Disparities in COVID-19-related trauma and internalizing symptoms across sexual orientation and race/ethnicity during the pandemic: An intersectional approach (preprint)

Background. Sexual minorities face elevated risk for internalizing problems due to minority stress, and these may have been particularly exacerbated with the onset of the COVID-19 pandemic. This study examined sexual orientation and race/ethnicity-related mental health disparities during the first two months of stay-at-home orders.Method. We investigated disparities in COVID-19-related trauma and internalizing (i.e., depression, anxiety, intolerance of uncertainty) symptoms in a university community via surveys in March (Wave 1) and May 2020 (Wave 2) cross-sectionally using t-tests and longitudinally using residualized change score regressions. The analytic sample (N = 646; M age = 25.70, SD age = 10.16 at Wave 1) comprised 350 (54.2%) White, non-Hispanic and 296 (45.8%) racial/ethnic minority participants; and 514 (79.6%) heterosexual and 132 (20.4%) sexual minority participants.Results. Sexual minorities reported greater symptomatology than heterosexuals across all outcomes at each wave. Racial/ethnic minorities reported no outcome differences compared to White, non-Hispanic individuals at each wave. Sexual minorities, compared to heterosexual individuals, reported decreased recovery of COVID-19-related trauma and increased intolerance of uncertainty at Wave 2.Conclusions. These findings build upon a growing body of literature of mental health disparities during the COVID-19 pandemic. Results highlight the importance of examining COVID-19-related trauma to understand the effects of the pandemic on minoritized populations, particularly sexual minorities. Further work is needed to elucidate the potential exacerbating effects of minority stress in these disparities.

Loss of Mental Health Support Among College Students During the COVID-19 Pandemic (preprint)

Purpose. The COVID-19 pandemic has exacerbated mental health concerns among college students. At the same time, pandemic response measures have made it more challenging for many students to access mental health support. However, little is known about the extent of mental health support loss among college students, or which students have lost support. This study investigated the scope of mental health support loss during the COVID-19 pandemic in a large university sample, as well as the factors associated with loss of support. Methods. Students completed an online questionnaire between March and May of 2020. Researchers examined the extent of mental health support loss in this sample and how support loss differed by a variety of demographic and mental health symptom variables. Methods were pre-registered at https://osf.io/m83hz. Results. Of n = 415 respondents, 62% reported loss of mental health support. Loss of support was associated with more severe depression symptoms (p < .001), more severe anxiety symptoms (p < .001), the presence of suicidal ideation (p < .001), and sexual minority identity (p = .017). Conclusions. Colleges and universities should be aware that many students have lost access to mental health support during the COVID-19 pandemic, and that students with more severe mental health symptoms, as well as sexual minority students, may be particularly vulnerable. Colleges and universities should make efforts to connect these students with sources of mental health support.

College student interest in teletherapy and self-guided mental health supports during the COVID-19 pandemic (preprint)

Objective: The COVID-19 pandemic has worsened college students’ mental health while simultaneously creating new barriers to traditional in-person care. Teletherapy and online self-guided mental health supports are two potential avenues for addressing unmet mental health needs when face-to-face services are less accessible, but little is known about factors that shape interest in these supports. Participants: 1,224 U.S. undergraduate students (mean age=20.7; 72.5% female; 40.0% White) participated. Methods: Students completed an online questionnaire assessing interest in teletherapy and self-guided supports. Predictors included age, sex, ethnicity, sexual minority status, and anxiety and depression symptomatology. Results: Interest rates were 20% and 25% for at-cost supports and 70% and 72% for free supports. Older age, higher anxiety symptomatology, and identifying as Asian significantly predicted greater interest levels. Conclusions: Results may inform universities’ efforts to optimize students’ engagement with nontraditional, digital mental health supports, including teletherapy and self-guided programs.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students’ Mental Health and Treatment Use amid the COVID-19 Pandemic (preprint)

Objective: To investigate gender and racial/ethnic disparities in mental health and treatment use in college and graduate students amid the COVID-19 pandemic. Method: Based on a large-scale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020, we examined gender and racial disparities in current internalizing severity and treatment use with t-tests and logistic regression models. Results: Specifically, we found that students with marginalized gender (e.g., woman [p < .001], non-binary gender [p < .001]) or Hispanic/Latinx identity (p = .002) reported higher levels of internalizing problem severity compared to their privileged counterparts (e.g., man, non- Hispanic/Latinx White). Regarding treatment use, Asian (p < .001) and multiracial students (p = .002) reported lower treatment use after controlling for internalizing problem severity. Internalizing severity was generally associated with higher treatment use (logit = 0.53, p = .001), indicating a match of objective needs with service use. However, this relationship was offset by a negative interaction between internalizing problem severity and Asian (logit = -0.49, p < .001) or Black identity (logit = -0.57, p = .03) in predicting treatment use. Conclusion: The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students, and promotion of mental health awareness and trust in Asian/Black students, are desperately needed.