Mental disorders, service use, and perceived treatment need among college students after the COVID-19 pandemic and the role of social connection: an epidemiological study

Abstract Background College students affected by mental disorders can be very impaired; yet, treatment rates remain low. The COVID-19 pandemic undoubtably posed strain on students, limiting their social life, which is an important determinant of health. However, recent estimates of mental health problems and service use are lacking and the understanding of the association between social connection and mental health and service use is limited. Methods Cross-sectional data from the Flemish College Surveys conducted in 2022–2023 were used to estimate the 12-month prevalence of six common mental disorders (major depressive episode, general anxiety disorder, panic disorder, (hypo)mania, alcohol use disorder, and substance use disorder), suicidal thoughts and behaviors (STBs), functional impairment, social connection, service use and perceived need for treatment. A total of 21,313 students completed the surveys. Results Our results show that mental disorders remain highly prevalent, with 57% of students suffering from any disorder or STB, with substantial variations in functional impairment. Service use remains low (42% with any disorder or STB), and many students perceive an unmet need for treatment (33% with any disorder or STB). Although most students have a social network, 34% often feel lonely, and almost 6% has no one to confide in. Social connection reduced the odds of any mental disorder or STB and increased the odds of service use and perceived unmet need. Conclusions Social connection might be a valuable protective factor for mental health among college students, both in reducing the odds for mental disorders as in increasing the odds for service use.