Repeated cross-sectional analysis of mental distress among students seeking care at the University of Pittsburgh Counseling Center during the COVID-19 pandemic

Background: Prior research has reported steadily increasing rates of mental health disorders among college students. Thus, when the COVID-19 pandemic emerged, there was concern for its potential impacts on mental wellbeing of college students. Little research attempting to investigate this relationship has included a baseline mental health status prior to the pandemic. The goal of this study was to address this common limitation and investigate how psychological distress among students seeking mental health services differed between academic terms before and during the COVID-19 pandemic. Methods: This study included students who sought mental health services at the University of Pittsburgh Counseling Center in the fall semester prior to the onset of the pandemic (Fall 2019, N=1,548), the fall semester following the onset of the pandemic (Fall 2020, N=820), and one and a half years after the pandemic onset (Fall 2021, N=1,194). Multivariate linear regression was used to determine if attending school during the COVID-19 pandemic impacted CCAPS-62 Distress Index scores. Results: Students who sought care at the University Counseling Center during the COVID�19 pandemic experienced greater psychological distress compared to students who sought care in the Fall of 2019, before the pandemic onset. Students scored 0.125 points higher on the CCAPS-62 Distress Index in the Fall 2020 semester (95% CI: 0.057, 0.193) and students seeking care in the Fall of 2021 scored 0.111 points higher, on average, than those who received care in the Fall 2019 (95% CI: 0.049, 0.172). Conclusion: Many students reported additional challenges due to COVID-19. However, the relationship between the pandemic and psychological distress among college students is nuanced. Although the Distress Index scores of students seeking care during COVID-19 were statistically significantly higher than the scores of students seeking care prior, the differences were not as large as prior research suggests. This study has significant public health implications, as it addresses a common limitation on this topic; the inclusion of a baseline mental health status of the study population. These findings can be used to inform institutions on how to identify and support students more susceptible to adverse mental health experiences during unprecedented times