University of Southern California Dissertations and Theses

The relationship between Latinx undergraduate students’ mental health and college graduation rates

(USC Thesis Other)

The relationship between Latinx undergraduate students’ mental health and college graduation rates

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content 1

The Relationship Between Latinx Undergraduate Students ’ Mental Health and College
Graduation Rates

Adriana Merlo

Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education

August 2023

2

© Copyright by Adriana Merlo 2023
All Rights Reserved

3

The Committee for Adriana Merlo certifies the approval of this Dissertation

Maria Ott
Don Trahan
Rudolph Crew, Committee Chair

Rossier School of Education
University of Southern California
2023

iv
Abstract
This study explored the impact of mental health support and the cultivation of a culture of
caring within universities on the experiences of Latinx undergraduate students and their journey
toward graduation. Drawing on Bronfenbrenner’s ecological systems model, the study analyzed
four key predictors of mental health among Latinxs: family cohesion, social network or
cohesion, acculturative stress, and discrimination (Badiee & Andrade, 2018). These predictors
served as the lens through which the problem of practice was examined.
The study employed 11 semi-structured in-depth interviews with Latinx young adults
who graduated from college in the past 15 years. The findings shed light on significant barriers
that hinder access to mental health resources and underscore the role of caring relationships with
university figures in supporting educational journeys.
The findings yielded six actionable recommendations for universities to enhance Latinx
students’ educational experience: rebranding mental health as mental wellness, leveraging
technology, integrating mental health in the classroom, fostering a culture of care in the
university setting, providing mentorship programs, and increasing cultural representation and
competency among key staff. These actionable recommendations aim to provide practical
guidance for future research and improve retention and graduation rates among Latinx students
while prioritizing their overall well-being.
The limitations and delimitations of the study inform these recommendations, aiming to
provide practical guidance for future research. By addressing these recommendations,
universities can improve retention and graduation rates among Latinx students and foster a
campus culture that prioritizes all students’ well-being.

v
The insights generated by this study contribute to higher education institutions’ ability to
meet the needs of this diverse student population. Ultimately, this can improve outcomes and
increase the representation of Latinx students in higher education, thus shaping a more equitable
and diverse future for the United States.

vi
Dedication
To my beloved Lara and Nando, thank you for walking this challenging path with me
offering nothing but love. You are my most profound teachers and the ultimate heavenly
inheritance. Siempre juntos.

vii
Acknowledgements
I would like to express my most heartfelt gratitude to all those who have supported me
throughout my doctoral journey and the completion of this thesis. Firstly, I am deeply grateful to
my chair, Dr. Rudolph Crew, for his guidance, expertise, and unwavering support. His valuable
insights, constructive feedback, and dedication have been instrumental in shaping the direction of
this research.
Additionally, I extend my sincere appreciation to the members of my doctoral committee,
Dr. Maria Ott and Dr. Don Trahan, for their valuable contributions and scholarly input. Their
expertise and thoughtful suggestions have enhanced the quality and rigor of this work.
Furthermore, I would like to acknowledge the invaluable contributions of the participants
who generously shared their time, experiences, and insights, without whom this study would not
have been possible.
Moreover, I am indebted to my family and friends for their unconditional love,
encouragement, and belief in my abilities. Their constant support, understanding, and patience
have sustained me throughout this challenging journey.
Finally, I would like to express my deep appreciation to all my colleagues and professors
who have provided valuable guidance, intellectual stimulation, and fruitful discussions. Their
contributions have broadened my perspectives and enriched my scholarly endeavors.
In conclusion, the successful completion of this doctoral thesis would not have been possible
without the support and contributions of the individuals and organizations mentioned above. I am
profoundly grateful for their assistance, and I remain indebted to them for their role in shaping
my academic and personal growth.

viii
Table of Contents
Abstract .......................................................................................................................................... iv
Dedication ...................................................................................................................................... vi
Acknowledgements ....................................................................................................................... vii
List of Figures ................................................................................................................................ xi
Chapter One: Introduction to the Study ...........................................................................................1
Context and Background of the Problem: Latinx Student Mental Health ...........................2
A Review of College Students’ Mental Health....................................................................2
Latinx College Students and Mental Health ........................................................................3
Purpose of the Project and Research Questions ...................................................................8
Importance of the Study .......................................................................................................8
Overview of Theoretical Framework and Methodology ...................................................14
Overview of the Methodology ...........................................................................................17
Definitions..........................................................................................................................17
Organization of the Dissertation ........................................................................................20
Chapter Two: Review of the Literature .........................................................................................22
Conceptual Framework ......................................................................................................23
The Convergence of the Predictors and Cultural Values on Latinx Mental Health ..........26
Past Research Exploring Latinx Mental Health and Graduation Rates .............................36
University’s Lack of Success in Addressing Student Mental Health Issues .....................44
Best Practices Related to Latinx Student Retention and Mental Health Interventions ......49
Approaches to Measurement of Higher Education Efforts to Address Latinx Students’
Mental Wellness.................................................................................................................55
Summary ............................................................................................................................61
Chapter Three: Methodology .........................................................................................................62

ix
Research Questions ............................................................................................................62
Overview of Design ...........................................................................................................62
Data Analysis Plan .............................................................................................................67
The Researcher...................................................................................................................68
Data Collection and Analysis.............................................................................................71
Validity and Reliability ......................................................................................................73
Ethics..................................................................................................................................73
Chapter Four: Results ....................................................................................................................75
Participating Stakeholders .................................................................................................78
Results for Research Question 1 ........................................................................................88
Results for Research Question 2 ......................................................................................105
Results for Research Question 3 ......................................................................................120
Summary ..........................................................................................................................128
Chapter Five: Recommendations .................................................................................................131
Recommendations ............................................................................................................131
Limitations .......................................................................................................................146
Delimitations ....................................................................................................................151
Recommendations for Future Research ...........................................................................153
Conclusion .......................................................................................................................158
References ....................................................................................................................................160
Appendix A: Survey Draft ...........................................................................................................225
Appendix B: Survey Draft ...........................................................................................................229
Appendix C: In-Depth Interview .................................................................................................233
Appendix D: Entrevista Profunda ................................................................................................237

x
List of Tables
Table 1: Cultural Values and Predictors 28
Table 2: Sample Framework Utilizing the Indicators 60
Table 3: Data Sources 65
Table 4: Overview of Findings 76
Table 5: Participants’ Demographic Information 79
Table 6: Findings for Research Question 1 93
Table 7: Findings for Research Question 2 110
Table 8: Findings Research Question 3 122
Appendix A: Survey Draft 225
Appendix B: Survey Draft 229
Table C1: English Interview Protocol 234
Table D1: Spanish Interview Protocol 238

xi
List of Figures
Figure 1: Illustration of Ecological Systems Theory 16
Figure 2: Illustration of Ecological Systems Theory as a Conceptual Framework 24
Figure 3: Cultural, Social, and Economic Divides Affecting Latinx College Students’ Mental
Health 64

1

Chapter One: Introduction to the Study
Mental health issues have risen to the forefront of local, regional, and national debate in
the United States. Mental health is particularly pertinent in the context of students and their
persistence in higher education because “by nearly every metric, student mental health is
worsening” and deeply affecting student graduation rates on a national scale (Abrams, 2022, p.
1). The literature shows a strong correlation between students’ mental health and their graduation
rates, demonstrating that psychological suffering is likely to hinder their retention and ability to
earn a post-secondary degree (Del Savio et al., 2022; Ishii et al., 2018; Lipson & Eisenberg,
2017; Mostert & Pienaar, 2020). As mental health is a key determinant of graduation rates,
universities must focus on all students’ psychological wellness. However, Latinx students should
be a population of particular focus since mental health problems among this population have
outpaced the resources available to them, consequently increasing their rates of attrition (Aguayo
et al., 2011; Colarossi, 2022; Cook et al., 2012; de Brey et al., 2019; Lipson et al., 2022; Sáenz &
Ponjuan, 2012).
Benuto et al. (2019) found that Latinx students have lower mental health literacy skills,
substantial mental illness stigma, and lower behavioral health service utilization rates than other
student groups. Additionally, research indicates that these young adults are less likely than other
minorities to consult mental healthcare providers (Aguilar-Gaxiola et al., 2002; Alegría et al.,
2007; Basurto, 2020; Dobalian & Rivers, 2007; Office of the Surgeon General, 2001).
Academically speaking, these students account for one of the highest attrition rates among
universities, with over 50% dropping out (Pew Hispanic Center, 2016; U.S. Census Bureau,
2008). In higher education, these students fall significantly behind academically compared to
2

other student populations and have higher incidences of being placed on academic probation
(Genthe & Harrington, 2022; McPherson & Arbelo Marrero, 2021).
Latinx students’ difficulty completing higher education and the knowledge that they
struggle with mental health make this population a critical area of study, especially since they are
the fastest-growing demographic in the United States (Contreras, 2017; Ruarte, 2018). Left
unaddressed, these current mental health trends will harm the United States’ economic, social,
and educational future outcomes (Durand & Flashman, 2006; Pérez et al., 2021).
Context and Background of the Problem: Latinx Student Mental Health
Mental health issues among all students are a serious concern at higher education
institutions (Eisenberg et al., 2011; Lipson et al., 2022). Although psychological distress affects
all students, the difference is that it disproportionately hinders Latinx students’ ability to
complete a college education compared to other student populations (Colarossi, 2022; Lipson et
al., 2022). The following section will describe the context and consequences of the mental health
crisis facing all college students in the United States and then will probe deeper into
understanding why and how these students are disproportionately affected.
A Review of College Students ’ Mental Health
As a whole, college student mental health issues are on the rise (Colarossi, 2022; Kessler
et al., 2007; Pedrelli et al., 2014). One recent study found that the mental health of college
students across the United States has been worsening over the past 8 years, with an overall 135%
increase in depression and a 110% increase in anxiety from 2013 to 2021 (Lipson et al., 2022).
Furthermore, the number of students who met the criteria for one or more mental health
problems in 2021 had doubled since 2013 (Lipson et al., 2022). Approximately 25% of 2,000
undergraduates surveyed in March 2022 rated their mental health as poor (Inside Higher Ed &
3

College Pulse, 2022). This result is unsurprising, considering most mental health issues peak
between ages 18 and 24, the average college student’s age (Barrable et al., 2018). In this age
group, studies have reported 25% increases in anxiety, depression, and suicidal thoughts
(Barrable et al., 2018; Kessler et al., 2007; Pedrelli et al., 2014).
Latinx College Students and Mental Health
The previous section discussed the general basis of student mental health across all
demographics of that age cohort, but Latinx students have a unique set of circumstances to which
universities have yet to respond. This section will provide a general overview of these students’
mental health status. Additionally, it will provide context about the socioeconomic and cultural
factors that influence their utilization of behavioral services.
Latinx Student Mental Health Landscape
Psychiatric distress among Latinx college students is under-researched, and most studies
in academia are outdated (Martinez, 2022). Specifically, there is limited understanding of the
mental health experiences that this unique student population encounters in higher education
(Contreras, 2017; Martinez, 2022). From the limited data available, research indicates these
students experience particularly elevated levels of stress, anxiety, and depression compared to
non-Latinx White peers (CDC, 2017; Del Pilar, 2008; Eisenberg et al., 2013; Fernandez et al.,
2022; Granillo 2020; Holliday et al., 2015; Hwang & Goto, 2008; Ibarra-Mejia et al., 2022; Kann
et al., 2016; Mental Health America, 2020; Ramirez Villa et al., 2022; Ramirez, 2017; Silva &
Van Orden, 2018; Zvolensky et al., 2021). Additionally, psychological distress is on the rise
among Latinx youth aged 18 to 25, with one study reporting that serious mental illness among
this population increased from 4% to 6.4% between 2008 and 2018 (Mental Health America,
2020).
4

Despite being vulnerable to mental health disorders, Latinx college students are
increasingly at risk of not receiving counseling and mental health services (Bucay-Harari et al.,
2020; Garcia & Valdez, 2021; Granillo, 2020; Soto, 2016). Latinxs, as a demographic, tend to
avoid mental health care services, posing a significant hurdle for university leaders attempting to
retain these students (Arana et al., 2011; Castillo et al., 2006; Fernandez et al., 2022). This
avoidance of behavioral health service utilization has historically been noted in the literature as
one of the main barriers to receiving these services (Bucay-Harari et al., 2020; Garcia & Valdez,
2021; Granillo, 2020; Soto, 2016).
Latinx Shy Away From Mental Healthcare
Despite the increase in mental health diagnoses and service utilization on college
campuses, Latinx students seeking psychological support face a racial-ethnic gap (Chen et al.,
2019; Lipson et al., 2019; Zhou et al., 2021). Research indicates that these students are less likely
than other minority groups to visit a mental health provider (Dobalian & Rivers, 2007;
Menendez et al., 2019; Whaling, 2015). Additionally, “Latinxs had lower levels of mental health
literacy, higher levels of stigma, and lower lifetime prevalence rates of behavioral health service
use” (Benuto et al., 2019, p. 1122).
There has also been a 63% increase in Latinx students’ unmet need for mental health
treatment or counseling on college campuses between 2017 and 2019 (Basurto, 2020).
Consequently, these students experience higher rates of deteriorating mental health but lower
rates of university mental healthcare service utilization than their White peers (Chen et al., 2019;
Downs & Eisenberg, 2012; Hunt et al., 2014; Lipson et al., 2018; Zhou et al., 2021). Zhou et al.
(2021) estimated that about 65% of Latinx college students with mental health issues go
untreated nationwide.
5

One of the reasons Latinx college students underutilize campus mental health resources is
that, as a group, they tend to have low help-seeking behaviors (Zhou et al., 2021). Studies have
found that students tend to avoid mental health counseling on college campuses because they do
not trust these to be confidential and fear the social stigma attached to being seen contacting a
mental health center (Cyz et al., 2013; Hof et al., 2014; Kalkbrenner & Neukrug, 2018; Vogel et
al., 2007). Despite strong campus efforts, including virtual operations, student guides to mental
wellness at home, asynchronous content such as video series and workshops, and support groups,
only 15% of students engaged in college-offered counseling in the year prior to a 2022 study
(Inside Higher Ed & College Pulse, 2022).
The literature suggests that socioeconomic and cultural factors prevent Latinx students
from seeking mental health services, which is why these nuances must be considered when
analyzing a university’s role in students’ mental wellness (Benuto et al., 2019; Casas et al., 2020;
Cabassa et al., 2006; Garcia & Valdez, 2021).
Exploring Cultural and Socioeconomic Inhibitors
Latinx students’ cultural and socioeconomic perceptions of mental health are worth
exploring because these students underperform in higher education compared to every other
student group (Aguayo et al., 2011; Cook et al., 2012; Pappamihiel & Moreno, 2011).
Consequently, universities could benefit financially from investing in retaining this population,
which is expected to increase to 28.6% of the U.S. population by 2060 (Vespa et al., 2018). The
following sections provide an overview of the cultural and socioeconomic barriers influencing
these students’ mental health service utilization.

6

Socioeconomic Inhibitors
Prior researchers have evaluated the disparity in mental health help-seeking behavior and
barriers to obtaining appropriate care among Latinx youth (Aguilar-Gaxiola et al., 2002; Alegría
et al., 2007; Cabassa et al., 2006; Cardemil et al., 2007; Johnson et al., 2004; Menendez et al.,
2019; Singh, 2022; Valdez et al., 2018; Vega & Lopez, 2001). Latinx students face significant
socioeconomic barriers that make timely, affordable, and efficient access to psychological
counseling difficult. This section will provide insight into how socioeconomic status, language
barriers, and time constraints can inhibit these students from seeking behavioral care services.
Regarding socioeconomic status, Macartney et al. (2013) reported that Latinx students
have double the poverty rate of non-Latinx White students. Thus, they have fewer financial
resources to spend on mental health treatment. In particular, undocumented Latinxs experience
constant fear and stress surrounding deportation but have limited income and cannot afford
treatment (Enriquez, 2017; Lewis et al., 2005). Furthermore, language barriers can hinder
awareness about mental health resources and completing the paperwork to access them. Non-
English-speaking college students may feel overwhelmed by the effort required to seek and
engage in therapy in their second language (Benuto et al., 2019; Cheung, 1991; Colon, 1997;
Enriquez, 2017; Kouyoumdjian et al., 2003).
Additionally, researchers have identified time constraints as a significant barrier to Latinx
students seeking mental health treatment due to familial responsibilities, employment, or
geographic distance between school and home or place of work (Cheung & Snowden, 1990;
Martinez, 2019; Pumariega et al., 1998; Valdez et al., 2018). Particularly if individuals have
temporary employment, they may have limited time to seek assistance (Enriquez, 2017;
Martinez, 2019; Pumariega et al., 1998). Due to time constraints, students may look for services
7

in their neighborhood; however, these services may not consider their primary language or
relevant cultural values, resulting in lower utilization rates (Cheung & Snowden, 1990; Enriquez,
2017; Valdez et al., 2018). Despite socioeconomic factors posing a significant barrier to the
utilization of behavioral health services, some studies suggest that cultural factors outweigh
logistical barriers (Benuto et al., 2019; Menendez et al., 2019).
Cultural Inhibitors
Shame and stigma are the main cultural inhibitors keeping Latinxs from receiving mental
health treatment (Eno Louden et al., 2023). Some of these students may feel ashamed to admit
they need treatment because they associate the word “mental” with loco or “crazy” (Barrio et al.,
2008; Interian et al., 2005). Similarly, some Latinx youth could view emotional problems as a
sign of weakness, lack of strength of character, bad luck, the result of a spell or supernatural
event, or God’s will rather than a medical problem related to biological and emotional processes
(Echeverry, 1997; Hinojos, 2013). Also, going to a therapist or clinician may be perceived as an
admission of weakness or instability (Bledsoe, 2008; Echeverry, 1997). One reason for this is
that some Latinxs value representing themselves and their families in the best possible light
(Guajardo et al., 2020). To break through stigma and cultural barriers, university leaders must
foster trust among these students through culturally targeted interventions (Beals et al., 1999;
Nichter, 2010).
Because of the positive correlation between mental wellness and academic achievement,
increasing Latinx students’ graduation rates requires that higher education leaders recognize the
socioeconomic and cultural factors affecting access to institutional mental health resources that
address stress reduction and wellness to guide these students toward graduation (Benjet, 2020;
Brocato et al., 2021; Eisenberg et al., 2009; Jenkins, 2019; White, 2016; Zhai & Du, 2020).
8

Purpose of the Project and Research Questions
The purpose of this study was to examine higher education student support strategies and
best practices regarding mental wellness to improve Latinx students’ graduation rates. The study
used Bronfenbrenner’s (1994) ecological systems theory as a lens and framework for a deeper
investigation of reasons these students struggle to graduate to determine how caring for their
mental well-being might improve their graduation rates. In this sense, it is important to answer
the following research questions:
1. How do Latinx undergraduate students perceive the need for access to relevant
systems of mental health support for purposes of improving their graduation rates?
2. What services, supports, and relationships have enabled Latinx undergraduate
students to improve their mental health and persist to graduation?
3. How does instilling a culture of caring within the university increase the number of
Latinx student graduates?
Importance of the Study
The significance of this study lies in the convergence of two critical outcomes: mental
health disorders and low higher education graduation rates among Latinxs, a population
projected to shape the future of the United States significantly (Pérez et al., 2021). This section
discusses the relationship between mental wellness and poor educational results among these
undergraduate students, as well as how these factors affect the socioeconomic fabric of the
United States.
Psychological Distress Leads to Poor Educational Outcomes
Psychological disorders are associated with adverse student outcomes, including
suboptimum academic performance and increased dropout rates (Arria et al., 2013; Eisenberg et
9

al., 2009; Kessler et al., 2007; Sontag-Padilla et al., 2016). Moreover, untreated psychological
distress increases suicide risk (Appelbaum, 2006; Eisenberg et al., 2013; Gollust et al., 2008;
Kisch et al., 2005). These outcomes are more prevalent among Latinx students (Lipson et al.,
2022). Research indicates that 22% of Latinx youth have depressive symptoms, a rate higher
than any minority group other than Native American youth (Guzmán et al., 2009; Perou et al.,
2013; Ramirez et al., 2012). The likelihood that students facing psychological distress will drop
out of 4-year higher education institutions is 51% (Excelencia in Education, 2020b).
Collectively, the data show that college students face psychological distress (Colarossi,
2022; Eisenberg et al., 2009; Kessler et al., 2007; Lipson et al., 2022; Pedrelli et al., 2014).
However, gaining a comprehensive view of the importance behind the problem of practice
requires considering the consequences mental health issues can have on Latinx students, the
university, and society as a whole.
Student Impact of Mental Health Disorders
On an individual level, mental health problems hinder students’ stamina, attention span,
and academic responsibility, leading to lower grade point averages and increased dropout rates
(Eisenberg et al., 2009; Salzer, 2012). Although most 4-year universities provide resources like
counseling, wellness centers, and digital content, those strategies do not reduce mental anguish
sufficiently, leading to increased attrition and psychological distress (Eisenberg et al., 2011). In a
survey conducted by the National Alliance on Mental Illness (NAMI, 2012), 64% of students
reported dropping out of college due to mental health problems, yet 50% of them did not access
any mental health resources. In one study, 14% of college students cited mental health issues as a
reason for abandoning their studies, and 33% mentioned these as contributing factors (Sallie Mae
Bank & Ipsos, 2022). These studies allude to the mental health crisis afflicting college students
10

and shed light on how current mental health interventions are not sufficiently guiding students
toward graduation.
Furthermore, an individual may suffer from the unintended consequences of mental
health issues in the long term. Mental disorders triggered by an academic environment may
persist throughout students’ lives, harming their psychological health and financial stability
(Eisenberg et al., 2009; Eisenberg et al., 2011; Wang, 2007). In addition, untreated psychological
distress may increase an individual’s risk of attempting or dying by suicide, which is the third
leading cause of death among young adults aged 15 to 25 in the United States (Centers for
Disease Control and Prevention, 2020a; Gollust et al., 2008; Kisch et al., 2005).
Although mental health issues among students can lead to low college graduation rates,
adverse long-term outcomes, and even death, it is worth noting that psychological issues also
impact the university campus and society at large.
Campuswide and Societal Impact of Mental Health Disorders
Student mental health problems also harm University campuses both financially and in
terms of building a healthy learning environment. Financially, universities feel the burden when
students underperform academically or drop out due to a loss in tuition, fees, and external
donations (Meilman & Hall, 2006). The American Institutes for Research (2010) found that
higher education institutions received $6.18 billion in subsidies between 2003 and 2008 for
students who dropped out after a year. In addition, $2.9 billion in federal and state grants were
paid to students who did not continue their education after their first year. Consequently, these
attrition rates and misuse of resources for promoting retention do not bode well for higher
education institutions or the future of the U.S. economy (O’Keeffe, 2013). Per Wimshurst et al.
(2006),
11

Governments have become increasingly serious about a range of performance indicators,
and particularly those indicators that point to progress or otherwise in areas such as:
widening access to higher education, student retention, and the measurement of quality
teaching and education. (p. 10)
The impact of student attrition is also felt in broader economic terms, especially since former
U.S. President Barack Obama alluded to increased dropout rates as a “major threat to the
country’s position as a leading world economy” (American Institutes for Research, 2010, p. 1).
In terms of a healthy school environment, increased attrition contributes to a lack of
student belonging, which has been linked to mental health problems (Murphy et al., 2020;
O’Keeffe, 2013; Raab, 2022). Additionally, mental illness is a risk factor for students
abandoning their higher education studies prematurely (O’Keeffe, 2013). Approximately “5
million students or 4.7% of the total college student population drop out each year due to mental
illness” (Stevenson 2010, p. 42). A lack of culturally competent support for students’ emotional
and mental health needs leads to attrition and may impact student enrollment and graduation
rates (O’Keeffe, 2013). There is more at stake than simply an influx of funds for universities.
Student wellness will be compromised if the university does not create a caring learning
environment, develop a sense of student belonging, and provide adequate counseling services on
campus (O’Keeffe, 2013).
On a larger scale, society is negatively affected when students cannot finish their degree
programs and contribute their skills to a competitive job market and the economy. Unaddressed
mental health problems can increase homelessness, poverty, employment, safety, and the
regional and national economy (American Psychological Association, 2011; Cook et al., 2012;
Dobbie et al., 2018; Jacome, 2021; Kessler et al., 2007; Knifton & Inglis, 2020; Mueller-Smith
12

2015; Tacoma-Pierce Health Department, 2016). Over time, unattended mental health issues may
hinder the productivity of local businesses, increase healthcare costs, impede the ability of
children and youth to succeed in school, and disrupt families and communities (American
Psychological Association, 2011; Jacome, 2020; Tacoma-Pierce Health Department, 2016).
Lack of attention to and treatment of mental health disorders has consequences that
extend well beyond the individual impacted by the illness (American Psychological Association,
2011; Jacome, 2020; Tacoma-Pierce Health Department, 2016). Societies prosper when the
mental health needs of their members are met. Thus, effective mental health treatment for college
and university students might improve their and society’s academic, psychosocial, and economic
outcomes (Blanco et al., 2008; Gallagher, 2008; Lipson et al., 2015).
In view of the prevalence of mental health disorders among students, universities have an
ethical duty to review mental health initiatives to save students’ lives, prepare them for a more
solid future, and ensure future socioeconomic stability in the United States (Kravets-Cohen,
2007). As United Nations Secretary-General Antonio Guterres noted, universities must address
the “tsunami of psychiatric illness” plaguing college students (Tandon, 2020, p. 1). Positive
educational outcomes depend on a university’s ability to support students’ environmental,
academic, and psychological challenges (Eisenberg et al., 2007).
Potential Effects on the United States
Education strongly influences a country’s economic growth, employment, and earnings
(Grant, 2017). Over the next 40 years, the Latinx population is projected to triple from 49.7
million in 2010 to 132.8 million (Andrade & Viruell-Fuentes, 2011; Sáenz, 2010; U.S. Census
Bureau, 2021). Therefore, Latinxs will be increasingly integrated into all U.S. socioeconomic
sectors as consumers and providers. As a result, it is essential to view them as strong human
13

capital that will benefit the economy (Flores, 2020; Sáenz, 2010). For Latinx students,
graduating college enables them to compete in an economy that has not traditionally opened up
to them (Flores, 2020; National Center for Education Statistics, 2017). “Ignoring the economic
dimension of education would endanger the prosperity of future generations, with widespread
repercussions for poverty, social exclusion, and sustainability of social security systems”
(Woessmann, 2015, p. 3). At present, Latinxs’ lack of higher education completion contributes to
their higher unemployment rates, restricted access to medical care, and lower income per capita
than other ethnic groups (Flores, 2020; Funk & Lopez, 2022; Schneider & Ownes, 2006).
College degrees are essential to socioeconomic mobility, income growth, home ownership,
purchasing power, access to goods, and healthcare quality (Barro & Lee, 2010; Grant, 2017;
Woessmann, 2015; World Economic Forum, 2016).
As mentioned, academic success is intrinsically connected with mental health (Bas, 2021;
Houri & Kincade, 2021; Jenkins, 2019; Lipson & Eisenberg, 2017; Mahdavi et al., 2021; White,
2016). Latinx undergraduate students, as an underrepresented minority, must have access to
culturally sensitive mental healthcare services to ensure the nation’s higher education system
does not continue to exacerbate inequities (Gallup-Lumina Foundation, 2022; Lipson et al.,
2022).
One way to provide this access is by ensuring a culture of caring that guides and
accompanies Latinx students in their psychological well-being to give them the best chances of
graduating (Biglan et al., 2012; Gallup-Lumina Foundation, 2022). Since Latinxs hold the lowest
numbers of degrees across racial and ethnic groups, universities must instill a culture of caring
for their well-being and adopt cultural adaptations so that Latinx graduates can contribute to the
increasingly globalized and tech-savvy workforce (Sáenz, 2010). “The future of the United
14

States will increasingly be tied to the fortunes of its Latinx population” (Sáenz, 2010, para. 12).
These students need effective mental health services to benefit their livelihoods and overall life
satisfaction beyond the classroom (Blanco et al., 2008; Gallagher, 2008; Lipson et al., 2019;
Lipson et al., 2015).
University leaders are ethically obligated to review mental health initiatives in light of the
prevalence of student mental health issues, suicides, and overall stress (Eisenberg et al., 2009;
Eisenberg et al., 2011; Ezarik, 2014; Kravets-Cohen, 2007; Lipson et al., 2022). If educational
results depend on student wellness, then ensuring mental health is essential to ensure universities
achieve their mission to educate future generations (Eisenberg et al., 2009).
Overview of Theoretical Framework and Methodology
Bronfenbrenner’s (1994) ecological systems theory served as the theoretical framework
for the study. According to Bronfenbrenner’s model, five interdependent systems directly
interact with an individual and influence their development: microsystem, mesosystem,
exosystem, macrosystem, and chronosystem. Each structure is arranged according to how much
impact or influence it has on a person’s development.
Bronfenbrenner’s (1994) socio-ecological model recognizes that each system influences
individuals differently based on their cumulative and intersectional experiences (Michaels et al.,
2022). In the context of this study, Bronfenbrenner’s model provides a pathway to fully
understand and support Latinx college students’ healthy development toward graduation because
it examines all contexts, systems, and environments (Cadigans & Alberts, 2009; Michaels et al.,
2022; Vasta & Bronfenbrenner, 1989). However, when addressing mental health issues, most
universities’ interventions fail to consider the multiple levels, or ecosystems, of influence on
psychological distress (Biglan et al., 2012; Vasta & Bronfenbrenner, 1989).
15

The power of the socio-ecological model lies in that it shifts the focus from an individual
issue to one that encompasses social responsibility, particularly when considering the role of the
environment in a person’s decision to seek counseling (Biglan & Embry, 2013; Michaels et al.,
2022; Miville & Constantine, 2006; Vogel et al., 2007). Additionally, this model shifts the
mental health narrative from one centered on illness to one centered on mental well-being
because it allows for multiple levels of support between each stratum (Keyes, 2013; Michaels et
al., 2022). Also, the model shifts from a medical framework that pathologizes the differences in
an individual to one that examines the environmental factors and supports that influence well-
being (Keyes, 2013; Michaels et al., 2022).
Based on Bronfenbrenner’s (1994) model, family, school, community, and mental health
agencies are dynamically interrelated (Reupert, 2017; Vasta & Bronfenbrenner, 1989), as shown
in Figure 1. Each system describes the related contributors to a person’s psychological well-
being. At the individual and microsystem levels, the individual is the level of influence, referring
to everything the individual is born with and how they influence and are influenced by the world
around them, such as age, personality, skills, race/ethnicity, sexual orientation,
education/knowledge, economic status, geographic location (Michaels et al., 2022). The next
level of influence, the mesosystem, describes formal and informal social groups, including
family, friends, neighbors, teachers, co-workers, and service providers.

Figure 1
Illustration of Ecological Systems Theory

16
17

The exosystem centers around organizations and the relationships between private,
public, and nonprofit organizations and could include schools, workplaces, agencies, businesses,
healthcare, childcare, and faith groups. The macrosystem centers around the communities or
broader social settings where interactions occur, such as neighborhoods or cultural groups.
Finally, the chronosystem encompasses policies, laws, culture, beliefs, values, and norms that
regulate and support healthy behaviors. The systems and their interrelations collectively offer
university leaders a way to promote mental wellness through key initiatives that contribute to
mental health and, as a result, increase graduation rates (Keyes, 2013; Michaels et al., 2022).
Overview of the Methodology
This study employed a qualitative method to give voice to the target population. The
study sought to capture the perceptions of 10 Latinx adults aged 20 to 40 who earned
undergraduate degrees in the last 10 years. The methodology consisted of in-depth interviews
with 10 interview respondents. The data will then be coded into emerging themes and used to
write recommendations (Moran, 2021; Patton, 1999).
Definitions
This section will define and contextualize keywords pertinent to this study. The terms are
considered culture-bound syndromes prevalent among Latinxs and included in the American
Psychiatric Association’s (2013b) Diagnostic and Statistical Manual’s fifth edition (DSM-V)
glossary.
Culturally adapted interventions: The term “cultural adaptation” refers to the systematic
modification of a treatment or intervention so that it is consistent with the client’s cultural
patterns, values, and meanings (Castro et al., 2010; Sit et al., 2020).
18

Culture: The American Psychological Association (2003) defined culture as “the shared
learned behavior and belief systems and value orientations that shape customs, norms, practices,
and social institutions of a group” (p. 380). Individuals’ culture can be found in their artifacts,
roles, language, consciousness, and attitudes (American Psychological Association, 2003;
Goldston et al., 2008; Marsella, 2000).
Culture of caring: The culture of caring theory suggests that schools, curricula, and
workplaces should focus on relationships when determining their institutional and lifelong
objectives (Cavanagh et al., 2012). For this study, the phrase “culture of caring” refers to
encouraging one-on-one relationships between university staff members and students by
supporting students’ holistic well-being and adopting an ethic of care for building trusting and
respectful relationships (Cavanagh, 2003, 2004; Cavanagh et al., 2012; Noddings, 2003).
Distress: commonly serves as an indicator of mental health (Deasy et al., 2014; Drapeau
et al., 2012). Horwitz (2007, as cited in Deasy et al., 2014) described it as a transient emotional
response to stress, which, if left untreated, can lead to depression. Other researchers pointed out
that psychological distress affects social functioning and everyday life (Deasy et al., 2014;
Wheaton, 2007). Generally speaking, the literature agrees that distress is an emotional state
characterized by symptoms of depression and anxiety (Barlow & Durand, 2012; Deasy et al.,
2014).
Education leaders: In this study, the primary definition of education leaders is individuals
tasked with ensuring student success by maintaining a safe and receptive learning environment.
Education leaders are deans, program directors, and department heads who delegate
responsibility to others and lead other staff members in student support services.
19

Help-seeking behavior refers to the ways in which students seek out and utilize support,
guidance, and resources when facing academic, social, or personal challenges during their
college experience (Umubyeyi et al., 2015). This behavior can take many different forms,
including seeking assistance from professors, advisors, tutors, peers, counseling services, or
other support services available on campus (American Psychological Association, 2023).
Latinx: a gender-neutral term intended to encompass people in the Latinx racial-ethnic
group who do not identify as Latino or Latina, which have male and female associations (Noe-
Bustamante et al., 2021).
Latinx students: a term used to describe Latinx undergraduate students aged 18 to 25.
Mental health: The mental health of an individual consists of their psychological, social,
and emotional well-being, which impacts their thoughts, feelings, and behaviors (Health Center,
2021; World Health Organization, 2022). In addition, mental health affects how a person handles
stress, relates to others, and makes healthy choices (Centers for Disease Control and Prevention,
2021; World Health Organization, 2022). It is important to understand that poor mental health
and mental illness are not synonymous (Centers for Disease Control and Prevention, 2021). It is
possible to experience poor mental health without being diagnosed with a mental illness (Centers
for Disease Control and Prevention, 2021). In the same way, someone with a mental illness can
experience periods of physical, mental, and social well-being (Centers for Disease Control and
Prevention, 2021).
Mental wellness or well-being: The World Health Organization (2022) defined mental
wellness as “a state of well-being in which the individual is aware of his or her abilities, able to
cope with the normal stressors of life, able to work productively and fruitfully, and able to
contribute to the community” (p. ?).
20

Nerves: The DSM-V Glossary of Culture-Bound Syndromes defines nervios (nerves) and
ataque de nervios as idioms of distress with overlapping symptoms of anxiety, depression, and
dissociation used throughout Latin America and the Caribbean (Alcántara et al., 2011; American
Psychiatric Association, 1994, 2013a). Specifically, “between 15.5% to 62.5% of Latinxs from
Central America, Mexico, the Caribbean, and the U.S. endorse a lifetime history of nervios with
variations in rates by geographic region” (Alcántara et al., 2011, p. 4). Moreover, z refers to a
chronic, generalized sense of psychological distress (Alcántara et al., 2011; Baer et al., 2003).
Student support services: “refers to the range of services both for individuals and for
students in groups that complement the course material or learning resources that are uniform for
all learners” (Tait, 2000, p. 289). A good student support system is designed to meet students’
academic and personal needs (Vimal et al., 2021). This system’s goal is to promote a friendly
learning environment for students so that they develop personally, emotionally, intellectually,
and academically and are motivated to succeed in life (Vimal et al., 2021). Examples of student
support services include wellness centers, writing centers, university-affiliated religious centers,
athletic programs, academic advising services, counseling services, and mentoring programs.
Stress: a non-stigmatized code word for an emotional problem occurring in the context of
an interpersonal incident or physical condition, often accompanied by distressing negative
emotions, associated behavioral changes, and co-occurring depressive symptoms (Alcántara et
al., 2011; Baer et ak,, 2003; Cabassa et al., 2008; Casas et al., 1978; Davis & Low, 2009; Low,
1981).
Organization of the Dissertation
Chapter One of this study includes an introduction to the problem of practice, context,
and background of how university leaders can further support Latinx students’ mental wellness
21

and, consequently, graduation rates. The chapter also presents the project’s purpose, research
questions, and importance alongside an overview of the methodology and definitions of
keywords and phrases. Chapter Two presents a comprehensive literature review, including the
conceptual framework and cultural background pertinent to the topic under review and an
overview of past research and best practices. Chapter Three outlines the research method,
participant pool, data analysis, sampling criteria, and interview protocol. Chapter Four describes
and synthesizes the research findings, and Chapter Five discusses the recommendations based on
the outcomes of this study.

22

Chapter Two: Review of the Literature
This literature review provides a general summary of several areas integrated into the
explanation of Latinx students’ experience when pursuing an undergraduate degree in the United
States. The review provides an overview of (a) the conceptual framework, (b) Latinx cultural
characteristics associated with mental health, (c) best practices when it comes to mental health
interventions for Latinx, (d) past research on the correlation between mental health, cultural
adaptations in mental health interventions, and instilling a culture of caring in a university setting
and graduation rates in higher education, and (e) a review of current approaches to measurement.
This chapter will first review Bronfenbrenner’s (1994) ecological systems model as a
conceptual framework for data collection to analyze four key systematic predictors of mental
health among Latinxs (Badiee & Andrade, 2018). These four predictors are family cohesion
(how tightly knit the family unit is), social network (information relationships), acculturative
stress (stress related to assimilating to a dominant culture), and discrimination (differential
treatment due to cultural background; Badiee & Andrade, 2018). Collectively, they serve as the
lens through which to examine this problem of practice.
Additionally, the literature review explores research on mental health interventions for
Latinx students. Extensive research shows the correlation between mental health and graduation
rates among higher education students (Abrams, 2022; Arria et al., 2013; Bas, 2021; Blanco et
al., 2008; Cook et al., 2012; Eisenberg et al., 2009; Eisenberg et al., 2007; Heiligenstein et al.,
1996; Houri & Kincade, 2021; Mahdavi et al., 2021). However, the gap in the literature lies in a
lack of studies measuring the effectiveness of mental health interventions specifically for Latinx
students and their impact on graduation rates to higher education institutions. To bridge that gap,
23

past research on key mental health initiatives specifically shown to improve retention was
examined.
Conceptual Framework
Bronfenbrenner’s (1994) ecological systems theory was used to examine the diverse,
interwoven factors at play when evaluating Latinx students’ mental health and graduation rates.
Under Bronfenbrenner’s (1994, 2005) framework, an individual’s development should be viewed
as a product of contexts, systems, and environments (Cadigans & Alberts, 2009; Michaels et al.,
2022). Because Bronfenbrenner’s (1994, 2005) theory focuses on intrapersonal and
environmental factors and their dynamic interplay, this study used this framework to examine
Latinx students’ ecological needs in the context of their mental health in higher education
institutions to increase their graduation rates. The framework also highlights the narrative of
psychological health from an individual issue to one that incorporates the responsibility of others
in the university ecosystem (Biglan & Embry, 2013; Michaels et., 2022). Further, it emphasizes
psychological well-being rather than focusing on mental illness without forsaking the recognition
of the presence of psychological distress (Keyes, 2013; Michaels et al., 2022).
However, although Bronfenbrenner’s model provides insight into the elements
influencing a person’s psychological development, this study focused on specific items in the
entire ecosystem. Badiee and Andrade’s (2018) peer-reviewed, systematic research analyzed
multiple studies using Bronfenbrenner’s model to identify four predictors of Latinx’s mental
health: family cohesion, social networks, acculturative stress, and discrimination. The next
sections explore these predictors.
24

Four Predictors of Latinx Mental Health
Family cohesion, social networks, and acculturative stress emerged as Latinx mental
health predictors, which fit into Bronfenbrenner’s microsystem strata (Badiee & Andrade, 2018).
Another predictor was racial stressors or discrimination, which form part of the macrosystem, the
outermost layer of broad cultural characteristics (Badiee & Andrade, 2018; Byrd & McKinney,
2012; Eriksson et al., 2018). These characteristics encompass the four major predictors of Latinx
mental health (Badiee & Andrade, 2018; Eriksson et al., 2018). Figure 2 highlights these most
prevalent mental health predictors under Bronfenbrenner’s model (Michaels et al., 2022).

