Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study

Abstract Background: Post-secondary students are at a greater risk of developing mental health problems than the general population. However, they present meagre rates of treatment-seeking behaviours. This elevated prevalence of mental health problems, particularly after the COVID-19 pandemic, can lead to distress, poor academic performance, and lower job prospects following the completion of their education. To address the needs of this population, it is important to understand students' perceptions of mental health and the barriers preventing or limiting their access to care. Methods: A broad-scoping online survey was publicly distributed to post-secondary students, collecting demographic, sociocultural, economic, and educational information while assessing various components of mental health. Results: In total, 448 students across post-secondary institutions in Ontario, Canada, responded to the survey. Over a third (n = 170; 38.6%) of respondents reported a formal mental health diagnosis. Depression and generalized anxiety disorder were the most commonly reported diagnoses. Most respondents felt that post-secondary students have poor mental health (n = 253; 60.5%) and inadequate coping strategies (n = 261; 62.4%). The most frequently reported barriers to care were financial (n = 214; 50.5%), long wait times (n = 202; 47.6%), insufficient resources (n = 165; 38.9%), time constraints (n = 148; 34.9%), stigma (n = 133; 31.4%), cultural barriers (n = 108; 25.5%), and past negative experiences with mental health care (n = 86; 20.3%). Most students felt their post-secondary institution needed to increase mental health resources (n = 306; 73.2%) and awareness (n = 231; 56.5%). Most students who had or were receiving care viewed in-person therapy as more helpful than online care. However, there was uncertainty about the helpfulness and accessibility of different forms of treatment, including online interventions. Conclusions: Lack of resources, barriers to care, and uncertainty surrounding interventions contribute to the low treatment-seeking behaviours observed in post-secondary students. The survey findings indicate that multiple upstream approaches, including formal mental health education, may address the varying needs of this critical population. Online mental health interventions may be a promising solution to accessibility issues.