Mental Health Help-Seeking by US College Students with a Diagnosis of Psychosis

Purpose This study aims to examine the perceptions, beliefs, and attitudes that affect help-seeking behaviors among college students with a diagnosis of psychosis. Methods Cross-sectional 2015-2024 national survey data from the Healthy Minds Study (HMS) were used to examine mental health service utilization among 2,819 U.S. college students with a diagnosis of psychosis. Descriptive statistics and adjusted logistic regression models were used to examine students’ help-seeking behaviors. Results Approximately eight-in-ten students with a diagnosis of psychosis reported utilizing formal services, eight-in-ten reported engaging in informal supports, and one-in-ten did not engage in either. A majority of students strongly agreed (50.7%) or agreed (26.6%) that therapy or counseling would be helpful for their mental health. Encouragement from a friend to seek help was associated with significantly higher odds of therapy/counseling in the past 12 months (aOR = 4.89, 95% CI: 1.03– 23.1). Encouragement from others—such as health professionals—was also associated with higher odds of antipsychotic medication use (aOR = 1.49, 95% CI: 1.01–2.20). Compared to students who believed that medication is very helpful for their mental health, students who identified medication (aOR=0.17, 95% CI: 0.09–0.31) or therapy/counseling as not helpful had lower odds of formal service use (aOR=0.31, 95% CI: 0.15–0.62). Conclusions This is the largest known study of formal service and informal support engagement in students with a diagnosis of psychosis. Therapy and/or counseling in this population is highly utilized, and therapeutic resources available on college campuses may play an important role in supporting students diagnosed with psychosis. Encouragement from friends or healthcare professionals to seek help for mental health may promote help-seeking behaviors.