Understanding Mental Health Outcomes in U.S. Undergraduate Students: A Comparative and Predictive Study of Sexual and Gender Minority (SGM) and Non-SGM Students

Abstract

Sexual and gender minority (SGM) college students continue to report higher levels of negative mental health outcomes than their heterosexual, cisgender peers. Many studies have relied on participants’ self-report of mental health outcomes rather than utilizing validated instruments designed to identify and assess these outcomes as well as the factors influencing them. Therefore, utilizing validated mental health instruments administered through a national survey of college students, the purpose of this study was twofold: first, to compare the overall mental health of SGM and non-SGM undergraduate students in the U.S., and second, to identify factors that predict mental health outcomes among undergraduate students in the U.S. This study was a secondary analysis of data collected by the American College Health Association National College Health Assessment III (ACHA NCHA III). Independent samples t-tests were used to compare levels of negative and positive mental health outcomes as well as mental health risk factors and protective factors between SGM and non-SGM students. Analyses showed significantly higher levels of negative mental health outcomes and mental health risk factors, as well as significantly lower levels of positive mental health outcomes and mental health protective factors, for SGM students compared to non-SGM students. Regression analyses were used to determine the extent to which various factors predict mental health outcomes in undergraduate students. Results indicated that loneliness and diminished resilience were the strongest predictors of psychological distress, SGM status and loneliness were the strongest predictors of suicide risk, and resilience and diminished loneliness were the strongest predictors of psychological well-being in SGM undergraduate students. These findings were supported by existing research. Future studies would benefit from examining within-group differences among sexual minority and gender minority subgroups in order to develop appropriately tailored interventions. Additional research through the lens of intersectionality could also provide a more detailed picture of mental health outcomes in undergraduate college students and the factors affecting them. This information is key to transitioning from awareness to action by developing and implementing institutional and systemic policy changes that promote inclusivity and mental health equity for all students.