Date of Award

May 2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Public Health

First Advisor

Paul Florsheim

Committee Members

Young Cho, Diane Reddy, Elise Papke, Nicole Webber

Abstract

Background: There is a mental health crisis among college students in the United States, with approximately 40% of students reporting a significant mental health issue. Institutions of higher education are key venues for mental health targeted public health interventions, as the onset of mental health problems often occurs in late adolescence and early adulthood. However, as the online student population continues to grow and evolve there is little known about the specific mental health needs and help-seeking behaviors of online students in comparison to traditional, on-campus students.

Methods: A cross-sectional study design explored mental health symptoms, help-seeking intentions and behaviors, factors influencing help-seeking, and cues to help-seeking action including social support and academic impact among online and on-campus students. Data was collected though an online survey administered by Qualtrics and the final study sample included 118 online students and 115 on-campus students. Data analysis procedures were performed using IBM SPSS27 statistical software. Independent samples t-test, bivariate analyses, and two-way MANOVA procedures examined expected differences in mental health symptoms, factors influencing help-seeking, and help-seeking intentions and behaviors. Multiple regression analyses examined effects of enrollment status, academic function, social support, and factors influencing help-seeking on reported help-seeking behavior and intentions.

Results: This study shows that online and on-campus students self-report similar mental health symptoms. Few differences were found between enrollment groups in how various structural and psychological factors influenced help-seeking intentions but the most influential factors of privacy, effectiveness, insurance coverage, and personal relatability were consistent across both groups of students. On-campus students reported higher intentions to use and actual use of campus-based resources whereas online students reported higher intention to use and actual use of community-based resources and higher intentions to use self-help resources. Both groups shared a preferred reliance on others, such as family members or friends, for support. Enrollment status had minimal impact on help-seeking, however, structural factors related to resource access were found to be a significant and consistent predictor for help-seeking intentions, while perceived impact on academic performance was a significant predictor for help-seeking behaviors.

Significance: This research contributes to a greater understanding of the differences and similarities in mental health needs and preferred help-seeking resources between online and on-campus students. The study results call for expanding the types of help-seeking resources available to all students, including e-mental health resources. Findings also speak to the need to further support student engagement with available resources through effective staff/instructor referrals and tailored messaging to address access and efficacy-related factors that influence help-seeking. Taking full advantage of the opportunity to reach young adults in the college setting is crucial in addressing the mental health needs of this age group.

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