Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Lisa Cosgrove

Second Advisor

Sharon Horne

Third Advisor

Ester Shapiro


Increasing numbers of students are entering college with a mental health diagnosis, and many more students experience mental health issues for the first time as a part of their college experience. Understanding how students perceive their distress and access support is critical for supporting student success. The purpose of this project was: a) to investigate the meaning and influence of a diagnosis of depression on problem identification processes of first year college students and b) to examine how the diagnostic experience and the discourse of diagnosis impacts the students’ help-seeking pathways. In order to explore this issue, a convergent parallel mixed method design involving a quantitative survey analysis and a qualitative interview analysis was used with a sample from a single public institution. While survey results supported that certain students have accessed diagnosis and formal treatment, the qualitative analysis suggested that help-seeking pathways are varied. Experiences of receiving a diagnosis led to increased trust in services for some individuals, whereas others felt unheard and dissatisfied with formal treatment. Survey results suggest that for some students, help-seeking within informal support networks and through alternative services may precede or even replace steps toward formal treatment. Implications of these results for clinicians and researchers, as well as social justice implications, are discussed.


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