College Students Mental Health: Provision, Literacy, and Outcomes

Recent years have witnessed a decline in college students' mental health (MH). Despite substantial efforts by schools to address this issue, few studies have explored how these efforts impact MH outcomes, particularly regarding mental health knowledge and beliefs. This paper presents empirical evidence on the effect of college MH provisions on MH conditions through mental health literacy (MHL). Utilizing data from the Healthy Minds Study (2017-2022) and a multi-site, multi-mediator instrumental variable framework, I found evidence supporting the mediation effects of MHL, even when the total effects of MH provision remain ambiguous. With adjustment for selection bias, enhancing MH provision at the institution level would likely reduce depression and anxiety among college students primarily through increasing MHL. On average, a one standard deviation increase in the MHL score is associated with a 4.260-point decrease in the depression score and a 4.763-point reduction in the anxiety score, controlling for individual and school characteristics. Evidence for the mediation effect of MH service utilization, excluding the impact of MHL, was mixed.