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

This study examined the mental health status and barriers to services among student-athletes (SAs) at Historically Black Colleges and Universities (HBCUs) using a convergent mixed-methods design. We collected quantitative data from 205 SAs (Mage = 22.36 ± 3.54) across six HBCUs located in the southeastern United States, and qualitative data were obtained through interviews with 19 SAs. Descriptive statistics, correlations, t-tests, and logistic regression were conducted for the quantitative strand, while reflexive thematic analysis was used for the qualitative strand. The two strands were then integrated to identify convergence, divergence, and/or expansion patterns. Quantitative results showed that 59 % (n = 121) of SAs were at risk for clinical depression, and 51 % (n = 104) experienced mild to severe anxiety. Prior mental health service experience was linked to significantly lower depression and anxiety (ds = 0.37-0.57, ps < 0.001), with reductions of 46 % (OR = 0.54) and 54 % (OR = 0.46), respectively. Qualitative findings revealed three core themes: (1) Culturally grounded but inconsistent social support, (2) Stigma and institutional uncertainty limiting trust, and (3) Systemic underfunding and resource disparities reinforcing structural barriers to care. Integrated results showed that cultural belonging and social support partially buffer mental health risks, but stigma, gender norms, and systemic underfunding continue to restrict equitable access to care for HBCU SAs. These results necessitate the creation of interprofessional psychological support teams and culturally responsive, multilevel interventions to reduce mental health disparities among HBCU SAs.