Impacts of the COVID-19 pandemic on treatment-seeking college students

Figures & data

Table 1. Characteristics of study 1 cohorts

Variable	Pre-COVID	COVID
N	81,539	51,518
Age (mean (sd))	21.8 (4.0)	22.2 (4.4)
Academic class status (n (%))			***
Freshman/First-year	15076 (21.1)	7303 (16.2)
Sophomore	14851 (20.8)	8532 (18.9)
Junior	15549 (21.7)	9851 (21.8)
Senior	14887 (20.8)	9996 (22.1)
Graduate/Professional degree student	10342 (14.5)	9051 (20.0)
Non-student	99 (0.1)	70 (0.2)
High-school student taking college classes	6 (0.0)	2 (0.0)
Non-degree student	147 (0.2)	60 (0.1)
Faculty or staff	38 (0.1)	31 (0.1)
Other (please specify)	528 (0.7)	316 (0.7)
Race/Ethnicity (n (%))			*
African American/Black	6712 (9.5)	3961 (9.1)
American Indian or Alaskan Native	375 (0.5)	223 (0.5)
Asian American/Asian	6141 (8.7)	3693 (8.5)
Hispanic/Latino/a	6268 (8.9)	4000 (9.2)
Native Hawaiian or Pacific Islander	148 (0.2)	79 (0.2)
Multi-racial	3586 (5.1)	2149 (4.9)
White	46396 (65.6)	28816 (66.1)
Self-identify	1062 (1.5)	702 (1.6)
Gender identity (n (%))			***
Woman	45263 (65.4)	29735 (68.2)
Transgender woman^	0 (0.0)	147 (0.3)
Man	22143 (32.0)	12444 (28.5)
Transgender man^	0 (0.0)	204 (0.5)
Non-binary^	0 (0.0)	748 (1.7)
Transgender	626 (0.9)	21 (0.0)
Self-identify	1184 (1.7)	305 (0.7)
Sexual Orientation (n (%))			***
Asexual^	0 (0.0)	823 (2.0)
Bisexual	9022 (13.6)	5556 (13.6)
Gay	1889 (2.8)	1195 (2.9)
Heterosexual/Straight	49399 (74.3)	28893 (70.5)
Lesbian	1403 (2.1)	851 (2.1)
Pansexual^	0 (0.0)	932 (2.3)
Queer^	0 (0.0)	795 (1.9)
Questioning	2463 (3.7)	1463 (3.6)
Self-identify	2271 (3.4)	456 (1.1)
International student status = Yes (n (%))	3950 (5.8)	2281 (5.2)	***

^These identity options were added to the SDS gender identity and sexual orientation items between data collection for the pre-COVID and COVID cohorts.

**p < .01, ***p < .001.

Table 2. Post-hoc ANOVA tests comparing CCAPS-62 Subscales by Cohort

Subscale	Mean(pre-COVID cohort)	Mean (COVID cohort)	F(1, 107930)		Cohen’s d
Depression	1.82	1.83	2.09		0.01
Eating Concerns	1.06	1.11	88.48	***	0.06
Substance Use	0.62	0.58	66.84	***	−0.05
Generalized Anxiety	1.89	1.90	1.76		0.01
Frustration/Anger	0.96	0.96	0.29		0.00
Social Anxiety	2.08	2.06	8.26	**	−0.02
Family Distress	1.38	1.44	112.02	***	0.07
Academic Distress	1.89	2.04	574.60	***	0.15
Distress Index	1.83	1.86	32.65	***	0.04

** p < .005, *** p < .001

Table 3. Self-reported negative impacts of COVID-19

Area of Impact	Frequency (n)	Percent
Mental health	71166	72.3%
Motivation or focus	67901	69.0%
Loneliness or isolation	65601	66.7%
Academics	65305	66.4%
Missed experiences or opportunities	59875	60.9%
Relationships (Significant other, friends, family)	43383	44.1%
Career/Employment	41454	42.1%
Financial	33851	34.4%
Health concerns (others)	29324	29.8%
Health concerns (self)	26301	26.7%
Grief/loss of someone	11421	11.6%
Food or housing insecurity	8346	8.5%
Discrimination/Harassment	2804	2.9%
Other (please specify)	1299	1.3%

Figure 1. Prevalence of clinician-identified presenting concerns in Fall 2019 and Fall 2020.

Figure 2. Chi-Squared residuals for clients’ top concerns in COVID cohort.

Figure 3. CCAPS subscale scores for clients reporting mental health impact of COVID-19.

Note: No COVID-19 corresponds to client indicating that their reasons for seeking services were not in any way related to the COVID-19 pandemic and related events. No MH impact indicates they did not report mental health as a negative impact of COVID-19.