Figure 2
Illustration of Ecological Systems Theory as a Conceptual Framework

Note. Adapted from Mental health and well-being ecological model by C. Michaels, L. Blake, A.
Lynn, T. Greylord, & S. Benning, 2022, Minnesota Department of Health.
(https://mch.umn.edu/resources/mhecomodel/Michaels et al., 2022)
25

As the visual representation demonstrates, the problem of practice touches on all of
Bronfenbrenner’s diverse strata. However, this study focuses on the four terms in bold, located in
the micro and macrosystem, as the items to be directly measured because the literature has
identified them as the leading predictors of Latinx mental health (Badiee & Andrade, 2018;
Eriksson et al., 2018). The importance of focusing on these predictors lies in that they converge
with established cultural factors presented in the literature on Latinx mental health service
utilization.
Related to these predictors, researchers have also highlighted other cultural factors that
shape Latinxs’ perspective on mental health (Benuto & Leany, 2017; Benuto et al., 2019;
Bledsoe, 2008; Enriquez, 2017; Menendez et al., 2019; Sánchez et al., 2014). The next section
will describe the interrelatedness of the four key predictors to five specific Latinx cultural
elements associated with psychological well-being. The five factors are stigma (a set of negative
beliefs based on a certain characteristic), familismo (ideology prioritizing loyalty to a family),
religiosity (the importance of religion within the realm of emotional well-being), language
barriers (challenges associated with English as a second language), and discrimination
(differential treatment due to perceived differences; Ayón et al., 2010; Choi et al., 2019;
DeFreitas et al., 2018; Dillon et al., 2012; Enriquez, 2017; Eriksson et al., 2018; Leong et al.,
2013; Menendez et al., 2019; Sánchez et al., 2014). Moreover, this section will also provide
context for the relationship between cultural factors, academic performance, and mental health
literacy, which all influence Latinx college students’ graduation rates. This review focuses
specifically on cultural barriers related to mental health because research indicates that these
barriers have a greater impact on access to mental health resources among the Latinx population
26

than external factors like socioeconomic status, geographical distribution, and access to
insurance (Benuto & Leany, 2017; Enriquez, 2017; Menendez et al., 2019)
The Convergence of the Predictors and Cultural Values on Latinx Mental Health
This section will examine the convergence of family cohesion, social network,
acculturative stress, and discrimination with five Latinx cultural values influencing mental health
service utilization: stigma, familismo, religiosity, language barriers, and racism (Badiee &
Andrade, 2018; Eriksson et al., 2018). The study will also provide context for why Latinx
cultural characteristics are considered barriers to mental health services utilization.
Understanding Certain Latinx Cultural Values As Barriers to Mental Health Service
Utilization
Despite being the largest and fastest-growing minority group in the United States, Latinx
undergraduates’ behavioral health needs are often unmet (Benuto et al., 2019; Tran et al., 2014;
U.S. Census Bureau, 2015). Generally speaking, the literature highlights that Latinxs, as a
population, are at an increased risk of developing behavioral health issues and having decreased
access to services because of psychosocial and economic disparities (Benuto et al., 2019; Bridges
et al., 2014; Cho et al., 2014; Ramos Cortés et al., 2017). This section will explore the barriers to
mental health service utilization for Latinxs.
Social-psychological and economic factors associated with mental wellness can be
divided into internal and external barriers (Benuto & Leany, 2017). External barriers include
geographical location (Benuto & Leany, 2017), limited transportation (Cabassa et al., 2010), and
lack of health insurance (Benuto & Leany, 2017; Benuto & O’Donohue, 2016; Cabassa et al.,
2010; Falgas et al., 2017). External barriers partly explain disparities in behavioral health
services because they are primarily related to economic status and not culturally situated
27

(Bridges et al., 2014; Pickett & Wilkinson, 2015; Syed et al., 2013). Conversely, internal barriers
consist of attitudes and beliefs directly informed by cultural values.
Although mental illness is prevalent in all cultures, Latinxs are culturally less inclined to
engage in mental health services because they face more cultural inhibitors than other ethnic
groups (Benuto & Leany, 2017; Benuto & O’Donohue, 2016; Enriquez, 2017). Cultural barriers
include stigma, mental health literacy, acculturation, and the lack of culturally relevant services
in their communities (Altweck et al., 2015; Pérez-Flores & Cabassa, 2021; U.S. Department of
Health and Human Services, 2016).
Understanding the role of the Latinx culture in mental health services utilization in the
United States requires understanding that cultural differences can affect attitudes regarding
mental health (Benuto & Leany, 2017). Group values, harmonious interpersonal relationships,
deference to authority, obedience to relatives, and an emphasis on the present moment shape
some aspects of the Latinx culture (Bledsoe, 2008). One study found that cultural beliefs and
values about mental health are the primary barriers to accessing mental health services,
outweighing logistical barriers like transportation and health insurance (Menendez et al., 2019).
Accordingly, the cultural elements affecting perceptions of mental health service utilization
under the Latinx worldview must be contextualized under Eriksson et al.’s (2018) four key
mental health predictors. Toward that end, Table 1 depicts the interrelatedness between certain
cultural elements and Eriksson et al.’s (2018) four predictors. The following sections will
explore that interrelatedness.

28

Table 1
Cultural Values and Predictors
Mental health predictor Latinx cultural elements
associated with mental health
Description of the relationship
between them
Family cohesion Familismo
Stigma
Family cohesion and familismo
will be used interrelatedly
throughout the study as the
importance of having strong
emotional bonds with family
members is a cultural
characteristic and predictor of
mental health.
Social Networks Religiosity
Familismo
Stigma
The rich social fabric of the
Latinx population includes
relationships centered family
and, in some cases, religion.
Acculturative stress Language barriers
Stigma
Acculturative stress includes
language as a significant barrier
to mental health service
utilization. Two other emerging
barriers related to acculturation
are educational achievement
and mental health literacy.
Discrimination Stigma
Racism
Discrimination as a predictor
encompasses societal,
intrapersonal, and self-stigma,
as well as racism.

The Overarching Role of Stigma
As shown in Table 1, stigma is a cultural variable encompassing all aspects of Latinxs’
psychological well-being because it can become a hindrance to receiving support, mental
healthcare, or being receptive to any wellness intervention (Benuto & Leany, 2017; Benuto et al.,
2019; DeFreitas et al., 2018). Mental health stigma “occurs when people have negative thoughts
and beliefs of those with mental health illnesses or mental health treatment” (DeFreitas et al.,
2018, p. 1). Mental health stigma is particularly relevant to Latinx undergraduate students
29

because they may display higher levels of stigma toward those with mental illness and its
relevant interventions (Brown et al., 2010; Corrigan & Watson, 2007; DeFreitas et al., 2018).
The level of stigma in a social context or environment may influence how receptive
Latinx students may be to concepts of mental wellness, therapy, and other mental health
initiatives (Benuto & Leany, 2017; Benuto et al., 2019; Casas et al., 2020; NAMI, 2022; Sánchez
et al., 2014). The American Counseling Association (2014) reported that students with stigma-
centered counseling issues feared educational leaders might use them as negative examples
(Ezarik, 2021). One study reported that the possibility of devaluation of the self in the eyes of
others was a major source of anxiety among students who worried about what their peers thought
when they entered the college counseling center (ASCA, 2019). Other sources of anxiety were
the perception that counseling was for emotionally fragile students or that they were self-
sufficient enough to manage their problems and did not need any interventions (ASCA, 2019).
Lastly, students reported stigma made them avoid discussing personal problems and avoid
knowledge about counseling services (ASCA, 2019; Kamunyu et al., 2016).
Stigma enshrouds all the factors related to mental health under the Latinx worldview
(DeFreitas, 2018). Identifying its role among the four key predictors and cultural elements is
especially important because these beliefs have life-altering implications on Latinx employment,
social mobility, housing, mental health service utilization, income, and educational achievement
(Bledsoe, 2008; Casas et al., 2020; DeFreitas et al., 2018; Moll & Ruiz, 2002).
Family Cohesion and Familismo
Family cohesion, or family members’ emotional bonds with each other, is considered a
protective factor against psychological distress and internalizing discrimination (Ayón et al.,
2010; Badiee & Andrade, 2018; Dillon et al., 2012; Eriksson et al., 2018; Leong et al., 2013).
30

Researchers found that family cohesion was positively associated with psychological outcomes
among Latinx college students (Badiee & Andrade, 2018; Dennis et al., 2010; Eriksson et al.,
2018). On the other hand, weak family bonds were strong indicators of depression (Badiee &
Andrade, 2018; Dillon et al., 2012; Eriksson et al., 2018).
Culturally speaking, familismo, or familism, is a trait often found in Latinx cultures where
a “higher emphasis is placed on the family unit in terms of respect, support, obligation, and
reference” (Valdivieso-Mora et al., 2016, p. 4). Family roles, responsibilities, and support when
discussing emotional problems with loved ones and friends are cultural factors serving as either
mental health utilization barriers or promoters (Bledsoe 2008). Latinx families are socialized to
exhibit strong attachment, loyalty, deference, and obedience to revered relatives (Azpeitia &
Bacio, 2022; Bledsoe, 2008; Calzada et al., 2010; Marin & Marin, 1991; Pope Salerno, 2019).
Consequently, a Latinx undergraduate’s family may influence their perceptions of mental health
by encouraging or deterring professional treatment (Mitchell, 1989; Percival, 2022; Villatoro et
al., 2014; Woodward et al., 1992; Zhou et al., 2021).
Additionally, family cohesion is a vital component of social networks (Lois, 2022;
Villatoro, 2014). A family unit’s level of cohesion can be a key indicator of how receptive or
reluctant an individual may be to building outsider relationships that could influence their
emotional well-being and life choices (Menendez et al., 2019; Sánchez et al., 2014).
Social Networks and Religiosity
In the same way that family cohesion is vital for Latinx students’ well-being, social
networks are essential in their psychological support system (Ornelas et al., 2009). Among
Latinxs, social networks consist of informal relationships (friends, professors, coaches, mentors,
religious leaders, and organizations) that provide emotional, monetary, and informational
31

assistance (Badiee & Andrade, 2018; Eriksson et al., 2018; Ornelas et al., 2009). For Latinx
undergraduates, social networks help protect against psychological disorders by fostering a sense
of community and support (Badiee & Andrade, 2018; Eriksson et al., 2018; Leong et al., 2013).
Additionally, according to Payton et al. (2012), social network enhancement can increase Latinx
college student participation in wellness initiatives. Therefore, when serving these students, a
network of professors, coaches, religious leaders, student services staffers, program directors,
and counselors can serve as student wellness support leaders that guide students toward better
mental health (Blaisdell et al., 2021).
Moreover, another of these relationships that could influence an individual’s sense of
well-being is religion (Choi et al., 2019; Krys et al., 2022). Among the most significant factors in
some aspects of Latinx culture is an individual’s relationship with religion and religiosity (Choi
et al., 2019; Krys et al., 2022). Religiosity can be defined as adherence to organized beliefs that
reinforce the relationship between our worldview and morality (Jaramillo et al., 2022;
Pargament, 2001; Villani et al., 2019). Under religiosity, religious values are synchronized in a
culture, and psychological issues tend to be culturally defined as a spiritual ailment among the
Latinx faith-based communities rather than an “illness” (Caplan, 2019, p. 8). In this sense, it is
important to understand the role of religiosity within the social network context of the Latinx
perspective. Many Latinxs may find comfort and community care in religion because religious
leaders and congregation members may provide emotional support and relief from distressing
circumstances and emotions (Jagoo, 2022; Sánchez et al., 2014). Also, some Latinxs in the
United States value their social networks within religious settings as effective ways of treating
depression, emotional distress, and inner turmoil (Caplan, 2019; Dalencour et al., 2017; Moreno
& Cardemil, 2013).
32

Acculturative Stress
Despite Latinxs’ robust social relationships, acculturative stress can damage their
psychological wellness and academic achievement (Eriksson et al., 2018; Eisenberg et al., 2009;
White, 2016). This section will first describe acculturative stress and how it impacts mental
health among Latinx college students. Then, this section will provide details on language,
education, and mental health literacy as markers of acculturation and acculturative stress.
“Acculturation is the process by which a culture adopts the customs and ideas of another
culture. It is a process of learning and adopting the values, behaviors, and traditions of another
group or society” (Nickerson, 2022, para.1). Acculturative stress refers to the negative aspects of
assimilating to a dominant culture, such as language difficulties and perceived cultural
incompatibilities (Eriksson et al., 2018; Falgas et al., 2017; Smokowski & Bacallao, 2006).
Latinxs whose second language is English report higher levels of anxiety and depressive
symptoms, which are positively related to acculturative stress (Leong et al., 2013). Also, studies
have found that acculturative stress is positively associated with body image issues and
depressive symptoms (Castillo et al., 2015; Menon & Harter, 2012). Furthermore, a study at a
university with primarily Latinx students demonstrated the negative effects of acculturative
stress on well-being, specifically in terms of anxiety, depression, and self-esteem (Buchanan &
Smokowski, 2009; Rodriguez et al., 2003; Zeiders et al., 2015).
Additionally, research suggests that greater acculturation into the host country leads
Latinxs to perceive less stigma, and as a consequence, they are more willing to seek mental
health treatment (Cheng et al., 2013; Cheng et al., 2015; DeFreitas et al., 2018; Sánchez et al.,
2014). This reduction in stigma may be due to acquiring knowledge of disorders while becoming
more familiar with American culture (DeFreitas et al., 2018).
33

Part of becoming more familiar with another culture involves learning a new language
and earning a post-secondary degree in the host country, which could lead to more mental health
literacy (Cavazos Vela et al., 2014; Miles et al., 2020; Moní et al., 2018; Najera, 1997). Overall,
Latinx students’ acculturative stress frames how they perceive learning a new language and their
educational achievement, and, as a consequence, these two factors influence their mental health
literacy. The next section will cover this in detail.
Language
For some Latinx higher education students, a lack of a strong command of the English
language hinders their access to mental health resources (Menendez et al., 2019). Students who
are not fluent in English may feel overwhelmed with the process of seeking therapy or emotional
support in their second language (Barthelemy, 2022; Cheung, 1991; Colon, 1996; Hawkins et al.,
2020; Kouyoumdijan et al., 2003). In addition, the scarcity of Latinx therapists exacerbates
hesitation to seek psychological counseling because students may fear not being understood
(Hawkins et al., 2020; Menendez et al., 2019). The American Psychological Association (APA)
reported that only 5% of psychologists identify as Latinx, although this demographic makes up
20% of the U.S. population (Dingfelder, 2005; Lin et al., 2018). The lack of culturally and
linguistically competent mental health providers also hinders treatment for psychological
disorders (Del Pilar, 2008; Dingfelder, 2005; Falgas-Bague et al., 2019; Kouyoumdjian et al.,
2003).
Language can also be a barrier to attending and graduating from a higher education
institution and increasing one’s mental health literacy. Most college psychologists do not speak
Spanish and are not sufficiently educated in Latinx culture, leading to misinterpretations,
frustrations, and increased acculturative stress (DeFreitas et al., 2018; Dingfelder, 2005).
34

Education and Mental Health Literacy
A vast amount of research has examined the disparities among Latinxs when it comes to
mental health care (Aguilar-Gaxiola et al., 2002; Alegría et al., 2007; Cabassa et al., 2006;
Cardemil et al., 2007; Johnson et al., 2004; Lopez, 2002; Vega & Lopez, 2001). Poor educational
achievement and low mental health literacy have emerged as two significant barriers within the
Latinx population (Pérez-Flores & Cabassa, 2021).
Low academic achievement is the most prevalent cause of Latinx marginalization (Arbelo
Marrero, 2016; Berkel et al., 2010; Casas et al., 2005; Gonzalez-Adamski, 2021). Research
shows that many Latinx high school students in the United States strive for a college education,
yet only 39% of them enroll in college and, once there, significantly fall behind in terms of
academic performance and graduation rates (de Brey et al., 2019; Flores et al., 2008; Manzano-
Sánchez et al., 2019; McWhirter et al., 2014; McWhirter et al., 2013; Sáenz & Ponjuan, 2012).
Moreover, Latinx students’ university dropout rate exceeds 50% (U.S. Census Bureau, 2008).
Recent data suggests that less than 57% of these students complete college, compared to 81% of
their non-Latinx White peers (Gramlich, 2020; Pew Hispanic Center, 2016). Overall, only 7.9%
of Latinxs hold bachelor’s degrees in the United States (National Center for Education Statistics
& U.S. Department of Education, 2010). This limited educational achievement leads to lower
socioeconomic mobility and lower rates of mental health literacy (Garcia & Weiss, 2017; Moní
et al., 2018).
Poor knowledge of mental health disorders is particularly problematic because the lack of
knowledge about a mental illness often is related to individuals experiencing fear or anxiety
about mental illness (DeFreitas et al., 2018; Pinto & Bailey Jones, 2020). Lower mental health
literacy increases stigma and decreases behavioral service utilization (Tambling et al., 2021). In
35

sum, a lack of education can contribute to less mental health literacy and, as a result, increased
acculturative stress (Jorm, 2015; Miles et al., 2020; Tambling et al., 2021).
Discrimination
Finally, discrimination is the fourth predictor of psychological distress among Latinx
(Eriksson et al., 2018). Ojeda et al. (2012) defined discrimination as the perception of differential
treatment due to cultural background. Latinxs report perceiving more discriminatory treatment
than other racial/ethnic groups (Pérez et al., 2008). External discriminatory behavior from
distinct members of society and internal discriminatory attitudes within the Latinx community
regarding mental health increase their stress (Banasik, 2022). Data show that Latinx college
students experience more discriminatory stress than their Asian American counterparts and, as a
result, are more likely to suffer from anxiety and depression (Hwang & Goto, 2009; Leong et al.,
2013).
Banasik (2022) found that Latinx communities are regularly subjected to racism.
Similarly, according to FBI data, hate crimes against Latinx victims increased by 24% from 2016
to 2017 (Banasik, 2022; FBI, 2018). Moreover, although racism does not always manifest itself
in overt or violent ways, microaggressions may adversely affect mental health, educational
outcomes, and self-esteem (Aguirre-Molina et al., 2001; Anderson, 2012; Anderson & Finch,
2017; Banasik, 2022; Benton & Seide, 2022; Berkel et al., 2010; Brondolo et al., 2008; Finch et
al., 2000; Flores et al., 2008). A 2017 study found that acculturated Latinxs were more likely to
experience physical and emotional stress from perceived racial microaggressions than other
minority groups (Banasik, 2022; Freeman Anderson, 2017). Consequently, discrimination could
contribute to more serious mental health disorders, such as depression, anxiety, and suicidality
(Banasik, 2022).
36

Culturally speaking, Latinxs can also experience discrimination and stigma within their
communities. Individuals with depressive symptoms could be seen as mentally ill (Rastogi et al.,
2012). Moreover, individuals diagnosed with a psychological disorder may be perceived as a
threat to the community (Brennan et al., 2005; DeFreitas et al., 2015; Ginieniewicz & McKenzie,
2013). Additionally, Latinx are more likely to believe they will not recover from their
psychological distress and that their mental illness is their own fault (DeFreitas et al., 2018; Eno
Louden et al., 2023; Watson et al., 2006). Cultural stigma contributes to shame in discussing
mental health issues with counselors, family, religious figures, or members of their extended
social network (Kogan, 2004; Menendez et al., 2019). Furthermore, visiting a therapist or
clinician may be seen as an admission of weakness, instability, or insanity (Bledsoe, 2008;
Echeverry, 1997).
To recap, although mental illness is prevalent in all cultures, Latinx students are less
inclined than other ethnic groups to engage in mental health care services due to culturally
situated factors that closely align with the four key mental health predictors derived from the
work of Eriksson et al. (2018). Even though these students face other socioeconomic barriers to
mental health service utilization, cultural barriers bear more weight in mental healthcare service
utilization (Menendez et al., 2019). However, the literature review revealed a gap in past
research regarding the relationship between Latinx undergraduate students’ mental wellness and
college graduation rates. An examination of prior research in the next section will help fill the
knowledge gap.
Past Research Exploring Latinx Mental Health and Graduation Rates
Latinx students, in particular, are underrepresented in the literature when studying the
effects of on-campus mental health interventions on student graduation rates. As seen previously,
37

Eriksson et al.’s systematic review (2018) evaluated mental health outcomes in the Latinx
population using Bronfenbrenner’s work as a conceptual framework. However, that study did not
examine Latinx college students’ educational outcomes. Other studies examined the correlation
between psychological well-being and graduation rates and the role of a culture of caring and
cultural adaptations in an academic setting in influencing graduation rates. Those will be
discussed below.
No research has sufficiently investigated the mental health and academic outcomes of
Latinx undergraduate students through the lens of Bronfenbrenner’s ecological systems model.
However, some models, such as international tools for measuring positive mental health, have
been designed to investigate the systemic impact of mental health programs and retention, as
well as promising practices for future use (Bailey et al., 2018; Johnson, 2001). These are the
Psychological General Well-being Index, Personal Wellbeing Index, WHO-5 Well-Being Index,
The Warwick-Edinburgh Mental Well-being Scale, and the Mental Health Continuum Short
Form (Bailey et al., 2018; Johnson, 2001). The review of research will review the correlation
between mental wellness and increased graduation rates, the impact of a culture of caring on
graduation rates, and the effects of culturally sensitive adaptations on Latinx student graduation.
The research on the impact of these interventions on graduation rates sheds light on the
most appropriate mental health best practices that could be applied when guiding Latinx students
toward graduation. One of the best practices explored throughout this review is increasing
representation in both language and ethnicity among educational leaders, specifically by hiring
more Spanish-speaking and Latinx student support staff (Lorenzo, 2017; Wintemute, 2022).
Another is incorporating culturally sensitive support interventions and adaptations, such as
interventions targeting stigma and training key student support personnel on specific idioms
38

Latinxs could use when expressing themselves emotionally (Casas et al., 2020; Feldman et al.,
2016; Green et al., 2006; Hinton et al., 2011; Hovey et al., 2014; Lorenzo, 2017; Pappamihiel &
Moreno, 2011). Also, instilling a culture of caring for Latinx students’ wellness through apps,
telehealth opportunities, communication channels, and relationships between key staff will be
reviewed as best practices that could benefit these students (Aguayo et al., 2011; Banasik, 2022;
Benuto et al., 2019; Benuto & Leany, 2017).
Furthermore, although there is compelling data on Latinx mental health, culturally
sensitive interventions, and the power of instilling a culture of caring in an academic setting to
improve retention, no studies simultaneously evaluate all of these variables (Arria et al., 2013;
Carey et al., 2018; Cervantes et al., 1991; Rodriguez et al., 2000). Because no other studies have
examined the impact of culturally situated adaptations on Latinx university students’ mental
health and graduation rates, the emphasis here is on the lack of measurement methods meant to
study this precise problem of practice because it is lacking in the literature. Therefore, an
alternative evaluation method will be proposed. This alternative evaluation method is based on
the Positive Mental Health Surveillance Indicator Framework, which uses process and outcome
evaluation methodologies to examine the impact of mental health programs on a specific
population and has been applied consistently with the Ontario Center of Excellence for Child and
Youth Mental Health (Bailey et al., 2018).
The Correlation Between Psychological Well-being and Graduation Rates
When young adults pursuing an undergraduate degree struggle with mental health issues,
they often have attendance problems, difficulty completing assignments, increased interpersonal
conflicts, and low academic performance and retention (Bas, 2021). Several studies demonstrate
the correlation between mental health and academic achievement across higher education
39

settings (Bas, 2021; Bostani et al., 2014; Neal, 2022; Ketchen Lipson et al., 2019). For instance,
Bas’s (2021) meta-analysis examined the relationship between mental health and academic
achievement in young adults and confirmed a positive relationship between mental health and
academic achievement, which increases graduation rates. Similarly, the 2020 Healthy Minds
Study, which examined the relationship between student mental health and academic outcomes
such as GPA and retention, found that students with mental health problems were twice as likely
to leave an institution without graduating (Eisenberg et al., 2011; Ketchen Lipson et al., 2019).
Research also found that psychological health is related to young adults’ academic
achievement, future employment, and long-term income (Bas, 2021; Eisenberg et al., 2009). In
this regard, higher education institutions play a key role in providing students with appropriate
interventions to improve academic achievement, graduation rates, overall life satisfaction, and
socioeconomic outcomes (Bas, 2021; Dunn et al., 2015; Fleming et al., 2005).
Once again, it is worth mentioning that there is a gap in past research when attempting to
examine Latinx undergraduate students’ mental wellness and its relationship to their graduation
rates. Studies of other demographics allude to the correlation between mental health and
increased academic performance, but literature on these students is lacking (Eisenberg et al.,
2011, 2009, 2007).
The Culture of Caring and Graduation Rates
The ongoing mental health crisis facing all young college students will likely decrease
graduation rates and student engagement (Eisenberg et al., 2011; Lipson et al., 2022; Roberts,
2021). Developing a sense of being cared for is central to college students’ success, particularly
in retaining students considered at risk of non-completion (O’Keeffe, 2013). To address this risk,
higher education institutions must adopt a culture of caring (Noddings, 2002).
40

The premise behind the culture of caring stems from the position that “all people want to
be cared for,” which forms a “fundamental aspect of education” (Noddings, 2002, p. 11). The
culture of caring in an academic setting calls for educators, university support staff, faculty, and
administrators to embrace caring as a commitment to a student’s academic and personal learning
(Cavanagh et al., 2012; Stone, 2016; Valenzuela, 2002). The concept of a culture of caring is
pivotal among young Latinx adults attending college, especially since it is a time of significant
struggles and intense challenges (Ibarra-Mejia et al., 2022; Rodriguez et al., 2000; UNIDOS US,
2020). Results from the American College Health Association’s Spring 2017 National College
Health Assessment indicated that 60% of students experienced overwhelming anxiety, 40%
described themselves as too depressed to function, and 10% had severe thoughts of suicide.
These struggles significantly impact students’ lives, including their academic performance.
Although this data pertains to the general college student population, research from Eisenberg et
al. (2021), Ketchen Lipson (2019), and Lipson et al. (2022) found that these outcomes are
exacerbated among Latinx students (E). When they do not address mental health concerns, these
students encounter stressors that place them at higher risk of developing depression and limit
academic retention and school satisfaction (Lardier et al., 2020). Fostering a sense of belonging
correlates with positive mental health, especially when it provides integration into a learning
community and allows individuals to feel valued (Lardier et al., 2020; Stebleton et al., 2014).
According to Blum et al. (2002), young adults benefit from having a stable, trustworthy,
non-familial adult on whom they can rely for emotional support. External mentorship can
contribute to growth in all areas of a person’s life, in part because mentorship is a combination of
multiple processes. These processes include investments of thought, time, and effort that allow
people to expand their capabilities in all capacities of their lives (Burrell et al., 2001). Thus, a
41

positive educational environment enables students to feel cared for by ensuring that they feel
supported to perform their best and provide the necessary guidance to graduate (Heisserer &
Parette, 2002; Pearson, 2012).
Moreover, McLean et al. (1999) stated that students’ lack of connectedness to an
academic institution and its people is a decisive factor in their withdrawal from school. In an
academic institution, having a relationship with just one key individual can create a sense of
connection and care, and this relationship can significantly influence a student’s decision to
remain in college (Chickering & Gamson, 2000; Glennen et al., 1996; Heisserer & Parette 2002).
Latinx student attrition can be prevented and graduation rates increased by ensuring that students
at risk of dropping out feel like the institution cares about them (Bray, 1985; Braxton et al., 1995;
Heisserer & Parette, 2002; Holmes, 2000; Tinto, 2022). Graham-Smith and Lafayette (2004)
found that students at Baylor University indicated that “caring staff members and a safe
environment were … the most desirable factors at the university” (p. 1). As the previous section
noted, although the power of fostering a culture of caring in an academic environment has been
studied, the literature is outdated and has not been applied specifically to Latinx undergraduates.
Cultural Adaptations and Graduation Rates
Culturally responsive (also called culturally sensitive, culturally compatible, culturally
congruent and/or culturally relevant) pedagogy (CRP) has been a staple of elementary, middle,
and high school education (Pappamihiel & Moreno, 2011). This pedagogy emphasizes the need
for educational institutions to incorporate cultural adaptations in academics and psychosocial
learning, which include university mental wellness supports (Banks & McGee, 2020; Cummins,
1996; Gay 1995, 2002, 2018; Ladson-Billings, 1995; Nieto & Bode, 2007; Pappamihiel &
Moreno, 2011; Valenzuela, 1999). This review will focus on how CRP links directly to student
42

mental health and could be used as a way to guide Latinx students toward graduation
(Pappamihiel & Moreno, 2011).
Culturally responsive, university-driven relationships help increase Latinx undergraduate
student graduation rates (Myers, 2003; Pappamihiel & Moreno, 2011). Traditionally, “university
retention rates have been increased through such student-centered programs as living/learning
communities, first-year interest groups, tutoring, and mentoring” (Pappamihiel & Moreno, 2011,
p. 340). These models, however, “merely incorporate minorities into dominant cultural frames of
reference, which are transmitted within dominant cultural forms, leaving invisible cultural
hierarchies intact” (Tierney, 1992, p. 611). Rather than constantly placing minority students in
the position of adjusting to the predominant university culture, CRP allows universities to adapt
and accommodate Latinx students (Carter, 2006; Pappamihiel & Moreno, 2011).
According to Myers (2003), higher education institutions that retain and graduate
minority students at higher rates address their well-being and academic needs (Pappamihiel &
Moreno, 2011). Lynch and Engle (2010) argued that early, culturally focused interventions can
help Latinx undergraduate students stay in school; if educators are actively engaged in CRP,
struggling students may be more inclined to ask them for help or turn to on-campus facilities like
counseling centers and tutoring services (Pappamihiel & Moreno, 2011).
Since uninvolved students are unlikely to seek university-wide services, anyone affiliated
with the university who comes into contact with them must become the first line of defense
(Pappamihiel & Moreno, 2011). Tinto & Russo (1994) wrote that students who develop
relationships with their professors, advisors, counselors, or club leaders are more likely to obtain
their degrees (Pappamihiel & Moreno, 2011). According to Tinto (2022), students are more
likely to persist in classes when they are in an educational environment that makes them feel
43

cared for by student support staff and united in the belief that they can succeed (Pappamihiel &
Moreno, 2011).
Furthermore, Rendó n et al. (2000) argued that Latinx students’ dropout rates could be
mitigated and graduation rates increased by improving student integration on campus. Despite
this, campuswide programs cannot fully increase Latinx graduation rates because dropout-prone
students are less engaged and less likely to access these interventions (Pappamihiel & Moreno,
2011). It is most effective to engage students in the classroom or any university-wide area where
they interact with educational leaders and student support staff who can validate their cultural
identities (Pappamihiel & Moreno, 2011).
Overall, the literature notes that CRP could address Latinx students’ low graduation rates
at traditionally White-dominated colleges and universities (Lynch & Engle, 2010; Myers, 2003;
Tinto, 2022; Pappamihiel & Moreno, 2011). Colleges and universities that retain and graduate
these students usually maintain close personal relationships with them (Pappamihiel & Moreno,
2011). Past research indicates CRP could be a useful framework for university and student
support staff to apply when engaging with these students, as all faculty members, staff members,
and educational leaders are responsible for helping students earn their degrees (Pappamihiel &
Moreno, 2011). Lynch and Engle (2010) stated that a successful college believes every student
can graduate.
In summary, Latinx undergraduate students are underrepresented in the literature when
examining the relationship between mental health interventions and graduation rates at 4-year
higher education institutions. Consequently, the review of past research covers studies that
evaluated the correlation between mental health and graduation rates, the relationship between
44

instilling a culture of caring at college and graduation rates, and increased student engagement
and graduation rates when CRP is integrated into higher education.
University ’s Lack of Success in Addressing Student Mental Health Issues
Within a university, Latinx students face numerous challenges that may lower their
graduation rates (Parker et al., 2021), as explained in previous sections. As detailed in previous
sections, these students may face several challenges while pursuing undergraduate degrees,
including language barriers, acculturative stress, and perceived discrimination (Bacallao &
Smokowski, 2009; Gil & Vega, 1996; James, 1997; Koelsch, 2006; National Center for
Education Statistics, 2019; National Center for Education Statistics & U.S. Department of
Education, 2010; Pagan-Rivera, 2014; Parker et al., 2021; Sibley & Brabeck, 2017; Smokowski
& Bacallao, 2007; Roche & Kuperminc, 2012). Collectively, these experiences can harm
students’ academic performance and career and social development (Anctil et al., 2012; Parker et
al., 2021). The following sections will review how universities’ efforts to aid in student mental
health have not produced the expected outcomes. This portion of the review will cover the
current state of university mental health services and then explore the hurdles that need to be
overcome to better support Latinx undergraduate students’ mental health.
Current Status of University-Wide Mental Health Services
Despite universities offering mental health counseling and student support services,
students do not use them regularly (Inside Higher Ed, 2021). Counseling centers may be
available to struggling students, but students may not take advantage of them (Eisenberg et al.,
2011; Lipson et al., 2022). Although university administrators allocate mental health resources
for students, they result in ineffective mental health initiatives (Del Pilar, 2008; Osher et al.,
2014; Poirier et al., 2015). A longitudinal study analyzing student mental health data from 1975
45

to 2020 found that between 37% to 80% of university students experiencing mental health issues
do not receive treatment (Blanco et al., 2008; Eisenberg et al., 2011; Eisenberg et al., 2007;
Hernández-Torrano et al., 2020; Lipson et al., 2019). Furthermore, current strategies focus on
building treatment awareness yet fail to educate students on practical mental wellness skills
(Eisenberg et al., 2011; Lipson et al., 2022). According to a survey of 765 college students, 33%
accessed mental health resources through a college website and 27% through their student health
center (National Alliance for Mental Illness [NAMI], 2012). Collectively, 55% of students
ranked this information as somewhat helpful, not very helpful, or not at all helpful (National
Alliance for Mental Illness [NAMI], 2012). In sum, the previous studies indicate current efforts
do not help students navigate academic pressures alongside emotional stressors.
Moreover, mental health programs fail to address the role of stress and adversity in
mental well-being. The landmark adverse childhood experiences study found that two-thirds of
the 17,000 respondents experienced adverse/stressful life events shown to have a causative link
to mental illness. Relating this finding to Latinx students, one study reported that 63% of them
experience one adverse life event, and 27% grow up in poverty (Chapman et al., 2004; CDC,
2021; Cheng & Thomson, 2021; Felitti et al., 1998). Nonetheless, universities continue to focus
on treating mental illness and miss the opportunity to promote preventative stress management
education (Chapman et al., 2004).
Further, although higher education leaders implemented numerous mental health
programs, they have systematically neglected to design effective mental wellness initiatives
(Eisenberg et al., 2011; Eisenberg et al., 2009: Lipson et al., 2022). In the latest survey by Inside
Higher Ed and College Pulse (2022), 65% of students rated their mental health as fair or poor. In
addition, 63% rate their college’s response to student mental health and wellness services as C or
46

lower. Only 15% sought counseling during the prior year despite strong campus efforts,
including virtual operations, mental health guides at home, asynchronous content such as videos
and workshops, and support groups (Inside Higher Ed, 2021). Although the survey centers on the
experiences of the general student population (Eisenberg et al., 2011; Lipson et al., 2022), their
answers could translate to Latinx college students as well because the data has shown this
demographic is more susceptible to stress that may influence their mental health and,
consequently, their graduation rates.
Perceived Lack of Caring
As mentioned in the prior paragraph, students ranked their mental health as less than
optimal in an Inside Higher Ed study (2021).
One student survey respondent told Inside Higher Ed that mental health is
Just talk. … No one actively reaches out and makes sure students are doing OK, and no
one takes action to address the root causes of the issues. No matter how anxious or
depressed you are, that paper is still due on Friday. (p. 10)
Because students may seek guidance, social support, and mental health advice from other
university staff members (e.g., teachers, writing center staff, coaches, and academic counselors),
it is important to engage them on a personal level in the university ecosystem (Wei, 2022; Wei
Kai, 2021). Latinx undergraduate students may sometimes perceive the university views them as
just a number and that they and their emotional well-being do not belong in a higher education
setting may increase their distress and place them at an increased risk of dropping out of college
(Garcia, 2017).
47

Mistrust
Latinx students may perceive their school counselors and support staff as biased against
them based on their ethnicity, which could lead to mistrust of university resources and personnel
(Chávez-Reyes, 2010; Malott, 2010; Parker et al., 2021). Even though college counseling centers
are seeing a spike in student mental health issues and are struggling to keep up with demand,
only a small percentage (10% to 15% on average) use counseling services (Ezarik, 2021;
Kamunyu et al., 2016). When exploring the reasons why students shied away from seeking the
already saturated mental health counseling services on campus, studies indicate social mistrust
took second place, with 23% of students agreeing that it is a reason that makes them not seek
counseling (Inside Higher Ed, 2021).
Another reason included the perception that some of the students considered seeking help
from counselors as a waste of time since they have their own ways of resolving problems without
having to trust an outsider, which aligns with Latinx cultural values of using familismo and
religiosity to deal with emotional issues (Inside Higher Ed, 2021).
Current Interventions Not Aligned to Latinx Student Needs
Researchers have found, however, that Latinx students are dissatisfied with the activities
offered by their wellness and academic counselors, and support staff, suggesting there may be a
gap between what is needed and what is provided (Chávez-Reyes, 2010; Malott, 2010; Parker et
al., 2021; Vela-Gude et al., 2009). A study with a statistically significant sample size of 210
young adults found that Latinx students wanted counselors and support staff to guide them about
their GPA, career options, employment opportunities, and funding options outside of college and
use these topics as a platform to check in on their mental wellness (Parker et al., 2021). Students
identified the need for university-affiliated counselors to help minimize personal distractions so
48

they can focus on academics; balance family, cultural, and school responsibilities; and ensure
they are mentally healthy (Parker et al., 2021).
Among the most important things students expressed was their desire to be engaged and
encouraged by their school counselors to succeed in college (Parker et al., 2021). Leaders and
support staff in higher education can draw several conclusions from this study. First, Latinx
students realized that their personal/social and cultural backgrounds affected their academic
performance and desire to graduate (Parker et al., 2021). Second, students in this study expressed
a desire to integrate their cultural and personal/social experiences with their academic and career
success (Parker et al., 2021). Their responses align with the American School Counseling
Association (ASCA, 2004) model, emphasizing school counselors’ role in accompanying
students within the educational, personal/social, and career domains to support student academic
success (including guiding them toward graduation and beyond; American School Counseling
Association, 2004; Parker et al., 2021). Collectively, these studies point to a deep lack of
understanding of the cultural aspects relevant to Latinx undergraduates’ sense of psychological
well-being (Parker et al., 2021).
Confidentiality
Confidentiality is essential since it helps the client trust the privacy of students’
revelations to the mental health counselor and enhances the counseling relationship (American
Counselling Association, 2014; Ezarik, 2021). One study revealed how some counselors
occasionally made students’ issues public, which resulted in disillusionment (American
Counselling Association, 2014; Bond, 2009). Other studies reported that 7% of higher education
students shied away from college counseling (Ezarik, 2021; Inside Higher Ed, 2021; Kamunyu et
al., 2016). Recent research by Arun et al. (2021) and Varma et al. (2022) noted that concerns
49

about confidentiality were among the most common barriers to help-seeking for mental health
issues. These findings corroborate the need for mental health interventions that address
confidentiality and privacy (Arun et al., 2021). Moreover, since stigma is a barrier for Latinx
students, effectively communicating the confidential nature of any mental health initiative will
lead to increased use by all students.
Best Practices Related to Latinx Student Retention and Mental Health Interventions
Although there is a vast array of literature outlining the best practices related to Latinx
student graduation and mental health interventions, this section will outline those that align best
with those that include the concepts of cultural adaptations and methods for fostering an
environment caring for these students’ mental wellness (Cooper et al., 2019; Nelson et al., 2020).
Increased Representation in Ethnicity and Language Among Mental Health Care
Providers
Despite being the largest and fastest-growing minority group in the United States,
Latinxs’ behavioral health needs are often unmet (Benuto et al., 2020; U.S. Census Bureau,
2015; Tran et al., 2014). Latinxs are at an increased risk of developing behavioral health issues
and having decreased access to services because of social and economic disparities (Benuto et
al., 2020; Bridges et al., 2014; Cho et al., 2014; Ramos Cortés et al., 2017).
There are persistent financial hardships, discrimination, institutional marginalization, and
language barriers, not only in their higher education pursuits but in their accessibility to
appropriate mental health services (Ibarra-Mejia et al., 2022; Rodriguez et al., 2000; UNIDOS
US, 2020). The number of Latinxs who perceive a mental health need but do not receive mental
health care services has increased by 63% between 2017 and 2019, while the rate for whites
50

increased by 15% services (Ibarra-Mejia et al., 2022; Rodriguez et al., 2000; UNIDOS US,
2020).
Latinx students may have difficulty communicating with professionals in the
predominantly Caucasian mental health and academic field, which can lead to mistrust,
miscommunication, and misdiagnoses (Carpenter-Song et al., 2010; Lin et al., 2018; Wintemute,
2022). When students are not fluent in English, communicating in a second language can be
uncomfortable, and mental health professionals, counselors, and educational leaders may not be
familiar with culture-bound syndromes, resulting in misunderstandings (Wintemute, 2022).
“Communication is essential to diagnosing and treating mental disorders, so
understanding what patients are expressing is critical” (Lorenzo, 2017, para.7). In counseling
centers and other student support services, bilingual staff members are essential to helping Latinx
students feel understood due to their understanding of cultural nuances and jargon (Lorenzo,
2017).
As well as language barriers, the lack of Latinx representation among psychologists,
counselors, and student support staff may deter students from seeking therapy (Lorenzo, 2017;
Wintemute, 2022). These students may shy away from revealing their emotional and
psychosocial needs to someone who does not understand their cultural background (Lorenzo,
2017). According to the APA, approximately 5% of psychologists in the United States are
Latinx, and less than 1% work in higher education settings (Smith, 2018; Wintemute, 2022).
With a lack of Latinx counselors in higher education, Latinx students may feel less emotionally
safe sharing their stressors because they may fear being stigmatized or misunderstood
(Carothers, 2019).
51

