Distinct patterns of formal treatment and informal support strategies among U.S. college students with elevated symptoms of depression and/or anxiety: A cluster analysis.

OBJECTIVE

Elevated depressive and anxiety symptoms, as well as depressive and anxiety disorders, are prevalent among U.S. college students, yet formal mental health treatment use remains low. Informal support strategies, such as seeking help from non-professionals and using self-guided therapy, are common responses to distress that may function independently of or alongside formal treatment. This study aimed to characterize how college students with elevated depression and/or anxiety symptoms combine formal treatments with informal strategies.

METHOD: Data were drawn from the 2022-2023 Healthy Minds Study, including 29,945 U.S. college students (Mage = 20.98 years) with elevated PHQ-9 and/or GAD-7 scores. A TwoStep cluster analysis identified subgroups based on engagement across four behaviors: psychotherapy, psychopharmacology, non-professional help-seeking, and self-guided therapy. Post-hoc tests assessed sociodemographic differences across clusters.

RESULTS

Among participants, 91.9 % (n = 27,506) were categorized into seven clusters: (1) no engagement (10.2 %); (2) non-professional help-seeking only (24.7 %); (3) non-professional help-seeking and psychotherapy (12.8 %); (4) non-professional help-seeking and psychopharmacology (6.7 %); (5) psychotherapy and psychopharmacology (7.1 %); (6) non-professional help-seeking, psychotherapy, and psychopharmacology (19.1 %); and (7) non-professional help-seeking, psychotherapy, psychopharmacology, and self-guided therapy (11.3 %). Sociodemographic characteristics differed significantly across clusters.

CONCLUSIONS

Nearly 90 % of students with elevated symptoms engaged in at least one form of support, with many utilizing multiple. Non-professional help-seeking was a particularly common strategy, used both independently and alongside formal treatments. These findings underscore the importance of understanding informal supports, reducing barriers to formal care, and tailoring services to students' diverse needs and preferences.