Table 4. Post-hoc ANOVA tests exploring presenting concerns by yes COVID and Yes MH

Subscale	Yes COVID (vs. No COVID)			Yes MH (vs. No MH)			Interaction
	F	ηp^2	p	F	ηp^2	p	F	ηp^2	p
Depression	291.23	<.01	***	6610.21	.09	***	19.40	<.01	***
Eating Concerns	2.06	<.01		1593.12	.02	***	16.56	<.01	***
Substance Use	12.25	<.01	***	559.58	<.01	***	0.79	<.01
Generalized Anxiety	85.16	<.01	***	5557.56	.07	***	3.47	<.01
Frustration/Anger	1.66	<.01		1404.45	.02	***	11.92	<.01	***
Social Anxiety	0.09	<.01		1814.04	.02	***	10.32	<.01	**
Family Distress	2.35	<.01		1195.66	.02	***	20.57	<.01	***
Academic Distress	1496.23	.02	***	3318.57	.04	***	32.88	<.01	***
Distress Index	510.20	<.01	***	7915.17	.10	***	23.74	<.01	***

All values displayed are F(1, 70810). Yes COVID represents the group of students whose reasons for seeking treatment were related to COVID-19, while the No COVID group was not seeking treatment for COVID-19-related reasons. Yes MH represents the group of students whose mental health was negatively impacted by COVID-19, while the No MH group did not report a negative mental health impact of COVID-19.

** p < .005, *** p < .001.

Table A1. Endorsement rates of negative impacts of COVID-19 by Academic Class Status

COVID Impact	Freshman/First-year	Sophomore	Junior	Senior	Graduate/Professional degree student
n per group (% of total N)	15438 (17.1%)	17118 (19.0%)	20394 (22.6%)	19227 (21.3%)	17963 (19.9%)
Mental health	75.6%	76.2%	74.1%	71.1%	67.0%
Motivation or focus	70.6%	71.6%	70.4%	68.7%	65.8%
Loneliness or isolation	71.3%	69.2%	66.1%	64.5%	64.1%
Academics	69.4%	72.3%	68.8%	65.4%	59.2%
Missed experiences or opportunities	69.8%	61.0%	60.2%	60.2%	55.5%
Relationships (Significant other, friends, family)	42.3%	44.9%	44.8%	44.4%	44.0%
Career/Employment	31.6%	38.2%	45.4%	51.7%	42.4%
Financial	28.9%	33.9%	38.4%	41.2%	29.9%
Health concerns (others)	28.6%	28.2%	29.2%	30.4%	32.5%
Health concerns (self)	24.4%	26.2%	27.3%	28.1%	27.6%
Grief/loss of someone	11.1%	11.4%	11.7%	11.7%	12.0%
Food or housing insecurity	6.1%	8.3%	10.1%	10.4%	6.9%
Discrimination/Harassment	2.2%	2.5%	2.6%	3.0%	3.4%
Other (please specify)	1.0%	1.1%	1.2%	1.4%	1.8%

Table A2. Endorsement Rates of Negative Impacts of COVID-19 by Race and Ethnicity

COVID Impact	African American/ Black	American Indian or Alaskan Native	Asian American/Asian	Hispanic/ Latino/a	Native Hawaiian or Pacific Islander	Multi-racial	White	Self-identify
n per group (% of total N)	8302 (9.1%)	461 (0.5%)	9007 (9.9%)	8900 (9.7%)	186 (0.2%)	4544 (5.0%)	58579 (64.1%)	1452 (1.6%)
Mental health	62.8%	75.7%	68.1%	71.0%	74.2%	73.7%	74.3%	70.2%
Motivation or focus	65.3%	70.9%	66.4%	70.5%	68.3%	72.7%	69.2%	71.1%
Loneliness or isolation	59.5%	64.2%	63.0%	64.2%	66.1%	68.9%	68.4%	68.5%
Academics	63.2%	69.0%	63.6%	66.0%	73.7%	67.9%	67.1%	67.1%
Missed experiences or opportunities	50.4%	56.0%	53.9%	55.2%	60.2%	61.7%	64.3%	59.9%
Relationships (Significant other, friends, family)	40.3%	42.7%	43.1%	44.3%	52.2%	45.9%	44.1%	47.9%
Career/Employment	40.3%	45.3%	37.8%	42.2%	41.4%	44.6%	43.0%	43.1%
Financial	42.9%	52.5%	26.4%	43.7%	42.5%	39.1%	32.5%	37.3%
Health concerns (others)	23.5%	31.7%	25.9%	30.1%	29.6%	32.7%	30.8%	34.6%
Health concerns (self)	26.2%	34.7%	28.8%	28.5%	31.2%	29.2%	25.5%	33.5%
Grief/loss of someone	17.2%	23.9%	10.5%	13.9%	19.4%	12.7%	10.2%	14.2%
Food or housing insecurity	12.6%	19.3%	7.2%	11.5%	13.4%	11.3%	7.1%	12.7%
Discrimination/Harassment	5.7%	4.1%	10.1%	2.6%	8.6%	5.0%	1.0%	4.6%
Other (please specify)	1.1%	1.5%	1.1%	1.1%	0.5%	1.3%	1.3%	1.4%