Working through deeply personal issues in therapy is difficult enough without doing so in
a second (or third) language (Wintemute, 2022). In addition to not being able to understand
certain issues unique to the Latinx community, the lack of diversity among mental health
professionals and key staff may also lead to implicit bias, creating further obstacles to receiving
adequate care (Wintemute, 2022). Consequently, one of the best practices universities can
employ when addressing these students’ mental health is to hire mental health professionals from
a similar ethnic background or who speak the same native Spanish language (Wintemute, 2022).
Cultural Adaptations
Cultural humility and competency are essential for any university-affiliated counselor,
educational leader, or student support service staffer (Khan, 2021). A person’s culture plays a
significant role in their mental health and well-being, and lacking knowledge about cultural
nuances may sometimes affect a provider’s ability to provide the most appropriate guidance for
patients (National Alliance on Mental Illness, 2020). When a provider understands a patient’s
culture and needs, he or she will know culturally specific information. As an example, “me duele
el corazón” means “my heart hurts,” but it expresses emotional distress - not physical pain
(Benuto et al., 2019). Culturally sensitive counselors or staff would ask for more information
rather than assuming the issue is solely physical (National Alliance on Mental Illness, 2020).
In addition, cultural adaptations can increase social validity and make treatment seem
more acceptable and relevant to Latinxs by reducing internal barriers to treatment (Benuto et al.,
2019; Cabassa & Baumann, 2013; Castro et al., 2004; Casas et al., 2020; Feldman et al., 2016;
Green et al., 2006; Hinton et al., 2011). Hovey et al. (2014) examined how cultural adaptations
might improve these students’ mental health outcomes in a systematic review of two studies that
used adaptations that appealed to these students’ cultural values. Casas et al. (2020) described
52

how these cultural adaptations increased participant comfort and trust and decreased the stigma
associated with mental health. For instance, Hovey et al. (2014) emphasized validating
participants’ experiences through empathy, warmth, kindness, respect, and personalization,
which closely align with notions of fostering a culture of caring in the university setting, as
discussed by Noddings (2002). Hovey et al.’s (2014) study also demonstrated how culturally
centered interactions could increase comfort and trust between students and educational leaders.
Some of these culturally situated interactions and interventions are described below.
Mental Health Interventions Targeting Stigma
Latinxs tend to ignore mental health conditions rather than discuss them openly due to
stigma (Interian et al., 2010; Lorenzo, 2017). In light of this, universities should collaborate with
mental health professionals to develop interventions (e.g., education, entertainment, and
programs) that address stigma to increase behavioral health services utilization among these
students. A variety of health problems can be improved through entertainment-education (E-E)
digital or offline media campaigns (Benuto et al., 2019; Wakefield et al., 2010).
Researchers at the Columbia University Mailman School of Public Health recently found
that a school-based educational program reduced mental health stigma among Latinx young
adults (DuPont-Reyes et al., 2022). A total of 751 students from 14 Texas schools participated in
the study. Three interventions were randomly assigned to classes: a teacher-led anti-stigma
curriculum, contact with a young adult who described their experience with bipolar disorder, and
materials with anti-stigma messaging (DuPont-Reyes et al., 2022).
The results demonstrated that Latinx young adults reported higher levels of stigma at
baseline than non-Latinx youth, but these disparities were mostly eliminated after receiving the
curriculum and contact interventions (DuPont-Reyes et al., 2022). Specifically, the curriculum
53

interventions were particularly effective in eliminating disparities in stigma among females,
while the contact interventions were most effective among Latinx males (DuPont-Reyes et al.,
2022). As a result of this study, universities can incorporate stigma-reducing components into
their curricula and train counselors and other key support staff on contact intervention to reduce
mental health stigma (DuPont-Reyes et al., 2022).
Instilling a Caring Culture Focused on Well-being
As mental health resources are no longer limited to counseling centers, higher education
institutions must begin to provide Latinx students with services designed to help them reach
graduation and achieve a sense of well-being. Multiple avenues for student support under the
framework of a caring culture will foster better mental health and increase graduation rates
(Ezarik, 2021; Nodding, 2002).
Other higher education institutions are instilling a culture of caring for students’ well-
being that could benefit Latinx students. The Ohio State University developed a wellness app
that allowed over 240,000 students to create wellness plans, challenge their peers with wellness
goals, and access timely content like stress management techniques during finals (Abrams, 2022;
Cappelucci et al., 2019). Johns Hopkins University educational leaders are exploring how to
adapt school policies and procedures to support student wellness (Abrams, 2022). As one
example, they adjusted their leave policy, including how refunds, grades, and health insurance
are handled, so that students could take time off more easily (Abrams, 2022).
Universities must adopt a culture of caring in their communication with students beyond
institutionalized programs and campaigns. Educational leaders do not need to be mental health
experts to guide their students toward better mental health (Hrala, 2022). By educating
professors, student support staff, counselors, and other university-affiliated personnel on how to
54

reach out to students in need and refer them to professionals, Latinx students will feel more
psychologically supported during their college years (Hrala, 2022). Educational leaders can
empower these students toward mental wellness using the V-A-R method of communication
(Active Minds, 2022; Hrala, 2022).
The acronym V-A-R stands for validate, appreciate, refer and was created by the mental
health nonprofit Active Minds (Active Minds, 2022; Hrala, 2022). Using this method,
educational leaders, counselors, and support staff can validate students’ feelings, acknowledge
their courage to speak up and refer them to an appropriate service to help them take beneficial
action (Active Minds, 2022; Hrala, 2022). In the referral stage, leaders can point students to
counseling services without giving concrete advice while making them feel cared for, heard, and
validated (Active Minds, 2022; Hrala, 2022).
Another way to foster a culture of caring and wellness among Latinx students is through
the use of technology and telehealth opportunities. The Latinx community was the most engaged
in telehealth for mental health visits in 2020, adopting online consultations more than any other
ethnicity (Anthem, Inc., 2021; Silva et al., 2021). Further, it has been found that online
communities benefit college students’ mental health, particularly during times of crisis (Griffiths
et al., 2012; Liu & Kong, 2021; Lu et al., 2021; Richards et al., 2014; Salesforce, 2022). Among
2000 student respondents to Salesforce’s annual university student connection report, 30% said
online communities created a sense of connection and caring at their universities, and 25% said
they supported their well-being. More specifically, over 40% of students said they were cared for
and believed their institutions were striving for success when they received personalized
communication messages (Salesforce, 2022).
55

As a whole, the proposed best practices aim to create various avenues for interventions
and connections between all members of the university ecosystem. These avenues aim to guide
Latinx students academically, emotionally, and mentally on a healthy path to graduation.
Approaches to Measurement of Higher Education Efforts to Address Latinx Students ’
Mental Wellness
While there are no sufficient models of measurement of the systemic impact of programs
designed for higher education achievement and mental wellness of Latinx university students
within the United States, there are some promising strategies worth mentioning since universities
measure many student-related factors (Christensen Institute, 2020).
The following section will provide an overview of mental health evaluation methods that
have been applied to young adults on an international scale. In addition, because there are no
previous studies that propose an exact measurement of Latinx undergraduate student mental
health and graduation rates, a proposed mental health program evaluation method will be
provided.
Mental Health Instruments
University students are already tracked for their academic performance, growth over
time, attendance, tuition, fees, and the number of courses (Rienties & Toetenel, 2016). Yet, many
universities fail to use mental health assessments in determining their likelihood of graduating
(Eisenberg et al., 2009). A common assumption in mental health programs is that the absence of
mental illness indicates psychological health (Provincial System Support Program, 2018). In this
view, mental health and mental illness occur separately, never simultaneously (Bailey et al.,
2018; World Health Organization, 2005; Provincial System Support Program, 2018). In reality,
mental health promotion programs exist to improve the mental health and well-being of all
56

participants, regardless of whether they have mental illnesses (Bailey et al., 2018; Provincial
System Support Program, 2018).
Mental health programs are designed to promote and maintain positive mental health
(Long et al., 2021). To measure the effectiveness of mental health programs, positive mental
health indicators must be assessed (Chouinard & Cousins, 2007). The following section presents
an overview of six scales and assessment tools developed by international organizations and
leading mental health professionals. Several tools are available in multiple languages; others
have already been validated with different ethnic groups. However, limited information is
available on how these instruments can be adapted to different cultures (Bailey et al., 2018;
Provincial System Support Program, 2018).
The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was developed by the
National Health Service Scotland, the University of Warwick, and the University of Edinburgh
(Warwick Medical School, 2015). The scale measures feelings and functioning and uses items
framed using positive language (Warwick Medical School b, 2015). The WEMWBS has been
validated with individuals aged 13 to 74 (Chouinard & Cousins, 2007; Health Canada &
Assembly of First Nations, 2015; NHS Health Scotland et al., 2008; Warwick Medical School b,
2015).
Another instrument is the WHO-5 Well-Being Index (WHO-5), developed by the
Psychiatric Research Unit in Denmark (Bailey et al., 2018). The index measures a person’s
mental well-being within the previous 2 weeks (Bailey et al., 2018). The WHO-5 is a validated
tool available in more than 30 languages and has been used internationally in research (Bailey et
al., 2018; Topp et al., 2015).
57

Moreover, the Australian Centre on Quality of Life developed the Personal Wellbeing
Index (The International Wellbeing Group, 2013). The index measures satisfaction across seven
life domains: standard of living, health, sense of accomplishment, relationships, safety,
community connectedness, and security. The seven domains aim to answer the question, “How
satisfied are you with your life as a whole?” (Australian Centre of Quality of Life, 2013, p. 5).
This tool has been adapted and validated for use with children, adults, and those with intellectual
disabilities (Cummins & Lau, 2005; Keyes, 2002; The International Wellbeing Group, 2013).
Also, the Psychological General Well-being Index was developed by Harold Dupuy, a
psychologist at the National Center for Health Statistics in the United States (Psychiatric Center
North Zealand). This index measures well-being and distress in six domains: anxiety, depression,
positive well-being, self-control, general health, and vitality. An overall well-being index is
calculated based on 22 items in the questionnaire. More than 30 translations and cultural
adaptations of this tool exist, and it has been used in over 30 countries with women and men,
young and old (Bailey et al., 2018; Chassaney et al., 2004).
In addition, the Mental Health Continuum Short Form (MHC-SF) was developed by
Corey Keyes, a sociologist at Emory University (Emory University, 2015). Based on an
individual’s total score, this tool assesses their emotional, psychological, and social well-being
and classifies them as flourishing, moderate, or languishing. The MHC-SF has been validated for
use with persons 12 years and older.
Lastly, the Canadian government developed a framework for measuring positive mental
health among young, minority adults. The Positive Mental Health Surveillance Indicator
Framework is proposed as a method to measure this problem of practice. The report includes five
positive mental health outcomes, their indicators, and their most recent estimates organized into
58

four domains: individual, family, community, and society, which are closely aligned with
Bronfenbrenner’s ecological systems (Bailey et al., 2018; Orpana et al., 2016). Since these
indicators are closely aligned with instrument questions from the Canadian Community Health
Survey, they can measure mental health at a program level (Orpana et al., 2016). This assessment
is most applicable to this study because it comes with a survey instrument, has been tested with
minority youths in Canada (which has a similar population makeup to the United States), has
been validated in both English and Spanish and has already been applied in practice to the
Ontario Center of Excellence for Child and Youth Mental Health for 10 years (2013).
In sum, by capturing student health and well-being data over time, schools can determine
the strategic adjustments necessary to achieve student mental wellness and increased graduation
rates for Latinxs (Eisenberg et al., 2009).
Mental Health Program Measurement for Impact on Latinx Students ’ Graduation Rates
Two methodologies can be used to assess the implementation and outcomes of best
practice guidelines to measure the effectiveness of college-led mental health interventions on
Latinx undergraduate students and its correlation to their graduation rate: process and outcome
evaluation (Bailey et al., 2018). By analyzing the processes involved in program implementation,
it is possible to determine whether the mental health program is being implemented according to
plan, if the target audience is being reached, and whether the desired outcomes are being
achieved (Bailey et al., 2018; Public Health Ontario, 2016). Outcome measures assess whether a
patient’s symptoms are actually improved by the care they receive (Bailey et al., 2018; Kilbourne
et al., 2018). For this study, an outcome assessment includes measuring if Latinx students’ sense
of mental wellness improved and if that improvement increased graduation rates thanks to
university-wide initiatives. Both process and outcome assessments will be described below.
59

More specifically, process evaluation focuses on assessing activities and documenting the
program’s reach (e.g., the number of participants), as well as the quality and capacity of
individuals, organizations, and/or systems to deliver the program effectively (Bailey et al., 2018;
Victorian Government Department of Human Services, 2003). A process evaluation can
determine how well a mental health promotion program adheres to the best practice guidelines
mentioned in the previous section (Bailey et al., 2018). Alternatively, an outcome evaluation
measures how a program has achieved its goals and objectives and what changes have occurred
(Bailey et al., 2018; Public Health Ontario, 2016; Public Health Ontario, 2015). For this problem
of practice, an outcome evaluation would include tracking graduation rates and Latinx mental
health assessment scores and seeing if there is a correlation between them.
Moreover, the Positive Mental Health Surveillance Indicator Framework helps to assess
program effectiveness (Bailey et al., 2018). The Public Health Agency of Canada (PHAC)
developed a Positive Mental Health Surveillance Indicator Framework to assess the state of
positive mental health among adults aged 18 or older (Bailey et al., 2018; PHAC, 2016). It
includes five positive mental health outcomes, their indicators, and the most recent estimates for
each outcome (Bailey et al., 2018). Also included are determinants of positive mental health
outcomes, grouped into four domains: individuals, families, communities, and societies (Bailey
et al., 2018; Orpana et al., 2016). These domains serve as key measurements of the effectiveness
of a program overall and closely match many of Bronfenbrenner’s ecological strata or systems
(Bailey et al., 2018; Orpana et al., 2016). Table 2 presents a sample framework utilizing the
indicators discussed in this review.

60

Table 2
Sample Framework Utilizing the Indicators
Evaluation questions Indicators Data
collection
methods
Timing of
data
collection
Person
responsible for
data collection
Is the program
increasing the
perception that the
university cares for
the participants’ well-
being?
Increased levels
of confidence
and self-esteem
reported by
individuals and
assessed by
professionals
Participant
survey and
clinical
assessment
tool
Before and
after the
program
Program
coordinator
Are participants feeling
supported to graduate
as a result of this
program?
Increase service
utilization
Participant
survey

Beginning
and end of
each
semester
Program
coordinator
Is this program
promoting better
mental health and
academic
performance?
Better graduation
rates, increased
academic
performance,
and better
mental health
screening results
Participant
survey,
clinical
assessment
tool, and
grades
Beginning
and end of
each
semester
Program
coordinator
Is this program
promoting and
increasing graduation
rates?
Retention and
graduation rates
Enrollment
data
Beginning
and end of
each
semester
Program
coordinator

Note. Adapted from Program Evaluation Toolkit by The Ontario Centre of Excellence for Child
and Youth Mental Health, 2013.
(http://www.excellenceforchildandyouth.ca/sites/default/files/resource/toolkit_program_evaluati
on_tools_fo r_planning_doing_and_using_evaluation.pdf)

In sum, the Positive Mental Health Surveillance Indicator Framework was chosen as an
evaluation method because there has not been any performance-based construct or evaluation
method for this precise problem of practice. The framework is also closely aligned with what an
61

assessment of a mental health program looking to evaluate Latinx student mental health would
need to consider as a measurement tool.
Summary
In sum, this literature review begins by describing the conceptual framework composed
of four key predictors of Latinx mental health under Bronfenbrenner’s ecological systems
framework. Establishing the connection between these four key predictors of mental health and
cultural values is essential when framing the problem of practice for the study because it
highlights cultural values when attempting to improve Latinx mental health and college
graduation. The review then explains cultural perceptions of mental health and their influence on
educational achievement and mental health literacy. The outcomes of those interrelations
influence graduation rates and mental health. Then, the review provides an overview of the
undergraduate student mental health landscape, focusing on Latinx students’ mental health
experiences. Past research on best practices was also explored to shed light on the gaps in the
literature and what is known to work well with these students and their mental health. Finally, an
approach to measurement based on the Ontario Center of Excellence for Child and Youth Mental
Health model was adapted to fit this study’s objectives and the participants’ demographics.

62

Chapter Three: Methodology
This chapter discusses the study’s research design, data analysis, and interview protocols.
Moreover, it describes the researcher’s positionality and the corresponding ethical components.
The study examines the relationship between mental health, a culture of caring in colleges, and
its impact on graduation among a sample of Latinx alumni who attended The University of State
XYZ (pseudonym). To obtain this knowledge, the following research questions were addressed.
Research Questions
Three research questions guided this study:
1. How do Latinx undergraduate students perceive the need for access to relevant mental
health support systems to improve their graduation rates?
2. What services, supports, and relationships have enabled Latinx undergraduate
students to improve their mental health and persist to graduation?
3. How does instilling a culture of caring within the university increase the number of
Latinx student graduates?
Overview of Design
The methodological design is a qualitative format to give voice to the interviewees. The
data for this cross-sectional study was drawn from semi-structured in-depth interviews with
Latinx graduates of The University of State XYZ, a public, 4-year institution. The semi-
structured interview data were coded into emerging themes to gain a comprehensive perspective
on the study’s outcomes (Creswell, 2014; Merriam & Tisdell, 2016; Roberts, 2014).
Merriam and Tisdell (2016) noted in-depth interviews enable participants to explain their
behaviors and experience as undergraduate students and their perspective on university supports.
63

As such, I conducted semi-structured, in-depth interviews with 11 Latinxs who completed
undergraduate studies at The University of State XYZ.
The theoretical lens guides the researcher ’s perspective while conducting a study, which
is why Bronfenbrenner ’s ecological framework provides the ideal backdrop to explore the
interrelatedness of an array of environmental components that affect Latinxs ’ well-being and
graduation rates (Creswell, 2014). A wide range of sociodemographic factors influences these
students’ mental health status, such as discrimination, acculturative stress, and access to higher
education (Casas et al., 2015). While socio-psychological factors are commonly overlooked in
higher education, cultural factors described in Bronfenbrenner’s model are influential in Latinx
undergraduates’ decisions to seek counseling and earn a college degree (Benuto & Leany, 2017).
The conceptual framework explores Latinx cultural concepts of feeling cared for,
engaging in health-seeking behaviors, familismo, religiosity, acculturative stress, language
barriers, and stigma as stressors contributing to psychological distress and poor college
graduation rates. This study explored these concepts extensively, as they are key components of
Bronfenbrenner’s ecological model. Additionally, this study examined the issues connected to
Latinxs ’ sense of mental wellness and the ecosystem of psychological support that universities
could provide to improve their graduation rates. Figure 3 explains the interrelatedness of the
cultural, social, and economic disparities that affect student well-being, psychological
functioning, academic performance, and graduation. This study explored only the cultural divide.
Moreover, Table 3 describes the data sources to explore how each research question was
examined.

64

Figure 3
Cultural, Social, and Economic Divides Affecting Latinx College Students’ Mental Health

Note. Latinx undergraduate students may face economic, social, and cultural divides that affect
their academic achievement and long-term outcomes. Inequalities are amplified if higher
education institutions do not intervene appropriately.

65

Table 3
Data Sources
Research questions In-depth interview
How do Latinx undergraduate students perceive the need for access to
relevant mental health support systems to improve their graduation
rates?
X
What services, supports, and relationships have enabled Latinx
undergraduate students to improve their mental health and persist to
graduation?
X
How does instilling a culture of caring within the university increase
the number of Latinx student graduates?
X

Overall, the study examined whether there is a relationship between higher education
mental health initiatives tailored to Latinx students’ cultural values and their graduation rates.
Bronfenbrenner’s (1994) work connects mental health issues and low graduation rates among
these college students. A culture of caring responds to these issues and is the crux of this
dissertation. A cross-reference was made between student responses, how students perceive
university interventions, and their influence on graduation rates. The end product resulted in
precise recommendations that higher education institutions can use to implement culturally
sensitive interventions to improve Latinx students’ graduation rates.
Research Setting
The in-depth interviews were administered via Zoom to Latinxs who obtained their
bachelor’s degrees from the University of State XYZ, a Hispanic-serving institution (HSI; U.S.
Department of Education, 2020). This study focused on this HSI because 67% of Latinx
undergraduates are enrolled at an HSI (Excelencia in Education, 2020a). According to Brown
66

(2022), approximately 51% of Latinx students graduate from a 4-year public university within 6
years, compared with 70% of White students. Furthermore, a National Center for Education
Statistics (2020) report indicated that 51% of these students think about quitting college or
shifting to part-time status, while 37% drop out. Furthermore, an American Enterprise Institute
study of national college graduation data found that 4-year universities graduate less than half of
their Hispanic students (Carey et al., 2018). Due to the declining Latinx graduation rates at HSI
universities, it is vital to understand the mental health problems possibly affecting these rates at
these schools.
Participants
The study participant group comprised 11 Latinx between 20 and 35 years old. Inclusion
criteria were identifying as Latinx, having obtained a degree from The University of State XYZ,
having graduated less than 15 years ago, and having engaged in at least one help-seeking
behavior on campus. The reason for selecting these participants is that it is vital to ensure
minorities have a voice in educational policies and initiatives meant to influence their wellness,
lives, and academic outcomes (Kymlicka, 1996; Lipson et al., 2022).
The primary recruitment strategy was respondent-driven convenience and random
sampling. This technique is effective when recruiting participants from difficult-to-reach
populations, especially since this population has historically shied away from disclosing
emotional vulnerability (Salganik & Heckathorn, 2003; Soto, 2016). Referrals help ensure the
participants will be more likely to trust, open up and engage in the study, so respondent-driven
sampling is the most appropriate approach (Passel & Cohn, 2016). Each participant was asked to
refer three individuals in his/her social network who meet the eligibility criteria (Sánchez et al.,
67

2019). The interview questions will be available in Spanish and English and will take
approximately 1 hour to complete.
Translation
Given that some participants could have various levels of acculturation and English
proficiency, the interview was available in English and Spanish. I developed in-house Spanish
translations for the interview protocol, as shown in Appendix B. Specifically, the measures went
through a process of translation/back translation, modified direct translation, and checks for
semantic and conceptual equivalence to ensure accurate conversion from English to Spanish
(Behling & Law, 2000; Sánchez et al., 2019). Spanish versions of the interview protocol were
not utilized.
Data Analysis Plan
Due to the explanatory sequential design of data analysis, which includes collecting
qualitative data, some preprocessing is usually required, such as coding and descriptive analysis
(Onwuegbuzie & Combs, 2011; Onwuegbuzie, 2003; Onwuegbuzie & Teddlie, 2003). Data
analysis consisted of collecting and categorizing the qualitative data into emerging themes. The
themes will be quantized (e.g., data transformation) such that if a student identified a
characteristic that eventually fit under a particular theme, the theme was awarded a score of 1.
Otherwise, it received a score of 0 (Onwuegbuzie & Combs, 2011). Onwuegbuzie (2003)
referred to this dichotomy as a participant theme matrix consisting of only 0s and 1s, which was
then entered into a Word document alongside the other variables.
To ensure a comprehensive analysis, students’ direct quotes and phrases were coded into
a codebook, creating a robust database of their perspectives as evidence to support the identified
themes (Gibbs, 2007).
68

The Researcher
I draw on my personal and professional experience as a Latinx student who suffers from
mental health disabilities in silence. I am wary of faculty and peer perceptions and choose to live
through physical and mental health struggles on my own (NAMI, 2012). A robust body of
literature sheds light on certain sociocultural factors contributing to Latinx students’ resistance to
mental health resources due to religiosity, familiarity, and social stigma (DeFreitas et al., 2018).
As a member of this in-group, I am a testament that these characteristics have fueled my
insecurities about airing out the dirty laundry of my physical and psychological health status
(Soto, 2016). My positionality on this topic is fueled by the systems of power, oppression, and
privilege that mark my experience as a Latinx student (Diller et al., 1996).
Power
Powerlessness is one of the most prevalent symptoms of depression (Eisenberg et al.,
2009). The feeling of powerlessness over my mental health situation is overwhelming to me as a
minority student who strives to excel academically. I also experienced insecurity whenever I
considered speaking up about my current mental health status to counselors, friends, or faculty
members (Aguayo et al., 2011). Initially, I was worried that I would be pigeonholed as an at-risk
student, judged, or sent to complete more remedial treatment. Since I was barely getting by, this
prospect seemed daunting to me (Diller et al., 1996). Additionally, undergraduate studies were
marked by gun violence on campus, making me uneasy about approaching mental health
professionals (Diller et al., 1996). Since I was afraid of being labeled as unstable, I worried it
would have repercussions on potential faculty recommendations, graduate school sponsorship,
and other university leadership opportunities (Eisenberg et al., 2009). As a result, I never
communicated my mental distress to academic leaders or counseling services, which is why I
69

deduce these fears are anxiety-based and due to the social-cultural factors attributed to Latinx
students (Aguayo et al., 2011).
Privilege
Despite my feeling of powerlessness, I recognize that I have blindspots as a Latinx higher
education student. Education is regarded as one of the highest forms of privilege in the world
(Diller et al., 1996). As a young, single, heterosexual female Latinx student with mental health
problems, I am aware of how my privilege and positionality intersect, especially since I have
never had to rely on on-campus mental health services because I have always afforded my
therapy (Diller et al., 1996). I also recognize that my middle-class upbringing gives me greater
access to education, and my ample mental health literacy is a testament to my privileged status.
Furthermore, although I recognize that academic leadership and faculty have fostered
open communication with me, I still do not quite understand why I resist communicating openly
with them (Echeverry, 1997). It could be a personality characteristic and not necessarily
attributed to my cultural identity as a Latinx with a culturally bound stigma surrounding mental
illness. Moreover, since I do not utilize the university’s mental health resources fully, I may have
a tainted view of their effectiveness. Finally, although I struggled with the same mental health
issues as an undergraduate, my current situation as a doctoral student involves a separate set of
circumstances, maturity, and stressors. These differences could lead to privileged biases or
knowledge gaps in how other Latinx undergraduate students perceive the university’s role in
addressing mental health issues and if they influence their graduation rates.
Oppression
Regarding oppression, Latinx students’ social-cultural factors create an environment of
oppression because mental health issues are considered taboo or stigmatized (Benuto et al., 2019;
70

Cheng et al., 2013). Historically, Latinxs tend to resolve mental health issues at home without
seeking help from authority figures outside their families (Ayón et al., 2010; Azpeitia & Bacio,
2022; Echeverry, 1997). Furthermore, mental health issues are perceived as a sign of weakness
rather than a chemical deficiency or illness (Casas et al., 2015). A second sociocultural
contributing factor is religion. Faith is a substantial value in Latinx society, and psychiatric
disorders are perceived as a punishment from God for sin or misbehavior (Echeverry, 1997;
Moreno et al., 2022). Finally, few therapists with cultural sensitivity training tend to Latinx
students and their unique psychosocial characteristics that may serve as barriers or promoters of
mental health counseling (Casas et al., 2015). Together, these factors result in low mental health
literacy in Latinx communities, making it difficult for younger Latinx students to obtain
psychological counseling.
My own experience as a Latinx student who carries mental health stigma and has faced
oppression and judgment from other members of society allows me to experience these issues
first-hand (Echeverry, 1997). I relate to the sense of not wanting to expose my vulnerabilities,
physical or mental, for fear of judgment or coming across as weak (Casas et al., 2015). For this
reason, I want to work to create more inclusive mental health initiatives for students like me in
order to support their higher education journeys.
Bias and Ethics
As the researcher, I found my positionality on this topic to be a source of insight and a
potential bias. As a member of this study’s population of focus, I am a testament that these
cultural stressors influenced my relationship with mental health care initiatives in the past and
my reluctance to seek support, specifically in academic settings. Furthermore, despite
understanding how Latinx students feel about mental health, I recognize that I have blind spots
71

as a researcher (Creswell & Creswell, 2018). Researchers should consider ethical issues that may
arise as they plan and design quantitative studies and plan how they will be addressed. It is a
common misconception that these issues only surface during data collection when in reality, they
must always be considered during all phases of the research project, especially when providing a
rationale for the IRB (Creswell & Creswell, 2018). To address the ethical considerations for
navigating the IRB, one of the first steps is to ensure that no vulnerable nor sensitive populations
are targeted, which is why this study’s participants must be 20 or older (Creswell & Creswell,
2018). The review involves submitting a proposal that explains the selection, access, sampling,
and collection strategies, which will ensure ethical treatment on behalf of the participants
(Creswell & Creswell, 2018). Participants will receive an overview of the study, a consent form,
a confidentiality agreement, and a copy of the data collection procedures.
Data Collection and Analysis
The method of inquiry consisted of qualitative, in-depth, semi-structured in-depth
interviews. The interviews were semi-structured to allow for probing questions and deeper,
richer insights (Merriam & Tisdell, 2018). The interviews consisted of 12 questions and
appropriate probes to ensure students could explain attitudes, mindsets, beliefs, and perceptions
associated with their cultural experiences. All interview questions related directly to at least one
research question to ensure the study’s results focused on the appropriate topics. The data were
then coded into emerging themes and analyzed for optimal cross-references and reliable data
results.
72

Participants
As described previously, the 11 interviewees were Latinxs who had graduated from The
University of State XYZ within the 15 years prior to this study. The interview participants’ ages
ranged from 20 to 35. The interviews lasted no more than an hour.
Instrumentation
The interview questions were also adapted from the MOS-SSS to increase the validity
between the qualitative and quantitative data sets. Part of the adaptation included reducing the
number of questions from 19 to 12, framing them as open-ended inquiries, and adding probing
questions to give students ample opportunities to respond to the questions in a familiar manner.
Furthermore, the questions touch on the MOS-SSS subscales, the cultural aspects of familism,
language barriers, and stigma, as well as the supports that guided them toward graduation. The
instruments used can be referenced in Appendix A in English and Appendix B in Spanish.
Data Collection Procedures
The study’s logistics involved sending the participants a confidentiality agreement, the
purpose of the study, and a preview of what to expect during the interview via email before their
interview takes place. Using the Calendly automated appointment scheduler, they scheduled their
interview times and dates. Interviews via Zoom lasted 45 to 60 minutes. All interviews were
recorded and transcribed using specialized software. Participants also received the interview
protocol (Appendix A) on the interview day to ensure they were aware of confidentiality and
ethical procedures. Data were captured through online Zoom transcriptions and notes, and the
emerging themes were coded in a Word document.
73

Data Analysis
After the interviews, coding began. Each interviewee’s response was color coded into an
emerging theme. Then, each response was categorized thematically to create a data pattern
corresponding to the appropriate research questions. As responses are coded into emerging
themes, the validity of their statements becomes truer (Patton, 1999).
Validity and Reliability
Among the many strengths of this interview instrument is that since it was adapted from
the MOS-SSS scale and subscales, it demonstrates high construct and factorial validity as well as
high stability over time, as they have been used with both English and Spanish-speaking Latinx
research participants (Calderón et al., 2010; Campos et al., 2008; Kaltman et al., 2016; Salkind,
2014; Sherbourne & Stewart, 1991; Surkan et al., 2006). Participants will be selected from a
convenience sample to increase reliability (Creswell & Creswell, 2018). To be eligible for the
study, participants had to be between 20 and 45 years old, Latinx, and have completed their
undergraduate degrees at The University of State XYZ and accessed university resources or
sought assistance while in school. The data were more reliable due to pre-selecting participants
according to the criteria (Salkind, 2014). Additionally, to maximize response rates, interviewees
were pre-selected and told why they were chosen and how their feedback would affect
universities’ ability to support similar students. Participants’ immersion in the purpose of the
study would increase reliability (Salkind, 2014).
Ethics
Researchers should consider ethical issues that may arise as they plan and design
qualitative studies and plan how they will be addressed, especially since it is a common
misconception that these issues only surface during data collection (Creswell & Creswell, 2018).
74

Nevertheless, it is important to consider them during all phases of the research project, especially
when providing a rationale for the IRB (Creswell & Creswell, 2018). A first step to address the
ethical considerations for navigating the IRB is ensuring that no vulnerable or sensitive
populations are targeted, so study participants must be 20 or older (Creswell & Creswell, 2018).
The review process involves submitting a proposal that explains the selection, access, sampling,
and collection strategies (Creswell & Creswell, 2018). Participants were informed that all
identifying markers were changed or eliminated from the research. Furthermore, interviewees
received a consent and confidentiality form to grant permission to record them.

75

Chapter Four: Results
This doctoral thesis investigated the experiences and perspectives of Latinx students at
the University of State XYZ regarding their path toward graduation and the support systems that
influenced their journey. The study explored strategies and best practices for student support in
higher education, particularly in relation to mental health, with the goal of improving Latinx
graduation rates. Bronfenbrenner’s (1994) ecological systems theory was used as a conceptual
framework to guide the research, providing a lens to understand the factors contributing to
Latinx students’ struggles in completing their degrees. By focusing on their mental health, the
study seeks to identify ways to enhance their graduation rates. The research methodology
involved individual interviews with 11 Latinx graduates of the University of State XYZ aged 25–
35. The interviews were analyzed using coding techniques to identify themes and patterns in the
data.
The chapter begins with an overview of participants, reflecting on their unique
educational experiences and utilization of college resources. Despite the individual differences,
several overarching themes emerged, which will be explored in this chapter. The participants
represent a range of ages (22 to 35) and have graduated from college within the past 12 years.
Among the participants, the majority self-identified as Mexican, while one had Colombian and
another had Venezuelan heritage. It is important to note that this limited sample represents only a
narrow glimpse of the complete Latinx worldview, as each Latinx subculture has its own distinct
practices, perspectives, and belief systems.
Additionally, it is worth noting that almost 70% of the participants came from financial
backgrounds that did not require financial aid resources to pay for their higher education. This
factor could have influenced their stress level and the data analysis outcomes.
76

The literature review conducted for this study focused on topics such as the key
relationships and support systems Latinx undergraduate students use to help them manage their
stress and guide them toward graduation. These topics are interwoven throughout the data
analysis. The findings suggest that mental health resources and support systems offered by
universities are often unknown or underutilized by Latinx students. The study reveals that Latinx
students often feel a lack of personalized support that takes their cultural context into
consideration, leading to barriers in accessing mental health resources and other support systems
provided by the university.
This study’s research questions aimed to understand the participants’ perspectives on
their experiences at the University of State XYZ and the factors that influenced their path toward
graduation. The study involved 11 individual, semi-structured interviews, and the findings for
each research question are presented in separate sections. The evidence from the interviews is
synthesized and presented throughout the sections. Each section concludes with a summary
specific to that research question, and the chapter concludes with an overarching summary of the
overall findings. A table overviewing the findings is shown in Table 4 below.

Table 4
Overview of the findings according to research question
Research question Findings Themes associated with
conceptual framework
Research question 1:
How do Latinx undergraduate
students perceive the need for
access to relevant systems of
mental health support for
purposes of improving their
graduation rates?

Finding 1: Personal motivators are
sufficient driving forces to
graduate.
Avoid marginalization and
discrimination
Lean towards social cohesion,
familism and stigma

Findings 2: Cultural and social
stigma are significant barriers.
Cultural and social stigma
Familism
77

Social cohesion
Research question 2: Given
undergraduate students’ many
stressors, what services,
supports, and relationships
have enabled Latinx students
to improve their mental
health and persist to
graduation?

Finding 1: The power of strategic
academic relationships
Social cohesion
Acculturative stress

Finding 2: Strong personal
relationships support students
toward graduation.
Language barriers
Religiosity
Stigma
Research question 3: How does
a culture of caring for Latinx
students’ psychological well-
being at the institution
influence their graduation
rates?

Findings 1: There are key figures
within the university ecosystem
that need to be tapped into and
leveraged to inculcate a culture of
caring
Social cohesion
Language barriers
Stigma
Familism

This chapter outlines the following elements of the research study: participating
stakeholders, interview results according to each research question, and findings. Three questions
guide this study:
1. How do Latinx undergraduate students perceive the need for access to relevant
systems of mental health support for purposes of improving their graduation rates?
2. Given undergraduate students’ many stressors, what services, supports, and
relationships have enabled Latinx students to improve their mental health and persist
to graduation?
3. How does a culture of caring for Latinx students’ psychological well-being at the
institution influence their graduation rates?
In summary, this chapter provides an overview of the research methodology, conceptual
framework, literature review, and interview findings. It sets the stage for a deeper exploration of
the strategies and best practices for supporting Latinx undergraduate students on their journey
78

toward graduation. Out of the 12 persons who were reached, only 11 ended up participating in
the interview.
Participating Stakeholders
To fully describe the lived experience of the participants, it is necessary first to build
context that will support a better understanding of these unique individuals and their cultural
perspectives. The outline of the findings within the section begins with an introduction to the
participants, then a description of their undergraduate experience, specifically focusing on the
key relationships, resources, and support systems that aided them on their path toward
graduation. The participants, specific locations, and other identifying markers were assigned
pseudonyms to protect their identities.
Eleven Latinx young adults who graduated from the University of State XYZ participated
in this study: five students who graduated in 2019, one who graduated in 2021, four who
graduated in 2011, and three who graduated in 2012. Seven participants were female and had the
longest time from graduation. The four male participants graduated in 2018–2019. Five
participants majored in liberal arts, five in business, and one in communication. Table 4
identifies the participant’s pseudonyms, key demographics, and relevant information pertaining
to their majors and cultural background.

