Is university attendance associated with differences in health service use for a mental health problem in emerging adulthood? Evidence from the ALSPAC population-based cohort

PURPOSE: It is unclear whether attending university is associated with health service use for mental health problems in emerging adulthood. As this can be a marker of the onset of mental disorders, we aimed to investigate whether attending university was associated with health service use for a mental health problem by age 24. METHODS: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The analytic sample comprised of 2,649 individuals with data on university attendance reported approximately between ages 25 and 26, and health service use for a mental health problem reported around age 24. Logistic regression models were used to investigate the association between university attendance and health service use, employing confounder adjustment, multiple imputation and propensity score matching to assess the robustness of associations. The study was reported using STROBE guidelines. RESULTS: University attendees were less likely to report having used services for mental health problems by 24 years compared to non-university attendees (6.5% vs. 11.4%, odds ratio (OR) = 0.54[95%CI = 0.40;0.72], p < 0.001). This association was robust in the fully adjusted model (aOR = 0.38[95%CI = 0.15;0.94], p = 0.04), propensity score matching and multiple imputation. There was evidence of a differential association among those who were and were not heterosexual and according to maternal education level. CONCLUSIONS: Our findings suggest individuals who attend university are less likely to use a health service for a mental health problem. Further longitudinal research is needed to investigate potential explanations for these differences. PRE-REGISTRATION: A study protocol was submitted to the ALSPAC team.