Table A3. Endorsement rates of negative Impacts of COVID-19 by gender identity

COVID Impact	Woman	Transgender woman	Man	Transgender man	Non-binary	Self-identify
n per group (% of total N)	60817 (67.0%)	294 (0.3%)	26774 (29.5%)	409 (0.5%)	1820 (2.0%)	597 (0.7%)
Mental health	74.1%	71.8%	67.2%	79.2%	85.4%	79.7%
Motivation or focus	70.5%	63.9%	64.8%	75.6%	78.8%	74.4%
Loneliness or isolation	67.0%	67.0%	64.9%	73.8%	79.5%	76.7%
Academics	66.1%	68.7%	66.6%	72.9%	76.8%	70.0%
Missed experiences or opportunities	62.8%	54.4%	56.0%	67.5%	70.8%	64.8%
Relationships (Significant other, friends, family)	43.4%	40.5%	44.8%	45.2%	49.7%	51.3%
Career/Employment	41.7%	41.5%	42.4%	44.7%	51.8%	44.4%
Financial	35.2%	36.1%	32.4%	43.0%	45.9%	38.5%
Health concerns (others)	31.1%	32.7%	25.7%	38.9%	44.4%	44.6%
Health concerns (self)	26.8%	31.0%	25.3%	32.3%	38.6%	35.5%
Grief/loss of someone	12.1%	9.9%	10.2%	8.1%	14.8%	13.4%
Food or housing insecurity	8.2%	12.2%	8.2%	15.4%	17.0%	14.4%
Discrimination/Harassment	2.8%	5.1%	2.5%	6.8%	6.3%	6.2%
Other (please specify)	1.2%	3.4%	1.4%	1.7%	1.9%	2.5%

Table A4. Endorsement rates of negative impacts of COVID-19 by Sexual Orientation

COVID Impact	Asexual	Bisexual	Gay	Heterosexual/ Straight	Lesbian	Pansexual	Queer	Questioning	Self-identify
n per group (% of total N)	1792 (2.1%)	11411 (13.2%)	2529 (2.9%)	61113 (70.7%)	1786 (2.1%)	2039 (2.4%)	1876 (2.2%)	3158 (3.7%)	792 (0.9%)
Mental health	69.1%	81.7%	76.3%	69.5%	80.5%	82.8%	84.2%	80.6%	74.2%
Motivation or focus	65.9%	75.8%	71.3%	66.8%	73.9%	77.1%	79.0%	78.0%	69.3%
Loneliness or isolation	61.7%	74.1%	70.5%	64.4%	72.5%	77.0%	77.5%	76.0%	71.0%
Academics	68.0%	72.6%	67.6%	64.5%	69.3%	73.9%	72.7%	73.2%	66.4%
Missed experiences or opportunities	55.8%	67.9%	62.2%	59.1%	65.6%	67.5%	69.6%	70.5%	61.9%
Relationships (Significant other, friends, family)	38.4%	46.8%	48.6%	42.8%	46.2%	50.9%	51.9%	51.3%	50.1%
Career/Employment	40.3%	47.9%	44.6%	40.3%	43.5%	52.1%	51.0%	44.6%	43.8%
Financial	33.0%	41.4%	37.5%	32.2%	39.5%	48.9%	41.8%	35.8%	37.2%
Health concerns (others)	28.3%	36.8%	27.9%	27.3%	35.3%	42.8%	44.6%	36.8%	33.8%
Health concerns (self)	27.5%	31.5%	28.1%	24.8%	30.3%	35.0%	36.9%	33.2%	29.4%
Grief/loss of someone	12.8%	13.1%	10.8%	10.9%	10.5%	15.3%	15.1%	11.8%	12.2%
Food or housing insecurity	9.1%	11.9%	10.0%	7.0%	11.0%	17.5%	14.3%	10.3%	10.9%
Discrimination/Harassment	3.4%	3.3%	4.2%	2.4%	3.2%	5.4%	6.6%	3.1%	3.3%
Other (please specify)	1.6%	1.2%	1.1%	1.2%	1.3%	1.7%	1.7%	1.1%	2.9%

Table A5. Endorsement rates of negative impacts of COVID-19 by international student status

COVID Impact	No	Yes
n per group (% of total N)	85543 (94.0%)	5493 (6.0%)
Mental health	73.0%	60.6%
Motivation or focus	69.6%	59.8%
Loneliness or isolation	67.1%	59.4%
Academics	67.0%	59.4%
Missed experiences or opportunities	62.0%	45.5%
Relationships (Significant other, friends, family)	44.1%	41.7%
Career/Employment	42.6%	36.9%
Financial	34.9%	29.1%
Health concerns (others)	30.3%	24.5%
Health concerns (self)	26.7%	27.7%
Grief/loss of someone	11.7%	10.2%
Food or housing insecurity	8.4%	9.6%
Discrimination/Harassment	2.6%	6.2%
Other (please specify)	1.3%	1.7%

Data Availability Statement

Raw data were generated by the Center for Collegiate Mental Health (CCMH). Derived data supporting the findings of this study are available from the corresponding author (NP) on reasonable request.