In an era marked by escalating mental health challenges among young adults, a groundbreaking study published in BMC Psychiatry highlights the intricate connections between psychological symptoms and the self-reported mental health service needs of college students. Conducted with a vast cohort exceeding 22,000 participants, this research sheds new light on how anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD) interrelate, revealing anxiety as a pivotal factor influencing the demand for mental health resources.
Psychological distress among college students has surged in recent years, undermining their academic success, social interactions, and overall well-being. While past investigations have predominantly focused on the prevalence of individual psychological symptoms, this study ventures further to unravel the complex networks of symptom co-occurrence and their direct impact on self-identified needs for mental health services. Such a nuanced perspective is critical in refining support structures within academic institutions.
Employing standardized tools such as the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), and Impact of Event Scale-Revised (IES-R), the study quantified key symptom dimensions among the large student sample. In parallel, a bespoke questionnaire gauged participants’ perceptions of their mental health service requirements, marking a significant advance in capturing subjective service needs linked to psychological distress.
A striking finding from the analysis is the relatively low overall self-reported mental health service need—2.2% of all students and 5.0% among those experiencing at least one psychological symptom. This underscores ongoing gaps between symptomatology and help-seeking behavior in young adults, which may be influenced by stigma, awareness, and accessibility barriers.
Delving deeper, the data reveal that students experiencing anxiety symptoms exclusively report higher mental health service needs compared to those experiencing depression, insomnia, or PTSD singularly. This prioritization of anxiety within self-reported needs challenges existing paradigms that often foreground depression, suggesting that anxiety may yield more immediate or distressing functional impairments prompting students to seek support.
Interestingly, anxiety’s role extends beyond a mere symptom category; when comorbid with other conditions such as depression or insomnia, it does not significantly amplify the expressed demand for mental health services. This nuanced insight reframes assumptions about symptom burden, indicating that anxiety may serve as a gateway or mediator rather than simply compounding distress in combination with other disorders.
The research utilizes sophisticated mediation analysis to elucidate these dynamics, revealing robust reciprocal effects between psychological symptoms and mental health service needs. Crucially, anxiety symptoms account for approximately 42-45% of the mediation effect across depression, insomnia, and PTSD symptoms, positioning anxiety as a central pivot through which psychological distress translates into service demand.
Network analysis further enriches the interpretation by elucidating symptom interdependencies on a granular level. Among PHQ-9 items, the ninth item, which assesses suicidal ideation, demonstrates the strongest association with self-reported mental health service needs. This finding underscores the imperative to prioritize urgent intervention pathways for students experiencing suicidal thoughts, aligning resource allocation with critical risk indicators.
Beyond identifying needs, the study also captures students’ preferences regarding mental health service modalities. The prominence of psychological hotline services and self-learning psychological knowledge as favored support avenues highlights the potential for scalable, accessible interventions that could extend the reach of mental health care on campuses.
The cumulative insights from this study hold significant implications for university mental health strategy. By spotlighting anxiety as a central mediator and identifying suicidal ideation as a key predictor for service demand, institutions can refine screening protocols to detect high-risk students early and implement stratified interventions tailored to symptom profiles.
Providing an infrastructure that ensures timely support for anxiety-related distress and suicidal ideation could dramatically alter the trajectory of mental health outcomes for students, enhancing retention, performance, and life quality. Moreover, empowering students through self-directed psychological knowledge resources reflects a paradigm shift towards autonomy and stigma reduction in mental health care delivery.
This comprehensive investigation not only bridges a critical knowledge gap in understanding the intersections of psychological symptoms and service needs but also creates a compelling case for integrated, symptom-focused mental health programs in higher education. Future research might explore longitudinal trajectories and the efficacy of tailored interventions inspired by these findings.
As mental health challenges continue to surge globally, this study’s contribution underscores the urgency for evidence-based, nuanced, and student-centered approaches in addressing the evolving landscape of college mental health needs. Universities, policymakers, and mental health practitioners alike stand to benefit from the clarifying lens this research provides into the lived experiences of students navigating psychological distress.
In summary, the study offers a paradigm-shifting view on the role of anxiety and symptom interplays in driving self-reported mental health service needs among college populations. By emphasizing early anxiety detection, addressing suicidal ideation urgently, and reallocating resources towards symptom-specific care, this research charts a path forward for enhancing mental health support frameworks in academic environments.
Subject of Research: Psychological symptoms, comorbidities, and self-reported mental health service needs in college students.
Article Title: Psychological symptoms, comorbidities and symptom items associated with self-reported mental health needs in college students
Article References:
Liu, Y., Yang, P., Feng, H. et al. Psychological symptoms, comorbidities and symptom items associated with self-reported mental health needs in college students. BMC Psychiatry 25, 1058 (2025). https://doi.org/10.1186/s12888-025-07469-w
Image Credits: AI Generated
DOI: 10.1186/s12888-025-07469-w
Keywords: psychological distress, anxiety, depression, insomnia, PTSD, college students, mental health service needs, mediation analysis, network analysis, suicidal ideation, mental health intervention

