Mental health service use in a national sample of college students with co-occurring depression or anxiety and substance use

Associations between college enrollment and trends in substance use among young adults in the US from 2015 to 2019

Background: Substance use among college students has negative academic and health outcomes. Identifying substances that are more commonly used by students than non-students can reveal specific risks in the college environment.Objectives: To examine associations between college enrollment and prevalence and trends of use of a comprehensive list of substances.Methods: The sample included 2015-2019 participants in the National Survey on Drug Use and Health who were aged 18 to 22 and who were full-time enrolled or not enrolled in college. Prevalence of substance use was calculated for four subgroups: college males (n = 6,707), college females (n = 8,284), non-college males (n = 10,019), and non-college females (n = 9,266). Multivariate logistic regression was used to model the relationships between enrollment and substance use. Temporal trends in substance use prevalence were calculated for each subgroup.Results: College enrollment was associated with prescription stimulant misuse (aOR 1.50, 95% CI: 1.35-1.67), alcohol use (aOR 1.36, 95% CI: 1.27-1.47), and binge drinking (aOR 1.22, 95% CI: 1.15-1.30). From 2015 to 2019, the only substance whose use significantly increased among any subgroup was cannabis. The increase occurred among females only (+4.7% in college females and +5.6% in non-college females; both p < .01).Conclusions: College enrollment is most strongly associated with prescription stimulant misuse, suggesting that colleges should consider explicitly including stimulant misuse prevention in their health promotion strategies. The increasing use of cannabis among females warrants clinicians' attention to routine screening for use and provision of information about the mental health impacts of cannabis.

Associations between vicarious discrimination and mental health among young adult college students: Findings from the 2020-2021 Healthy Minds Study

BACKGROUND

Poor mental health among young adults in higher education is a growing concern. In recent years, the visibility of racism has sharply risen. Vicarious discrimination is defined as the secondhand witnessing of racism, and given society's increased accessibility to social media and the Internet, addressing indirect violence is urgently needed to inform anti-racism and mental health efforts. The current study examined associations between vicarious discrimination and mental health across a large sample of young college students in the United States.

METHODS

We analyzed data from the Healthy Minds Study (HMS; 2020-2021; N=130,566) and used multivariable logistic regression to examine whether past-year vicarious discrimination was associated with various mental health outcomes, adjusting for age, gender, race/ethnicity, and direct discrimination.

RESULTS

The sample was predominantly white (n=31,438, 63.66%) and female-identifying (n=34,313, 69.49%) with an average age of 21.1 years. Approximately 35.9% of the sample endorsed experiencing vicarious discrimination. Vicarious discrimination was associated with greater depression (OR:1.97; 95% CI: [1.86,2.09], p< 0.001), anxiety (OR:1.82; 95% CI: [1.72,1.92], p<0.001), languishing (OR:1.75; 95% CI: [1.65,1.87], p<0.001), perceived need for treatment (OR:2.24; 95% CI: [2.10,2.40], p<0.001), suicidal ideation (OR:1.86; 95% CI: [1.73,2.01], p<0.001), suicide plan (OR:1.91; 95% CI: [1.71,2.14], p<0.001), suicide attempt (OR:1.89; 95% CI: [1.51,2.36], p<0.001), self-injurious behavior (OR:2.0; 95% CI: [1.88,2.12], p<0.001), and loneliness (OR:1.67; 95% CI: [1.58,1.77], p<0.001).

DISCUSSION

Consistent with growing literature, vicarious discrimination was associated with poorer mental health among young college students. Additional research should investigate moderators, mediators, and interventions to support those who may be impacted indirectly by discrimination.

Depression and Substance Use Among Brazilian University Students During the COVID-19 Pandemic

The prevalence of depression and substance use changed significantly during the COVID-19 pandemic. The present study explored the association between the use of psychoactive substances and depression in Brazilian university students. This cross-sectional study was conducted between 2021 and 2022. A sample of 1271 students were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Hierarchical multivariate logistic regression models were used to assess the association between tobacco use, alcohol consumption, illicit substance use, and depression. Among the participants, 424 (33.4%; 95%CI 30.7-36) screened positive for depression (PHQ-9 ≥ 10). Alcohol was the most consumed substance. Recent use of illicit substances was associated with depression (adjusted odds ratio [aOR] 1.59; CI 1.02-2.50). The pattern of moderate or high-risk tobacco use (aOR 2.11; CI 1.31-3.42), alcohol use (aOR 3.40; CI 2.29-5.06), and illicit substances (aOR 1.82; CI 1.15-2.89) were associated with higher chances of depression in adjusted models. Findings highlight the importance of implementing support for mental health among university students. These policies are crucial for addressing maladaptive behaviors, such as substance use, and for mitigating psychological distress, such as depression, which has been exacerbated during the pandemic.