The influence of demographic factors on mental health support amongst equity-denied student groups : a mixed methods study

Mental health concerns continue to increase in prevalence among university students. It is also well established that students from equity-denied groups often face disparities when seeking mental health support. To address this, HEARTSMAP-U, a psychosocial self-screening tool was previously developed for students attending the University of British Columbia (UBC). Following screening with HEARTSMAP-U, the tool provides personalized resource recommendations based on students’ self-reported responses. This thesis, leveraging HEARTSMAP-U, uses a mixed methods approach to explore the relationship between demographic factors and access to mental health support for equity-denied student groups at UBC. First, a quantitative secondary analysis of the HEARTSMAP-U predictive validity cohort study was conducted to explore differences in the prevalence of accessing HEARTSMAP-U-recommended mental health resources among equity-denied students at UBC. Descriptive statistics were used to assess the proportion of students who: (1) received resource recommendations, (2) found them appropriate, (3) attempted to access recommended services, and (4) successfully accessed them. Univariate logistic regression analyses were conducted to compare equity-denied student groups to student groups without marginalized identities, examining whether there were differences in the likelihood of each of the four outcomes. Next, a qualitative semi-structured interview study was conducted to explore students' experiences with their HEARTSMAP-U recommendations, and how their perceptions of their identity influence their experiences with the mental health support system, if at all. Interpretive description was used to develop themes that described the mental health help-seeking experiences of students. Findings from the first study showed significant differences in help-seeking behaviors based on sexual orientation. While gender and race differences were not statistically significant, certain outcomes indicated potential clinical relevance. The second study results revealed that while universal barriers exist, students with more marginalized identities often perceived additional identity-related barriers. Students with fewer marginalized identities generally found resources to be neutral, not providing any advantage to any specific group of students. The findings from this mixed methods study highlight the importance of targeted efforts to promote equitable access to mental health support for students, especially given that the intersection of gender, sexual orientation, and race can shape students' experiences when seeking mental health support.