Table 5
Participants’ Demographic Information
Participant
pseudonym
Gender Major Graduation
year
Latinx
cultural
background
First-
generation
student
Transfer Use of
financial aid
Karla Female Liberal arts 2011 Mexican Yes Yes No
Fatima Female Liberal arts 2019 Mexican Yes No Yes
Martin Male Business 2019 Mexican No No No
Nando Male Business 2019 Mexican No No No
Mario Male Business 2019 Mexican No No Yes
Lara Female Business 2021 Colombian No No No
Cinthia Female Business 2011 Mexican No No No
Sonia Female Liberal arts 2018 Mexican No No No
Maria Female Communication 2012 Venezuelan Yes No Yes
Pedro Male Business 2018 Mexican No Yes No
Andrea Female Liberal Arts 2011 Mexican Yes Yes No
78
80

All participants self-identified as Latinx and were employed full-time in corporations
across the United States. They were located in metropolitan areas, including New York, San
Antonio, Texas, Austin, Texas, and San Francisco. All participants earned undergraduate degrees
in 4 years at the University of State XYZ. Three were transfer students who came to the
university in their sophomore year of college. Three relied on financial aid, and four identified as
first-generation college students. No findings indicated differences in mental health and its
impact on graduation for transfer students or students who began their college education at the
university. However, based on the data from this limited sample, participants who became
involved in student organizations from their first year reported a higher sense of belonging and
lower stress than individuals who transferred later in their undergraduate careers. Additionally,
students mentioned that being a first-generation college student made them feel isolated from
their family support group, as their parents could not guide them in navigating the American
college experience. This contributed to their sense of loneliness and stress in college. The
following section introduces the study participants, providing enough information to give the
reader an insight into their experiences while protecting their identities.
Karla
Karla exhibited confidence and assertiveness in her interview responses. Her
undergraduate memories and experiences from her degree became vivid. Being a first-generation
college student who transferred in her sophomore year, she recalled feeling isolated without a
supportive group to turn to for help and guidance. Karla also expressed feelings of isolation from
her family during her college years. As her parents had never attended college, she could not turn
to them for support and guidance in navigating challenges. This further contributed to her sense
81

of isolation and made it difficult for her to seek the support she needed from her immediate
family.
However, she discovered a sense of support within the university’s unique and small
department. She found a network of support to navigate the challenges of being a Latinx transfer
student. Through these connections, she obtained recommendation letters and secured
scholarships for a master’s degree in law, even 10 years after her graduation. Karla mentioned
that she now has a greater awareness of the importance and impact of mental health and seeks
strategies and support. However, she recalled that mental health was highly stigmatized during
her college years, and she felt that she lacked the resources and knowledge to reach out for help
and utilize college resources for her mental well-being due to cultural stigma.
Fatima
Fatima was quiet and reserved initially, offering blunt and short answers at the beginning
of the interview. However, as the conversation progressed, she revealed more about her
experiences with mental health and academics at the University of State XYZ. She emphasized
the fear of displaying struggles, as it appeared that no one else was going through similar
challenges. This fear of failure and the pressure to maintain an image of success within the
college environment were recurring themes throughout the interviews. It is important to mention
that Fatima graduated more than 10 years prior to this study, and she reflected on her experiences
retrospectively. She now has greater knowledge and awareness of the importance and impacts of
mental health compared to her college years. Fatima underscored the significance of breaking
down barriers by encouraging professors, guest speakers, and fellow students to share their
vulnerabilities openly. She is adamant that this would help normalize the struggles experienced
by students, fostering a sense of unity and support within the student body.
82

Martin
Martin appeared confident and assertive throughout his interview. He approached the
questions with focus and was initially hesitant when discussing more vulnerable topics, such as
mental health and stress, during his college years. However, after further exploration, Martin
revealed that his reluctance to open up might stem from his Latinx male identity and the stigma
surrounding mental health and distress within the Latinx community. He emphasized the
importance of family as a primary source of motivation and support during college. Interestingly,
Martin was the only male participant who mentioned religion as a significant source of support,
socially, culturally, and for his mental well-being throughout his college journey.
Nando
In his interviews, Nando came across as a highly competitive young man, driven to excel
in all his endeavors. He expressed feelings of insecurity and uncertainty, seeking validation to
ensure that his responses met the expectations and requirements of the interview. He sought
reassurance that he was on the right track and delivering the data I required, demonstrating his
commitment to excelling in the task at hand. Nando also exhibited a sense of discomfort and
hesitation when delving into his inner vulnerabilities and discussing the potential stressors
associated with being a student at the University of State XYZ. He repeatedly emphasized his
tendency to independently address and overcome challenges without seeking assistance from
others. He briefly mentioned that this self-reliance could be influenced by cultural expectations
placed on Latinx males. Overall, Nando’s approach focused on powering through toward
graduation, leaving little time for self-reflection or dwelling on the stressors he encountered
during his undergraduate degree. However, he emphasized the significance of the business
school in his journey toward graduation. Among all the participants, Nando provided the most
83

detailed insights into the business school’s resources. These resources included mandatory
resource classes and regular check-ins from advisors and counselors. He noted that the business
school, often considered a “cash cow,” invests in ensuring an almost 100% graduation rate for its
students.
Mario
Mario was among the three participants who did not have financial support for his college
education. To afford his tuition, he took on multiple jobs, relied on scholarships, and received
financial aid. The financial burden had a noticeable impact on his mental health and stress levels,
which he openly discussed during the interviews. Unlike other male participants, Mario was
forthcoming about his struggles with anxiety and depression while simultaneously navigating his
financial and academic responsibilities. He attributed his comfort in discussing mental health
issues and being vulnerable to the fact that his mother is a therapist, providing him with a
familiar and supportive context. However, he did share hesitancy to disclose his personal
vulnerabilities with his peers due to social stigma. Mario also emphasized the importance of
establishing connections with academic advisors, professors, and social groups to cope with the
stressors inherent in the college experience.
Lara
Lara initially appeared reserved and quiet during the interview. Notably, she was the sole
participant who experienced her final year and a half of undergraduate studies during the
COVID-19 pandemic. This distinction is crucial as it coincided with a significant increase in
university mental health awareness initiatives upon students’ return to campus. Lara openly
discussed her mental health challenges during the pandemic and provided a clear comparison of
the support provided by colleges before and after the onset of the pandemic.
84

In contrast to the other student participants, Lara highlighted how she and her friends
were transparent about their mental health struggles. They openly discussed seeking support
through both on-campus counseling services and private practice. Furthermore, Lara emphasized
the social acceptance surrounding the utilization and discussion of these resources, indicating a
positive cultural shift in acknowledging and addressing mental health concerns among her peers.
Cinthia
Cinthia, an articulate and knowledgeable participant, belonged to a prestigious and highly
sought-after group in the business school. This elite honors program provided its members with
exceptional access to top professors, resources, and personalized attention. Notably, her
professors included the dean of the business school, scholars leading the MBA program, and
accomplished business leaders. Cinthia emphasized the significance of this exclusive
community, as it offered a unique environment where like-minded individuals with shared goals
attended the same classes and belonged to the same social circle, fostering her focus and
dedication throughout college. This personalized and selective community also provided a sense
of familial connection she longed for from her home.
Initially, when discussing mental health issues and stress levels, Cinthia appeared hesitant
to delve into the more vulnerable aspects of her college experience. However, as the interview
progressed, she gradually revealed that she had experienced more stigma around mental health at
that time compared to her current perspective. She candidly mentioned that in her younger years,
she would mask much of her angst, stress, and anxiety by turning to alcohol to cope or “plugging
into all the social groups” to deal with the pressure of excelling academically. Cinthia even
shared how the high expectations in the top academic environment caused her to lose 15 pounds
85

due to stress, contrasting with the common phenomenon of weight gain in the first year of
college.
Sonia
Sonia exhibited a calm and composed demeanor throughout the interview, expressing
confidence in her identity. She took her time to articulate her thoughts thoughtfully. Notably,
Sonia was one of the first participants to emphasize the significance of her small, specialized
college department as a crucial support system for her academic journey. She pursued her major
in a small liberal arts department that offered personalized guidance to its students. Even today,
Sonia maintains contact with professors, the major’s director, and her advisor from that
department.
Furthermore, Sonia repeatedly emphasized the importance of forming a sense of family
within her social network. Engaging in activities like cooking dinner and checking in on each
other’s safety created familial connections with other Latinx students, contributing significantly
to her sense of belonging and mental well-being.
Interestingly, Sonia, like other participants, mentioned being unaware of stress
management resources on campus. In retrospect, she expressed a desire to take advantage of such
resources but was unaware of their existence at the time. She relied primarily on word-of-mouth
recommendations from friends or guidance from her department chair for support during her
college years.
Maria
Maria was one of the students whose college experience revolved less around social
connections and a sense of belonging and more on achieving her goals. What stood out in
Maria’s interview was her perception of college as a task to be completed to gain financial
86

independence from her family. She viewed her classes and interactions with peers primarily as
responsibilities. She did not attribute much significance to friendships, socializing, or
involvement in organizations in terms of her mental well-being. Maria described her college
campus experience as isolating, as she approached her undergraduate degree with a determined
and driven mindset, aiming to achieve financial freedom from her parents as quickly as possible.
She emphasized the importance of destigmatizing failure for other Latinx undergraduate
students. Maria believed that sharing stories of struggle and discussing available resources and
lessons learned from failures could be beneficial. She suggested that professors, guest speakers,
and messaging within the college community could play a role in creating a culture of openness
and resilience among students.
Maria expressed a sense of distress when looking back on her college experience. She
expressed regret for not receiving adequate career guidance, which would have helped her
discover her true career path. Maria believes that if she had devoted more time to understanding
her professional strengths during college, she could have pursued a more fulfilling career in the
present moment.
Pedro
Pedro emerged as one of the most emotionally vulnerable participants in this study. From
the onset, he expressed a strong desire to be transparent and genuine, explicitly stating his
intention to remove any “Latino male masks” during the interview. His insights were particularly
valuable, as he was the only male participant who sought assistance from the mental health
center.
Unfortunately, his experience at the center shed light on the lack of cultural training
typically observed in such facilities within the United States. After his consultation, Pedro left
87

feeling defeated and saddened, as he was informed that the university network could not provide
the help he needed and that he would have to seek treatment from a private clinician. Given his
limited financial resources, he found it impossible to afford the luxury of paying for a private
therapist. Furthermore, he felt a strong stigma associated with reaching out to his parents for
financial support in seeking therapy. Pedro had mixed feelings about this experience. While he
expressed gratitude that the university had some resources available, he also felt that the mental
health service treated him as merely a statistic, without genuine care or concern for his well-
being.
Additionally, Pedro highlighted the issue of gender stigma within Latinx culture, where
admitting to needing help is seen as a sign of weakness and a lack of masculinity, with
expectations to resolve one’s challenges independently.
Finally, Pedro acknowledged his advisor’s pivotal role in guiding him toward graduation.
His advisor went beyond to support him, ensuring that he completed his degree in four years,
considering the financial constraints that prevented him from extending his time in college. He
even recalled her name with fondness.
Andrea
Andrea, a participant in the study, expressed a strong willingness to share her experiences
as a Latinx undergraduate student at the University of State XYZ. She found the interview
therapeutic, as it allowed her to unload the cultural burden associated with acculturative stress
that she carried throughout her undergraduate journey. Andrea was the only participant who was
involved in the elite athletics program and revealed how her physical appearance as a Hispanic
individual made her feel like an outsider and exception within the predominantly White athletic
division. As a first-generation college student with limited financial resources compared to her
88

more affluent peers, she struggled to find a sense of belonging within the white American
affluent student profile and the Latinx community, as she had been raised in the United States.
Furthermore, Andrea disclosed that she had a learning disability, which further isolated her from
her peers. She also visited the mental health center and had a negative perception of the
treatment she received. Her narrative reflected her deep understanding of the intersectionality of
her experience as a Latinx attending the University of State XYZ, highlighting how her cultural
heritage shaped her college journey.
Results for Research Question 1
The data presented below is organized by research question. Under each research
question are the initial insights that frame the context of the findings, followed by the findings,
which are categorized by emerging themes per the conceptual framework.
The first research question aimed to understand how Latinx students perceive the need
for mental health support and stress management during their undergraduate experience at the
University of State XYZ. Before delving into the specific findings, it is crucial to highlight that
72% of the participants reported experiencing feelings of isolation, anxiety, or a lack of support
at some point during their undergraduate careers. Furthermore, 64% identified their cultural
background as a reason for not accessing school resources to address their mental health needs.
In addition, 55% of the participants mentioned a lack of awareness as the primary factor
contributing to their non-utilization of mental health resources. The following sections will
examine the sources of anxiety, pressure, and fear of failure, as they are essential for interpreting
the findings related to research question one. Moreover, this section will provide more insight
into the prevalence of limited knowledge about available resources among the participants.
Lastly, this section will provide an overview of the two key findings: first, the participants’
89

personal drivers as sufficient resources to get them to graduation, and second, the considerable
influence of cultural and social stigma in impeding their willingness to seek mental health
support on their journey toward graduation.
Students Have Anxiety, Fear of Failure, and Impostor Syndrome
Nando acknowledged the pressure to excel due to competition for jobs or internships,
recognizing there were moments when stress became overwhelming. Maria reflected on her
anxiety, particularly regarding doubts about her chosen path and prospects after graduation.
Pedro shared his struggle with the transition of living independently for the first time, including
responsibilities such as cooking, laundry, and making new friends in a different language. Fatima
described experiencing prominent levels of anxiety and resorting to all-night study sessions to
pass exams. All 11 participants expressed how anxiety and a fear of failure were prevalent, given
the competitiveness and prestigious reputation of the school.
For instance, Fatima admitted feeling like a failure and even considered dropping out
after her first year to escape those feelings. She said, “I felt like I was a failure. I actually wanted
to drop off after my first year because it was, in my mind, better than failing.” Andrea stated,
I barely got a C, and that was like the first time I had gotten a C in my life. So, I
remember being like, I don’t know, maybe I’m not gonna cut it here. This is really hard,
… but looking back at it, I think being in huge courses like that with 300-plus people,
maybe it wasn’t the best learning environment for me.
Similarly, Karla highlighted the embarrassment of acknowledging academic struggles,
discouraging her from seeking help or support when she stated,
90

I think it is embarrassing, too, in a sense, because it means accepting that you’re failing at
something, and I definitely think that’s why I wouldn’t seek out. I didn’t seek out
[because] it’s embarrassing to accept that you’re failing at something.
Mario shared that fear and stress were constantly on his mind, especially considering his
Latinx immigrant family’s sacrifices to set him up for success:
Fear failure 100% was top of mind. Still is in a lot of, in a lot of ways. I think when you
come from a Latino background or an immigrant family or something like that, parents
go through a lot of sacrifices to make sure that you are set up for success.
He reflected that, at the time, there was no one he felt he could turn to for assistance with
managing his stress.
These narratives shed light on the participants’ experiences, highlighting the challenges
they faced, including anxiety, fear of failure, and limited support systems. Cinthia framed it
appropriately when she stated,
It’s so hard that, if you really think about it, for most of us, we were raised living under
our parents [roof], and then it’s like, “You’re 18. Go spread your wings and fly away.”
It’s crazy because that’s a huge life change, and you’re thrown into this college campus
with thousands of other people. … There’s a spectrum of how you approach college. But,
I mean, it’s one of the biggest life changes to leave home and leave the comfort of what is
home, right? And kind of be out on your own for the first time. It’s actually kind of crazy
to think that we didn’t prepare better for this because it’s a huge shift.
Despite intense stress and emotional turmoil, nine participants did not seek on-campus
mental health support. The next section will reveal some of the reasons for this finding.
91

Reasons Students Did Not Access Relevant Systems of Mental Health Support
Understanding the sources of anxiety, pressure, and fear of failure is crucial in
interpreting the findings for Research Question 1. Equally important is exploring why students
hesitated to seek support from available school resources to address these negative emotions.
One significant reason the participants identified was their cultural background. Among
the 11 participants, nine mentioned that their cultural upbringing inhibited them from seeking
mental health resources. Nando explained that there is a stigma associated with asking for help
among Latinx students, and Latinx males are expected to solve their problems independently. He
stated, “I think the fact that none of my friends that were Latinos ever did that either. Everybody
grew up kind of everyone dealing with their own … stuff. Maybe not talked about it as much.”
Pedro highlighted the cultural perception that seeking psychological help implies having
a severe issue when he said, “I mean, at the end of the day, it’s whole culture that people think
that they go to a psychologist because they have a really big problem.” Fatima mentioned the
belief ingrained in Latinx culture that therapy is solely for “crazy people.” Martin, reflecting on
his cultural background, shared that he had never sought medical or therapeutic assistance in his
life, and he did not plan to adopt new behaviors in college, especially since none of his Latinx
friends did so, either.
Furthermore, six participants mentioned a lack of awareness as the reason for not
utilizing on-campus support or mental health resources. Karla admitted being unaware of
resources, recalling a lack of guidance. She described the experience of arriving at a large
campus as overwhelming, with limited direction:
I don’t think I had a lot of guidance. Coming to a campus as big as [this one], it was
really kind of a free for all. Maybe I didn’t know where to go for guidance, but it was just
92

basically get on the online portal [and] choose your classes. I don’t remember talking to a
specific counselor about, you know, what classes I should take, how to kind of guide my
search for a career, that type of thing. What happens after graduation? It was very much
on my own.
Nando admitted his lack of awareness, acknowledging that it can be challenging to stay
informed about the various services at a large institution. He stated, “Maybe I just wasn’t aware
of any other resources available, to be honest. You know, it’s a big school. … There’s a lot of
things going on at the same time.” Sonia also echoed the sentiment of unawareness, indicating
the need for more visibility and guidance in accessing resources, “I didn’t tap into that resource
because I just didn’t know what I would get out of it. … Just being more aware of these services
would’ve been great.”
Overview of Findings for Research Question 1
This next section will unveil the two key findings for Research Question 1. The first
finding is that the participants’ personal drivers or motivators were sufficient to get them toward
graduation. Financial independence is a significant motivator, pushing students to secure stable
employment and avoid relying on their parents or returning home after college. Additionally, the
allure of status and self-achievement associated with graduating from a prestigious university
drives their pursuit of educational success. The social pressure to graduate alongside friends
further propels their determination, while the desire to follow in their family’s footsteps and
make them proud reinforces their commitment to academic excellence. These intrinsic drivers
create an intense sense of self-sufficiency among Latinx students, reducing their reliance on
external school resources as they navigate toward graduation.
93

The second key finding for this research question is closely related to the impact of
stigma on the accessibility and utilization of mental health resources. Building upon the
conceptual framework described in Chapter Two, this study’s findings shed light on the
pervasive role of stigma in hindering students’ ability to seek and benefit from mental health
support. Cultural and social stigma emerged as significant barriers, reflecting the complex
interplay of societal norms and personal beliefs that contribute to reluctance to use mental health
resources. Moreover, the participants’ age during their college years may have amplified stigma,
further impeding their willingness to engage with mental health services. Table 5 provides a
comprehensive overview of the key themes and sub-themes identified in the research and the
corresponding findings. This table allows a clearer understanding of the underlying patterns and
insights derived from the data analysis. Subsequent sections will explore the subthemes related to
this research question.

Table 6
Findings for Research Question 1
Overarching
theme
Sub-theme Findings Themes associated
with conceptual
framework
Finding 1:
Personal
motivators are
sufficient driving
forces to
graduate.
Financial
independence
Participants were driven by the
goal of avoiding dependence on
their parents or having to return
to their parents’ home after
college.
Avoid
marginalization
and
discrimination.

Achievement,
status, and
self-identity
The participants viewed higher
education and the chance to
attend a renowned university as
a symbol of status and a means
to set themselves apart from
others. They eagerly embraced
the opportunity to venture away
from home, assuming the
Avoid
marginalization
and
discrimination.
94

Overarching
theme
Sub-theme Findings Themes associated
with conceptual
framework
responsibilities of adulthood,
and regarded these experiences
as sources of pride and a
pathway to personal autonomy.
Social
pressure
Social pressure drives a strong
desire to graduate together with
peers, avoiding being left
behind and maintaining
accountability within the
academic community.
Social cohesion,
acculturative stress
Family
pressure
Family pressure and expectations
strongly influence the desire to
graduate, with a sense of
following in their sibling’s
footsteps, meeting social
expectations, and fulfilling
financial obligations tied to
education.
Familism,
acculturative stress
Findings 2:
Cultural and
social stigma are
significant
barriers.

Cultural
stigma
Cultural factors, including
negative societal perspectives
on mental health and family
resistance, contribute to the
reluctance of participants to
seek help, perpetuating the
belief that therapy is uncommon
and only necessary for
individuals with severe issues
within the Latinx community.
Familism
Stigma
Gender
stigma
Gender norms and cultural
expectations within the Latinx
community shape the utilization
of mental health resources
among Latinx undergraduate
students, with males
experiencing significant barriers
due to internalized struggles,
fear of appearing weak, and
pressure to conform to
traditional masculine norms,
underscoring the need to
address these gendered
dynamics to promote mental
Stigma

95

Overarching
theme
Sub-theme Findings Themes associated
with conceptual
framework
well-being and academic
success.
Social stigma
Financial
Fear of judgment and pressure to
conform to societal expectations
discourage help-seeking
behaviors, emphasizing the need
to address and combat this
stigma for the well-being of
these students.
Social cohesion
Stigma
Stigma
Age Five out of 11 students mentioned
that at the time in college, they
didn’t have the maturity or
awareness to access mental
health resources.
Stigma
Familism

Finding 1 for Research Question 1: Personal Motivators are Sufficient Driving Forces to
Graduate
Financial Independence
Five out of 11 participants mentioned financial independence as a significant driver
toward graduation. The desire to secure a job and earn a salary was a prominent theme, driven by
the goal of avoiding dependence on their parents or having to return to their parent’s home after
college. Mario stated,
It’s pride. … I want to be independent. I came to college to be independent, maybe to get
away from my parents. I didn’t wanna go back to my parents’ house, and second, I had to
start paying my student loans. Only had 6 months, I think, before I need to start paying
them off.
Fatima mentioned that college gave he a sense of independence and status that she craved to
replicate after she graduated. She said, “The experiences that I was already living while in
96

college made me feel that I was, you know, one step closer to being that … independent
woman.”
Additionally, participants expressed a strong drive to establish financial stability and not
be left behind while their peers graduated. Lara stated, “I wanted to get a job right outta college
because I didn’t wanna come back and live with my parents.” Martin mentioned, “I wanted to get
out there in the world and make my own money, be my own man, just like my friends were
doing.” This focus on financial independence significantly shaped their determination to
complete their education and not feel the need to seek out additional resources for their mental
health to guide them toward graduation.
Achievement, Self-Identity, and Family Expectations
Additionally, the findings revealed a prominent subtheme centered around the
significance of graduation as a symbol of personal achievement and self-identity. More than half
of the participants expressed strong confidence in their abilities and a determination to excel
academically. They also discussed the status that came with graduating from a well-ranked
college. The pursuit of graduation was driven by an intrinsic desire to prove themselves to their
parents, teachers, and professors who imparted knowledge and inspired them along the way.
For many participants, the aspiration for higher education and the opportunity to attend a
prestigious university represented a status symbol and a way to differentiate themselves from
their peers. They embraced the challenge of moving away from home and taking on the
responsibilities of adulthood, viewing these experiences as badges of honor and a means to
establish their independence. Fatima stated,
For me, it was more of, like, I needed to graduate. I was gonna graduate no matter what.
And I don’t think I ever was not gonna graduate. … I’m unique in that since I was 4 years
97

old, ... I wanted to go abroad to the [United States] to study in a big university and live by
myself and go to college. So, moving away from home was not an issue or a stressor for
me.
All participants expressed a strong sense of personal accountability and a commitment to
seeing things through to completion. During the interviews, all expressed unwavering confidence
in their graduation prospects. In fact, the questions had to be framed hypothetically to elicit a
response from them. They attributed their determination to a deep-seated desire to avoid failure
and not to leave things unfinished.
Additionally, the support and scrutiny from family members served as both motivation
and accountability, reinforcing the need to excel academically and showcase their achievements.
Martin, Pedro, Maria, and Lara all mentioned experiences where they had to share grades and
academic progress with their family members at least weekly. They saw academic success as a
way to demonstrate their intelligence and capabilities, validating their decision to pursue higher
education and fulfilling the expectations of their families.
Overall, the theme that emerged from the study highlights how the pursuit of graduation
was driven by the desire for personal accomplishment, self-identity, and meeting family
expectations. Participants saw graduation as a means to achieve status, establish independence,
and prove themselves capable of success in both academic and personal realms.
Social Pressure and the Desire to Graduate Together
Another key subtheme centered on how the participants expressed a strong awareness of
internal and social pressures to graduate within a specific timeframe. Six participants attributed
these pressures to factors such as the influence of friends, the desire to be on par with their peers,
and the perceived expectations of their social circle. Martin mentioned,
98

I would have felt like a loser if I didn’t graduate with my friends. I was the student
speaker at commencement, president of the Latin Business Association, and if I didn’t
graduate, I would’ve felt like I didn’t live up to my own hype.
Eight participants emphasized the importance of graduating alongside their friends and
classmates, viewing it as a shared milestone and an integral part of their college experience.
Sonia stated, “I wanted to graduate with my friends. I would have felt weird if it lasted more than
four years.” The drive to avoid being left behind and the sense of accountability they felt within
their academic community further motivated at least five participants to stay on track and
complete their degrees within the expected timeframe.
Family Influence and Following in Their Footsteps
The findings reveal a significant subtheme of family pressure and expectations as key
factors influencing the participants’ desire to graduate. Participants spoke of their older siblings
or parents who had pursued higher education, establishing a path for them to follow. For
example, one participant, Sonia, mentioned how their older sister’s journey into college had set
the course for their educational pursuits. Pedro also felt a duty to go to college because his older
brothers graduated from prestigious universities in Mexico. Andrea, as a first-generation student,
felt a different kind of family influence. She stated,
There was a lot of pressure on academics, right? We came to this country for a better life,
and what you need to do is go to school. So, that message has been ingrained for a long
time. Like, we pioneered this for our entire family. Our cousins, whether they ended up
doing school or not, that are younger had us a resource. We just didn’t have other people
in our family as resources. No one had done it. So, we really relied on each other to do it.
And Mom and Dad, you know, did what they can financially to afford us living in [city]
99

and never wanted us to work. So, that was a big message like that. What we’re able to
give you is because we need school to be your focus. We don’t need you working. I
babysat and made money on the side anyways, but their hope was that we didn’t work
and we just did school, and that was our job, which I think is an important message.
This sense of following in the footsteps of family members created a strong motivation to
graduate and fulfill the expectations set by their familial role models. The participants felt a
sense of duty and obligation to meet the educational milestones achieved by their family
members.
Moreover, the participants noted their own accountability and the desire to make their
parents proud as additional motivating factors for graduation. Eight participants spoke of feeling
embedded with the expectation to graduate from an early age as if it were a non-negotiable
aspect of their lives. Six expressed a deep sense of responsibility and a drive to pursue their own
career goals, tying their success to fulfilling their parents’ expectations. Martin stated, “Probably
the Number 1 reason why I graduated and went to college in the first place is because of my
parents. I kept up the motivation to graduate to keep them proud and get a career.” The
participants’ families actively monitored their academic progress, reinforcing the notion that
good grades and timely completion were essential for their continued support. Maria mentioned,
My family always asked about my grades. I think that was part of, like, I’m paying for
this, and I need to know that you’re doing well. So, showing my grades and keeping up
with my grades and even showing the idea of, like, I am excelling, and I’m also going
very fast to my family was positive reinforcement for me.
Meeting the threshold set by their families became a motivating force that held them accountable
and fueled their determination to graduate.
100

In summary, these first finding illuminates the significant influence of family pressure
and expectations on the participants’ desire to graduate. The participants felt a strong sense of
following in their family members’ footsteps, fulfilling social expectations, and meeting
financial obligations tied to education. The combination of these factors created a powerful
motivation for the participants to persist in their educational journey and earn their degrees.
Finding 2 for Research Question 1: Cultural and Social Stigma Are Significant Barriers
The results from the qualitative study shed light on the pervasive cultural stigma
surrounding mental health issues among Latinx undergraduate students and its impact on their
ability to access necessary resources for their journey toward graduation.
Cultural Stigma and Barriers to Accessing Mental Health Resources Among Latinx
Undergraduate Students
Participants revealed that seeking therapy or counseling was not a customary practice in
their culture. Andrea stated,
It’s not talked about in the home as often. It’s meant to be seen as weak. If you have a
problem, you don’t tell others about it. It’s meant to be brushed underneath the rug. I
think culturally, it’s just such a private to struggle. It’s such a prideful culture. But when
you struggle, and you struggle in big ways, it’s frowned upon.
Similarly, Martin stated,
I didn’t and won’t use mental health stuff because it is cultural. I think the fact that none
of my friends that were Latinos ever did that either. You know, grew up kind of everyone
dealing with their own stuff [and] maybe not talked about it as much.
Participants expressed their reluctance to seek mental health services, attributing it to the
perception that such services were primarily meant for individuals with severe problems or
101

deemed “crazy,” with six participants specifically mentioning this phrase. For instance, Maria
recalled,
If you come from a cultural background that tells [you that] you shouldn’t go to a
psychologist or a therapist because that is for people that are actually crazy, it will deter
the student or the young adult from seeking out the services themselves. It will make
them taboo.
Along the same line, Andrea mentioned, “I think, naturally, our culture says things like if you see
a psychologist, you’re crazy.”
In addition, participants expressed the belief that accessing mental health resources in
college was seen as a sign of weakness. Specifically, four participants mentioned associating not
seeking help with weakness. For instance, Martin shared that while it may seem obvious to
utilize mental health resources when needed, a cultural belief held him back because using these
services is perceived as “almost like a sign of weakness.” Pedro and Andrea echoed this
sentiment. They felt it was not culturally appropriate to use mental health resources as it would
imply that they were failing. Considering their families' sacrifices to allow them to attend a
prestigious school, they believed they could not show “emotional weakness” by struggling to
cope with student life. This cultural stigma, deeply ingrained within the Latinx community,
created a barrier that deterred students from seeking the mental health support they needed.
This perception of weakness was prevalent among the male participants, which led to
another insight: male gender identity can function as a significant barrier to accessing mental
health resources. Nando, for instance, acknowledged his tendency to avoid seeking help when
feeling overwhelmed, citing his internal nature. He expressed concerns about being perceived as
unintelligent or inferior, reflecting a common fear in the Latinx community. Similarly, Martin
102

admitted to a sense of embarrassment and reluctance to seek support, viewing doing so as a sign
of weakness. He acknowledged the societal expectation for male Latinxs to suppress their
emotions and avoid discussing feelings, which further deters them from utilizing mental health
resources. Pedro highlighted the influence of cultural norms and societal expectations,
emphasizing that talking about personal feelings is not widespread among Latinx males. He
noted how he, too, had been molded by this cultural perspective, exhibiting a reluctance to
address his emotional well-being during college. These quotes collectively illustrate the complex
interplay between male gender identity, cultural beliefs, and the limited openness to using mental
health resources within the Latinx community.
The Social Stigma of Latinx Undergraduate Students and Its Impact on Accessing Mental
Health Resources
In addition to cultural stigma, the participants’ responses highlight the pervasive social
stigma Latinx undergraduate students face, hindering their ability to access mental health
resources. The findings reveal how cultural expectations and societal pressures impede help-
seeking behaviors among this population.
The first subtheme that emerged was the fear of appearing “not normal” or different from
their peers. One participant shared their observation of a roommate with ADHD but was
reluctant to ask for help due to concerns about being made fun of or seen as intellectually
inferior. The participant described the roommate’s struggle to fit in and the dilemma of feeling
like they did not belong. Karla mentioned how she did not seem to perceive other peers
struggling and was reluctant to seek help to deal with her anxiety because “I felt like the odd one
out.” Cinthia recalled that at the time, she would have perceived peers negatively if they used on-
campus mental health resources: “I definitely would have judged them back then. It’s not like it
103

is now.” This fear of not fitting in and the potential negative social consequences associated with
seeking help contributed to the reluctance of Latinx students to utilize mental health resources.
Another subtheme that surfaced was the pressure to succeed academically. Participants
expressed how they internalized the achievements of their peers, creating a sense of inadequacy
and the need to hide their struggles. Fatima highlighted the tendency to compare oneself to others
who appeared to be thriving academically, leading to shame and keeping their own difficulties
hidden. She stated, “Nobody else seemed to be struggling like I did. I just felt like I wasn’t gonna
make it and I was really dumb.” Mario, Karla, Nando, Pedro, Andrea, and Maria mentioned they
felt pressure to maintain a facade of competence, and the fear of being perceived as not smart
enough or not belonging further discouraged them from seeking the support they needed. Pedro
stated, “I had always been a top student until here. I felt really stupid.” Similarly, Karla
mentioned she felt intellectually inferior because she “struggled so much with the general
curriculum.”
Seven participants also discussed the influence of age and maturity on their willingness to
seek help. They recognized that their desire to fit in and the belief that they should be able to
manage problems independently hindered their readiness to ask for assistance. Moreover, 54% of
the participants acknowledged that seeking help and accepting the need for support required a
certain level of maturity and self-awareness, which they felt they lacked during their college
years. The perception that seeking help was a sign of weakness or immaturity added to the
barriers the participants faced in accessing mental health resources.
Overall, the second part of the findings for Research Question 1 shed light on the
complex interplay of social stigma, cultural factors, and personal perceptions that deter Latinx
undergraduate students from seeking mental health resources. The stigma surrounding mental
104

health contributes to a culture of silence and hiding struggles. Latinx students often keep their
difficulties hidden, feeling the need to maintain a façade of success and competence. This
perpetuates a cycle of isolation as individuals compare themselves to their seemingly thriving
peers and refrain from seeking the support they need. Recognizing and addressing this stigma is
crucial for promoting a more inclusive and supportive environment that encourages Latinx
students to prioritize their mental well-being and ultimately thrive on their journey toward
graduation.
Conclusion
In conclusion, the findings for Research Question 1 shed light on the numerous factors
that influence Latinx undergraduate students’ journey toward graduation. The first key finding
highlights the participants’ personal drivers and motivators that propel them to complete their
studies. Financial independence was a significant motivator, pushing students to secure stable
employment and avoid relying on their parents. The allure of status and self-achievement
associated with graduating from a prestigious university also drives their pursuit of educational
success. Social pressure to graduate alongside friends and the desire to follow in their family’s
footsteps further reinforce their commitment to academic excellence. These intrinsic drivers
create a sense of self-sufficiency among Latinx students, reducing their reliance on external
school resources.
The second key finding revolves around the impact of stigma on the accessibility and
utilization of mental health resources among Latinx undergraduate students. Cultural and social
stigma emerged as barriers that perpetuate the belief that seeking therapy or counseling is
uncommon and only necessary for individuals with severe issues. Gender stigma also plays a
role, with male students experiencing additional barriers due to societal expectations of
105

masculinity and the fear of appearing weak. Stigma, coupled with the participants’ age during
college, further hindered their willingness to access mental health services.
Overall, these findings underscore the need to address the personal drivers and motivators
of Latinx students, as well as the need to combat the stigma surrounding mental health. In
regards to how Latinx students perceive the need to access relevant systems and mental health
support for the purpose of facilitating their graduation, the results reveal a low perception of
access to mental health resources due to stigma. To address this issue, it is recommended to
implement a rebranding effort that destigmatizes access to resources and aligns them with
students' personal motivations for graduation. This rebranding can also include leveraging
technology to provide anonymous and personalized access to mental health resources, thereby
reducing public exposure and stigma.By recognizing and addressing these factors, institutions
can better support Latinx students on their path to graduation and promote their overall well-
being.
Results for Research Question 2
Students face a myriad of stressors that trigger mental health issues and cause them to
consider dropping out. As one participant, Sonia, expressed, “Friends fighting or like [trouble in
the] family business or your dog died and all those external pressures … put a lot of stress on
academic work and performing well.” Pedro described life as an undergraduate as stressful
because it was “a new language, new school, new way of learning, new friends, away from
home, and feeling like I was really stupid.”
These are just some of the external triggers that significantly impact their ability to
maintain stability in school. This section aims to provide an overview of the stressors identified
by the participants that may have impacted their mental health and ability to graduate from
106

college. It will then proceed to present the findings that address research question 2, their
subthemes, and a summary of each one at the end.
Participants identified five major sources of stress that could directly affect their mental
health and, consequently, their ability to finish their undergraduate degree. These included
academic pressure, financial constraints, social isolation, and severe mental or physical
impairment or struggles.
Academic pressure and failure were mentioned as one of the emerging stressors. Sonia
explained, “If you’re not succeeding in college, that would definitely push you to wanna drop
out. … What if I fail a class and then what if I never graduate or what if I never get the job?”.
Karla stated, “Whenever I got a grade that I was not expecting or when something was harder
than I thought it needed to be, especially classes like in the science realm, it would maybe make
me reconsider my whole trajectory.” Fatima’s sense of academic pressure tied in a financial
aspect. She shared her perspective:
It was super stressful because I had to have a 2.5 minimum GPA every semester. And
when I finished the first year, I had 2.0 or something like that. So, I remember leaving
and going straight to my mom, crying that I was gonna lose this financial aid and I would
have to drop out. But, thank God, it didn’t happen. But, yeah, I was always super stressful
because I needed to maintain a certain GPA.
As Fatima’s quote emphasizes, financial stress is a prominent stressor for Latinx students.
Sonia emphasized that “any financial situation where I really couldn’t afford college would be a
definite driver to drop out.” The inability to meet the financial demands of education and basic
needs can be overwhelming. Cinthia echoed this sentiment, stating, “If I feel that I don’t know
how I’m gonna pay my bills or like break even, that would make me wanna go work instead of
107

study.” Eight participants mentioned that financial constraints, including the inability to pay for
tuition and living expenses, could create immense pressure and lead to thoughts of dropping out.
Mario described feeling a “tsunami coming on top of me” when he felt the financial burden of
seeking a loan for his books, tuition, apartment, and other expenses. He stated, “If I felt that I just
could not bear the financial burden of school, I would’ve absolutely dropped out.”
Moreover, the perception of being the only one struggling can exacerbate stress levels.
Lara explained that not having a support system or having rude and terrible professors, as well as
a hostile learning environment, can be detrimental to students’ mental health and would have
provoked a sense of wanting to leave. Feelings of isolation and the absence of peers to share
experiences with can intensify the stress experienced by Latinx students.
Lara also noted that hating school, lacking friends, and disliking classes could contribute
to contemplating dropping out. Andrea’s experience highlights a particular incident where she
realized that her cultural background did not align with the conventional physical appearance
expected in a university athletic program:
And [the coach] is like, “I’m gonna put you on the squad, but you can’t change your hair
color. You need to run that by me. If you cut your hair, you need to run that by that by
me.” So, it became very controlling in the sense of my look. And I got the message that I
wasn’t a preferred look, or it wasn’t a traditional look. So, that, in itself, was an
interesting stressor that drove me to not give up. … Part of me is like, “I deserve to be
here. I’m just as good as every other girl here. I just look different.” But it made for a
stressed environment in terms of if I get hurt or if I do something wrong, I feel like I’m
the first one to get cut before anybody else.
108

This encounter of feeling othered instilled a sense of not belonging at the university.
Similarly, Pedro expressed a sense of isolation and loneliness when he discovered he was the
only one grappling with the demanding coursework and, as a consequence, failed a course.
Sharing his academic setback with his roommate, who had not faced a similar challenge, further
deepened his feelings of being alone in his struggles. Pedro shared,
I told him I used the one-time exception policy, where I was allowed to fail one class
without any academic consequences, and he told me I was going to have a one-time
exception to him making fun of me about it and telling everyone else. I didn’t want to
have everyone know I failed.
Believing that their peers do not share similar experiences and emotions can damage
students’ mental health. This feeling of isolation and the belief that others do not go through the
same challenges can contribute to a decline in mental well-being. Consequently, this increased
strain on their mental health can significantly raise the likelihood of students considering
dropping out from their academic pursuits.
In addition to these stressors, severe mental or physical health issues can hinder students’
ability to continue their education. Sonia mentioned instances where a medical or personal
emergency prevented attendance in classes. Martin emphasized the impact of mental health
issues, stating, “depression, alcoholism. … Not going to classes, having anxiety attacks, stuff
like that” as a major influence for dropping out. The combination of academic and personal
challenges can make it incredibly challenging for Latinx students to prioritize their education and
overall well-being.
Lastly, family issues, such as conflicts or tragedies, can also contribute to stress. Sonia
noted that external pressures like friends fighting or family business can put immense stress on
109

academic performance. Seven participants mentioned that major life events, such as the death of
a loved one or a family member falling ill, can cause students to question their priorities and
potentially consider dropping out. The strong sense of familial duty and obligation within the
Latinx community can intensify the emotional toll of these situations.
It is evident from this data that Latinx students face a multitude of stressors that impact
their mental health and graduation rates. The challenges they encounter highlight the need for
appropriate services, support systems, and relationships to enable them to navigate these
stressors successfully. The next section will review the findings for this research question as well
as the associated subthemes.
An overview of findings for Research Question 2: Key Personal and Academic
Relationships Are Vital to Maintaining Positive Mental Health and Focus on Graduating
Regardless of the challenges students face in their personal lives or prior to entering
college, the university environment presents a multitude of stressors that can impact their mental
well-being and graduation outcomes. However, the findings of this second research question
shed light on the crucial role of relationships, both personal and academic, in fostering positive
mental health and promoting college graduation. The data presents key relationships both in the
academic and personal realm, as shown in Table 6.

