Mental Health Equity for Sexual and Gender Minority Students at a Rural University: Evidence from ETSU’s Healthy Minds Study
Abstract
Universities nationwide are reporting rising psychological distress among students, yet inequities in mental health for sexual and gender minority (SGM) students—those whose sexual orientation or gender identity differs from the majority—remain poorly understood in rural settings. This project examines whether SGM students at a rural public university in Central Appalachia experience greater mental health burden, distinct barriers to care, and less affirming service environments than their non-SGM peers, testing the hypothesis that SGM students have both higher symptom levels and greater unmet need for care. Guided by Minority Stress Theory (which links stigma-related stressors to health outcomes) and a social–ecological perspective (which considers influences from the individual to the institution), the study analyzes real-time, campus-specific 2023–2024 Healthy Minds Study survey data collected at East Tennessee State University. Using descriptive statistics and multivariable regression models—statistical techniques that allow comparison of groups while accounting for other student characteristics—the project estimates the prevalence of depression, anxiety, and suicidal ideation; patterns of counseling and psychiatric medication use; and structural and psychosocial barriers to care, including cost, time, stigma, and perceived inclusivity of services. Results indicate high overall psychological distress and substantial unmet need, with many students meeting clinical thresholds but not engaged in treatment. SGM students show markedly higher odds of depression, anxiety, and suicidal ideation and are more likely to report long wait times, difficulty finding affirming providers, financial constraints, and prior negative or non-affirming encounters with mental health systems, even after adjusting for sociodemographic and academic factors. These findings suggest that closing equity gaps will require an integrated, equity-focused campus mental health strategy that expands gender-affirming, culturally responsive care and embeds mental health promotion into policies, teaching practices, student services, and partnerships between ETSU and the surrounding community.
Start Time
15-4-2026 10:00 AM
End Time
15-4-2026 11:00 AM
Room Number
304
Presentation Type
Oral Presentation
Presentation Subtype
Grad/Comp Orals
Presentation Category
Health
Student Type
Graduate
Faculty Mentor
Erin Mauck
Mental Health Equity for Sexual and Gender Minority Students at a Rural University: Evidence from ETSU’s Healthy Minds Study
304
Universities nationwide are reporting rising psychological distress among students, yet inequities in mental health for sexual and gender minority (SGM) students—those whose sexual orientation or gender identity differs from the majority—remain poorly understood in rural settings. This project examines whether SGM students at a rural public university in Central Appalachia experience greater mental health burden, distinct barriers to care, and less affirming service environments than their non-SGM peers, testing the hypothesis that SGM students have both higher symptom levels and greater unmet need for care. Guided by Minority Stress Theory (which links stigma-related stressors to health outcomes) and a social–ecological perspective (which considers influences from the individual to the institution), the study analyzes real-time, campus-specific 2023–2024 Healthy Minds Study survey data collected at East Tennessee State University. Using descriptive statistics and multivariable regression models—statistical techniques that allow comparison of groups while accounting for other student characteristics—the project estimates the prevalence of depression, anxiety, and suicidal ideation; patterns of counseling and psychiatric medication use; and structural and psychosocial barriers to care, including cost, time, stigma, and perceived inclusivity of services. Results indicate high overall psychological distress and substantial unmet need, with many students meeting clinical thresholds but not engaged in treatment. SGM students show markedly higher odds of depression, anxiety, and suicidal ideation and are more likely to report long wait times, difficulty finding affirming providers, financial constraints, and prior negative or non-affirming encounters with mental health systems, even after adjusting for sociodemographic and academic factors. These findings suggest that closing equity gaps will require an integrated, equity-focused campus mental health strategy that expands gender-affirming, culturally responsive care and embeds mental health promotion into policies, teaching practices, student services, and partnerships between ETSU and the surrounding community.
