Communication strategies and barriers in friends’ mental health conversations on college campuses

Mental health challenges among college students are common yet difficult to identify and address. Friends often serve as the first line of support, making mental health conversations a critical but understudied intervention avenue. Research has emphasized disclosure over how friends offer support, engage with struggling peers, or handle emotional and relational complexities. These interactions is less studied. We conducted 10 focus groups (N = 68) to examine strategies friends use to navigate mental health conversations and identify facilitating and hindering factors. Participants identified signs of distress, created safe spaces, used direct and indirect strategies to foster conversation, attended to timing, and prioritized protection. Individual, relational, contextual, and societal factors shaped these conversations. We discuss conceptual and practical implications and propose future research.