110

Table 7
Findings for Research Question 2
Overarching
theme
Subtheme Findings Connection to
conceptual
framework
Finding 1: The
power of
strategic
academic
relationships
Professor Students value small class
sizes where the professor
can build a deeper
relationship with the
student.
Social cohesion
Familism
Advisor/counselor The advisor is a key figure
students will have to revisit
during their time in college,
and many expressed how
they wished this figure
could have provided a more
well-rounded perspective of
the college experience and
life as a working
professional.
Social cohesion
Acculturative stress
Familism
Language barriers
Department major Students in well-funded
majors or those in niche
programs received
personalized attention and
resources from the
university.
Social cohesion
Familism
Finding 2:
Strong
personal
relationships
support
students
toward
graduation.
Friends Participants felt the social
network was so strong they
didn’t need to reach out to
other sources of support.
Social cohesion
Familism
Family Family provides emotional
support and motivation for
college students who are
stressed by providing
guidance, motivation, and
fostering a sense of pride.
Familism
External supports External figures, including
religious figures, therapists,
and engagement in
volunteer work, provided
additional support for
students’ mental health
during college.
Social cohesion
Acculturative stress
Familism
Language barriers
Religiosity
Stigma

111

Finding 1 for Research Question 2
Professors in Small Classes
The first influential group identified in the study were professors, particularly those
teaching niche subjects in smaller class sizes. The participants expressed a strong connection
with and appreciation for these professors. Sonia acknowledged the passion and dedication of
professors in academia, stating, “I feel like especially in college professors and anyone from the
staff has chosen to be there … because they really wanna be there.”
The data revealed that students developed deep and meaningful connections with
professors in small class settings, predominantly in upper-division courses. Sonia and Nando
recalled feeling connected to their professors who knew their names. Mario bonded with teachers
who watched him evolve during college and felt that “deepens the relationship that you have
with that mentor or that teacher.”
Moreover, participants appreciated professors who demonstrated accessibility,
interpersonal skills, and a genuine interest in their students’ well-being. Karla discussed the
positive experiences she had during office hours, where conversations extended beyond
academic matters. She mentioned, “Whenever I went to a professor’s office hours with a
question, you end up talking about more personal things. … It was more along the lines of just a
normal conversation.”
Faculty involvement and support were also highlighted by Lara, who shared experiences
of faculty organizing events and demonstrating genuine care for students’ progress. Lara stated,
“They would do like a meet at their house, like a dinner at their house, every semester. … They
all were always available to support you.”
112

Advisors
The second key relationship is with advisors or counselors who guide students regarding
course selection during typically mandatory once-per-semester meetings. Maria felt a more
invested and attentive career counselor could provide tailored guidance based on students’
attitudes and backgrounds. Maria stated, “I think having a more invested career counselor … that
maybe does a little bit more of those aptitude assessments so that she knows who she’s
counseling … might have been helpful”.
Mario highlighted the need for academic counselors who understand students’ diverse
backgrounds, especially those from different countries or as first-generation or exchange
students. Mario believed such counselors could offer holistic guidance and help navigate the
challenges of college more effectively. He stated, “A different counselor probably would’ve been
extremely helpful in spending time, maybe understanding my background … having that
counselor perhaps understand a very holistic view of what the college is about.”
Furthermore, among the participants, five individuals expressed their appreciation for the
exceptional support received from their advisors. Lara mentioned that the key figure in
advancing her toward her degree was her advisor, who was from the same small town and spoke
Spanish. She said, “The cultural context my advisor had made me trust him and continually use
him as a resource.” Similarly, Pedro mentioned that his advisor was instrumental in helping him
not to drop out by helping him figure out which classes he could take at the community college
to advance his degree.
Although only seven participants explicitly mentioned the advisor as a key academic
figure for managing stress, all expressed either having a great advisor or desiring an advisor who
could guide them in college and toward a career.
113

Department Majors
Moving on to the third key pool of relationships, department majors were important in
building positive and deep connections with students. Two departments stood out for their ability
to foster such relationships and guide students toward graduation.
The first was the business school, which had more financial resources to allocate toward
counselors, programs, and supports for students, resulting in an overall better experience for
students compared to those in liberal arts or communication majors.
Six participants benefited from the intensive support provided by the business school.
Martin highlighted the personalized nature of the business school, stating,
[The business school] was tailored to me because I was part of a smaller subset of
students. All the resources, like the advisor, the diversity office were in [the business
school] building. It’s, you know, 2,000 students as opposed to 40,000.
Cinthia elaborated on the advantages of being in the business honors program within [the
business school], which provided exceptional resources and opportunities. She stated,
[The business school] was very, very thorough in a way that they would literally sit down
with you, walk around your resume, and they would help with setting up mock interviews
and just anything that you really needed. It sounds kind of like an unfair advantage to
have been in this program because you were also in this special little group that, just by
being in it, you were treated with the best of the best resources.
Furthermore, the two participants who pursued their studies in small, specialized liberal
arts departments also experienced a personalized approach from their departments because they
had 20 to 50 students. The small size allowed for closer guidance and the provision of tailored
resources. Karla shared how her department coordinator is” still the reference [for job
114

applications]. So, they never made me feel less. I even keep in touch to this day when asked to
promote the program to potential new students.” Karla also mentioned how her department
helped her achieve her goal of graduating in three years instead of four by assisting her in
creating a plan and supporting her throughout its execution. Additionally, Sonia highlighted the
dedication of the director of her major, who shared a common purpose and vision with the
students. The director went “above and beyond” to assist Sonia in securing a job in her desired
field, providing recommendation letters and opportunities for guest speaking in class.
Karla and Sonia emphasized their small niche departments more than 20 times as the
primary source of support during their college experience. Similarly, students from the business
school mentioned their department and professors approximately 11 times, on average,
throughout their interviews, highlighting them as the main source of support. Conversely,
students with large departments in liberal arts or communications did not mention their
departments as a means of support.
Finding 2 for Research Question 2: Strong Personal Relationships Support Students
Toward Graduation
While academic relationships help keep students on track toward graduation, personal
relationships are also significant. This section will explore three primary types of personal
relationships identified in the findings: friends, family, and other external support figures. These
figures can encompass religious, psychological, or other types of support that students rely on to
navigate the challenges of completing their undergraduate degrees.
Friends
All participants noted their social groups’ significant role in their overall well-being and
managing stress. The concept of social cohesion, a key element of the conceptual framework,
115

was evident as participants highlighted the importance of having a supportive social group. Their
social groups provided them with an outlet to relax, have fun, embrace diversity, and,
importantly, fostered a sense of belonging, support, and accountability to stay on track for
graduation.
Primarily, all participants acknowledged the importance of friends in their journey toward
graduation. As Sonia mentioned, “I would say friends for sure influenced my desire to finish my
degree.” Karla stated, “It would’ve been more my friends that told me not to quit than my
parents.” Since Mario had more friends than teachers or mentors, they “had more weight on how
I felt emotionally and my drive to graduate.” This demonstrates that social cohesion motivated
and supported the participants.
The participants also valued having a stable and healthy group of friends who provided
support in various aspects of their lives. Andrea said her group of athletic friends kept her
accountable for her schoolwork: “We would study a lot at the library together with other athletes.
… I was always with people. So, I feel like the sense of community, even if it was small, was
important for me to feel like we’re all in this together. We would take turns taking naps so that
the other person could study.” Similarly, Cinthia mentioned,
In the social group of friends I was with, everyone was hardworking. So, I was
surrounded by people that were on this path forward of, you know, growing and learning.
We had fun, and yeah, we did go out, and we got to do a lot of activities, but school was
always important. But I think, altogether, I was in an environment that promoted doing
well or studying or trying and giving it your best. And just like your friends, kind of,
especially your friends in your same program, keep you accountable because you’re
studying together. So, I think all of that helped me.
116

Sonia rounded it out by stating, “I had such a good support group within my friend[s]. …
I never needed university support.” This statement evidences that friends provide emotional
support and create a sense of belonging.” Six other participants echoed this sentiment.
Family
The family also provided students support in the university setting, especially when stress
and anxiety were high. Five participants mentioned that when things were tough in college, the
first person they called was their mother. Mario mentioned,
There wasn’t anybody that I thought of that I could go to [at school] to help me manage
that stress. I’m lucky that my mother is a practicing clinical psychologist with decades of
experience. So, like, she was always my go-to.
Sonia’s mother also was a practicing psychologist and often served as a sounding board
for her to vent her frustrations.
Students would also rely on having their families give them pep talks and motivation.
Lara stated, “My family is my biggest motivator. My family is very supportive.” Martin
mentioned he called his mother every day, and she teasingly called him a nerd whenever he
shared an academic achievement with her. Pedro stated that when school was “super stressful …
I just really needed to call my mom.” Fatima recalled,
[I] literally called my mom and told her like, “Hey, mom, going to an exam right now. I
think I need some cheering up because I am not feeling confident at all. And I really need
to do good in this exam. And I’m not feeling smart enough because I was not sure if I
belonged there.
In contrast, Andrea, as a first-generation college student, did not feel she could get
support from her parents and relied on her older sibling to guide her. She shared,
117

[My parents] don’t have an education like my brother and I did, so they didn’t know how
to help. Nor could they navigate a system, an American school system, given that they
don’t speak English. So, it was really talking to my brother and him telling me, “Well, do
you have access to this and that, and why don’t you look into it?” But he didn’t struggle
academically like I did, and I was involved in more things than when he was in college,
too, which I think can complicate it. But of course, I still think talking to him helped.
Overall, the family emerged as a significant source of support for eight out of the 11
participants. Whether it was seeking advice from a mother who is a practicing psychologist or
relying on regular calls with parents for encouragement, participants highlighted the invaluable
role of the family in providing emotional support, motivation, and a sense of belonging. Even in
cases where parents may not have been directly involved in the college experience, siblings
stepped in as guiding figures, offering advice and support throughout the journey.
External Support Figures
The third theme regarding relationships that emerged for Research Question 2 was that
other external figures supported students in their mental health while in college: religious figures,
external therapists, and people students met while doing volunteer work. Three participants
mentioned religion or religious figures at the university as a form of mental health relief. Martin
stated,
Yeah, definitely males at least [can use religion as therapy]. I see that me and my friends,
instead of going to therapy, did see my church or priest at school. I’m not sure what they
talked about with the priest, but I did have friends of mine that had a relationship with
this priest on campus as well because he was Latino. I know it felt like a release for them.
In the same vein, Andrea stated,
118

I think the Catholic church [was my relief]. It’s weird to say because I’m not religious
anymore, but it was a place where I had to have faith that I was capable and it was my
therapy at the time, right? Like, I go in every Sunday and pray that I can get through
another week of finals.
Cinthia also mentioned that her religious practice helped her grounded when her anxiety went
overboard.
Regarding external therapists, Lara mentioned an external therapist as part of her support
team when COVID-19 affected her college experience. She mentioned that her therapist was a
vital figure in allowing her to continue her studies, and because she had the financial means to
afford a therapist, she did not use campus resources.
Finally, one participant mentioned volunteer work as a source of giving back to others
and disconnecting from school-related stress. Sonia mentioned,
I volunteered with the sustainability department, and everyone in there was very like-
minded, and they really made me feel like part of a community, like people who were
fighting for the same thing. … Then, having them be part of my life post-graduation was
also beneficial, and I think that really pushed me to stay in college.
Overall, although not as powerful as the other two personal relationships, the participants
leaned on external sources of support during stressful times in their undergraduate experience.
The university could leverage these relationships to build trust to help Latinx students with their
mental health.
Conclusion
In conclusion, the data for Research Question 2 highlighted academic and personal
relationships in supporting undergraduate students. The participants shed light on the impact of
119

these relationships on their mental health and stress, motivation, and ability to navigate the
challenges during college.
The findings reveal that key academic figures such as counselors and professors provided
emotional support, created a sense of belonging, and fostered a supportive community.
Additionally, participants emphasized their friend groups in both academic and personal
contexts, describing them as sources of motivation, fun, and personal growth. The shared
experiences and camaraderie within these groups alleviated stress and provided a sense of home
away from home.
Additionally, these findings highlight fostering and nurturing relationships in the
university setting. They emphasize the need for universities to recognize and support students’
social and emotional health alongside their academic endeavors. Educational institutions can
create environments that foster community, resilience, and success by acknowledging and
leveraging the power of these relationships.
Overall, the results showcase the intricate interplay between relationships and
undergraduate students’ experiences. It reiterates the need for universities to prioritize social
connections and support systems as integral components of student success.The interviews and
data analysis revealed that Latinx students desire guidance, but their social, cultural upbringing,
and the presence of stigma may sometimes impede them from seeking support actively. To
address this issue, it is recommended to establish a mentorship program that provides
comprehensive support to students. Additionally, the university should make efforts to increase
cultural representation and competency among its staff, including advisors, counselors, and
professors. Integrating mental health discussions into the classroom can also play a crucial role
in creating a more supportive and inclusive learning environment for Latinx students.By
120

cultivating a sense of community, universities can empower students to navigate challenges,
enhance their well-being, and ultimately thrive.
Results for Research Question 3
The results show a need to cultivate a greater sense of care within the university
environment. Maria expressed the need for more human interaction, stating, “It [the university]
might need more of that human touch versus treating them [students] as just a number.” Fatima
criticized school services like the writing center, describing them as “bureaucratic” and treating
students as mere numbers.
Similarly, students felt that many of the school services designed to support them, such as
the writing, career, and mental health centers, were transactional and lacked empathy. Sonia
pointed out that the career center seemed more focused on meeting specific metrics, like a high
attention rate, rather than genuinely helping students find career opportunities aligned with their
goals and aspirations. Fatima echoed this sentiment by sharing, “When I went to the writing
center and career center for help, it was transactional. They didn’t even ask me for my name.”
While it is important for all student services to prioritize a sense of care, the mental health
center should especially embody this principle as a central aspect of the student experience.
However, regrettably, the two participants who visited the mental health center did not have this
experience. Pedro shared a detailed account of his experience at the mental health center.
Initially, he hesitated to seek help, assuming he would be treated as another anonymous
student. However, he eventually mustered the courage to go and was disappointed by the lack of
personalized care: “I didn’t feel like they actually cared when I was there and when the person
was hearing me, the psychologist, I didn’t feel like she cared and that she wanted to help me and
121

everything.” Furthermore, the limited number of sessions offered to him and the subsequent
referral to external clinicians left him feeling stigmatized and even more anxious than before:
I left feeling like, wow, I really have a big mental problem. Worse than I thought. But
now, what do I do? I can’t ask my parents for help. … They wouldn’t support me. The
university closed its doors. I have to pay for help, and I have no money. All they did was
call me after a few weeks to see if I had found a therapist, but I knew it was a protocol
call. They didn’t care. It was a student who just needed to fill out paperwork.
Andrea, another student who visited the mental health center, shared a similar experience.
She, too, was referred to an external clinician after a few sessions, which proved insufficient for
addressing her anxiety and learning disability. She said, “They let me hang out in the dust with
all my feelings.” She described her experience:
I couldn’t perform [an athletic maneuver] in practice, only at games. So, because of the
major, I decided to test out the wellness center. I didn’t tell anyone else because I knew
that would make me stand out even more on the team in a bad way. I knew I was already
on thin ice. So, I went to some sessions, used all the free ones, and was just aware I had
anxiety but then had nowhere else to turn.
Nando attributed the lack of care to the size of the University of State XYZ, suggesting
that being a large institution might hinder active engagement. He remarked, “Maybe cuz it was
such a big school. I don’t think they were that engaged.”
Despite the students’ overall perception that the school did not care for them as
individuals, each identified specific university figures who demonstrated care and concern. The
findings section will delve into the main findings: the key individuals and the school resources
122

that contribute to a culture of caring and foster a sense of being cared for and those who
positively influenced students.
Finding 1 for Research Question 3: Key University Figures Must Be Leveraged to Promote
a Culture of Caring
An important finding was that all participants pointed to their advisors and professors as
individuals from whom they desired or expected to receive care. Previously, some students
reported experiences with advisors and/or professors where they received personalized attention
and support. These university figures demonstrated a genuine sense of care by providing
guidance, resources, and a nurturing environment. However, there were also instances where
students did not connect with an advisor, counselor, or caring professor.
Given their important role, advisors and professors should have the tools and resources to
support and care for students effectively. By fostering stronger connections between students and
advisors and professors, universities can cultivate a culture of caring that extends beyond
academic guidance and empowers students to thrive personally and professionally. Table 7
provides an overview of the findings for research question 3.

Table 8
Findings Research Question 3
Overarching
theme
Subtheme Findings Connection to
conceptual
framework
Findings 1:
There are key
figures within
the university
ecosystem that
need to be
tapped into
Professors Getting to know students’
names and personal details
adds a sense of caring to
the classroom environment.
Social cohesion
Familism
Sharing personal stories or
stories from other students
who have completed their

123

and leveraged
to inculcate a
culture of
caring
degrees or coursework is
inspiring and motivating.
Small class sizes and more
niche topics created a
closer sense of community
and care between the
professor and students and
made it more likely they
would share relevant
resources that students
would find appealing.

Advisors/counselors Use the mandatory nature of
their relationships to
conduct soft check-ins.
Social cohesion
Familism
Provide exploratory
assessments to help
individuals gain a better
understanding of their
career development
prospects.

Recognize the crucial role of
cultural context in fostering
trust among students
towards university figures,
enabling them to feel more
comfortable being
vulnerable and following
their advice on accessing
relevant resources.
Cultural stigma
Language barriers
Social cohesion

124

Professors
Professors played a pivotal role in instilling a sense of caring among the students.
Students often reveled in having professors know their names, call them out in class, and even
guide them in their careers after graduation. Ten participants mentioned a specific memory or
interaction with a professor that instilled a sense that the university cared for them.
One recurring insight was the significance of personal connections and individual
recognition. Sonia emphasized the value of professors who remembered her name and treated her
as an individual, stating, “I really valued a couple of professors who would sit, and … they know
my name, they wanna know me as a person.” Maria stated, “If they knew my name, that made
me feel really special.” Jo described how professors in their specialized upper-division courses
demonstrated care by remembering personal details and displaying a passion for the university,
stating, “They would remember small human things that no teacher could do in a class of 300
students.” This sense of being a valued and unique member of the university community
contributed to meeting academic goals.
Moreover, hearing about previous students’ success stories from professors motivated
students and was a tangible sign that these professors and their classes would guide them to
success. Nando expressed how such stories provided an extra dose of confidence in graduating,
stating, “Professors talk about how their previous students have excelled...that just gives you that
extra motivation about really...pursue whatever you want.” Mario expanded on this: “Just
hearing about how other students who took this class graduated and doing cool stuff in the
workforce was great.” Karla mentioned, “Hearing them draw from their personal experience was
also very enriching.” The participants also emphasized the importance of active engagement
within the classroom environment. Nando described how professors who encouraged student
125

participation and created an inclusive atmosphere facilitated the development of strong
relationships, stating, “It kind of forces you to talk … and build that relationship with your
professor.”
Additionally, the participant feedback showed the role of specialized support and
personalized guidance. Participants mentioned the positive impact of advisors and smaller class
sizes within their majors. Martin shared their experience with advisors who focused on a smaller
subset of students and provided tailored support, stating, “They were more tailored to me...as
opposed to 40,000.” Maria also mentioned the benefits of summer programs, which offered more
personalized attention and support. Fatima recalled that her upper division professors, who led
smaller classes, were more open about resources available to their students.
In sum, the first subtheme for Research Question 3 demonstrates professors’ significant
role in instilling a culture of care among students and its impact on graduation rates. Personal
connections, individual recognition, and a sense of being valued were key factors in fostering a
caring environment. Professors who took the time to know their students’ names, remember
personal details, and create inclusive classroom environments were highly appreciated. Hearing
the success stories of previous students served as a powerful motivator and reinforced the belief
that success was attainable. Furthermore, specialized support from advisors and smaller class
sizes within specific majors were recognized as beneficial for personalized guidance and
academic success. These findings highlight the importance of fostering caring relationships
between professors and students to enhance graduation rates and overall student well-being. By
prioritizing these aspects in educational institutions, educators can create an environment that
supports students’ academic journeys and encourages their success.
126

Advisors
Based on the qualitative data analysis, several key findings emerged from the
participants’ experiences. Firstly, advisors provided significant support and guidance to students.
Martin mentioned that their advisor conducted “soft check-ins” and stated, “Their main goal is to
make sure you know which classes you need to take so you graduate with your requirements. …
Maybe I got lucky with my advisor that there were soft check-ins.” He stated that because of her
practical knowledge, he did not feel stigmatized when she asked about how he was feeling. Sonia
expressed gratitude towards her advisor, saying, “She immediately made me feel confident. …
She made me feel like she was a good person, so I felt really open talking to her. … She was
always super helpful.” Lara recalled how helpful and open her advisor had been since their first
meeting and how that cemented her trust in him for recommendation letters and guidance.
Secondly, selecting a major was a central aspect of students’ academic journey. Three
participants expressed a desire to have advisors take the time to get to know them as individuals
and offer them psychometric assessments so they can figure out their career paths. Maria
expressed regret about choosing a major too quickly, stating, “Choosing a major was too fast. It
was too preemptive. … There is a lack of exploration. … That is a pitfall of education and a bad
advisor.” Mario stated, “If I had had a better advisor, I would have gotten the exploratory stress
out of the way sooner and would have had better guidance in shifting from engineering to
business. I felt like I wasted time and money, which I didn’t have.”
Furthermore, the importance of personal connections and contextual understanding by
advisors was emphasized. Lara shared their experience with an advisor with a similar
background, which helped her feel cared for by stating, “He knew a lot about that, my
background and home life, and we were able to talk about that, … depending on what my goals
127

were, he would help me. The cultural connection definitely helped.” On the other hand, Andrea
felt like she missed being able to connect with Latinx counselors who could identify with her
cultural background, so she shied away from using those resources.
Additionally, the positive impact of supportive staff in specific classes was highlighted.
Karla mentioned, “The advisor there was the one that would guide me and help me... he was
always just very supportive”. Another participant, Pedro, described their academic advisor’s
assistance during a challenging financial situation, stating, “There was a whole month when I
didn’t know if I was gonna be able to continue school. … The academic advisor helped me. … It
worked out.” Cinthia recalls how her advisor in the business school was pivotal as he mapped
out career fairs, resume workshops, mock interviews and even resources within the business
school she could tap into for the more rigorous classes.
In conclusion, advisors played a crucial role in providing practical guidance, conducting
check-ins, and offering a sense of care and understanding. The participants expressed the need
for advisors to take the time to know them personally and provide aptitude assessments to aid in
major selection. Personal connections and cultural understanding by advisors were valued, as
they fostered a sense of trust and facilitated effective communication. The presence of supportive
staff in specific classes and their assistance during challenging situations were also recognized.
These findings underscore the significance of advisors’ role in students’ academic success and
well-being. By incorporating these insights into advisor training and support programs,
universities can enhance the quality of guidance and support provided to students, improving
their overall educational experience.
128

Summary
In sum, the research findings for the first research question provided valuable insights.
The first key finding reveals the role of personal drivers and motivators, such as financial
independence and the pursuit of status and self-achievement, in propelling the participants
toward graduation. Additionally, social pressure and the desire to follow family’s footsteps
reinforce the commitment to academic excellence. These intrinsic drivers foster self-sufficiency
and reduce reliance on external school resources. The second key finding highlights the
detrimental impact of stigma on access to and utilization of mental health resources. Cultural,
social, and gender stigma create barriers that discourage seeking therapy or counseling,
particularly among males. Recognizing and addressing these personal drivers and combatting the
stigma surrounding mental health will aid in supporting Latinx students’ academic success and
overall well-being. Institutions must prioritize these factors to better support Latinx students and
ensure their holistic development.
Regarding Research Question 2, which focused on the services, supports, and
relationships that Latinx students used to increase their mental health and graduation rates, the
findings shed light on the role of academic and personal relationships in helping undergraduate
students cope with stress. The participants’ direct quotes reveal the impact of these relationships
on their well-being, motivation, and ability to navigate the challenges in college. Counselors and
professors provided emotional support, created a sense of belonging, and fostered a supportive
community. Participants also emphasized friend groups in academic and personal contexts,
describing them as sources of motivation, fun, and personal growth. These findings showcase the
importance of nurturing relationships and highlight the need for institutions to prioritize students’
social and emotional well-being alongside their academic endeavors.
129

In regards to the third research question, the findings of this study revealed the role of
professors and advisors in fostering a culture of caring that positively impacts students’
graduation rates. Building personal connections, recognizing individuals, and creating inclusive
classroom environments were key factors in nurturing a caring atmosphere. Professors who got
to know their students by name, remembered personal details, and promoted inclusivity were
highly valued. Additionally, success stories from previous students were a powerful motivator
and reinforced the belief that success was achievable. Specialized support from advisors and
smaller class sizes in specific majors also contributed to personalized guidance and academic
success. These findings emphasize cultivating caring relationships between professors, advisors,
and students to enhance graduation rates and overall student well-being. Educators can create an
environment that supports students’ academic journeys and encourages their success by
prioritizing these aspects in educational institutions.
Overall, the research findings provide valuable insights into the perceptions and
experiences of Latinx students regarding mental health support systems, the role of relationships
in academic success, and the impact of a culture of caring on graduation rates. The findings
highlight the significance of personal drivers, such as financial independence and the pursuit of
status, while emphasizing the detrimental effects of stigma on accessing mental health resources.
Furthermore, the study underscores the impact of academic and personal relationships on
students’ well-being, motivation, and ability to navigate college life. It emphasizes nurturing
these relationships and prioritizing students’ social and emotional well-being alongside their
academic endeavors. Additionally, the research highlights the role of professors and advisors in
fostering a culture of caring, recognizing students' individuality, and providing personalized
support. It is crucial to explore various methods of cultivating a culture of care and support on
130

campus, which can be achieved through mentorship programs, fostering more personalized
relationships with professors, and providing cultural competency training to staff members who
have direct interactions with students.Educational institutions can better support Latinx students
on their path to graduation and promote their overall success and well-being by addressing these
findings and implementing supportive measures.

131

Chapter Five: Recommendations
This study examined higher education student support strategies and best practices that
promote mental wellness to improve Latinx students’ graduation rates. The results identified the
key relationships and support systems that aid Latinx students in completing their undergraduate
programs. Understanding their perspectives can help reduce Latinx student attrition and identify
university mental wellness practices that unintentionally isolate these students. The study utilized
qualitative methodology, specifically a case study design, wherein interviews were conducted to
collect and analyze data. The chapter discusses the findings, their connection to the literature and
the conceptual framework, as well as the study’s limitations, recommendations for practice, and
suggestions for future research. The chapter concludes with the key insights and conclusions
drawn from the study.
Recommendations
Latinx students in higher education face unique challenges and barriers that can impact
their mental health. Recognizing the importance of supporting their well-being, educational
institutions must adopt strategies that foster a culture of caring and provide tailored support. This
section presents recommendations based on this study’s findings and prior research to address
these students’ mental health needs. The recommendations primarily focus on two spheres:
addressing the stigma surrounding mental health and creating a culture of caring on campus. Key
strategies explored include rebranding mental health initiatives as mental wellness, leveraging
technology, instilling a culture of care within key figures at the university, providing guidance
through mentorship, and promoting cultural representation and competency among counselors
and advisors. By implementing these recommendations, universities can proactively support
Latinx students’ mental health and enhance their overall well-being and academic success.
132

Rebrand Mental Health Initiatives As Mental Wellness
The concept of rebranding mental health as mental wellness for college students has
gained attention in recent years and was mentioned by nine out of the 11 participants. The idea
behind this shift is to broaden the focus from mental illness to overall well-being and resilience.
By adopting a wellness-centered approach, educational institutions aim to reduce stigma,
encourage proactive engagement in self-care practices, and grow the culture of caring. Amber
Cowburn, a Cambridge graduate who is the founder of Invictus, a nonprofit aimed at guiding
youth with mental health issues, gave a TEDx Talk on the power of rebranding mental health
into wellness and stated, “If we want young people to be getting in touch with services early, to
be talking about mental health before mental illness then we need to provide them with a
platform, networks, and services they want to connect with” (TEDx Talks, 2018).
Along the same lines, a 2019 study by Rith Najarian et al. found that mental health
program recruitment effectively reached students with unaddressed mental health needs when
new branding and program titles were used instead of the phrase “mental health.” This mirrors
four of the participants’ recommendations. Cinthia mentioned: “If they would’ve included other
forms of wellness care like meditation, stress relief exercises, breathing classes and workouts, I
would’ve paid more attention.” Maria echoed this sentiment, stating, “Rebranding wellness into
more holistic care, like yoga or other forms of feeling better, would catch more Latino students.”
Nando mentioned that “meditation class would’ve been cool.” Additionally, Lara mentioned that
one of the best initiatives the mental wellness center had was an opportunity to play with stress-
relieving goats during finals: “It was weird and cool and definitely got me thinking about
releasing my anxiety.” Rebranding mental health into overall wellness can help reduce stigma
and encourage Latinx student engagement.
133

Leverage Technology
This rebranding should also consider the role of technology in providing easy access to
mental health resources. Karla mentioned the need for readily available resources, stating, “I
think just normalizing it and making sure everybody has the information at hand and that it’s not
as hard to find. … If you have those resources at hand, just kind of handed to you, it makes it
easier.” Maria further suggested using technology to provide virtual anonymity services and
personalized information tailored to individual needs and preferences.
Other higher education institutions recognize that fostering a culture of caring and well-
being can have significant benefits for Latinx students. One effective approach to promoting
wellness among Latinx students is to use technology and telehealth opportunities. In fact, the
Latinx community has shown the highest engagement in telehealth for mental health visits,
surpassing other ethnic and racial groups (Silva et al., 2021). This highlights the potential of
leveraging technology to provide accessible and convenient support for Latinx students’ mental
health needs.
Online communities have also been found to be important in supporting students’ mental
health, particularly during times of crisis. According to a survey of 2,000 student respondents in
Salesforce’s annual student connection report, 30% of students reported that online communities
fostered a sense of belonging at their universities, while 25% indicated that these communities
supported their overall well-being (Salesforce, 2022). Personalized communication messages
were particularly impactful, with over 40% of students feeling cared for and perceiving their
institutions as striving for their success when they received such messages.
Four participants in this study also highlighted incorporating technology to promote a
sense of caring. For example, the Ohio State University developed a wellness app that
134

empowered over 240,000 students to create personalized wellness plans, engage in wellness
challenges with their peers, and access relevant content, such as stress management techniques
during final exams (Abrams, 2022). This demonstrates the potential of technology in providing
students with tools and resources to support their well-being.
Another significant benefit of technology in promoting mental wellness among Latinx
students is its potential to address the issue of stigma. The study findings revealed that over 70%
of the participants mentioned experiencing social and cultural stigma as a major barrier to
seeking mental health resources on campus, despite experiencing anxiety and stress. This stigma
often deterred Latinx students from seeking help and support.
Technology can aid in overcoming this barrier by providing an anonymous and
comfortable platform for students to seek help. Online platforms and mobile applications allow
students to access mental health resources discreetly, without fear of judgment or disclosure (Lee
& Jung, 2018). Maria mentioned, “An app will make it easier for others to click and ask for
help.” Similarly, Sonia mentioned, “Using landing pages and other tech will make help just one
click away, and nobody has to find out.” By offering anonymity, technology creates a safe space
for Latinx students to explore and address their mental health concerns without the perceived
stigma associated with seeking help in person.
The confidential nature of digital platforms can help students feel more empowered and
in control of their mental health journey (Wies et al., 2021). It allows them to seek support at
their own pace without fear of negative repercussions or cultural taboos. By leveraging
technology, universities can destigmatize mental health issues and create an environment where
Latinx students feel comfortable seeking help (DuPont-Reyes, 2022). Incorporating technology
to remove stigma provides access to support and contributes to a broader cultural shift (DuPont-
135

Reyes, 2022). By normalizing the use of technology for mental health support, universities can
challenge societal norms and promote an inclusive and supportive environment for all students.
Instill a Culture of Care Within Key Figures at the University
In this study, 70% of the sample viewed professors and advisors as important figures who
provided care and had a significant impact on their stress levels and motivation to complete their
degree programs. Recognizing the importance of these relationships, universities can foster a
culture of care by actively nurturing and strengthening the connections between professors,
advisors, and Latinx undergraduate students (Semchuk et al., 2022). By creating a supportive
environment and offering various avenues for student support within these key relationships,
universities can enhance a sense of belonging and ultimately improve retention rates among
Latinx students (Nodding, 2002; Pedler et al., 2021).
However, based on the findings of this study, to effectively support Latinx students’
mental well-being, it is essential to leverage and train these key figures within the university
ecosystem. Professors can contribute to normalizing mental health discussions by incorporating
them early in the semester and periodically throughout the term. By integrating mental health
into the classroom environment, professors can help students normalize anxiety, stress, and other
overwhelming aspects of the college experience. The use of storytelling and personal anecdotes
by professors was mentioned by seven out of the 11 research participants as a way to capture
their attention and make them more likely to listen and absorb information.
Advisors and counselors also play a vital role in supporting Latinx students’ mental well-
being. These individuals can provide guidance, resources, and referrals to appropriate mental
health services. Advisors and counselors can create a safe and supportive environment where
136

students feel comfortable discussing their mental health concerns via training on effective
communication strategies and understanding Latinx students’ unique challenges.
While all university personnel should carry out these recommendations, the findings note
the role of professors and advisors in managing Latinx students’ mental health and fostering a
culture of care. Universities can create a supportive environment that promotes well-being and
enhances the overall undergraduate experience for Latinx students by leveraging the influence
and interactions that professors and advisors have with students regularly.
Latinx students can feel more psychologically supported throughout their college years if
their professors, student support staff, counselors, and other university-affiliated personnel
receive training on how to effectively reach out to and refer students in need (Semchuk et al.,
2022). One approach that can be adopted is the V-A-R method of communication, developed by
the mental health nonprofit Active Minds (Active Minds, 2022).
The V-A-R method enables educational leaders, counselors, and support staff to validate
students’ feelings, acknowledge their courage in expressing their concerns, and refer them to
appropriate services for beneficial action (Active Minds, 2022). In the referral stage, educational
leaders can guide students toward the right resources, such as student counseling services,
without providing concrete advice (Active Minds, 2022).
This study shed light on the role of professors, advisors, and counselors in providing care
and support to Latinx students to manage their stress levels and motivate them to graduate.
Higher education institutions must expand their mental health resources and services to cater to
Latinx students’ needs, foster a culture of care, and provide multiple avenues for support. The
findings emphasize the importance of educational leaders in promoting student mental well-
being, even without being mental health experts themselves. By utilizing communication
137

strategies like the V-A-R method, where students’ feelings are validated, their courage is
acknowledged, and appropriate referrals are made, educational leaders can empower Latinx
students toward better mental health and overall success.
Provide Guidance From a Mentor or Student Buddy
Promoting a culture of care involves providing multiple avenues of personalized support
for Latinx students. Mentorship programs can play a crucial role in offering comprehensive
support that goes beyond academic guidance. The concept of providing guidance was repeated
over 70 times throughout the interviews and by 72% of the participants. Andrea emphasized the
need for mentorship, highlighting the importance of identifying vulnerable students and
providing them with the necessary support throughout their college journey. Martin expressed
how having a mentor or guidance counselor from freshman year would have made seeking help
more comfortable. Maria recognized mentors as valuable figures who provide guidance and
expand students’ perspectives on career options.
Research has found that mentoring can benefit Latinx college students. A qualitative
analysis conducted by Zalaquett and Lopez (2006) found that 13 Latinx college students reported
positive effects of mentoring during and after their college experience. Another study, which
surveyed 541 Latinx college students at three urban universities over three years, revealed that
students with an advisor or mentor consistently demonstrated “higher levels of institutional
commitment, satisfaction with faculty, academic integration, cultural affinity, and
encouragement” (Torres & Hernandez, 2009, p. 141).
Universities can foster a culture of caring and support by implementing mentorship
programs and providing students with personalized support. These programs can help students
138

navigate challenges, expand their horizons, and foster a sense of belonging within the university
community.
Increase Cultural Representation and Competency Among Counselors and Advisors
Counselors, educational leaders, and student support service staff affiliated with
universities must have cultural humility and competency. A lack of knowledge about cultural
nuances can sometimes hinder a counselor’s ability to provide appropriate guidance (National
Alliance on Mental Illness, 2020). Counselors or advisors gain culturally specific information
when they understand a student’s culture and needs. For example, the phrase “me duele el
corazón” translates to “my heart hurts,” but it expresses emotional distress rather than physical
pain (Benuto et al., 2020). Culturally sensitive counselors or staff would seek further information
instead of assuming the issue is solely physical (National Alliance on Mental Illness, 2020).
Additionally, cultural adaptations can enhance social validity and make treatment more
acceptable and relevant to Latinx individuals by reducing internal barriers to accessing resources
and help (Benuto et al., 2020; Cabassa & Baumann, 2013; Castro et al., 2004; Cases et al., 2020;
Feldman et al., 2016; Green et al., 2006; Hinton et al., 2011).
Fifty-four percent of the study´s participants valued cultural representation and
competency among counselors. Alongside the challenges faced by the Latinx community, it is
important to address the limited diversity among key staff members. This lack of representation
can lead to implicit bias, which creates additional barriers to accessing adequate care
(Wintemute, 2022). In fact, 27% of the participants highlighted this concern during their
interviews.
Increasing the representation of counselors and advisors with similar backgrounds and
removing language barriers will address these disparities, a suggestion made by 36% of the
139

participants. Carpenter-Song et al. (2010) discussed the difficulty Latinx students face when
communicating with predominantly Caucasian academic professionals, leading to mistrust.
Pedro expressed discomfort in communicating in a language they were not fully comfortable
with, which could lead to misunderstandings. Andrea emphasized the significance of seeing
counselors who resemble her background, highlighting the absence of representation and power
figures during their college experience: “I didn’t have anyone that looked like me in a position of
power in college. No coach, advisor, counselor, or teacher. It was pretty sad.”
Universities can create an inclusive and supportive environment for Latinx students by
increasing cultural representation and eliminating language barriers. To address these disparities,
it is crucial to increase the representation of counselors and advisors who share similar
backgrounds with the Latinx community. Additionally, addressing language barriers is also
essential. This recommendation was made by 36% of the participants, emphasizing the
importance of having professionals who can understand and effectively communicate with
Latinx students. To enhance the mental well-being and academic success of Latinx students in
higher education, it is crucial to address these disparities and promote cultural competency
among counselors and advisors. This recommendation was mentioned by 45% of the
participants, emphasizing the significance of equipping professionals with the knowledge and
skills necessary to effectively support and understand the unique needs of Latinx students.
In line with these efforts, one of the recommended best practices for universities is to hire
more professionals from a similar ethnic background or who speak the same native Spanish
language, a concept which was suggested by 54% of the study´s participants.
Furthermore, Hovey et al. (2014) conducted a systematic review of how cultural
adaptations can improve the mental health outcomes of Latinx undergraduate students. Among
140

the four studies analyzed, two used affective motivational adaptations aligned with Latinx
cultural values (Casas et al., 2020; Feldman et al., 2016; Hovey et al., 2014). These cultural
adaptations increased participant comfort and trust and decreased the associated stigma with
mental health. Validating participants’ experiences through empathy, warmth, kindness, respect,
and personalization, as emphasized by Hovey et al. (2014), closely aligns with fostering a culture
of caring in the university setting (Noddings, 2002). The study demonstrated how culturally
valued interactions can enhance comfort and trust between students and educational leaders.
Integrate Mental Health in the Classroom
Over 85% of the participants also noted the importance of integrating mental health into
the classroom environment. Three participants mentioned how professors could play a significant
role in normalizing mental health discussions by incorporating them early in the semester and
periodically throughout the term. As Cinthia suggested, “Professors can start by incorporating
mental health discussions into their syllabus or dedicating a class session to it.”
Integrating mental health issues and awareness into the classroom environment is
essential for normalizing anxiety, stress, and other overwhelming aspects of the college
experience for Latinx students. Nine research participants emphasized the importance of
professors in facilitating these discussions and creating a supportive learning environment.
The majority of the participants, 63%, expressed that they would be more engaged and receptive
to information when it was presented by professors who incorporated storytelling to normalize
the challenges of college life. By sharing personal anecdotes or examples, professors can help
students understand that they are not alone in experiencing anxiety, stress, or other mental health
concerns.
141

