A large-scale analysis of health survey data from more than 560,000 college students across the United States has found a steady rise in depression symptoms over the past 15 years, with the sharpest increases among women, racial minorities and students facing financial hardship.
The research, led by investigators at the Johns Hopkins Children’s Center in collaboration with McDaniel College, the University of Maryland and other academic institutions in Maryland, examined mental health trends among college students between 2007 and 2022. The findings show that self-reported symptoms of depression have continued to climb during this period, reinforcing concerns raised by earlier studies about worsening mental health among young adults.
Carol Vidal, M.D., Ph.D., M.P.H., a child and adolescent psychiatrist at the Johns Hopkins Children’s Center and a lead author of the study, said that suicidal thoughts—referred to clinically as suicidal ideation—increased across all demographic groups regardless of race, age, gender or financial situation. However, other symptoms of depression, including restlessness and difficulty concentrating, rose most sharply among female students, those experiencing financial strain and members of minority groups.
The findings were published in the Journal of Affective Disorders. Researchers say the results point to widening mental health disparities among college students. The study suggests that the rise in depressive symptoms is not evenly distributed across the student population and highlights the urgent need for prevention efforts and targeted mental health support on college campuses.
To conduct the study, researchers analyzed responses from the Healthy Minds Study, a nationwide project that regularly surveys college students about their mental health and well-being. The project includes participation from numerous universities and has become one of the most comprehensive sources of data on student mental health in the United States.
Depression symptoms in the analysis were measured using the Patient Health Questionnaire-9 (PHQ-9), a widely used screening tool employed by mental health professionals to assess the presence and severity of depression. The questionnaire evaluates nine common symptoms, including suicidal thoughts, sleep disturbances and changes in appetite. Participants rate how frequently they experience each symptom on a scale from 0 to 3, with 0 indicating “not at all” and 3 indicating the symptom occurs nearly every day.
The scores from all nine questions are combined to produce an overall score ranging from 0 to 27. Scores between 0 and 4 typically indicate no significant depressive symptoms, while scores between 20 and 27 suggest severe depression.
According to the analysis, average PHQ-9 scores increased consistently each year during the study period. The most dramatic change occurred in reports of suicidal ideation, which rose by nearly 154 percent. Restlessness increased by almost 80 percent, while difficulty concentrating climbed by more than 77 percent.
Vidal explained that students from minority backgrounds and those dealing with financial stress are often considered vulnerable populations. These students may face both sudden life challenges and long-term stressors that can trigger psychological strain and physiological responses, including elevated levels of stress hormones.
The study also revealed notable gender differences in specific symptoms. Sleep disturbances and appetite problems increased significantly faster among women than among men. However, Vidal noted that men historically report mental health symptoms less frequently, even though suicide rates remain higher among men.
Financial hardship also appeared to intensify certain depression symptoms. Students who reported financial stress recorded higher PHQ-9 scores in areas such as poor appetite, feelings of worthlessness and suicidal thoughts.
Differences were also observed among racial and ethnic groups. Minority students overall reported higher levels of certain symptoms, with Hispanic students showing particularly elevated scores related to sleep problems.
Another finding showed that women experienced a faster increase in losing interest in previously enjoyable activities, a key symptom of depression. On average, this symptom rose by 0.041 points each year among women compared with a 0.028-point annual increase among men.
Vidal said the findings underscore the need for a coordinated response to student mental health challenges. Colleges, universities, parents and health care providers all have a role to play in recognizing mental health disparities, addressing the underlying stressors affecting vulnerable groups and ensuring that students receive appropriate care and support.
The study’s co-authors include Jenny Owens of the University of Maryland and Phillip Sullivan and Flavius Lilly of McDaniel College.
Vidal received research funding from the National Institute on Drug Abuse and the American Academy of Child and Adolescent Psychiatry through the NIDA/AACAP Physician Scientist Training Program in Substance Use Career Development Award. Additional funding for program implementation was provided by the Maryland State Community Health Resources Commission.
