Mental health and help-seeking behavior among at-risk university students in Germany: A descriptive analysis

University students mental health has become a growing concern worldwide with significant disparities among at-risk groups such as students with chronic illnesses, mental health diagnoses, migration histories, diverse gender identities, and parental responsibilities. These at-risk groups face unique challenges and increased psychological distress, highlighting the need for further research to better understand their specific needs and to shed a light on broader societal issues such as discrimination and stigmatization, thereby informing the development of tailored support measures in higher education settings. These disparities can also be interpreted through Andersen's Behavioral Model, which posits that help-seeking behavior is shaped by predisposing, enabling, and need-related factors. The analyses includes data that were collected between April and May 2022 from N = 5474 students from Saxony, Germany. Via an online survey, variables were assessed using standardized questionnaires on depressive symptoms, anxiety, stress and perceived social support. Further, students were asked on their professional and university help seeking-behavior. Across all five pre-defined at-risk groups of university students, individuals belonging to one of the at-risk groups showed worse mental health outcomes than their respective comparison group. Only for parental students, a different pattern was found, with lower psychopathology and higher perceived social support than non- parents. Regarding the use and knowledge of professional and university help offers, the respective subgroups showed different preferences and knowledge. Viewed through Andersen's Behavioral Model, these findings suggest that elevated psychological distress reflects higher need factors, whereas differences in perceived social support represent variations in enabling factors that may shape help-seeking patterns and service utilization. These findings highlight the urgent need for flexible, low-threshold support options such as online interventions, which can effectively complement traditional counseling services in universities. Study registration DRKS00030697.