Temporal Trends in Rates of Depression, Anxiety, and Suicidality Among Cisgender Sexual Minority and Heterosexual College Students

Sexual minority college students experience higher rates of depression, anxiety, and suicidality compared with their heterosexual peers. Significant social progress has been made in the last few decades, such that attitudes and policies toward sexual minorities in the United States have improved dramatically. It is unclear, however, whether this progress has decreased disparities in mental health outcomes between cisgender sexual minorities and heterosexuals. Therefore, the current study sought to determine whether disparities in depression, anxiety, and suicidality between cisgender sexual minority and heterosexual college students has decreased in the last 2 decades. Data were derived from the National College Health Assessment (NCHA), a national population-based survey of health outcomes among U.S. college students conducted every semester since 2000. Logistic regression was used to examine main and interaction effects of sexual orientation and time on lifetime and 12-month depression and anxiety diagnosis and treatment, suicidal ideation, and suicide attempt. As hypothesized, significant main effects of time and sexual orientation were observed such that sexual minorities had higher rates of all outcomes compared with heterosexuals, and rates of these outcomes increased over time for all participants. However, despite observed improvements in climate and policies toward sexual minority college students, disparities in rates of depression and anxiety diagnosis/treatment and suicidality among college students have expanded in recent years. These results indicate that further research is needed to determine the extent to which changes in minority stress and structural stigma lead to changes in rates of depression, anxiety, and suicidality in sexual minorities. Public Significance Statement This study suggests that, despite recent social progress, mental health disparities between sexual minority and heterosexual college students may be expanding. Results indicate a need for further examination of the interplay between social attitudes and policies with sexual minority mental health, as well as intervenable factors that may ameliorate sexual orientation-related disparities.