Determinants of Mental Health Service Utilization Among International College Students

Abstract

Objective: The present study examined mental health service utilization among international college students in the United States, with attention to differences across student characteristics and perceived stress. Methods: A cross-sectional secondary data analysis was conducted using data from the American College Health Association National College Health Assessment III, collected from Spring 2022 through Fall 2023. The sample included 13,242 international students. Descriptive statistics were used to summarize participant characteristics and mental health service utilization. A univariate logistic regression model was used to examine differences in lifetime and past-year use of psychological or mental health services. Results: Mental health service utilization differed significantly by biological sex, academic level, and perceived stress. For past-year service use, males had lower odds of service utilization than females (OR = 0.40, 95% CI [0.36, 0.43]), and graduate students had lower odds than undergraduate students (OR = 0.70, 95% CI [0.65, 0.76]). Students reporting no or low stress had higher odds of not using services than those reporting moderate or high stress (OR = 2.73, 95% CI [2.45, 3.03]). Among students who reported a source of care, 1,604 students (52.3%) used their current campus health and/or counseling center, 591 students (19.7%) used a local community provider near campus, 1,322 students (43.4%) used a provider in their hometown, and 304 students (12.2%) used another type of provider. Conclusion: Universities should strengthen culturally responsive outreach, reduce stigma, improve mental health literacy, and create clear pathways to campus and community-based mental health support for international students.