Mental Health Modulates Associations between Institutional Belonging and Substance Use Risk.

Objective: The present study aimed to characterize profiles of mental health, incorporating both indicators of psychopathology and well-being, among college students and determine whether institutional belonging differentially relates to past month substance use by mental health profile.

Method: Students (N = 4018; 59.5% female, 74.7% white) completed a survey regarding mental health (i.e., anxiety symptoms, depressive symptoms, stress, flourishing, academic confidence), institutional belonging, and whether they had engaged in any binge drinking of alcohol and use of cannabis and nicotine products, including nicotine vaping, over the past month.

Results: Latent profile analyses indicated five profiles of mental health with differing levels of psychopathology and well-being. Greater institutional belonging was only related to higher odds of binge drinking among students in profiles characterized by average or high well-being, irrespective of psychopathology. Among students with overall poor mental health, higher institutional belonging was related to higher odds of nicotine use. Results were generally invariant to campus and year at college.

Conclusions: Our findings highlight that both positive and negative aspects of mental health should be considered when assessing college students' substance use. Greater institutional belonging may incur risk for substance use differentially by mental health, with respect to binge drinking for those with high levels of positive well-being and non-vaping nicotine use for those with overall poor mental health. Because associations emerged between belonging and substance use risk, institutions could consider implementing or raising awareness of alcohol-free, inclusive activities to ensure that students can feel a sense of belonging while abstaining from drinking.