Intersectional Predictors of Mental Health Problems Among Black College Students: A Multi-Level Analysis Examining Individual, Institutional, and Societal Level Factors.

Purpose: This study examined the roles of financial hardship indicators, financial stress, encounters with racism, campus belonging, and demographic factors among Black college students, utilizing the Social Determinants of Mental Health (SDoMH) framework to identify factors associated with mental health problems and inform evidence-based interventions.

Materials and methods: A cross-sectional analysis was conducted using 2023-2024 Healthy Minds Study data from 8,769 Black college students across 196 institutions. Mental health was assessed using validated instruments (PHQ-9, GAD-7, SCOFF questionnaire) and operationalized as a dichotomous variable indicating clinically significant depression, anxiety, eating disorders, self-injury, or suicidality. Binary logistic regression was used to examine predictors of any mental health problems.

Results: Among participants, 54.8% reported mental health problems. Transgender, nonbinary, and queer students had over five times higher odds of mental health problems (OR = 5.89, p < .001), while female students had 39% higher odds compared to males (OR = 1.39, p < .001). Sexual minorities reported higher rates than heterosexual students (OR = 0.41, p < .001). Financial stress (OR = 1.68, p < .001) and racial discrimination experiences (OR = 1.94, p < .001) significantly increased mental health risks. Campus belonging demonstrated protective effects (OR = 0.79, p < .001).

Discussion: Findings highlight the complex intersections of identity, discrimination, and socioeconomic factors in shaping mental health among Black college students, emphasizing the need for culturally responsive, intersectional support services.

Conclusion: Results underscore the importance of addressing multiple social determinants simultaneously through comprehensive campus interventions targeting financial stress, discrimination, and belonging to promote mental health equity for Black students.