Recognizing the significance of integrating mental health into the classroom, 72% of
participants highlighted professors' role in normalizing these discussions. Cinthia suggested that
professors can begin by incorporating mental health topics into their syllabus or dedicating a
class session to mental health. Lara stated she would “definitely pay attention to someone’s story
because I can’t ignore it like I would a poster.”
By proactively including mental health discussions in the curriculum, professors create an
opportunity for open dialogue and provide students with the necessary information and
resources. This approach helps to destigmatize mental health concerns and encourages students
to seek support when needed. It also promotes a culture of care and understanding wherein
students feel validated and supported in their struggles.
Recently, researchers at the Columbia University Mailman School of Public Health found
that a school-based educational program reduced mental health stigma among Latinx young
adults (DuPont-Reyes et al., 2022). A total of 751 students from 14 Texas schools participated in
the study. Three interventions were randomly assigned to classes: a teacher-led anti-stigma
curriculum, contact with a young adult who described their experience with bipolar disorder, and
materials with anti-stigma messaging (DuPont-Reyes et al., 2022). The results demonstrated that
Latinx young adults reported higher levels of stigma at baseline than non-Latino youth, but these
disparities were mostly eliminated after receiving the curriculum and contact interventions
(DuPont-Reyes et al., 2022). Specifically, the curriculum interventions were particularly
effective in eliminating disparities in stigma amongst females, while the contact interventions
were most effective amongst Latinx males (DuPont-Reyes et al., 2022). As a result of this study,
universities can incorporate stigma-reducing components into their curricula and train counselors
142

and other key support staff on the importance of contact intervention in reducing mental health
stigma (DuPont-Reyes et al., 2022).
In line with the recommendations from the DuPont-Reyes (2022) study, four participants
went beyond the integration of mental health discussions in the classroom and proposed that a
mandatory online class on mental wellness and resources should be implemented for all students.
They emphasized the importance of providing comprehensive education about mental health and
equipping students with the knowledge and tools to seek help when needed.
According to Maria, “It should be a required class for everyone, like an online course that
covers mental wellness, stress management, and where to find resources on campus.” Similarly,
Javier stated, “If we had a mandatory class or module on mental health, it would help all
students, not just Latinx students, to understand the importance of seeking help and knowing
where to go.”
Over 70% of the participants recognized that mental health issues could impact students
from diverse backgrounds and believed that providing universal education on mental wellness
would benefit the entire student population. They emphasized the need for students to understand
the significance of seeking help, managing stress, and being aware of the available mental health
resources on campus.
Implementing a mandatory online class on mental wellness and resources would ensure
that all students receive education and support to prioritize their mental well-being. It would
equip them with the skills and knowledge to navigate the challenges of college life and seek help
proactively.
By making mental health education mandatory, the university communicates that mental
wellness is a priority and that it encourages a campus-wide culture of support and understanding.
143

It removes the stigma of seeking help and promotes a proactive approach to mental well-being.
By acknowledging and discussing mental health concerns in the classroom, professors can
contribute to the overall well-being and success of Latinx students.
In conclusion, integrating mental health issues and awareness into the classroom
environment is crucial for normalizing anxiety, stress, and other overwhelming aspects of the
college experience for Latinx students. By incorporating storytelling and initiating mental health
discussions, professors can create a supportive and inclusive learning environment that validates
students’ experiences and encourages them to prioritize their mental well-being.
Implement Wellness Centered Messaging in Strategic Locations
Implementing wellness-centered messaging in key locations on campus, such as
cafeterias and hallways, is crucial in breaking down the barriers of stigma and encouraging
Latinx students to access mental health resources. Over 60% of participants in the study
highlighted the significance of having outreach efforts and reminders of mental health awareness
in visible and accessible areas on campus.
Andrea emphasized the need for more outreach in general, stating that wellness
messaging should be present in common spaces where students frequently gather, like cafeterias
and hallways. She acknowledged that increasing the visibility of mental health resources in these
areas could benefit Latinx students’ well-being. Similarly, Martin recognized the importance of
constant reminders of mental health awareness. He mentioned wellness-centered messaging in
the library, where snacks and materials related to mental health were provided. According to
Martin, these reminders served as a continuous encouragement for students to prioritize their
mental well-being.
144

By strategically placing mental wellness messaging in key campus locations, 6
participants mentioned universities can create an environment that normalizes conversations
around mental health. These messages serve as a constant reminder to Latinx students that
seeking support is not only acceptable but also actively encouraged. They help to break down the
cultural and social barriers associated with mental health and provide a visible and tangible
display of the university’s commitment to the well-being of its students.
Incorporating wellness-centered messaging in key locations on campus can play a
significant role in reducing the stigma surrounding mental health among Latinx students. It
creates a welcoming and supportive atmosphere that fosters a sense of belonging and encourages
individuals to seek help and resources for their mental well-being.
Summary
The concept of rebranding mental health initiatives as mental wellness has gained
attention in recent years, particularly in college settings. The aim is to shift the focus from solely
addressing mental illness to promoting overall student well-being and resilience. By adopting a
wellness-centered approach, educational institutions hope to reduce stigma, encourage proactive
engagement in self-care practices, and foster a culture of caring.
Leveraging technology is another important aspect of promoting mental wellness among
college students, especially Latinx students. Technology can provide easy access to mental
health resources, offer virtual anonymity for seeking help, and deliver personalized information
tailored to individual needs and preferences. Online communities and mobile applications can
help support students’ mental health, providing a sense of belonging and convenient access to
support.
145

Creating a culture of care within the university requires the active involvement of key
figures such as professors and advisors. They can contribute to normalizing mental health
discussions, incorporating them into the classroom environment, and periodically addressing
them throughout the term. Training these individuals on effective communication strategies and
understanding Latinx students' unique challenges can create a safe and supportive environment
where students feel comfortable discussing their mental health concerns.
Mentorship programs also play a crucial role in offering comprehensive support beyond
academic guidance. By implementing mentorship programs, universities can provide
personalized support, help students navigate challenges, and foster a sense of belonging within
the university community.
Cultural representation and competency among counselors and advisors are essential for
supporting the mental well-being of Latinx students. Increasing the representation of
professionals with similar backgrounds and eliminating language barriers can create an inclusive
and supportive environment. Cultural adaptations in mental health services can also improve
outcomes by aligning with Latinx cultural values and reducing stigma.
Integrating mental health into the classroom environment is important for normalizing mental
health discussions and addressing the challenges of college life. Professors can play a significant
role by incorporating mental health topics into their syllabi, sharing personal anecdotes, and
creating a supportive learning environment.
Overall, universities can enhance Latinx students’ mental well-being and academic
success by rebranding mental health as mental wellness, leveraging technology, instilling a
culture of care, providing guidance through mentorship, and promoting cultural representation
and competency.
146

Limitations
This section discusses the limitations and delimitations of the study conducted to explore
the mental health experiences of Latinx undergraduate students. By recognizing and
understanding these limitations, researchers can comprehensively assess the study’s scope,
applicability, and potential biases. The limitations encompass several aspects, including the small
sample and pre-existing relationships with participants, the findings’ generalizability, timeframe
considerations, research design, reliance on a single researcher, and delimitations related to the
use of established relationships, geographic boundaries, digital interviews, focus within specific
disciplines, urban settings, and age range. By acknowledging these limitations and delimitations,
researchers can enhance the transparency and validity of the study while also identifying
opportunities for future research to expand on these findings in more diverse contexts and
populations.
Preexisting Relationships
The interviews conducted as part of this study had a deliberate limitation in terms of the
small sample and population. Participant selection was based on my pre-existing relationships
with them, aiming to mitigate my positionality’s potential influence.
However, leveraging these pre-established relationships with the participants may have
introduced bias into the data. Participants might have been less transparent than with an
unknown interviewer, as they may have been guarded in their responses due to their respect for
their existing relationship rather than their perception of the undergraduate student experience.
My experience working within the Latinx cultural context informed the concept of establishing
relationships based on trust. While this was expected to yield positive results, it was not
guaranteed.
147

Generalizability
Another limitation is the findings’ generalizability. The study focused on a specific
geographic location and higher education institution, and the findings may not apply to other
contexts or populations. Various factors, such as cultural backgrounds, socioeconomic status,
and institutional characteristics, can significantly influence Latinx students’ experiences and
challenges in different educational settings. For example, cultural norms and values may vary
across regions, impacting how Latinx students navigate their educational journey and seek
support. Socio-economic disparities can also play a role in access to resources and opportunities,
which may differ between institutions or geographic locations. Moreover, each higher education
institution has unique policies, programs, and support structures, which can influence the overall
student experience.
Therefore, it is important to consider that this study’s findings may provide valuable
insight into the experiences of Latinx undergraduates at the University of State XYZ, but caution
should be exercised when generalizing these findings to other universities or regions. Further
research in diverse settings is needed to enhance the generalizability and applicability of the
findings to a broader population of Latinx students.
Timeframe
The timeframe of the study presents a potential limitation. The research was conducted
within a specific period, and various factors such as evolving campus environments, policies, or
external events may have influenced the participants’ experiences differently before or after the
study timeframe. In particular, the mental health landscape at universities underwent significant
changes following the COVID-19 pandemic, which may have impacted the availability of
148

resources and students’ perceptions and experiences. Some recommendations discussed in this
study may have already been implemented in response to the pandemic.
Additionally, it is important to consider that all but one interviewee had graduated before
the COVID-19 pandemic. Their perspectives on mental health and its impact on their academic
performance may differ significantly from those of current students who experienced the
pandemic’s effects firsthand. The level of stigma surrounding mental health, which emerged as a
significant finding, could have undergone a dramatic shift in the post-pandemic context.
Another aspect related to time is that many participants graduated over 10 years ago, and
their recollection of events and experiences as undergraduates may have changed and been
influenced by their personal growth and development over time. Whether their memories
accurately reflect their experiences, relationships, and support systems during their
undergraduate years is uncertain.
These considerations highlight the need for future research to explore the experiences of
Latinx students in more recent contexts and to ensure that the findings capture the dynamic
nature of mental wellness support strategies over time.
Research Design
This study’s research design may pose certain limitations. One limitation stems from the
use of interviews as the primary data source. While qualitative interviews offer in-depth insights
and perspectives from participants, they may not capture the full range of experiences and
nuances those quantitative methods, such as surveys or experiments, can provide. Consequently,
the findings derived from qualitative interviews may not be statistically generalizable to the
larger population of Latinx students.
149

Moreover, it is essential to recognize the subjective nature of qualitative research. The
interpretation of data in qualitative studies is influenced by the researcher’s perspective,
preconceived notions, and biases. This potential for interpretation bias could affect the
objectivity and reliability of the findings. It is important for researchers to employ rigorous
techniques, such as member checking or peer debriefing, to minimize bias and enhance the
study's credibility.
Furthermore, the small sample of 11 Latinx participants limited the breadth and diversity
of perspectives represented. While qualitative studies often prioritize depth over breadth, a larger
and more diverse sample could provide a more comprehensive understanding of the experiences
and challenges faced by Latinx students in the context of mental wellness and graduation.
To address these limitations, researchers should acknowledge the specific focus and
scope of their studies, emphasizing the unique insights gained from the participants. They should
also discuss the limitations regarding generalizability and potential interpretation bias,
highlighting the need for future research with larger and more diverse samples to validate and
expand on the findings. By doing so, the study can provide valuable insights while
acknowledging its inherent limitations.
Digital Interviews
Another limitation of the study was the reliance on digital interviews via Zoom, as
opposed to in-person conversations, due to the geographic distance because I was based in
Mexico City, Mexico. This digital format may have led to assumptions or gaps in understanding
and interpretation, as it limited my ability to observe participants’ nuanced behaviors and social
cues.

150

A Single Researcher
Lastly, the study’s reliance on a single researcher introduces potential bias and
subjectivity in data collection, analysis, and interpretation. During data collection, my personal
beliefs, experiences, and perspectives could have influenced how I asked questions or the
direction of the interview. This bias may have shaped participants’ responses or limited the
exploration of certain topics. Moreover, my existing relationship with participants could also
have introduced bias, as pre-established connections may affect the dynamics and openness of
the interviews.
In terms of data analysis, a researcher’s personal biases and interpretations can influence
the coding, categorization, and identification of key themes or patterns. Different researchers
with diverse perspectives and expertise might have brought alternative interpretations to the data,
enhancing the study’s validity and reliability.
Finally, in interpreting the findings, a single researcher’s subjective lens may lead to a
narrow understanding of the data. Having multiple researchers or employing a team-based
approach would offer the opportunity for diverse viewpoints, discussions, and debates, which
can enrich the interpretation process and ensure a more comprehensive data analysis. To mitigate
these limitations, researchers could consider involving multiple researchers or forming a research
team to enhance objectivity and minimize individual bias. Collaborative discussions and peer
debriefing among researchers can provide valuable checks and balances, ensuring a more
rigorous and well-rounded study. Furthermore, transparently documenting the researchers’
backgrounds, perspectives, and potential biases can increase transparency and allow readers to
evaluate the influence of researcher subjectivity on the study’s outcomes.
151

Overall, acknowledging the limitation of a single researcher and considering strategies to
address potential bias can strengthen the credibility and validity of the study, providing a more
robust foundation for drawing conclusions and making recommendations.
Delimitations
Use of Established Relationships and Geographic Boundaries
The delimitation of the use of established relationships and geographic boundaries in the
study helped provide a specific focus and context for understanding Latinx student experiences.
By leveraging pre-existing relationships with participants and focusing on a particular
geographic location, the study aimed to gain in-depth insights into the experiences of Latinx
students who graduated from the University of State XYZ.
However, it is important to acknowledge that these delimitations also have implications
for the generalizability of the findings. While the study’s findings can provide valuable insights
into the experiences of Latinx students within the specific context of the University of State
XYZ, it may not fully capture the diversity and range of experiences among all Latinx students.
Latinx students at other institutions or in different geographic locations may encounter
unique challenges, cultural influences, and institutional dynamics that could significantly shape
their experiences and support systems. The findings of this study may not be directly transferable
to those contexts.
Moreover, within the study’s defined boundaries, there may still be variations in
experiences among Latinx students that were not fully captured. Factors such as socioeconomic
backgrounds, cultural traditions, gender identities, and individual circumstances can influence
how Latinx students navigate their undergraduate journeys.
152

Focus on Specific Disciplines
Another delimitation was the focus on undergraduate Latinx students within a specific
academic discipline or program. Since this was purposeful, random sampling, the pool of
participants fell into liberal arts, business, and communication departments. The findings may
not have fully captured the experiences and challenges Latinx students face in other disciplines
or programs. Different majors or areas of study may present unique academic demands, social
dynamics, and support systems that could impact the mental wellness of Latinx students
differently.
Urban Setting
Additionally, the study’s delimitation was a specific focus on an urban educational
setting. By excluding rural or remote areas, the findings may not account for the distinct
challenges and resources available to Latinx students in non-urban environments. Factors such as
access to mental health services, community support, and cultural representation may vary across
different geographic contexts.
Age Range
Furthermore, participants’ ages were in a narrow range. Also, focusing solely on
undergraduate students may overlook the experiences of Latinx graduate students or non-
traditional students who may have unique perspectives and needs related to mental wellness.
By acknowledging these delimitations, it is important to recognize that the findings may
provide valuable insights within the specified parameters, but they may not fully represent the
experiences of all Latinx students across various academic disciplines, geographic locations, and
educational stages.
153

Summary
In sum, the study identified limitations such as the reliance on digital interviews, the
focus on specific academic disciplines, the exclusion of rural areas, and the potential omission of
diverse experiences among Latinx students. These limitations underscore the need for future
research to replicate the study in different contexts, increase sample size, adopt mixed methods
approaches, and narrow the scope to capture a deeper understanding of specific student
populations or majors. Additionally, the delimitations of the study provided a specific context
and focus for understanding Latinx student experiences. However, it is important to acknowledge
that these delimitations limit the generalizability of the findings to other institutions and
locations. Additionally, by addressing these limitations and delimitations, researchers can
contribute to a more comprehensive understanding of Latinx student experiences and inform
evidence-based strategies to support their mental well-being and academic success.
Recommendations for Future Research
This section presents a set of recommendations for future research based on the findings
of a qualitative study that examined the experiences of Latinx undergraduate students at a 4-year
public university. The objective of these recommendations is to advance the understanding of the
factors that influence Latinx students’ mental health and academic achievement and provide
evidence-based strategies for supporting their educational journey. The recommendations include
replicating the study with Latinx students at a public university in California, increasing the
sample size, designing a mixed-methods study with Latinx student graduates across the United
States, and narrowing the scope of the study to focus on a specific student population or major
within a particular university. These recommendations aim to enrich our understanding of Latinx
154

student experiences, inform institutional practices, and contribute to the development of targeted
interventions that enhance their retention, well-being, and graduation rates.
Replicate the Study With A University in Another State
Based on the findings of this qualitative study, it is recommended that future research
endeavors replicate the study with Latinx undergraduate participants at a different public 4-year
university, such as in California. This recommendation stems from the understanding that
different states may have unique cultural contexts, educational systems, and support structures
that can significantly influence the experiences and challenges faced by Latinx students
(Schneider & Ownes, 2006). By conducting a comparative study between the university in this
study and a California university, researchers can gain valuable insights into the similarities and
differences in mental health experiences and support needs of Latinx students across different
geographic locations.
Replicating the study in California would provide an opportunity to examine the
influence of regional and cultural factors on the mental health experiences of Latinx students.
California is known for its diverse population and higher education institutions that attract many
Latinx students (The Campaign for College Opportunity, 2021). By selecting a public 4-year
university in California, researchers can explore how factors such as cultural norms, community
resources, and institutional policies shape the mental wellness of Latinx students in this specific
context. Comparing the findings between states would broaden the generalizability of the study
and contribute to a more comprehensive understanding of the experiences of Latinx students in
different parts of the United States.
Moreover, a comparative study would allow for an analysis of the effectiveness of mental
health support strategies implemented in these different contexts. By examining the similarities
155

and differences in the availability of resources, cultural competence of counselors and advisors,
and campus-wide initiatives promoting mental wellness, researchers can identify best practices
and potential areas for improvement. For instance, if the university in this study had
implemented strategies to address Latinx students’ mental health needs, researchers could
investigate whether similar approaches are employed in the Californian university and assess
their impact on students’ well-being. This comparative analysis can inform evidence-based
recommendations for universities in both states and serve as a starting point for the development
of tailored interventions and support systems to enhance the mental health outcomes of Latinx
students across the nation.
Compare Findings
The second recommendation is to leverage a larger sample size, if possible. By increasing
the number of participants in future studies, a deeper understanding of Latinx student
perspectives on their engagement and experiences on the path toward graduation can be
obtained. A larger sample would allow for collecting insights from a more diverse range of
majors and capturing the perspectives of both men and women. Exploring potential differences
in perceptions among various academic disciplines and gender groups would add nuance and
depth to the findings.
The study identified social cohesion and a culture of care among professors and advisors
as helping to improve mental wellness and facilitating degree attainment among Latinx students.
A future study should investigate whether these subthemes contribute to positive engagement at
other 4-year universities. Replicating the study in different institutional contexts would provide
valuable insights into the generalizability of these findings and shed light on potential variations
in the importance of social cohesion and a culture of care across diverse university settings.
156

Understanding the broader applicability of these themes can inform the development of targeted
interventions and support systems to enhance Latinx students’ experiences and academic success
at various institutions.
Design a Mixed-Methods Study
The third recommendation is to collaborate with other 4-year public universities and
design a mixed-methods study incorporating quantitative and qualitative data collection from
Latinx student graduates across the United States. This approach would enable a high-level and
comprehensive examination of Latinx student perspectives regarding the support systems they
require on their journey toward graduation and mental health. By combining quantitative data,
such as surveys or statistical analyses, with qualitative data from in-depth interviews or focus
groups, a more holistic understanding of the challenges and needs of Latinx students can be
achieved.
The outcomes of this study could then be shared with other universities, serving as
valuable insights to inform and enhance their strategies for improving Latino student retention
and graduation rates. By sharing the findings and best practices, universities can learn from each
other’s experiences and implement evidence-based approaches to better support Latinx students
in their educational journeys. This collaborative effort would contribute to developing a broader
knowledge base and foster a culture of knowledge sharing and continuous improvement in
supporting Latinx students’ success across multiple institutions.
Narrow the Scope
The fourth and final recommendation is to narrow the scope of the study by adopting an
in-depth, qualitative design focused on a specific student population or major within the
University of State XYZ. This approach aims to provide a deeper understanding of participant
157

perspectives by delving into individual student worldviews. The study’s findings, along with a
review of the literature, suggest that each Latinx population has unique cultural practices,
financial circumstances, and belief systems (Benuto et al., 2020). The study began to uncover
these nuances, particularly in relation to mental health and its relationship to graduation rates, but
there is still much more to explore.
This recommendation is to leverage a sample that represents diverse Latinx cultural and
socioeconomic backgrounds to better understand how these specific cultural perspectives
influence gender norms and potentially shape students’ interactions with various support systems
within the university on their journey toward graduation. By focusing on the cultural and gender
nuances that emerged as important factors in engagement with university support systems, the
study can delve deeper into how these factors influence undergraduate experiences and
graduation rates. Understanding the specific cultural perspectives that impact gender norms and
interactions with support systems can provide valuable insights for universities to tailor their
support services and create a more inclusive and effective environment for Latinx students to
thrive academically and mentally.
Summary
As a whole, this section provides several recommendations for future research on Latinx
undergraduate students. Replicating the study with participants from another public four-year
university, such as in California, would explore the influence of regional and cultural factors on
student experiences. A comparative analysis between universities in different states would
broaden the findings’ generalizability and contribute to a comprehensive understanding of Latinx
students nationwide. Additionally, a larger sample size and a mixed-methods approach would
deepen our understanding of Latinx student perspectives and inform interventions and support
158

systems. Lastly, narrowing the study’s focus to a specific student population or major within a
university would allow for a more in-depth exploration of cultural and gender nuances, offering
insights for tailored support services and creating an inclusive environment. These
recommendations aim to advance knowledge in higher education and support the well-being and
success of Latinx students.
Conclusion
In conclusion, this study investigated how mental health support and a culture of caring
within universities impact the experiences of Latinx undergraduate students and their journey
toward graduation. The findings highlight the significant barriers that hinder Latinx students’
access to mental health resources and the importance of addressing them to improve their well-
being. Additionally, the study emphasizes the critical role of caring relationships with university
figures in supporting Latinx students’ educational journeys.
The recommendations emerging from this study provide actionable steps for universities
to enhance the educational experience of Latinx students. Institutions can create a more inclusive
and supportive environment by integrating mental health awareness in the classroom, leveraging
technology for support initiatives, and investing in cultural competence training for key
university figures. These efforts could improve retention and graduation rates among Latinx
students and contribute to a campus culture that prioritizes the well-being of all students.
Moreover, the findings of this study have broader implications for universities across the
United States. By understanding the unique challenges faced by Latinx students and tailoring
support systems accordingly, institutions can better meet the needs of this diverse student
population. This, in turn, can lead to improved outcomes and increased representation of Latinx
students in higher education.
159

Overall, this study goes beyond a mere summary of findings and holds significant
importance and impact. By caring about and implementing the recommendations of this study,
universities can create an inclusive and supportive environment that fosters the academic success
and mental well-being of Latinx students. The implications of this research extend beyond a
single institution, offering valuable lessons and best practices that can be applied to universities
nationwide. Through these efforts, Latinx students can thrive and succeed in higher education,
shaping a more equitable and diverse future for the United States.

160

References
Abrams, Z. (2022). Student mental health is in crisis. Campuses are rethinking their approach.
Monitor on Psychology, 53(7), 60. https://www.apa.org/monitor/2022/10/mental-health-
campus-care
Active Minds. (2022). Active Minds’ story - A movement of hope created out of tragedy.
https://www.activeminds.org/about-us/our-story/
Agency for Healthcare Research and Quality. (2017). 2016 national healthcare quality and
disparities report. https://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/index.html
Aguayo, D., Herman, K., Ojeda, L., & Flores, L. Y. (2011). Culture predicts Mexican
Americans’ college self-efficacy and college performance. Journal of Diversity in Higher
Education, 4(2), 79–89. https://doi.org/10.1037/a0022504
Aguilar-Gaxiola, S. A., Zelezny, L., Garcia, B., Edmondson, C., Alejo-Garcia, C., & Vega, W.
A. (2002). Mental health care for Latinos: Translating research into action: Reducing
disparities in mental health care for Mexican Americans. Psychiatric Services, 53(12),
1563–1568. https://doi.org/10.1176/appi.ps.53.12.1563
Aguirre-Molina, M., Molina, C. W., & Zambrana, R. E. (2001). Health issues in the Latino
community. Jossey Bass Publishers.
Alcántara, C., Abelson, J. L., & Gone, J. P. (2011). Beyond anxious predisposition: Do padecer
de nervios and ataque de nervios add incremental validity to predictions of current
distress among Mexican mothers? Depression and Anxiety, 29(1), 23–31.
https://doi.org/10.1002/da.20855
Alegría, M., Mulvaney-Day, N., Woo, M., Torres, M., Gao, S., & Oddo, V. (2007). Correlates of
past-year Mental Health Service use among Latinos: Results from the National Latino
161

and Asian American study. American Journal of Public Health, 97(1), 76–83.
https://doi.org/10.2105/AJPH.2006.087197
Ambrose, A. R., Moore, G. W., Slate, J. R., & Martinez-Garcia, C. (2018). Differences in
dropout rates as a function of high school size for students in poverty: A Texas multiyear,
statewide study. School Leadership Review, 12(2), 55–67.
American Institutes for Research. (2010). Finishing the first lap: The cost of first year student
attrition in America’s four year colleges and universities.
http://www.air.org/files/AIR_Schneider_Finishing_the_First_Lap_Oct101.pdf
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders. American Psychiatric Publishing, Inc.
American Psychological Association. (2003). Guidelines on multicultural education, training,
research, practice, and organizational change for psychologists. The American
Psychologist, 58(5), 377–402. https://doi.org/10.1037/0003-066X.58.5.377
American Psychiatric Association. (2013a). Cultural concepts in DSM-5.
https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Cul
tural-Concepts-in-DSM-5.pdf
American Psychiatric Association. (2013b). Diagnostic and Statistical Manual of Mental
Disorders, 5th Edition: DSM-5.
American Psychological Association. (2023). APA dictionary of psychology.
https://dictionary.apa.org/
American Psychological Association. (2011). Health and homelessness.
https://www.apa.org/pi/ses/resources/publications/homelessness-health
162

The American School Counseling Association. (2004). The ASCA national model workbook: A
companion guide to implementing a comprehensive school counseling program (4th ed.).
American School Counselor Association. (2019). ASCA national model executive summary.
https://schoolcounselor.org/getmedia/bd376246-0b4f-413f-b3e0-1b9938f36e68/ANM-
executive-summary-4th-ed.pdf
Anctil, T. M., Smith, C. K., Schenck, P., & Dahir, C. (2012). Professional school counselors’
career development practices and continuing education needs. The Career Development
Quarterly, 60(2), 109–121. https://doi.org/10.1002/j.2161-0045.2012.00009.x
Anderson, K. F. (2012). Diagnosing discrimination: Stress from perceived racism and the mental
and physical health effects. Sociological Inquiry, 83(1), 55–81.
https://doi.org/10.1111/j.1475-682X.2012.00433.x
Anderson, K. F., & Finch, J. K. (2017). The role of racial microaggressions, stress, and
acculturation in understanding Latino health outcomes in the USA. Race and Social
Problems, 9(3), 218–233. https://doi.org/10.1007/s12552-017-9212-2
Andrade, F. C., & Viruell-Fuentes, E. A. (2011). Latinos and the changing demographic
landscape: Key dimensions for infrastructure building. In L. P. Buki & L. M. Piedra
(Eds.), Creating infrastructures for Latino mental health (pp. 3–30). Springer.
https://doi.org/10.1007/978-1-4419-9452-3_1
Appelbaum, P. S. (2006). Law & psychiatry: “Depressed? Get out!”: Dealing with suicidal
students on college campuses. Psychiatric Services, 57(7), 914–916.
https://doi.org/10.1176/ps.2006.57.7.914
163

Arana, R., Castañeda-Sound, C., Blanchard, S., & Aguilar, T. E. (2011). Indicators of persistence
for Hispanic undergraduate achievement: Toward an ecological model. Journal of
Hispanic Higher Education, 10(3), 237–251. https://doi.org/10.1177/1538192711405058
Arria, A. M., Caldeira, K. M., Vincent, K. B., Winick, E. R., Baron, R. A., & O’Grady, K. E.
(2013). Discontinuous college enrollment: Associations with substance use and mental
health. Psychiatric Services, 64(2), 165–172. https://doi.org/10.1176/appi.ps.201200106
Artiga, S., & Ubri, P. (2013). Living in an immigrant family in America: How fear and toxic
stress are affecting daily life, well-being, & health. Kaiser Family Foundation.
https://www.kff.org/racial-equity-and-health-policy/issue-brief/living-in-an-immigrant-
family-in-america-how-fear-and-toxic-stress-are-affecting-daily-life-well-being-health/
Atkins, R., & Oglesby, A. (2018). Interrupting racism. In R. Atkins & A. Oglesby (Eds.),
Interrupting racism: Equity and social justice in school counseling (pp. 119–136). Taylor
& Francis Group. https://doi.org/10.4324/9781351258920-9
Bacallao, M. L., & Smokowski, P. R. (2009). Entre dos mundos/between two worlds: Bicultural
development in context. The Journal of Primary Prevention, 30(3-4), 421–451.
https://doi.org/10.1007/s10935-009-0176-x
Badiee, M., & Andrade, E. (2018). Microsystem and macrosystem predictors of Latinx college
students’ depression and anxiety. Journal of Hispanic Higher Education, 18(4), 422–434.
https://doi.org/10.1177/1538192718765077
Baer, R. D., Weller, S. C., de Alba Garcia, J. G., Glazer, M., Trotter, R., Pachter, L., & Baer, R.
D. (2003). A cross-cultural approach to the study of the folk illness nervios. Culture,
Medicine and Psychiatry, 27(3), 315–337. https://doi.org/10.1023/A:1025351231862
164

Bailey, J., Weafer-Schiarizza, S., & Yoo, L. (2018). Evaluating mental health promotion
programs: A supplement to the best practice guidelines series. The Centre for Addiction
and Mental Health. https://kmb.camh.ca/uploads/26ce0941-1e9a-4da2-a45a-
715cd474ba28
Banasik, B. (2022). Supporting the health and well-being of Latinx college students. Timely MD.
https://timely.md/blog/supporting-the-health-and-well-being-of-latinx-college-students/
Barlow, D. H., & Durand, V. M. (2012). Abnormal psychology: An integrative approach.
Cengage Learning.
Barrable, A., Papadatou-Pastou, M., & Tzotzoli, P. (2018). Supporting mental health, wellbeing
and study skills in higher education: An online intervention system. International Journal
of Mental Health Systems, 12(1), 54. Advance online publication.
https://doi.org/10.1186/s13033-018-0233-z
Barro, R., & Lee, J.-W. (2010). A new data set of educational attainment in the world, 1950–
2010. National Bureau of Economic Research. https://doi.org/10.3386/w15902
Bas, G. (2021). Relation between student mental health and academic achievement revisited: A
meta-analysis. In B. Bernal-Morales (Ed.), Health and academic achievement: New
Findings. IntechOpen. https://doi.org/10.5772/intechopen.95766
Basurto, L. E. (2020, October 22). Why we should be talking about mental health among Latinx
communities. Urban Institute. https://www.urban.org/urban-wire/why-we-should-be-
talking-about-mental-health-among-latinx-communities
Beals, M. J., Beals, K. L., & Cordova de Sartori, A. B. (1999). Transcultural counseling and the
Hispanic community. In K. L. Beals (Ed.), Transcultural counseling (pp. 221–257).
American Counseling Association.
165

Behling, O., & Law, K. S. (2000). Translating questionnaires and other research instruments:
Problems and solutions. Sage.
Bekele, T., Rourke, S. B., Tucker, R., Greene, S., Sobota, M., Koornstra, J., Monette, L., Rueda,
S., Bacon, J., Watson, J., Hwang, S. W., Dunn, J., Guenter, D., & Positive Spaces
Healthy Places. (2012). Direct and indirect effects of perceived social support on health-
related quality of life in persons living with HIV/AIDS. AIDS Care, 25(3), 337–346.
https://doi.org/10.1080/09540121.2012.701716
Benjet, C. (2020). Stress management interventions for college students in the context of the
COVID-19 pandemic. Clinical Psychology: Science and Practice. Advance online
publication. https://doi.org/10.1111/cpsp.12353
Benton, E., & Seide, M. (2022). Here’s how racism can affect the mental health of Latinx
individuals. Verywell Mind. https://www.verywellmind.com/the-mental-effects-of-
racism-on-the-latinx-community-5186495#citation-1
Benuto, L. T. (2012). Guide to psychological assessment with Hispanics: An introduction. In L.
T. Benuto (Ed.), Guide to Psychological Assessment with Hispanics (pp. 1–13). Springer.
https://doi.org/10.1007/978-1-4614-4412-1_1
Benuto, L. T., Gonzalez, F., Reinosa-Segovia, F., & Duckworth, M. (2019). Mental health
literacy, stigma, and behavioral health service use: The case of Latinx and non-Latinx
Whites. Journal of Racial and Ethnic Health Disparities, 6(6), 1122–1130.
https://doi.org/10.1007/s40615-019-00614-8
Benuto, L. T., & Leany, B. D. (2017). Evidence-based practices for conducting therapy with
Spanish-speaking clients. In L. T. Benuto (Ed.), Toolkit for counseling Spanish-speaking
clients (pp. 1–6). Springer. https://doi.org/10.1007/978-3-319-64880-4_1
166

Benuto, L. T., & O’Donohue, W. (2015). Is culturally sensitive cognitive behavioral therapy an
empirically supported treatment? The case for Hispanics. International Journal of
Psychology & Psychological Therapy, 15(3), 405–421.
https://ijpsy.com/volumen15/num3/425/is-culturally-sensitive-cognitive-behavioral-
EN.pdf
Berkel, C., Knight, G. P., Zeiders, K. H., Tein, J.-Y., Roosa, M. W., Gonzales, N. A., & Saenz,
D. (2010). Discrimination and adjustment for Mexican American adolescents: A
prospective examination of the benefits of culturally related values. Journal of Research
on Adolescence, 20(4), 893–915. https://doi.org/10.1111/j.1532-7795.2010.00668.x
Bernstein, H. B., Gonzalez, D., Karpman, M., & Zuckerman, S. (2019). Adults in immigrant
families report avoiding routine activities because of immigration concerns. The Urban
Institute.
https://www.urban.org/sites/default/files/publication/100626/2019.07.22_immigrants_avo
iding_activities_final_v2_1.pdf
Biglan, A., & Embry, D. D. (2013). A framework for intentional cultural change. Journal of
Contextual Behavioral Science, 2(3-4), 95–104.
https://doi.org/10.1016/j.jcbs.2013.06.001
Biglan, A., Flay, B. R., Embry, D. D., & Sandler, I. N. (2012). The critical role of nurturing
environments for promoting human well-being. The American Psychologist, 67(4), 257–
271. https://doi.org/10.1037/a0026796
Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S.-M., & Olfson, M. (2008).
Mental health of college students and their non–college-attending peers. Archives of
167

General Psychiatry, 65(12), Article 1429. Advance online publication.
https://doi.org/10.1001/archpsyc.65.12.1429
Bledsoe, S. E. (2008). Barriers and promoters of mental health services utilization in a Latino
context: A literature review and recommendations from an ecosystems perspective.
Journal of Human Behavior in the Social Environment, 18(2), 151–183.
https://doi.org/10.1080/10911350802285870
Blume, H., & Gomez, M. (2021, December 7). Surgeon general warns of emerging youth mental
health crisis in rare public advisory. Los Angeles Times.
https://www.latimes.com/california/story/2021-12-07/surgeon-general-advisory-youth-
mental-health-crisis-looms
Bostani, M., Nadri, A., & Nasab, A. R. (2014). A study of the relation between mental health and
academic performance of students of the Islamic Azad University Ahvaz Branch.
Procedia: Social and Behavioral Sciences, 116(21), 163–165.
https://doi.org/10.1016/j.sbspro.2014.01.186
Braxton, J. M., Vesper, N., & Hossler, D. (1995). Expectations for college and student
persistence. Research in Higher Education, 36(5), 595–611.
https://doi.org/10.1007/BF02208833
Bray, C. S. (1985). Early identification of dropout prone students and early intervention
strategies to improve student retention at a private university [Unpublished doctoral
dissertation]. University of North Texas, Denton, Texas.
Bridges, A. J., Andrews, A. R., Villalobos, B. T., Pastrana, F. A., Cavell, T. A., & Gomez, D.
(2014). Does integrated behavioral health care reduce mental health disparities for
168

Latinos? Initial findings. Journal of Latina/o Psychology, 2(1), 37–53.
https://doi.org/10.1037/lat0000009
Brocato, N., Luebber, F., Taylor, M., Gonzalez, Á. de J., Chessman, H. M., & Zhao, Y. (2021).
Well-being for students with minoritized identities. American Council on Education.
https://www.acenet.edu/Documents/Well-Being-Minoritized-Identities.pdf
Bromley, E., Nunes, A., & Phipps, M. G. (2011). Disparities in pregnancy healthcare utilization
between Hispanic and Non-Hispanic white women in Rhode Island. Maternal and Child
Health Journal, 16(8), 1576–1582. https://doi.org/10.1007/s10995-011-0850-5
Brondolo, E., Gallo, L. C., & Myers, H. F. (2008). Race, racism and health: Disparities,
mechanisms, and interventions. Journal of Behavioral Medicine, 32(1), 1–8.
https://doi.org/10.1007/s10865-008-9190-3
Bronfenbrenner, U. (1994). Jobs and psychological development: A new sociological
perspective. Contemporary Psychology: A Journal of Reviews, 39(8), 803–805.
https://doi.org/10.1037/034560
Bronfenbrenner, U. (2005). Making human beings human: Bioecological perspectives on human
development. Sage Publications.
Brown, C., Conner, K. O., Copeland, V. C., Grote, N., Beach, S., Battista, D., & Reynolds, C. F.,
III. (2010). Depression stigma, race, and treatment seeking behavior and attitudes.
Journal of Community Psychology, 38(3), 350–368. https://doi.org/10.1002/jcop.20368
Brown, S. (2022, July 14). The missing Hispanic students. The Chronicle of Higher Education.
https://www.chronicle.com/article/the-missing-hispanic-students
Bucay-Harari, L., Page, K. R., Krawczyk, N., Robles, Y. P., & Castillo-Salgado, C. (2020).
Mental health needs of an emerging Latino community. The Journal of Behavioral
169

