Exploring mental health and service access among HBCU Student-Athletes: A mixed-methods study.

A majority of HBCU student-athletes were at risk for clinical depression.

• 59% (n = 121) of the 205 student-athletes screened were at risk for clinical depression.
• The sample had a mean age of 22.36 ± 3.54 years.
• Data were collected from six HBCUs located in the southeastern United States.
• Descriptive statistics, correlations, t-tests, and logistic regression were used for quantitative analysis.

Over half of HBCU student-athletes experienced mild to severe anxiety.

• 51% (n = 104) of student-athletes experienced mild to severe anxiety.
• The sample consisted of 205 student-athletes across six HBCUs.
• Both depression and anxiety outcomes were assessed in the quantitative strand of the convergent mixed-methods design.

Prior mental health service experience was associated with significantly lower depression and anxiety among HBCU student-athletes.

• Prior mental health service experience was linked to significantly lower depression and anxiety (ds = 0.37–0.57, ps < 0.001).
• Having prior mental health service experience was associated with a 46% reduction in odds of depression (OR = 0.54).
• Having prior mental health service experience was associated with a 54% reduction in odds of anxiety (OR = 0.46).
• These associations were identified through logistic regression analysis.

Qualitative analysis revealed three core themes related to mental health and service access among HBCU student-athletes.

• Theme 1: Culturally grounded but inconsistent social support.
• Theme 2: Stigma and institutional uncertainty limiting trust.
• Theme 3: Systemic underfunding and resource disparities reinforcing structural barriers to care.
• Qualitative data were obtained through interviews with 19 student-athletes, analyzed using reflexive thematic analysis.

Integration of quantitative and qualitative findings showed that cultural belonging and social support partially buffer mental health risks but do not overcome structural and attitudinal barriers.

• Integrated results identified convergence, divergence, and/or expansion patterns between the two data strands.
• Stigma, gender norms, and systemic underfunding continue to restrict equitable access to care for HBCU student-athletes.
• A convergent mixed-methods design was used to integrate the two strands.
• The authors concluded that interprofessional psychological support teams and culturally responsive, multilevel interventions are needed to reduce mental health disparities.