Mental Health Symptoms and Alcohol Counseling Among Young Adults: Implications for Equitable Preventive Care

Young adulthood is a critical period for preventing alcohol-related harm, as heavy drinking and mental health challenges often peak, yet preventive counseling remains underused. This study examined associations between depressive and anxious symptoms and receipt of alcohol-related advice from healthcare providers among U.S. young adults aged 18–29, with attention to differences across sexual identity groups. Data were drawn from the 2022 National Health Interview Survey, with a final analytic sample of participants aged 18–29 (N = 2256). Weighted logistic regressions estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Overall, 49.0% of participants reported receiving alcohol advice. Odds were higher among lesbian/gay participants (aOR = 1.81; 95% CI: 1.03–3.18) and those with severe anxiety symptoms (aOR = 2.10; 95% CI: 1.11–3.94). Interaction effects indicated disparities by sexual identity, with plurisexual males showing the lowest predicted probability of receiving advice when meeting the clinical threshold for anxiety (20.9% vs. 62.4% for monosexual individuals). The findings underscore the need to strengthen alcohol-related counseling and integrate mental health screening in preventive care for diverse young adult populations.