Health Services & Research, 47(3), 388–398. https://doi.org/10.1007/s11414-020-09688-
3
Cabassa, L. J., & Baumann, A. A. (2013). A two-way street: Bridging implementation science
and cultural adaptations of mental health treatments. Implementation Science: IS, 8(1),
90. Advance online publication. https://doi.org/10.1186/1748-5908-8-90
Cabassa, L. J., Hansen, M. C., Palinkas, L. A., & Ell, K. (2008). Azúcar y nervios: Explanatory
models and treatment experiences of Hispanics with diabetes and depression. Social
Science & Medicine, 66(12), 2413–2424.
https://doi.org/10.1016/j.socscimed.2008.01.054
Cabassa, L. J., Zayas, L. H., & Hansen, M. C. (2006). Latino adults’ access to mental health
care: A review of epidemiological studies. Administration and Policy in Mental Health,
33(3), 316–330. https://doi.org/10.1007/s10488-006-0040-8
Cadigans, K., & Alberts, M. (2009). Section one: Special education policies through an
ecological and family impact lens. Minnesota Department of Health.
https://www.purdue.edu/hhs/hdfs/fii/wp-content/uploads/2015/07/s_mnfis02report.pdf
The Campaign for College Opportunity. (2021). The state of higher education for Latinx
Californians. Department of Education.
Cano, M. Á., Sánchez, M., Trepka, M. J., Dillon, F. R., Sheehan, D. M., Rojas, P., Kanamori, M.
J., Huang, H., Auf, R., & De La Rosa, M. (2016). Immigration stress and alcohol use
severity among recently immigrated Hispanic adults: Examining moderating effects of
gender, immigration status, and social support. Journal of Clinical Psychology, 73(3),
294–307. https://doi.org/10.1002/jclp.22330
170

Cappelucci, K., Zindel, M., Knight, H. C., Busis, N., & Alexander, C. (2019). Clinician well-
being at the Ohio State University: A case study. NAM Perspectives. Advance online
publication. https://doi.org/10.31478/201908b
Cardemil, E. V., Adams, S. T., Calista, J. L., Connell, J., Encarnación, J., Esparza, N. K.,
Frohock, J., Hicks, E., Kim, S., Kokernak, G., McGrenra, M., Mestre, R., Pérez, M.,
Pinedo, T. M., Quagan, R., Rivera, C., Taucer, P., & Wang, E. (2007). The Latino mental
health project: A local mental health needs assessment. Administration and Policy in
Mental Health, 34(4), 331–341. https://doi.org/10.1007/s10488-007-0113-3
Carey, K., Kelly, A. P., & Schneider, M. (2018). Low Hispanic college graduation rates threaten
U.S. attainment goals. American Enterprise Institute. https://www.aei.org/press/low-
hispanic-college-graduation-rates-threaten-u-s-attainment-goals/
Carothers, A. L. (2019, May 10). “It’s all in your head”: Black and Latinx students’ mental
health experiences from the perspective of their counselors and teachers [Unpublished
honors thesis]. The University of Texas at Austin.
Carpenter-Song, E., Chu, E., Drake, R. E., Ritsema, M., Smith, B., & Alverson, H. (2010).
Ethno-cultural variations in the experience and meaning of mental illness and treatment:
Implications for access and Utilization. Transcultural Psychiatry, 47(2), 224–251.
https://doi.org/10.1177/1363461510368906
Casas, J. M., Keefe, S. E., & Newton, F. (1978). The Mexican American emic system of mental
illness: An exploratory study. In J. M. Casas & S. E. Keefe (Eds.), Family and mental
health in the Mexican American community (pp. 69–90). Spanish Speaking Mental
Health Research Center.
171

Castillo, L. G., Conoley, C. W., Choi-Pearson, C., Archuleta, D. J., Phoummarath, M. J., & Van
Landingham, A. (2006). University environment as a mediator of Latino ethnic identity
and persistence attitudes. Journal of Counseling Psychology, 53(2), 267–271.
https://doi.org/10.1037/0022-0167.53.2.267
Castro, F. G., Barrera, M., Jr., & Martinez, C. R., Jr. (2004). The cultural adaptation of
prevention interventions: Resolving tensions between fidelity and fit. Prevention Science,
5(1), 41–45. https://doi.org/10.1023/B:PREV.0000013980.12412.cd
Cavanagh, T. (2003). Schooling for peace: Caring for our children in school. Experiments in
Education, 31(8), 139–149.
Cavanagh, T. (2004). Criminalising our schools: Effects on caring and nurturing teachers.
University of Waikato.
Cavanagh, T., Macfarlane, A., Glynn, T., & Macfarlane, S. (2012). Creating peaceful and
effective schools through a culture of care. Discourse, 33(3), 443–455.
https://doi.org/10.1080/01596306.2012.681902
Center for Behavioral Health Statistics and Quality. (2019). 2019 National Survey on Drug Use
and Health (NSDUH). Section 8 pe tables – results from the 2019 National Survey on
Drug Use and Health: Detailed tables, SAMHSA, CBHSQ. Substance Abuse and Mental
Health Services Administration.
https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/NSDUHDetailedTabs20
19/NSDUHDetTabsSect8pe2019.htm
Centers for Disease Control and Prevention. (2017). WISQARS (web-based injury statistics query
and reporting system). https://www.cdc.gov/injury/wisqars/index.html
172

Centers for Disease Control and Prevention. (2020a). 10 leading causes of death, United States.
https://wisqars.cdc.gov/data/lcd/home
Centers for Disease Control and Prevention. (2020b). 2019 BRFSS survey data and
Documentation. https://www.cdc.gov/brfss/annual_data/annual_2019.html
Centers for Disease Control and Prevention. (2021). About mental health.
https://www.cdc.gov/mentalhealth/learn/index.htm
Cervantes, R. C., Gattamorta, K. A., & Berger-Cardoso, J. (2018). Examining difference in
immigration stress, acculturation stress and mental health outcomes in six
Hispanic/Latino nativity and regional groups. Journal of Immigrant and Minority Health,
21(1), 14–20. https://doi.org/10.1007/s10903-018-0714-9
Cervantes, R. C., Padilla, A. M., & Salgado de Snyder, N. (1991). The Hispanic Stress
Inventory: A culturally relevant approach to psychosocial assessment. Psychological
Assessment, 3(3), 438–447. https://doi.org/10.1037/1040-3590.3.3.438
Cervantes, W., Ullrich, R., & Matthews, H. (2018). Our children’s fear: Immigration policy’s
effects on young children. Center for Law and Social Policy.
Chávez-Reyes, C. (2010). “Starting at the top”: Identifying and understanding later generation
Chicano students in schools. Journal of Latinos and Education, 9(1), 22–40.
https://doi.org/10.1080/15348430903252037
Chen, J., Fang, H., Vargas-Bustamante, A., Rizzo, J. A., & Ortega, A. N. (2010). Latino
disparities in prescription drug use and expenditures: A nationally representative analysis.
The Annals of Pharmacotherapy, 44(1), 57–69. https://doi.org/10.1345/aph.1M467
173

Cheng, H.-L., Kwan, K.-L. K., & Sevig, T. (2013). Racial and ethnic minority college students’
stigma associated with seeking psychological help: Examining psychocultural correlates.
Journal of Counseling Psychology, 60(1), 98–111. https://doi.org/10.1037/a0031169
Cheng, H.-L., McDermott, R. C., & Lopez, F. G. (2015). Mental health, self-stigma, and help-
seeking intentions among emerging adults. The Counseling Psychologist, 43(3), 463–487.
https://doi.org/10.1177/0011000014568203
Chen, J. A., Stevens, C., Wong, S. H., & Liu, C. H. (2019). Psychiatric symptoms and diagnoses
among U.S. college students: A comparison by race and ethnicity. Psychiatric Services,
70(6), 442–449. https://doi.org/10.1176/appi.ps.201800388
Cheung, F. K. (1991). The use of mental health services by ethnic minorities. In H. F. Myers, P.
Wohlford, L. P. Guzman, & R. J. Echeverria (Eds.), Ethnic minority perspectives on
clinical training and services in psychology (pp. 23–31). American Psychological
Association. https://doi.org/10.1037/10102-003
Cheung, F. K., & Snowden, L. R. (1990). Community mental health and ethnic minority
populations. Community Mental Health Journal, 26(3), 277–291.
https://doi.org/10.1007/BF00752778
Chickering, A., & Gamson, S. (2000). Seven principles for good practice in undergraduate
education. CORE. https://doi.org/10.25071/1497-3170.2711
The Children’s Partnership. (2018). Healthy mind, healthy future: Promoting the mental health
and wellbeing of children in immigrant families. The Children’s Partnership, California
Immigrant Policy Center. https://childrenspartnership.org/research/healthy-mind-healthy-
future/
174

Cho, H., Kim, I., & Velez-Ortiz, D. (2014). Factors associated with mental health service use
among Latino and Asian Americans. Community Mental Health Journal, 50(8), 960–967.
https://doi.org/10.1007/s10597-014-9719-6
Cobas, J. A., Duany, J., & Feagin, J. R. (2016). How the United States racializes Latinos: White
hegemony and its consequences. Routledge.
Cohen, J. W., Cohen, S. B., & Banthin, J. S. (2009). The medical expenditure panel survey.
Medical Care, 47(7, Supplement_1), S44–S50. Advance online publication.
https://doi.org/10.1097/MLR.0b013e3181a23e3a
Colarossi, J. (2022, April 21). Mental health of college students is getting worse. Boston
University. https://www.bu.edu/articles/2022/mental-health-of-college-students-is-
getting-worse/
Collins, S. R., Gunja, M. Z., Doty, M. M., & Beutel, S. (2016). Who are the remaining uninsured
and why haven’t they signed up for coverage? The Commonwealth Fund.
https://www.commonwealthfund.org/publications/issue-briefs/2016/aug/who-are-
remaining-uninsured-and-why-havent-they-signed-coverage
Colon, E. (1997). Program design and planning strategies in the delivery of culturally competent
health and mental health prevention and treatment services to Latino communities.
Journal of Multicultural Social Work, 4(4), 85–96.
https://doi.org/10.1300/J285v04n04_06
Contreras, B. (2017). The study of Latino student attrition and retention [Unpublished master’s
thesis]. California State University, Long Beach.
https://scholarworks.calstate.edu/downloads/j67315654
175

Cook, A., Pérusse, R., & Rojas, E. D. (2012). Increasing academic achievement and college-
going rates for Latina/o English language learners: A survey of school counselor
interventions. The Journal of Counselor Preparation and Supervisor, 4(2).
https://doi.org/10.7729/42.0023
Corrigan, P. W., & Watson, A. C. (2007). The stigma of psychiatric disorders and the gender,
ethnicity, and education of the perceiver. Community Mental Health Journal, 43(5), 439–
458. https://doi.org/10.1007/s10597-007-9084-9
Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed method
approaches. Sage Publications.
Crum, A. J., Akinola, M., Martin, A., & Fath, S. (2017). The role of stress mindset in shaping
cognitive, emotional, and physiological responses to challenging and threatening stress.
Anxiety, Stress, and Coping, 30(4), 379–395.
https://doi.org/10.1080/10615806.2016.1275585
Csordas, T. J., & Low, S. M. (2003). Embodied metaphors: nerves as lived experience. In T. J.
Cordas (Ed.), Embodiment and experience: The existential ground of culture and self (pp.
294–295). Cambridge University Press.
Czeisler, M. É., Drane, A., Winnay, S. S., Capodilupo, E. R., Czeisler, C. A., Rajaratnam, S. M.
W., & Howard, M. E. (2021). Mental health, substance use, and suicidal ideation among
unpaid caregivers of adults in the United States during the COVID-19 Pandemic:
Relationships to age, race/ethnicity, employment, and caregiver intensity. Journal of
Affective Disorders, 295, 1259–1268. https://doi.org/10.1016/j.jad.2021.08.130
176

Davis, D. L., & Low, S. M. (2009). Gender, emotion, and nervios in urban Guatemala. In D. L.
Davis & S. M. Low (Eds.), Gender, health, and illness: The case of nerves (pp. 25–47).
Routledge.
Deasy, C., Coughlan, B., Pironom, J., Jourdan, D., & Mannix-McNamara, P. (2014).
Psychological distress and coping amongst higher education students: A mixed method
enquiry. PLoS One, 9(12), e115193. Advance online publication.
https://doi.org/10.1371/journal.pone.0115193
de Brey, C., Musu, L., McFarland, J., Wilkinson-Flicker, S., Diliberti, M., Branstetter, C., Wang,
X., & Zhang, A. (2019). Status and trends in the education of racial and ethnic groups
2018. U.S. Department of Education. https://nces.ed.gov/pubs2019/2019038.pdf
DeFreitas, S. C., Crone, T., DeLeon, M., & Ajayi, A. (2018). Perceived and personal mental
health stigma in Latino and African American college students. Frontiers in Public
Health, 6, 49. Advance online publication. https://doi.org/10.3389/fpubh.2018.00049
del Pilar, W. (2022). Counselors matter: Why Latinx counselors are crucial to student
attainment. Latinos for Education.
https://www.latinosforeducation.org/2021/03/30/counselors-matter-latinx-counselors-
crucial-student-attainment/
Del Pilar, J. A. (2008). Mental health and Latino/a college students. Journal of Hispanic Higher
Education, 8(3), 263–281. https://doi.org/10.1177/1538192708328891
Del Savio, A. A., Galantini, K., & Pachas, A. (2022). Exploring the relationship between mental
health-related problems and undergraduate student dropout: A case study within a civil
engineering program. Heliyon, 8(5), Article e09504. Advance online publication.
https://doi.org/10.1016/j.heliyon.2022.e09504
177

Dennis, J., Basañez, T., & Farahmand, A. (2009). Intergenerational conflicts among Latinos in
early adulthood: Separating values conflicts with parents from acculturation conflicts.
Hispanic Journal of Behavioral Sciences, 32(1), 118–135.
https://doi.org/10.1177/0739986309352986
Denzin, N. K. (1978). Triangulation a case for methodological evaluation and combination.
Sociological Methods, 339–357. https://doi.org/https://doi.org/10.4324/9781315129945
Dillon, F. R., De La Rosa, M., & Ibañez, G. E. (2012). Acculturative stress and diminishing
family cohesion among recent Latino immigrants. Journal of Immigrant and Minority
Health, 15(3), 484–491. https://doi.org/10.1007/s10903-012-9678-3
Dobalian, A., & Rivers, P. A. (2007). Racial and ethnic disparities in the use of mental health
services. The Journal of Behavioral Health Services & Research, 35(2), 128–141.
https://doi.org/10.1007/s11414-007-9097-8
Dobbie, W., Goldin, J., & Yang, C. S. (2018). The effects of pre-trial detention on conviction,
future crime, and employment: Evidence from randomly assigned judges. The American
Economic Review, 108(2), 201–240. https://doi.org/10.1257/aer.20161503
Downs, M. F., & Eisenberg, D. (2012). Help seeking and treatment use among suicidal college
students. Journal of American College Health, 60(2), 104–114.
https://doi.org/10.1080/07448481.2011.619611
Drapeau, A., Marchand, A., & Beaulieu-Prévost, D. (2012). Epidemiology of psychological
distress. In L. LAbate (Ed.), Mental illnesses: Understanding, prediction and control (pp.
105–134). IntechOpen.
Duke University. (2022). Dukereach. https://students.duke.edu/wellness/dukereach/
178

Dunn, E. C., Milliren, C. E., Evans, C. R., Subramanian, S. V., & Richmond, T. K. (2015).
Disentangling the relative influence of schools and neighborhoods on adolescents’ risk
for depressive symptoms. American Journal of Public Health, 105(4), 732–740.
https://doi.org/10.2105/AJPH.2014.302374
DuPont-Reyes, M. J., Barkin, K., Villatoro, A. P., Phelan, J. C., Painter, K., & Link, B. (2020). A
school-based intervention for mental illness stigma: A cluster randomized trial.
Pediatrics, 145(6), Article e20190780. Advance online publication.
https://doi.org/10.1542/peds.2019-0780
Duran, D., Usman, H. R., Beltrami, J., Alvarez, M. E., Valleroy, L., & Lyles, C. M. (2010). HIV
counseling and testing among Hispanics at CDC-funded sites in the United States, 2007.
American Journal of Public Health, 100(S1), S152–S158. Advance online publication.
https://doi.org/10.2105/AJPH.2009.166355
Durand, J., & Flashman, J. (2006). The demographic foundations of the Latino Population. In E.
Telles (Ed.), Hispanics and the future of America. National Academies Press.
https://www.ncbi.nlm.nih.gov/books/NBK19901/
Echeverry, J. J. (1997). Treatment barriers accessing and accepting professional help. In M. C.
Zea & J. G. Garcia (Eds.), Psychological interventions and research with Latino
populations (pp. 94–107). Allyn & Bacon.
EdTrust. (2022). School counselors matter. https://edtrust.org/resource/school-counselors-matter/
Eisenberg, D., Golberstein, E., & Hunt, J. B. (2009). Mental health and academic success in
college. The B.E. Journal of Economic Analysis & Policy, 9(1). Advance online
publication. https://doi.org/10.2202/1935-1682.2191
179

Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007). Prevalence and correlates
of depression, anxiety, and suicidality among university students. The American Journal
of Orthopsychiatry, 77(4), 534–542. https://doi.org/10.1037/0002-9432.77.4.534
Eisenberg, D., Hunt, J., & Speer, N. (2013). Mental health in American colleges and
Universities. The Journal of Nervous and Mental Disease, 201(1), 60–67.
https://doi.org/10.1097/NMD.0b013e31827ab077
Eisenberg, D., Hunt, J., Speer, N., & Zivin, K. (2011). Mental health service utilization among
college students in the United States. The Journal of Nervous and Mental Disease,
199(5), 301–308. https://doi.org/10.1097/NMD.0b013e3182175123
Eno Louden, J., Avila, A., del Villar, O. A. E., Jung, H., Kosyluk, K. A., & Flores, E. (2023).
Self-stigma of mental illness among Latino people on the U.S.-México border. Stigma
and Health, 8(1), 21–30. https://doi.org/10.1037/sah0000365
Enriquez, J. D. (2017). Latino mental health: Exploring barriers towards mental health services
among the Latino community within San Bernardino [Unpublished doctoral dissertation].
California State University San Bernardino.
Eriksson, M., Ghazinour, M., & Hammarström, A. (2018). Different uses of Bronfenbrenner’s
ecological theory in public mental health research: What is their value for guiding public
mental health policy and practice? Social Theory & Health, 16(4), 414–433.
https://doi.org/10.1057/s41285-018-0065-6
Escarce, J. J., & Kapur, K. (2006). Access to and quality of healthcare. In M. Tienda & F.
Mitchell (Eds.), Hispanics and the future of America (pp. 410–490). National Academies
Press.
180

Excelencia In Education. (2020a). Hispanic-Serving Institutions (HSIs): 2019–20 fact sheet.
https://www.edexcelencia.org/research/publications/hispanic-serving-institutions-hsis-
2019-2020-fact-sheet
Excelencia in Education. (2020b). Latino college completion in the United States.
https://pnpi.org/latino-college-completion-in-the-united-
states/#:~:text=42%25%20of%20Latino%20students%20are,%2DHispanic%20students
%20at%2038%25
Ezarik, M. (2014, April 14). Students struggling but not seeking campus mental health support.
Inside Higher Ed. https://www.insidehighered.com/news/2021/04/14/students-struggling-
not-seeking-campus-mental-health-support
Falgas, I., Ramos, Z., Herrera, L., Qureshi, A., Chavez, L., Bonal, C., McPeck, S., Wang, Y.,
Cook, B., & Alegría, M. (2017). Barriers to and correlates of retention in behavioral
health treatment among Latinos in 2 different host countries: The United States and
Spain. Journal of Public Health Management and Practice, 23(1), e20–e27. Advance
online publication. https://doi.org/10.1097/PHH.0000000000000391
Federal Bureau of Investigations. (2018). Uniform Crime Reporting (UCR) Program.
https://ucr.fbi.gov/hate-crime/2017
Fernandez, L. R., Girón, S. E., Killoren, S. E., & Campione-Barr, N. (2022). Latinx college
students’ anxiety, academic stress, and future aspirations: The role of sibling relationship
quality. Journal of Child and Family Studies, 2022, 1–10.
https://doi.org/10.1007/s10826-022-02474-z
181

Finch, B. K., Kolody, B., & Vega, W. A. (2000). Perceived discrimination and depression among
Mexican-origin adults in California. Journal of Health and Social Behavior, 41(3), 295.
https://doi.org/10.2307/2676322
Fiscella, K., & Holt, K. (2007). Impact of primary care patient visits on racial and ethnic
disparities in preventive care in the United States. Journal of the American Board of
Family Medicine, 20(6), 587–597. https://doi.org/10.3122/jabfm.2007.06.070053
Fiscella, K., & Sanders, M. R. (2016). Racial and ethnic disparities in the quality of health care.
Annual Review of Public Health, 37(1), 375–394. https://doi.org/10.1146/annurev-
publhealth-032315-021439
Fleming, C. B., Haggerty, K. P., Catalano, R. F., Harachi, T. W., Mazza, J. J., & Gruman, D. H.
(2005). Do social and behavioral characteristics targeted by preventive interventions
predict standardized test scores and grades? The Journal of School Health, 75(9), 342–
349. https://doi.org/10.1111/j.1746-1561.2005.00048.x
Flores, A. (2020, July 29). How the U.S. Hispanic population is changing. Pew Research Center.
https://www.pewresearch.org/fact-tank/2017/09/18/how-the-u-s-hispanic-population-is-
changing/
Flores, E., Tschann, J. M., Dimas, J. M., Bachen, E. A., Pasch, L. A., & de Groat, C. L. (2008).
Perceived discrimination, perceived stress, and mental and physical health among
Mexican-origin adults. Hispanic Journal of Behavioral Sciences, 30(4), 401–424.
https://doi.org/10.1177/0739986308323056
Freeman Anderson, K. (2017). The role of racial microaggressions, stress, and acculturation in
understanding Latino health outcomes in the USA. Race and Social Problems, 9(3), 218–
182

223. https://hri.uh.edu/publications/role-racial-microaggressions-stress-and-acculturation-
understanding-latino-health
Funk, C., & Lopez, M. H. (2022). Hispanic American’s trust in and engagement with science:
Hispanic Americans’ experiences with health care. Pew Research Center.
https://www.pewresearch.org/science/2022/06/14/hispanic-americans-experiences-with-
health-care/
Gallagher, R. P. (2008). National Survey of Counseling Center Directors 2008. The American
College Counseling Association and The International Association of Counseling
Services, Inc.
https://immagic.com/eLibrary/ARCHIVES/GENERAL/ACCA_US/A081007G.pdf
Gallup-Lumina Foundation. (2022). The state of higher education 2022 report. Gallup-Lumina
Foundation. https://www.gallup.com/analytics/391829/state-of-higher-education-
2022.aspx
Gandara, P., & Ee, J. (2018). U.S. immigration enforcement policy and its impact on teaching
and learning in the nation’s schools. https://www.civilrightsproject.ucla.edu/research/k-
12-education/immigration-immigrant-students/u.s.-immigration-enforcement-policy-and-
its-impact-on-teaching-and-learning-in-the-nations-schools/Immigration-enforcement-on-
schools-093018.pdf
Garcia, E., & Weiss, E. (2017). Education inequalities at the school starting gate: Gaps, trends,
and strategies to address them. Economic Policy Institute.
https://www.epi.org/publication/education-inequalities-at-the-school-starting-gate/
Garcia, J., & Valdez, E. (2021). Perception of mental health among the Latinx community
[Unpublished doctoral dissertation]. California State University San Bernardino.
183

Genthe, C. B., & Harrington, C. (2022). Low completion rates of Latinx community college
students. Impacting Education: Journal on Transforming Professional Practice, 7(2), 32–
38. https://doi.org/10.5195/ie.2022.205
Gil, A. G., & Vega, W. A. (1996). Two different worlds: Acculturation stress and adaptation
among Cuban and Nicaraguan families. Journal of Social and Personal Relationships,
13(3), 435–456. https://doi.org/10.1177/0265407596133008
Glasgow, R. E., Toobert, D. J., Barrera, M., & Strycker, L. A. (2004). A social–ecologic
approach to assessing support for disease self-management: The chronic illness resources
survey. Health Education Research, 20(4), 402–409. https://doi.org/10.1093/her/cyg140
Glennen, R. E., Farren, P. J., & Vowell, F. N. (1996). How advising and retention of students
improves fiscal stability. NACADA Journal, 16(1), 38–41. https://doi.org/10.12930/0271-
9517-16.1.38
Golding, J. M., & Burnam, M. A. (1990). Immigration, stress, and depressive symptoms in a
Mexican-American community. The Journal of Nervous and Mental Disease, 178(3),
161–171. https://doi.org/10.1097/00005053-199003000-00003
Goldston, D. B., Molock, S. D., Whitbeck, L. B., Murakami, J. L., Zayas, L. H., & Hall, G. C.
(2008). Cultural considerations in adolescent suicide prevention and psychosocial
treatment. The American Psychologist, 63(1), 14–31. https://doi.org/10.1037/0003-
066X.63.1.14
Gollust, S. E., Eisenberg, D., & Golberstein, E. (2008). Prevalence and correlates of self-injury
among university students. Journal of American College Health, 56(5), 491–498.
https://doi.org/10.3200/JACH.56.5.491-498
184

Gonzalez, J. M., Applewhite, S. R., & Barrera, I. (2015). Older Mexican Americans: Pathways to
mental health service use. Social Work in Mental Health, 13(4), 390–414.
https://doi.org/10.1080/15332985.2014.927813
Graham-Smith, S., & Lafayette, S. (2004). Quality disability support for promoting belonging
and academic success within the college community. College Student Journal, 38(1), 90.
Granillo, T. (2020, July 27). The Latina college student experience. Steve Hicks School of Social
Work. https://socialwork.utexas.edu/projects/the-latina-college-student-experience/
Grant, C. (2017). The contribution of education to economic growth. Institute of Development
Studies.
https://assets.publishing.service.gov.uk/media/5b9b87f340f0b67896977bae/K4D_HDR_
The_Contribution_of_Education_to_Economic_Growth_Final.pdf
Green, B. L., Krupnick, J. L., Chung, J., Siddique, J., Krause, E. D., Revicki, D., Frank, L., &
Miranda, J. (2006). Impact of PTSD comorbidity on one-year outcomes in a depression
trial. Journal of Clinical Psychology, 62(7), 815–835. https://doi.org/10.1002/jclp.20279
Gresenz, C. R., Rogowski, J., & Escarce, J. J. (2009). Community demographics and access to
health care among U.S. Hispanics. Health Services Research, 44(5p1), 1542–1562.
https://doi.org/10.1111/j.1475-6773.2009.00997.x
Griffiths, K., Mackinnon, A., Crisp, D., Christensen, H., Bennett, K., & Farrer, L. (2012). The
effectiveness of an online support group for members of the community with depression:
A randomised controlled trial. PLoS One, 7(12), e53244. Advance online publication.
https://doi.org/10.1371/journal.pone.0053244
Gruttadaro, D., & Crudo, D. (2012). College students speak: A survey report on mental health.
National Alliance on Mental Illness. https://www.nami.org/Support-
185

Education/Publications-Reports/Survey-Reports/College-Students-Speak_A-Survey-
Report-on-Mental-H
Guajardo, A. D., Robles‐Schrader, G. M., Aponte‐Soto, L., & Neubauer, L. C. (2020). LatCrit
theory as a framework for social justice evaluation: Considerations for evaluation and
evaluators. New Directions for Evaluation, 2020(166), 65–75.
https://doi.org/10.1002/ev.20409
Guzmán, Á., Koons, A., & Postolache, T. T. (2009). Suicidal behavior in Latinos: Focus on the
youth. International Journal of Adolescent Medicine and Health, 21(4). Advance online
publication. https://doi.org/10.1515/IJAMH.2009.21.4.431
Harvard Graduate School of Education. (2011). Pathways to prosperity: Meeting the challenge
of preparing young Americans for the 21st Century. Harvard Graduate School of
Education. https://www.gse.harvard.edu/news/11/02/pathways-prosperity-meeting-
challenge-preparing-young-americans-21st-century
Hayes, J. R. (2013). The complete problem solver. Routledge.
https://doi.org/10.4324/9780203062715
Heisserer, D., & Parette, P. (2002). Advising at-risk students in college and university settings.
College Student Journal, 36(1), 1–12.
Hinojos, B. (2013). Stressors and coping strategies of undocumented Latinos in therapy.
(Publication No. 3590317) [Doctoral dissertation, University of Nebraska]. ProQuest
Dissertations and Theses Global.
Holliday, R., Anderson, E., Williams, R., Bird, J., Matlock, A., Ali, S., Edmondson, C., Morris,
E. E., Mullen, K., & Surís, A. (2015). A pilot examination of differences in college
adjustment stressors and depression and anxiety symptoms between white, Hispanic and
186

White, non-Hispanic female college students. Journal of Hispanic Higher Education,
15(3), 277–288. https://doi.org/10.1177/1538192715607331
Holmes, S. (2000). Student recruitment, retention and monitoring. Diversity Web.
http://www.diversityweb.org/Leadersguide/RRAA/Student_Retention/intrusive.html
Horwitz, A. V. (2007). Distinguishing distress from disorder as psychological outcomes of
stressful social arrangements. Health, 11(3), 273–289.
https://doi.org/10.1177/1363459307077541
Houri, A., & Kincade, L. (2021). The connection between Mental Health and academic success.
Groves Learning Organization. https://www.groveslearning.org/connection-between-
mental-health-academic-success/
Hovey, J. D., Hurtado, G., & Seligman, L. D. (2014). Findings for a CBT support group for
Latina migrant farmworkers in Western Colorado. Current Psychology, 33(3), 271–281.
https://doi.org/10.1007/s12144-014-9212-y
Hrala, J. (2022, April 19). How mental health is impacting student retention. NSLS.
https://www.nsls.org/blog/how-mental-health-is-impacting-student-retention
Human Research Protection Program. (2022). Children and minors in research. University of
California San Francisco. https://irb.ucsf.edu/children-and-minors-research
Hunt, J. B., Eisenberg, D., Lu, L., & Gathright, M. (2014). Racial/ethnic disparities in mental
health care utilization among U.S. college students: Applying the institution of medicine
definition of health care disparities. Academic Psychiatry, 39(5), 520–526.
https://doi.org/10.1007/s40596-014-0148-1
187

Hwang, W.-C., & Goto, S. (2008). The impact of perceived racial discrimination on the mental
health of Asian American and Latino College students. Cultural Diversity & Ethnic
Minority Psychology, 14(4), 326–335. https://doi.org/10.1037/1099-9809.14.4.326
Ibarra-Mejia, G., Lusk, M., & Jeon, S. (2022). Stress, anxiety, and depression among Latinx
university students during the COVID-19 pandemic. Social Development Issues, 43(1).
https://doi.org/10.3998/sdi.1815
Inside Higher Ed. (2021). Inside Higher Ed: 2021 Survey of college and university chief
academic officers. Inside Higher Ed & Hanover Research.
https://universityservices.wiley.com/ihe-provost-survey-2021/
Inside Higher Ed & College Pulse. (2022). Student voice: Current state of mental health. Kaplan.
Interian, A., Ang, A., Gara, M. A., Link, B. G., Rodriguez, M. A., & Vega, W. A. (2010). Stigma
and depression treatment utilization among Latinos: Utility of four stigma measures.
Psychiatric Services, 61(4), 373–379. https://doi.org/10.1176/ps.2010.61.4.373
Interian, A., Guarnaccia, P. J., Vega, W. A., Gara, M. A., Like, R. C., Escobar, J. I., & Díaz-
Martínez, A. M. (2005). The relationship between ataque de nervios and unexplained
neurological symptoms. The Journal of Nervous and Mental Disease, 193(1), 32–39.
https://doi.org/10.1097/01.nmd.0000149216.29035.31
Ishii, T., Tachikawa, H., Shiratori, Y., Hori, T., Aiba, M., Kuga, K., & Arai, T. (2018). What
kinds of factors affect the academic outcomes of university students with mental
disorders? A retrospective study based on medical records. Asian Journal of Psychiatry,
32, 67–72. https://doi.org/10.1016/j.ajp.2017.11.017
188

Jagoo, K. (2022, October 15). The role of religion in Latinx mental health. Verywell Mind.
https://www.verywellmind.com/what-is-the-role-of-religion-in-latinx-mental-health-
6666245
James, D. C. S. (1997). Coping with a new society: The unique psychosocial problems of
immigrant youth. The Journal of School Health, 67(3), 98–102.
https://doi.org/10.1111/j.1746-1561.1997.tb03422.x
Jenkins, A. S. (2019). Associations between mental health, academic success, and perceived
stress among high school freshman in accelerated coursework (Publication No.
27545082) [Doctoral dissertation, University of South Florida Tampa]. ProQuest
Dissertations and Theses Global.
Johnson, B., & Christensen, L. (2014). Educational research: Quantitative, qualitative, and
mixed approaches. Sage Publications.
Johnson, J., & Morales-Brown, L. (2021, September 23). How prevalent are mental health
conditions in Latinx people? Medical News Today.
https://www.medicalnewstoday.com/articles/latino-mental-health
Johnson, R. L., Saha, S., Arbelaez, J. J., Beach, M. C., & Cooper, L. A. (2004). Racial and ethnic
differences in patient perceptions of bias and cultural competence in health care. Journal
of General Internal Medicine, 19(2), 101–110. https://doi.org/10.1111/j.1525-
1497.2004.30262.x
Jones, N. N. (2017). Rhetorical narratives of black entrepreneurs. Journal of Business and
Technical Communication, 31(3), 319–349. https://doi.org/10.1177/1050651917695540
Jorm, A. F. (2015). Why we need the concept of “mental health literacy.”. Health
Communication, 30(12), 1166–1168. https://doi.org/10.1080/10410236.2015.1037423
189

Kai, W. N. (2021, August 4). Students prefer their teachers to counsellors for mental health
support. The Straits Times. https://www.straitstimes.com/singapore/parenting-
education/students-prefer-their-teachers-to-counsellors-for-mental-health
Kamunyu, R. N., Ndungo, C., & Wango, G. (2016). Reasons why university students do not seek
counseling services in Kenya. Journal of Education and Practice, 7(15), 142–145.
https://files.eric.ed.gov/fulltext/EJ1103132.pdf
Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Hawkins, J., Queen, B.,
Lowry, R., Olsen, E. O. M., Chyen, D., Whittle, L., Thornton, J., Lim, C., Yamakawa, Y.,
Brener, N., & Zaza, S. (2016). Youth risk behavior surveillance United States, 2015.
MMWR Surveillance Summaries, 65(6), 1–174. https://doi.org/10.15585/mmwr.ss6506a1
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007).
Age of onset of mental disorders: A review of recent literature. Current Opinion in
Psychiatry, 20(4), 359–364. https://doi.org/10.1097/YCO.0b013e32816ebc8c
Ketchen Lipson, S., Abelson, S., Ceglarek, P., Phillips, M., & Eisenberg, D. (2019). Investing in
student mental health: Opportunities & benefits for college leadership. American
Council on Education. https://www.acenet.edu/Documents/Investing-in-Student-Mental-
Health.pdf
Keyes, C. L. (2013). Promoting and protecting positive mental health: Early and often
throughout the lifespan. In C. L. M. Keyes (Ed.), Mental well-being (pp. 3–28). Springer.
https://doi.org/10.1007/978-94-007-5195-8_1
Kilbourne, A. M., Beck, K., Spaeth-Rublee, B., Ramanuj, P., O’Brien, R. W., Tomoyasu, N., &
Pincus, H. A. (2018). Measuring and improving the quality of Mental Health Care: A
190

Global Perspective. World Psychiatry; Official Journal of the World Psychiatric
Association, 17(1), 30–38. https://doi.org/10.1002/wps.20482
Kisch, J., Leino, E. V., & Silverman, M. M. (2005). Aspects of Suicidal Behavior, Depression,
and Treatment in College Students: Results from the Spring 2000 National College
Health Assessment Survey. Suicide & Life-Threatening Behavior, 35(1), 3–13.
https://doi.org/10.1521/suli.35.1.3.59263
Knifton, L., & Inglis, G. (2020). Poverty and mental health: Policy, practice and research
implications. BJPsych Bulletin, 44(5), 193–196. https://doi.org/10.1192/bjb.2020.78
Koelsch, N. (2006). Improving literacy outcomes for English language learners in high school:
Considerations for states and districts in developing a coherent policy framework.
Institute of Education Sciences. https://doi.org/10.1037/e538512012-001
Kouyoumdjian, H., Zamboanga, B. L., & Hansen, D. J. (2003). Barriers to community mental
health services for Latinos: Treatment considerations. Clinical Psychology: Science and
Practice, 10(4), 394–422. https://doi.org/10.1093/clipsy.bpg041
Kravets-Cohen, V. (2007). Keeping students alive: Mandating on-campus counseling saves
suicidal college students’ lives and limits liability. Fordham Law Review.
https://www.ncbi.nlm.nih.gov/pubmed/17593588
Kymlicka, W. (1996). Multicultural citizenship: A liberal theory of minority rights. Oxford
Academic Press. https://doi.org/10.1093/0198290918.003.0007
Lee, C. C. (1995). Counseling for diversity: A guide for school counselors and related
professionals. Allyn and Bacon.
191

Lee, R. A., & Jung, M. E. (2018). Evaluation of an mhealth app (destressify) on university
students’ mental health: Pilot trial. JMIR Mental Health, 5(1), e2. Advance online
publication. https://doi.org/10.2196/mental.8324
Leventhal-Weiner, R., & Wallace, M. (2011). Racial differences in high school dropout rates: An
analysis of U.S. metropolitan areas. Research in Social Stratification and Mobility, 29(4),
393–413. https://doi.org/10.1016/j.rssm.2010.12.007
Lewis, M. J., West, B., Bautista, L., Greenberg, A. M., & Done-Pérez, I. (2005). Perceptions of
service providers and community members on intimate partner violence within a Latino
community. Health Education & Behavior, 32(1), 69–83.
https://doi.org/10.1177/1090198104269510
Lewis-Fernández, R., Garrido-Castillo, P., Bennasar, M. C., Parrilla, E. M., Laria, A. J., Ma, G.,
& Petkova, E. (2002). Dissociation, childhood trauma, and ataque de nervios among
Puerto Rican psychiatric outpatients. The American Journal of Psychiatry, 159(9), 1603–
1605. https://doi.org/10.1176/appi.ajp.159.9.1603
Lewis-Fernández, R., Gorritz, M., Raggio, G. A., Peláez, C., Chen, H., & Guarnaccia, P. J.
(2010). Association of trauma-related disorders and dissociation with four idioms of
distress among Latino psychiatric outpatients. Culture, Medicine and Psychiatry, 34(2),
219–243. https://doi.org/10.1007/s11013-010-9177-8
Lin, L., Stamm, K., & Christidis, P. (2018). How diverse is the psychology workforce? Center
for Workforce Studies, 49(2), 19. https://www.apa.org/monitor/2018/02/datapoint
Lipson, S. K., & Eisenberg, D. (2017). Mental health and academic attitudes and expectations in
university populations: Results from the Healthy Minds Study. Journal of Mental Health,
27(3), 205–213. https://doi.org/10.1080/09638237.2017.1417567
192

Lipson, S. K., Gaddis, S. M., Heinze, J., Beck, K., & Eisenberg, D. (2015). Variations in Student
Mental Health and Treatment Utilization Across U.S. Colleges and Universities. Journal
of American College Health, 63(6), 388–396.
https://doi.org/10.1080/07448481.2015.1040411
Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities
among college students of color. The Journal of Adolescent Health, 63(3), 348–356.
https://doi.org/10.1016/j.jadohealth.2018.04.014
Lipson, S. K., Lattie, E. G., & Eisenberg, D. (2019). Increased rates of mental health service
utilization by U.S. college students: 10-year population-level trends (2007–2017).
Psychiatric Services, 70(1), 60–63. https://doi.org/10.1176/appi.ps.201800332
Lipson, S. K., Zhou, S., Abelson, S., Heinze, J., Jirsa, M., Morigney, J., Patterson, A., Singh, M.,
& Eisenberg, D. (2022). Trends in college student mental health and help-seeking by
Race/ethnicity: Findings from the National Healthy Minds Study, 2013–2021. Journal of
Affective Disorders, 306, 138–147. https://doi.org/10.1016/j.jad.2022.03.038
Liu, J., & Kong, J. (2021). Why do users of online mental health communities get likes and
reposts: A combination of text mining and empirical analysis. Healthcare, 9(9), 1133.
https://doi.org/10.3390/healthcare9091133
Lois, D. (2022). Social networks, family social capital, and child health. In A. Klarner, M.
Gamper, S. Keim-Klarner, I. Moor, H. von der Lippe, & N. Vonneilich (Eds.), Social
Networks and Health Inequalities (pp. 109–128). Springer. https://doi.org/10.1007/978-3-
030-97722-1_7
193

