Arts , Humanities & Social Science

Abstract

First-generation (FG) college students face persistent barriers to mental health service utilization, rooted in structural, psychosocial, and financial constraints. Using three waves of the Healthy Minds Study (AY 2022-2024; N ≈ 277,000; ~18% FG), a multi-institution, nationally distributed survey, we examined generational differences in mental health experiences, access, and current therapy use. Analyses incorporated survey weights and campus-year clustering. We produced weighted descriptives and design-based group tests, then fit survey-weighted logistic regressions predicting current therapy from financial stress, perceived provider access, perceived stigma, sense of belonging, and discrimination, with FG status and year fixed effects. We summarized marginal effects on the probability scale and ran a sensitivity check excluding rare contradictory responses.

Descriptively, first-generation students reported higher financial stress, slightly higher perceived provider access and campus belonging, and lower perceived stigma and discrimination than continuing-generation (CG) peers; therapy prevalence was broadly similar, with small CG advantages in 2022-2023. In multivariate models, reporting discrimination (OR ≈ 1.29) and higher perceived access (OR ≈ 1.06 per scale unit) were the most consistent correlates of being in therapy; financial stress (OR ≈ 1.06) and perceived stigma (OR ≈ 1.05) showed smaller positive associations, whereas belonging was not significant net of covariates. FG students had slightly lower odds of therapy than CG peers (OR ≈ 0.86). Interactions by FG status and by year were limited in size; marginal effects were modest for financial stress (Δp ≈ .011-.014) and access (Δp ≈ .021-.026) and moderate for discrimination (Δp ≈ .052-.060). Findings point to institutional-level levers, such as expanding provider access and improving campus climate, as central to narrowing generational gaps, alongside targeted support for students experiencing high financial strain.