and health services at lower rates compared to Black women and White men. Also, among this sample, rates of utilization for recreational sports were higher among Black men compared to others, suggesting that Black men may be resorting to alternative coping measures, such as physical activity.⁵⁰ This finding complements current literature. Studies show that even when experiencing high levels of stress or dealing with a mental health issue, Black men refrain from seeking formal help; however, will engage in other coping strategies, such as physical activity, talking to loved ones, or self-reliance.^50,51 While this is consistent with other findings, it is important to note that this study is able to look at utilization rates specific to Black men and offer insight into their preference for various services.

Limitations

Though the data from this analysis provides significant results, there are limitations to consider. Primarily, this is a secondary data analysis and the current researchers were not involved in data collection; however, the measures included have been utilized and adapted for specific use in studies concerning the proposed issues and college students.³¹ Further, the dataset used for this study has a breadth of data for analysis, allowing us to look at trends and changes within the population over time. Sample size and attrition are also limitations of this study. As presented, each group, Black men being the smallest, show a high response rate in Year 1; however, by senior year, size decreases. This is expected as current literature shows that Black men are less likely to participate in research⁵² and less likely to return to school each year and graduate.⁵³ These limitations are also a reflection of the systemic issues surrounding the enrollment and retention of Black men in higher education. Importantly, this underscores the urgent need for targeted efforts to increase retention of this underrepresented population and create avenues for their participation in research.

Another limitation lies in the focus of three ethnic groups, limiting the generalizability of the results. However, as mentioned, much of the literature to date focuses heavily on Black females and White populations which leaves much to learn about Black male experiences with mental health risk. In this study, we are able to ascertain that Black men are in fact experiencing anxiety and depressive symptoms at similar rates to their counterparts and still remain less likely to utilize services. Future studies should aim to conduct work focusing on Black men’s mental health, particularly their risk and its role in utilizing and not utilizing services. Further, as social and environmental factors may vary for Black men, Black women and white men, a look into contextual factors would be important to address, as well. This can provide evidence for future studies focusing on minority populations on college campuses.

Public Health Implications

The significance of the findings for this study is not overpowered by the limitations and offers numerous avenues for future research. Future work should aim to conduct similar analyses, examining prevalence of symptoms and help-seeking among emerging adults, specifically Black men. Research and prevention efforts should also aim to conduct this research on varying campuses ensuring data is reflective of many cultures and backgrounds of individuals from other universities. Mainly, future research should examine prevalence across multiple campuses, including but not limited to community colleges, historically Black colleges, 2-year universities and those in urban and rural areas. These campuses vary in entry requirements, size, and structural and institutional factors and policies. Therefore, prevalence and help-seeking rates between and among groups may vary, influencing one’s experiences with mental health stressors differently.⁵⁴ For example, there is research to suggest that Black male experiences on predominantly white campuses occur more frequently (e.g. racial microaggressions).⁵⁵ Research looking into these factors can offer evidence that can guide the development of tailored programs effective in addressing campus level risk/protective factors among specific race and gender groups.

This study also looked at different sources of campus service utilization. Some studies either explore one source or calculate a poly variable for its analysis.⁶ Though this is beneficial, researchers should aim to separately explore utilization of multiple sources to ascertain which health services are more prevalent for certain populations. For example, it is well-documented in the literature that Black boys and men refrain from using formal services.⁵⁶ Research that takes this into account may better service this population and others alike offering effective, non-traditional ways for mental prevention, as well as sustainability of future programs. In addition, this approach can complement other frameworks and strategies geared towards effective health behavior change.⁵⁷

This study provides some evidence to support that, during the transition into college, Black men are experiencing mental health symptoms are similar rates compared to their counterparts; and that depressive symptoms are more prevalent than anxiety symptoms. Future research should aim to understand this and examine social and environmental factors that exacerbate mental health symptoms, as well as those that’s buffer the effect of stress on this population. A better understanding of this will aid in the development of program and initiatives that are tailored and well-rounded and better able to address unique needs of minority student populations. This will be a step forward in reducing health and educational disparities on college campuses and other educational contexts.

Conclusion

The evidence-base for understanding mental health risk and utilization of mental health services are limited, lacking data specific to Black men on a college campus. Therefore, the key findings from this study contribute to the literature and advance the field of mental health. Major findings suggested that Black men are experiencing symptoms associated with anxiety and depression, and at similar rates to their male and female counterparts. Further analyses showed utilization of mental health services on campus were low among Black men compared to their peers. Among this sample, Black men did utilize recreational sports at higher rates compared to White men and Black women. Importantly, amongst Black men who reported high endorsement of anxiety or depressive symptoms, they utilized counseling services at lower rates but recreational sports at higher rates, overall. Such findings can help inform future efforts geared towards improving help-seeking among this vulnerable population and preventing mental health concerns among Black men and men like them. Given the current climate and new challenges set forth due to the COVID-19 pandemic, future policy and systems level efforts must focus on the enrollment and retention of Black men in college and health promotion and prevention efforts must focus on how best to support Black men’s mental health and well-being during this critical transition. More research and programming is needed to address both of these areas and should be tailored to the health and educational disparities which persist for young Black men.