The identification of ≥1 minority groups on the part of counseling centers has been shown to be associated with a higher risk for suicidality and depression, according to a study published in the Journal of American College Health.

Kalibatseva and colleagues aimed to examine the combined effects of race, gender, sexual orientation, and socioeconomic status, and their link to depression and suicidality, among a clinical population of college students who had sought care at a large public research Midwestern university counseling center.

Their study tested the following 5 hypotheses or conducted exploratory analyses in those cases in which insufficient evidence was available to formulate a hypothesis:

(1) Asian/Asian American college students will report higher depression scores than European American college students; (2) women will report higher suicidality and depression scores compared with men; (3) lesbian/gay/bisexual/questioning (LGBQ) individuals will report higher suicidality and depression scores than heterosexual individuals; (4) individuals with high levels of financial stress will report higher suicidality and depression scores than those with low levels of financial stress; and (5) the presence of multiple minority statuses will be associated with higher suicidality and depression scores.

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In total, 3189 participants were enrolled in the study, with approximately 40% of them living on the college campus. Since both undergraduate and graduate students were involved in the study, the age of the sample was probably older than that of the traditional undergraduate student samples. The Patient Health Questionnaire – Depression Module (PHQ-9), which includes 9 self-report items, was used to indicate participants’ current depressive symptoms. To assess suicide ideation and attempts, participants were asked to disclose whether they had ever “seriously considered attempting suicide” and “made a suicide attempt” at any time in their life, based on a 4-point scale (1 = “Never”; 2 = “Prior to college”; 3 = “After starting college”; and 4 = “Both”).

The results revealed that Asian American college students reported the presence of more depressive symptoms compared with European American and Hispanic students. Furthermore, Asian American college students were more likely to be diagnosed with depression than were European American and African American students. Additionally, female and LGBQ participants had higher depressive symptom scores and were more likely to be diagnosed with depression, as well as being more likely to have a history or suicidal ideation and suicide attempts, compared with male and heterosexual individuals, respectively.

Regarding levels of financial stress, those students who had high financial stress had higher depression scores. They were also more likely to have experienced prior and current suicidality. The presence of more minority statuses was associated with greater levels of depression and suicidality.

A limitation of the current study is the fact that in spite of the large sample size, insufficient subgroups were evaluated that would help to examine interactions for some of the within-group differences. Moreover, students who identified as Native American or biracial/multiracial were not included in the analysis.

The investigators concluded that the findings from the current study highlight the importance of providing culturally sensitive services to culturally diverse individuals who may identify with 1 or more minority groups.


Kalibatseva Z, Bathje GJ, Wu IHC, Bluestein BM, Leong FTL, Collins-Eaglin J. Minority status, depression and suicidality among counseling center clients [published online April 28, 2020]. J Am Coll Health. doi: 10.1080/07448481.2020.1745810