Lorenzo, D. (2017, November 21). Overcoming mental health stigma in the Latino community.
Consult QD. https://consultqd.clevelandclinic.org/overcoming-mental-health-stigma-in-
the-latino-community/
Low, S. M. (1981). The meaning of nervios: A sociocultural analysis of symptom presentation in
San Jose, Costa Rica. Culture, Medicine and Psychiatry, 5(1), 25–47.
https://doi.org/10.1007/BF00049157
Lu, Y., Pan, T., Liu, J., & Wu, J. (2021). Does usage of online social media help users with
depressed symptoms improve their mental health? Empirical evidence from an online
depression community. Frontiers in Public Health, 8, Article 581088.
https://doi.org/10.3389/fpubh.2020.581088
Macartney, S., Bishaw, A., & Fontenot, K. (2013). Poverty rates for selected detailed race and
Hispanic groups by state and place: 2007–2011. U.S. Census Bureau.
https://www.census.gov/library/publications/2013/acs/acsbr11-17.html
Mahdavi, P., Valibeygi, A., Moradi, M., & Sadeghi, S. (2021). Relationship between
achievement motivation, mental health and academic success in university students.
Community Health Equity Research & Policy, 43(3), 311–317.
https://doi.org/10.1177/0272684X211025932
Mallot, K. M. (2010). Being Mexican: Strengths and challenges of Mexican-origin adolescents.
Journal of School Counseling, 8(12), 1–39. http://jsc.montana.edu/articles/v8n12.pdf
Marsella, A.-M. (2000). The study of culture & psychopathology. In A. J. Yamada (Ed.),
Handbook of multicultural mental health (pp. 3–24). Academic Press.
https://doi.org/10.1016/B978-012199370-2/50002-X
194

Martinez, A. R. (2022). Latina/o college students with psychiatric disabilities: Experiences
encountered on the postsecondary educational trajectory (Publication No. 29064405)
[Doctoral dissertation, Claremont Graduate University]. ProQuest Dissertations and
Theses Global.
Martinez, M. M. M. (2019). Cultural barriers to mental health treatment among
Hispanics/Latino(a)s. Vecinos, Inc. https://vecinos.org/cultural-barriers-to-mental-health-
treatment-among-hispanics/
McCall, W. V., Reboussin, B. A., & Rapp, S. R. (2001). Social support increases in the year after
inpatient treatment of depression. Journal of Psychiatric Research, 35(2), 105–110.
https://doi.org/10.1016/S0022-3956(01)00009-7
McLaren, L. (2005). Ecological Perspectives in health research. Journal of Epidemiology and
Community Health, 59(1), 6–14. https://doi.org/10.1136/jech.2003.018044
Mclean, V., Lipka, R., & Brinthaupt, T. (1999). Becoming a teacher: The person in the process.
In R. P. Lipka & T. M. Brintquaupt (Eds.), The role of self in teacher development (pp.
55–91) SUNY Press.
McPherson, M. P., & Arbelo Marrero, F. (2021). Latinx community college students on
academic probation: Struggles and success. NACADA Journal, 41(1), 33–46.
https://doi.org/10.12930/NACADA-20-15
Meilman, P. W., & Hall, T. M. (2006). Aftermath of tragic events: The development and use of
community support meetings on a university campus. Journal of American College
Health, 54(6), 382–384. https://doi.org/10.3200/JACH.54.6.382-384
195

Menendez, J., Franco, M., Davari, J., Gnilka, P. B., & Ashby, J. S. (2019). Barriers and
facilitators to Latinx College students seeking counseling. Journal of College Student
Psychotherapy, 34(4), 302–315. https://doi.org/10.1080/87568225.2019.1600093
Mental Health America. (2020). Latinx/Hispanic communities and mental health.
https://www.mhanational.org/issues/latinxhispanic-communities-and-mental-health
Mental Health First Aid. (2022). Mental health first aid USA.
https://www.mentalhealthfirstaid.org/
Merriam, S. B., & Tisdell, E. J. (2017). Qualitative research: A guide to design and
implementation. Langara College.
Michaels, C., Blake, L., Lynn, A., Greylord, T., & Benning, S. (2022). Mental health and well-
being ecological model. Minnesota Department of Health.
https://mch.umn.edu/resources/mhecomodel/
Milicev, J., Gardani, M., & Biello, S. (2020, September). Title: Evaluating mental health and
wellbeing of postgraduate. Research Gate.
https://www.researchgate.net/publication/344165264_Title_Evaluating_Mental_Health_a
nd_Wellbeing_of_Postgraduate_Researchers_Prevalence_and_Contributing_Factors
Miville, M. L., & Constantine, M. G. (2006). Sociocultural predictors of psychological help-
seeking attitudes and behavior among Mexican American college students. Cultural
Diversity & Ethnic Minority Psychology, 12(3), 420–432. https://doi.org/10.1037/1099-
9809.12.3.420
Moran, M. (2021, June 23). What is trustworthiness in qualitative research? Statistics Solutions.
from https://www.statisticssolutions.com/what-is-trustworthiness-in-qualitative-research/
196

Mostert, K., & Pienaar, J. (2020). The moderating effect of social support on the relationship
between burnout, intention to drop out, and satisfaction with studies of first-year
university students. Journal of Psychology in Africa, 30(3), 197–202.
https://doi.org/10.1080/14330237.2020.1767928
Mulhern, C. (2020). Better school counselors, better outcomes: Quality varies, and can matter as
much as with teachers. Education Next, 20(3), 52–59. https://www.educationnext.org/wp-
content/uploads/2022/01/ednext_XX_3_mulhern.pdf
Murphy, M. C., Gopalan, M., Carter, E. R., Emerson, K. T., Bottoms, B. L., & Walton, G. M.
(2020). A customized belonging intervention improves retention of socially
disadvantaged students at a broad-access university. Science Advances, 6(29), Article
eaba4677. Advance online publication. https://doi.org/10.1126/sciadv.aba4677
National Alliance on Mental Illness. (2022). Hispanic/Latinx. https://www.nami.org/Your-
Journey/Identity-and-Cultural-Dimensions/Hispanic-
Latinx#:~:text=Hispanic%2FLatinx%20communities%20show%20similar,illness%20ma
y%20not%20receive%20treatment
National Alliance on Mental Illness. (2020). Identity and cultural dimensions: Hispanic/Latinx.
https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Hispanic-Latinx
National Center for Education Statistics. (2017). 2016–17 Integrated Postsecondary Education
Data System (IPEDS) methodology report. U.S. Department of Education.
https://nces.ed.gov/pubs2017/2017078.pdf
Neal, K. (2022, January 12). College students more concerned about COVID-19 than ever, new
survey by TIMELYMD finds. TimelyMD. https://timely.md/college-students-more-
concerned-about-covid-19-than-ever/
197

Nichter, M. (2010). Idioms of distress revisited. Culture, Medicine and Psychiatry, 34(2), 401–
416. https://doi.org/10.1007/s11013-010-9179-6
Nickerson, C. (2022). Understanding acculturation and why it happens. Simply Sociology.
https://simplysociology.com/acculturation-definition.html
Noddings, N. (2002). Starting at home: Caring and social policy. Braille Jymico Inc.
Noddings, N. (2003). Happiness and education. Cambridge University Press.
https://doi.org/10.1017/CBO9780511499920
Noe-Bustamante, L., Mora, L., & Lopez, M. H. (2021). About one-in-four U.S. Hispanics have
heard of Latinx, but just 3% use it. Pew Research Center’s Hispanic Trends Project.
https://www.pewresearch.org/hispanic/2020/08/11/about-one-in-four-u-s-hispanics-have-
heard-of-latinx-but-just-3-use-it/
Office of the Surgeon General. (2001). 2001 Surgeon General’s Report: Complete report. Center
for Disease Control and Prevention.
https://www.cdc.gov/tobacco/sgr/2001/complete_report/index.htm
Oh, H., Trinh, M. P., Vang, C., & Becerra, D. (2020). Addressing barriers to primary care access
for Latinos in the U.S.: An agent-based model. Journal of the Society for Social Work
and Research, 11(2), 165–184. https://doi.org/10.1086/708616
O’Keeffe, P. (2013). A sense of belonging: Improving student retention. College Student
Journal, 47(4), 605–613.
Ontario Centre of Excellence for Child and Youth Mental Health. (2013). Program evaluation
toolkit. Knowledge Institute on Child and Youth Mental Health and Addictions.
http://www.excellenceforchildandyouth.ca/sites/default/files/resource/toolkit_program_e
valuation_tools_for_planning_doing_and_using_evaluation.pdf
198

Onwuegbuzie, A. J., & Combs, J. P. (2011). Data analysis in mixed research: A primer.
International Journal of Education, 3(1), 13. https://doi.org/10.5296/ije.v3i1.618
Orpana, H., Vachon, J., Dykxhoorn, J., McRae, L., & Jayaraman, G. (2016). Monitoring positive
mental health and its determinants in Canada: The development of the Positive Mental
Health Surveillance Indicator Framework. Health Promotion and Chronic Disease
Prevention in Canada, 36(1), 1–10. https://doi.org/10.24095/hpcdp.36.1.01
Pagan-Rivera, M. (2014). Using integrative short-term treatment in addressing the social-
emotional needs of immigrant students: Implications for school social work practice.
School Social Work Journal, 38(2), 61–76.
Paniagua, F. A. (2013, July 25). Culture-bound syndromes, cultural variations, and
psychopathology. In F. A. Paniagua & A.-M. Yamada (Eds.), Handbook of multicultural
mental health: Assessment and treatment of diverse populations (2nd Ed., pp. 25–47).
ScienceDirect. https://doi.org/10.1016/B978-0-12-394420-7.00002-3
Pappamihiel, N. E., & Moreno, M. (2011). Retaining Latino students. Journal of Hispanic
Higher Education, 10(4), 331–344. https://doi.org/10.1177/1538192711410602
Parker, M. M., Das, B., & Kelly, C. T. (2021). Latinx students’ perceptions of school counseling
activities: A content analysis. Journal of School Counseling, 19(40).
https://files.eric.ed.gov/fulltext/EJ1328835.pdf
Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: A meta-
analytic review. Psychological Bulletin, 135(4), 531–554.
https://doi.org/10.1037/a0016059
Passel, J. S., & Cohn, D. V. (2020, May 30). Overall number of U.S. unauthorized immigrants
holds steady since 2009. Pew Research Center’s Hispanic Trends Project.
199

https://www.pewresearch.org/hispanic/2016/09/20/overall-number-of-u-s-unauthorized-
immigrants-holds-steady-since-2009/
Patton, M. Q. (2019). Qualitative research & evaluation methods: Integrating theory and
practice. Sage Publications.
Pazzaglia, A. M., Stafford, E. T., & Rodriguez, S. M. (2016). Survey methods for educators:
Selecting samples and administering surveys (part 2 of 3). Institute of Education
Sciences. https://files.eric.ed.gov/fulltext/ED567752.pdf
Pearson, M. (2012). Building bridges: Higher degree student retention and counselling support.
Journal of Higher Education Policy and Management, 34(2), 187–199.
https://doi.org/10.1080/1360080X.2012.662743
Pedler, M. L., Willis, R., & Nieuwoudt, J. E. (2021). A sense of belonging at university: Student
retention, motivation and enjoyment. Journal of Further and Higher Education, 46(3),
397–408. https://doi.org/10.1080/0309877X.2021.1955844
Pedrelli, P., Nyer, M., Yeung, A., Zulauf, C., & Wilens, T. (2014). College students: Mental
health problems and treatment considerations. Academic Psychiatry, 39(5), 503–511.
https://doi.org/10.1007/s40596-014-0205-9
Pérez, L., Sichel, B., Chui, M., & Calvo, A. P. (2021). The economic state of Latinos in America:
The American dream deferred. McKinsey & Company.
https://www.mckinsey.com/featured-insights/sustainable-inclusive-growth/the-economic-
state-of-latinos-in-america-the-american-dream-deferred
Pérez-Flores, N. J., & Cabassa, L. J. (2021). Effectiveness of mental health literacy and stigma
interventions for Latino/a adults in the United States: A systematic review. Stigma and
Health, 6(4), 430–439. https://doi.org/10.1037/sah0000343
200

Perou, R., Bitsko, R. H., Blumberg, S. J., Pastor, P., Ghandour, R. M., Gfroerer, J. C., Hedden, S.
L., Crosby, A. E., Visser, S. N., Schieve, L. A., Parks, S. E., Hall, J. E., Brody, D.,
Simile, C. M., Thompson, W. W., Baio, J., Avenevoli, S., Kogan, M. D., & Huang, L. N.
(2013). Mental health surveillance among children--United States, 2005–2011.
https://doi.org/23677130
Pineros-Leano, M., Liechty, J. M., & Piedra, L. M. (2017). Latino immigrants, depressive
symptoms, and cognitive behavioral therapy: A systematic review. Journal of Affective
Disorders, 208, 567–576. https://doi.org/10.1016/j.jad.2016.10.025
Pinto, S., & Bailey Jones, J. (2020). The long-term effects of educational disruptions. Federal
Reserve Bank of Richmond.
https://www.richmondfed.org/publications/research/coronavirus/economic_impact_covid
-19_05-22-20
President’s Advisory Commission on Educational Excellence for Hispanic Americans. (1996).
Our nation on the fault line: Hispanic American education. White House Initiative on
Educational Excellence for Hispanic Americans.
Public Health Agency of Canada. (2016). Positive mental health surveillance indicator
framework quick stats, adults (18 years of age and older).
http://www.phacaspc.gc.ca/publicat/hpcdp-pspmc/36-1/assets/pdf/ar-02-eng.pdf
Public Health Ontario. (2015). At a glance: The ten steps for conducting an evaluation. Public
Health Ontario.
https://www.publichealthontario.ca/en/eRepository/At_A_Glance_Evaluation_2015.pdf
Public Health Ontario. (2016). Evaluating health promotion programs introductory workbook.
Public Health Ontario.
201

http://www.publichealthontario.ca/en/eRepository/Evaluating_health_promotion_progra
ms_workbook_2016.pdf
Pumariega, A. J., Glover, S., Holzer, C. E., & Nguyen, H. (1998). Utilization of mental health
services in a tri-ethnic sample of adolescents. Community Mental Health Journal, 34(2),
145–156. https://doi.org/10.1023/A:1018788901831
Raab, M. (2022). How sense of belonging impacts student retention: Examining the experience
of first-generation Latino/a/x students attending PWIs [Unpublished master’s project].
Grand Valley State University, Allendale, Michigan.
https://scholarworks.gvsu.edu/cgi/viewcontent.cgi?article=1140&context=gradprojects
Ramirez Villa, R., Puebla, L., & Reyes Corona, A. (2022). Assessing the mental health
acceptance of Latino college students at California State University San Marcos
[Unpublished master’s thesis]. California State University San Marcos.
Ramirez, A. (2017). Mental health & Latino kids: A research review. Salud America!
https://salud-america.org/healthy-minds-research/
Ramirez, A. G., Gallion, K. J., Aguilar, R., & Dembeck, E. S. (2012). Mental health and Latino
kids: A research review. Salud America! https://salud-america.org/wp-
content/uploads/2017/09/FINAL-mental-health-research-review-9-12-17.pdf
Ramos, K., Cortes, J., Wilson, N., Kunik, M. E., & Stanley, M. A. (2017). Vida calma: CBT for
anxiety with a Spanish-speaking Hispanic adult. Clinical Gerontologist, 40(3), 213–219.
https://doi.org/10.1080/07317115.2017.1292978
Reupert, A. (2017). A socio-ecological framework for mental health and well-being. Advances in
Mental Health, 15(2), 105–107. https://doi.org/10.1080/18387357.2017.1342902
202

Richards, D., Timulak, L., Doherty, G., Sharry, J., Colla, A., Joyce, C., & Hayes, C. (2014).
Internet-delivered treatment: Its potential as a low-intensity community intervention for
adults with symptoms of depression: Protocol for a randomized controlled trial. BMC
Psychiatry, 14(1), Article 147. https://doi.org/10.1186/1471-244X-14-147
Rienties, B., & Toetenel, L. (2016). The impact of learning design on student behaviour,
satisfaction and performance: A cross-institutional comparison across 151 modules.
Computers in Human Behavior, 60, 333–341. https://doi.org/10.1016/j.chb.2016.02.074
Rith-Najarian, L., Sun, W., Chen, A., Chorpita, B., Chavira, D., Mougalian, S., & Gong-Guy, E.
(2019). What’s in a name? Branding of Online Mental Health Programming for
university students. Journal of Consulting and Clinical Psychology, 87(4), 380–391.
https://doi.org/10.1037/ccp0000383
Rivas-Drake, D., Seaton, E. K., Markstrom, C., Quintana, S., Syed, M., Lee, R. M., Schwartz, S.
J., Umaña-Taylor, A. J., French, S., & Yip, T. (2014). Ethnic and racial identity in
adolescence: Implications for psychosocial, academic, and health outcomes. Child
Development, 85(1), 40–57. https://doi.org/10.1111/cdev.12200
Roberts, J. M. (2014). Critical realism, dialectics, and qualitative research methods. Journal for
the Theory of Social Behaviour, 44(1), 1–23. https://doi.org/10.1111/jtsb.12056
Robinson, S. B., & Firth Leonard, K. (2019). Designing quality survey questions. Sage.
Roche, K. M., Vaquera, E., White, R. M. B., & Rivera, M. I. (2018). Impacts of immigration
actions and news and the psychological distress of U.S. Latino parents raising
adolescents. The Journal of Adolescent Health, 62(5), 525–531.
https://doi.org/10.1016/j.jadohealth.2018.01.004
203

Rodriguez, A. L., Guido-DiBrito, F., Torres, V., & Talbot, D. (2000). Latina college students:
Issues and challenges for the 21st century. NASPA Journal, 37(3), 511–527.
https://doi.org/10.2202/1949-6605.1111
Rogers, J., Franke, M. Yun, J.E., Ishimoto, M., Diera, C., Geller, R., Berryman, A., Brenes, T.
(2017). Teaching and learning in the age of Trump: Increasing stress and hostility in
America’s high schools. UCLA’s Institute for Democracy, Education, and Access.
https://idea.gseis.ucla.edu/publications/teaching-and-learning-in-age-of-trump
Ruarte, D. E. (2018). Rethinking Hispanic attrition rates at U.S. post-secondary institutions: An
evaluation study conducted at Latino private college (Publication No. 10930062)
[Doctoral dissertation, University of Southern California]. ProQuest Dissertations and
Theses Global.
Sáenz, R. (2010). Social and economic well-being and the future for Latinos in the United States.
Population Reference Bureau. https://www.prb.org/resources/social-and-economic-well-
being-and-the-future-for-latinos-in-the-united-states/
Sáenz, V., & Ponjuan, L. (2012). Latino males: Improving college access and degree
completion—A new national imperative. PERSPECTIVAS: Issues in Higher Education
Policy and Practice, (1), 2–9. https://doi.org/10.13140/RG.2.2.12359.34720
Salas-Wright, C. P., Kagotho, N., & Vaughn, M. G. (2014). Mood, anxiety, and personality
disorders among first and second-generation immigrants to the United States. Psychiatry
Research, 220(3), 1028–1036. https://doi.org/10.1016/j.psychres.2014.08.045
Salesforce. (2022). Connected student report: Insights into global higher education trends from
over 2,000 Students and Staff. https://www.salesforce.org/resources/report/connected-
student-report/
204

Salganik, M. J., & Heckathorn, D. D. (2004). 5. Sampling and estimation in hidden populations
using respondent-driven sampling. Sociological Methodology, 34(1), 193–240.
https://doi.org/10.1111/j.0081-1750.2004.00152.x
Salkind, N. J. (2014). Statistics for people who (think they) hate statistics. SAGE Publications,
Inc.
Salzer, M. S. (2012). A comparative study of campus experiences of college students with
mental illnesses versus a general college sample. Journal of American College Health,
60(1), 1–7. https://doi.org/10.1080/07448481.2011.552537
Sam, D. L., & Berry, J. W. (2010). Acculturation. Perspectives on Psychological Science, 5(4),
472–481. https://doi.org/10.1177/1745691610373075
Sánchez, M., Cardemil, E., Adams, S. T., Calista, J. L., Connell, J., DePalo, A., Ferreira, J.,
Gould, D., Handler, J. S., Kaminow, P., Melo, T., Parks, A., Rice, E., & Rivera, I. (2014).
Brave new world: Mental health experiences of Puerto Ricans, immigrant Latinos, and
Brazilians in Massachusetts. Cultural Diversity & Ethnic Minority Psychology, 20(1),
16–26. https://doi.org/10.1037/a0034093
Sánchez, M., Diez, S., Fava, N. M., Cyrus, E., Ravelo, G., Rojas, P., Li, T., Cano, M. A., & De
La Rosa, M. (2019). Immigration stress among recent Latino immigrants: The protective
role of social support and religious social capital. Social Work in Public Health, 34(4),
279–292. https://doi.org/10.1080/19371918.2019.1606749
Sánchez, M., Dillon, F. R., Concha, M., & De La Rosa, M. (2014). The impact of religious
coping on the acculturative stress and alcohol use of recent Latino immigrants. Journal of
Religion and Health, 54(6), 1986–2004. https://doi.org/10.1007/s10943-014-9883-6
205

Schneider, B., & Ownes, A. (2006). Barriers to educational opportunities for Hispanics in the
United States. In S. Martinez (Ed.), Hispanics and the future of America (pp. 179–219).
National Academies Press.
Semchuk, J. C., McCullough, S. L., Lever, N. A., Gotham, H. J., Gonzalez, J. E., & Hoover, S.
A. (2022). Educator-informed development of a Mental Health Literacy Course for
school staff: Classroom well-being information and strategies for educators (classroom
wise). International Journal of Environmental Research and Public Health, 20(1), 35.
https://doi.org/10.3390/ijerph20010035
Sherbourne, C. D., & Stewart, A. L. (1991). The MOS Social Support Survey. Social Science &
Medicine, 32(6), 705–714. https://doi.org/10.1016/0277-9536(91)90150-B
Sibley, E., & Brabeck, K. (2017). Latino immigrant students’ school experiences in the United
States: The importance of family-school-community collaborations. School Community
Journal, 27(1), 137–157. https://files.eric.ed.gov/fulltext/EJ1146470.pdf
Silva, C., & Van Orden, K. A. (2018). Suicide among Hispanics in the United States. Current
Opinion in Psychology, 22, 44–49. https://doi.org/10.1016/j.copsyc.2017.07.013
Silva, M. A., Perez, O. F., Añez, L. M., & Paris, M., Jr. (2021). Telehealth treatment engagement
with Latinx populations during the COVID-19 pandemic. The Lancet Psychiatry, 8(3),
176–178. https://doi.org/10.1016/S2215-0366(20)30419-3
Smith, B. L. (2018). Spanish-speaking psychologists in demand. Monitor on Psychology, 49(6),
68. https://www.apa.org/monitor/2018/06/spanish-speaking
Smith-Adcock, S., Daniels, M., Lee, S., Villalba, J., & Indelicato, N. (2006). Culturally
responsive school counseling for Hispanic/Latino students and families: The need for
206

bilingual school counselors. Professional School Counseling, 10(1), 92–101.
https://doi.org/10.5330/prsc.10.1.8r04h7727651174m
Smokowski, P. R., & Bacallao, M. L. (2006). Acculturation, internalizing mental health
symptoms, and self-esteem: Cultural experiences of Latino adolescents in North Carolina.
Child Psychiatry and Human Development, 37(3), 273–292.
https://doi.org/10.1007/s10578-006-0035-4
Sontag-Padilla, L., Woodbridge, M. W., Mendelsohn, J., D’Amico, E. J., Osilla, K. C., Jaycox,
L. H., Eberhart, N. K., Burnam, A. M., & Stein, B. D. (2016). Factors affecting mental
health service utilization among California public college and university students.
Psychiatric Services, 67(8), 890–897. https://doi.org/10.1176/appi.ps.201500307
Soto, S. A. (2016). Utilization of mental health services among Hispanics [Unpublished master’s
thesis]. California State University, San Bernardino.
Spotlight, S. to S. J. (2020, October 31). Bonilla, Carrasco: East San Jose needs college
investment. San José Spotlight. https://sanjosespotlight.com/bonilla-carrasco-east-san-
jose-needs-college-investment/
Stebleton, M. J., Soria, K. M., & Huesman, R. L., Jr. (2014). First-generation students’ sense of
belonging, mental health, and use of counseling services at public research universities.
Journal of College Counseling, 17(1), 6–20. https://doi.org/10.1002/j.2161-
1882.2014.00044.x
Stone, L. (2016). Chapter twenty-three: Nel Noddings, the challenge to care in schools: An
alternative approach to education (1992). In J. L. DeVitis (Ed.) Popular educational
classics: A reader (pp. 241–248). Peter Lang. https://doi.org/10.3726/978-1-4539-1735-
0/37
207

Storlie, C. A., & Toomey, R. B. (2016). Professional school counselor perceptions of systemic
barriers affecting Latino students: Implications for socially just preparation and practice.
The Journal of Counselor Preparation and Supervisor. Advance online publication.
https://doi.org/10.7729/82.1156
Tacoma-Pierce Health Department. (2016). Unattended mental health’s impact on society.
Office of Assessment, Planning & Improvement.
https://www.tpchd.org/home/showpublisheddocument/664/636427057087700000#:~:text
=Unaddressed%20mental%20health%20problems%20can,to%20family%20and%20com
munity%20disruption
Tait, A. (2000). Planning student support for open and distance learning. Open Learning, 15(3),
287–299. https://doi.org/10.1080/713688410
Talleyrand, R. M., & Vojtech, J. T.-G. (2018). Potential stressors of undocumented Latinx youth:
Implications and recommendations for school counselors. Professional School
Counseling, 22(1), 2156759X1984716. Advance online publication.
https://doi.org/10.1177/2156759X19847168
Tambling, R. R., D’Aniello, C., & Russell, B. S. (2021). Mental health literacy: A critical target
for narrowing racial disparities in behavioral health. International Journal of Mental
Health and Addiction. Advance online publication. https://doi.org/10.1007/s11469-021-
00694-w
Tandon, R. (2020). Covid-19 and mental health: Preserving humanity, maintaining sanity, and
promoting health. Asian Journal of Psychiatry, 51, Article 102256.
https://doi.org/10.1016/j.ajp.2020.102256
208

TEDx Talks. (2018). Why we need to re-brand adolescent mental health | Amber Cowburn |
TEDxCambridgeUniversity. YouTube. Retrieved June 8, 2023, from
https://www.youtube.com/watch?v=7nfxdId5RwY
Tiend, M., & Mitchells, F. (2006). Introduction: E pluribus plures or e pluribus unum? In
Hispanics and the future of America (1st ed., pp. 3–21). National Academies Press.
Tinto, V. (2022). Leaving college: Rethinking the causes and cures of student attrition.
University of Chicago Press.
Torres, V., & Hernandez, E. (2009). Influence of an identified advisor/mentor on urban Latino
students’ college experience. Journal of College Student Retention, 11(1), 141–160.
https://doi.org/10.2190/CS.11.1.h
Umubyeyi, A., Mogren, I., Ntaganira, J., & Krantz, G. (2015). Help-seeking behaviours, barriers
to care and self-efficacy for seeking mental health care: A population-based study in
Rwanda. Social Psychiatry and Psychiatric Epidemiology, 51(1), 81–92.
https://doi.org/10.1007/s00127-015-1130-2
UnidosUS. (2021, August 25). Following their dreams in an inequitable system: Latino students
share their college experience. UnidosUS. https://www.unidosus.org/publications/2078-
following-their-dreams-in-an-inequitable-system-latino-students-share-their-college-
experience/
U.S. Census Bureau. (2008). 2008 national population projections tables.
https://www.census.gov/data/tables/2008/demo/popproj/2008-summary-tables.html
U.S. Census Bureau. (2015). Annual estimates of the resident population by sex, age, race, and
Hispanic origin for the United States and states: April 1, 2010 to July 1, 2014.
https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
209

U.S. Department of Education. (2020). White House Initiative on Advancing Educational Equity,
Excellence, and Economic Opportunity for Hispanics. https://sites.ed.gov/hispanic-
initiative/hispanic-serving-institutions-hsis/
U.S. Department of Health and Human Services Office of Minority Health. (2016). Mental and
Behavioral Health - Hispanics.
https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=69
U.S. Department of Health and Human Services. (n.d.). Any anxiety disorder. National Institute
of Mental Health. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
Valenzuela, A. (2002). Subtractive schooling: U.S.-Mexican youth and the politics of caring.
International Journal of Bilingual Education and Bilingualism, 5(4), 244–248.
https://doi.org/10.1080/13670050208667759
Vargas Bustamante, A., Fang, H., Rizzo, J. A., & Ortega, A. N. (2009). Understanding observed
and unobserved health care access and utilization disparities among U.S. Latino adults.
Medical Care Research and Review: MCRR, 66(5), 561–577.
https://doi.org/10.1177/1077558709338487
Vasta, R., & Bronfenbrenner, U. (1989). Ecological systems theory. In Annals of child
development (pp. 187–248). JAI Press.
Vega, W. A., & Lopez, S. R. (2001). Priority issues in Latino mental health services research.
Mental Health Services Research, 3(4), 189–200.
https://doi.org/10.1023/A:1013125030718
Vela-Gude, L., Cavazos, J., Johnson, M., Fielding, C., Cavazos, A., Campos, L., & Rodriguez, I.
(2009). “My counselors were never there”: Perceptions from Latino college students.
210

Professional School Counseling, 12(4), 272–279. https://doi.org/10.5330/PSC.n.2010-
12.272
Vespa, J., Medina, L., & Armstrong, D. M. (2018). Demographic turning points for the United
States: Population projections for 2020 to 2060. U.S. Census Bureau.
https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-
1144.pdf
Victorian Government Department of Human Services. (2003). Measuring health promotion
impacts: A guide to impact evaluation in integrated health promotion.
https://www2.health.vic.gov.au/getfile//?sc_itemid=%7bE695B663-73AA-4F63-BAD1-
43A581089ABF%7d
Villatoro, A. P., Morales, E. S., & Mays, V. M. (2014). Family culture in mental health help-
seeking and utilization in a nationally representative sample of Latinos in the United
States: The NLAAS. American Journal of Orthopsychiatry, 84(4), 353–363.
https://doi.org/10.1037/h0099844
Vimal, M., Dongre, A. R., Nishanthi, A., & Kagne, R. N. (2021). Student support system for
medical undergraduates: A qualitative exploration of stakeholder perspectives. Journal of
Education and Health Promotion, 10(150). Advance online publication.
https://doi.org/10.4103/jehp.jehp_544_20
Vogel, D. L., Wade, N. G., Wester, S. R., Larson, L., & Hackler, A. H. (2007). Seeking help
from a mental health professional: The influence of one’s social network. Journal of
Clinical Psychology, 63(3), 233–245. https://doi.org/10.1002/jclp.20345
211

Wakefield, M. A., Loken, B., & Hornik, R. C. (2010). Use of mass media campaigns to change
health behaviour. Lancet, 376(9748), 1261–1271. https://doi.org/10.1016/S0140-
6736(10)60809-4
Wang, J. L. (2007). Mental health treatment dropout and its correlates in a general population
sample. Medical Care, 45(3), 224–229.
https://doi.org/10.1097/01.mlr.0000244506.86885.a5
Watson, A. C., Eack, S. M., Heller, N. R., & Gitterman, A. (2011). Oppression and stigma and
their effects. In N. R. Heller & A. Gitterman (Eds.), Mental health and social problems:
A social work perspective (pp. 21–43). Routledge.
Wei, P. (2022). The impact of social support on students’ mental health: A new perspective
based on Fine Art Majors. Frontiers in Psychology, 13, Article 994157.
https://doi.org/10.3389/fpsyg.2022.994157
Weinick, R. M., Jacobs, E. A., Stone, L. C., Ortega, A. N., & Burstin, H. (2004). Hispanic
healthcare disparities. Medical Care, 42(4), 313–320.
https://doi.org/10.1097/01.mlr.0000118705.27241.7c
Whaling, K. (2015). Mental health service utilization in Latino college students: A mixed
methods study [Unpublished master’s thesis]. California State University, Northridge.
https://doi.org/10.13140/RG.2.2.14228.73603
Wheaton, B. (2007). The twain meet: Distress, disorder and the continuing conundrum of
categories (comment on Horwitz). Health, 11(3), 303–319.
https://doi.org/10.1177/1363459307077545
212

White, G. W. (2016). Mental health and academic achievement: The effects of self-efficacy.
(Publication No. 10515051) [Doctoral dissertation, Rutgers, The State University of New
Jersey]. ProQuest Dissertations and Theses Global.
WHO & Calouste Foundation. (2014). Social determinants of mental health. World Health
Organization. https://www.who.int/publications-detail-redirect/9789241506809
Wies, B., Landers, C., & Ienca, M. (2021). Digital mental health for young people: A scoping
review of ethical promises and challenges. Frontiers in Digital Health, 3, Article 697072.
https://doi.org/10.3389/fdgth.2021.697072
Wimshurst, K., Wortley, R., Bates, M., & Allard, T. (2006). The impact of institutional factors
on student academic results: Implications for ‘quality’ in universities. Higher Education
Research & Development, 25(2), 131–145. https://doi.org/10.1080/07294360600610370
Wintemute, D. (2022, September 23). Mental health for Hispanic and Latino/a students:
BestColleges. BestColleges.com. https://www.bestcolleges.com/resources/hispanic-
latino-student-mental-health-guide/
Woessmann, L. (2015). The economic case for education. Education Economics, 24(1), 3–32.
https://doi.org/10.1080/09645292.2015.1059801
World Economic Forum. (2016). Education: Global competitiveness report 2015–2016.
https://reports.weforum.org/global-competitiveness-report-2015-
2016/education/#view/fn-53
World Health Organization. (n.d.). Health and well-being.
https://www.who.int/data/gho/data/major-themes/health-and-well-being
213

World Health Organization. (2022). Mental health. World Health Organization.
https://www.who.int/en/news-room/fact-sheets/detail/mental-health-strengthening-our-
response
Zhai, Y., & Du, X. (2020). Addressing collegiate mental health amid COVID-19 pandemic.
Psychiatry Research, 288(113003), 1–2. https://doi.org/10.1016/j.psychres.2020.113003
Zhou, E., Kyeong, Y., Cheung, C. S., & Michalska, K. J. (2021). Shared cultural values
influence mental health help-seeking behaviors in Asian and Latinx College students.
Journal of Racial and Ethnic Health Disparities, 9(4), 1325–1334.
https://doi.org/10.1007/s40615-021-01073-w

214

Appendix A: In-Depth Interview
Hello, my name is Adriana Merlo. It will be my pleasure to interview you today. My
current research project with USC’s doctoral program looks at the relationship between Latinx
students’ perceptions of student support services, their perception of the university and if it
makes them feel cared for, and the key support systems that empower students to graduate from
a 4-year institution.
Firstly, I would like to thank you for taking the time to talk with me. Your feedback is
essential and will help shape the way colleges support Latinx students in completing their
undergraduate programs.
This interview will last no more than 60 minutes. Would that be acceptable?
Great. Please let me know if you need a break or stop at any time.
During this interview, I will ask you a few questions about your perceptions of the
school-related resources and the university-driven supports that motivate you to finish your
undergraduate degree.
You are the expert here, so there are no wrong answers. These interviews aim to hear
from you and capture your point of view. Your honest feedback is vital to improving how
colleges can support Latinx students’ graduation rates.
Also, would you let me record this call? I will only use the recording for my research. I
will not share it with anyone. Do I have your consent to record?
Lastly, I would like to confirm that you have received a participant consent form. Is that
correct? If so, did you review it? What questions do you have? I would appreciate it if you could
sign it and send it back as soon as possible.

215

Thank you. What else can I help you with at this time? Do you have any follow-up
questions?
Next, I will share with you some essential details about the interview.
This study has obtained ethical clearance. I can provide you with contact information for
the interview at the end of the study if you have any comments or concerns.
Remember, you are free not to participate or respond to any questions. All information
you provide will remain confidential, and no individuals will be identified when the data is
published. Let’s begin if you are all set and have no more questions.

Table C1
English Interview Protocol
Interview questions Potential probes RQ addressed Key concept addressed
Tell me about your
experiences as an
undergraduate.
How was school for you?
What aspects of the
college experience were
the most enriching?
Which ones could’ve
been better? What
would have made them
better? How could the
school have better
supported you to stay
motivated to finish
school?
1
2
3
Graduation
Feeling of support and
care from the
university
Social cohesion
Acculturative stress
How has the school
provided resources
to support
managing your
stress to continue
your education?
What are the most
enriching
services/resources? Tell
me about a time you
used a school-wide
service, and it helped
you on your journey
toward graduation. How
come? If you didn’t use
one, what would have
been a great one for
1
2
3
Graduation
Feeling of support and
caring from the
university
Social cohesion
Acculturative stress
216

Interview questions Potential probes RQ addressed Key concept addressed
you? What would have
prompted you to seek
them out?
What/who has fed
your desire to
graduate?
What relationships have
influenced your desire
to stay in school? What
are the most essential
elements/factors/relatio
nships that keep you
focused on graduation?
What school-related
relationships (Faculty,
staff, or support service
team members)
influenced your desire
to finish your degree?
2 Feeling of support and
caring from the
university

Graduation
Social cohesion
Familismo
Religiosity
How has the school
helped you
navigate stressors
that made you
question whether
you stay in school?
What institutions within
the school played a
role? Which figures
were vital in keeping
you focused on
graduation when times
were tough? What made
you feel comfortable to
reach out to them and
open up? How did you
find out about these
services?
2
3

Mental wellness
Feeling of support and
caring from the
university
Graduation
Social cohesion
Religiosity
Familismo
Acculturative stress
What are the triggers
that alert you to an
intolerable stress
level that could risk
you dropping out?
What would you do?
From whom would you
seek help?
What made you feel
comfortable to seek out
their assistance?
2
3
Social cohesion
Familismo
Religiosity
Acculturative stress
Tell me about a
situation when you
had to overcome a
stressful situation
that provoked a
sense of needing to
pause your
education.
If you used school
resources, how was
your experience? If you
didn’t, what led you to
shy away from those
service?
What could have
prompted you to seek
them out?
1
2
3
Graduation
Feeling of support and
caring from the
university
Acculturative stress
217

Interview questions Potential probes RQ addressed Key concept addressed
Some people would
say they are
embarrassed to use
college resources to
keep them
supported to stay in
school. What
would you say to
them?

What do you think would
make someone
embarrassed or shy of
using school services?
How could the school
overcome these
challenges to reach
these students?
1
2
3
Graduation
Social cohesion
Feeling of support and
caring from the
university
What would you like
to see happen so
more students can
take advantage of
school resources
that help students
graduate?
What ideas do you have
around the messages
these school services
send out to the student
body? How did you find
out about these
services? What
prompted you to seek
them out? Did you
share your experience
with your friends? If so,
were more students
inspired to use these
services? If not, what
would have made you
more comfortable in
letting people know
about them?
1
2
3
Graduation
Social cohesion
Feeling of support and
caring from the
university

How would you
describe an ideal
graduation support
program?
How would this support
reach out to you? What
kind of messages would
it have? Describe to me
the kind of people
working there.
2
3
Familismo
Language barriers
Student mental health
Graduation
Feeling of support and
caring from the
university

What conditions or
circumstances of
life would prompt
you to leave your
college?
What could the school
have done to support
you best?
Hypothetically
speaking, would you
have asked for help? If
so, what resources
would you have used?
If not, what would have
2 Stigma
Graduation
Feeling of support and
caring from the
university
Acculturative stress
218

Interview questions Potential probes RQ addressed Key concept addressed
held you back from
doing so?
If you had to pick the
top three school
services that helped
you keep support
you to stay in
school, what would
they be?
What was so special about
these services? What
led you to seek them
out? What strategies
worked best? Which
ones were least
effective? How come
you felt this way?
1
2
3
Stigma
Familismo
Language barriers
Motivation to stay in
school
Social cohesion
Familismo
Religiosity.
What school service
helps you feel that
you are cared for
by the university?
How did they make you
feel cared for?
1
2
3
Feeling of support and
caring from the
university
Social cohesion
Graduation.

219

Appendix B: Entrevista Profunda
Hola, mi nombre es Adriana Merlo. Será mi placer llevar a cabo esta entrevista hoy. Mi
proyecto investigación actual con el programa de doctorado de la Universidad de Southern
California intenta explorar la relación entre la percepción de los servicios de apoyo académico, el
interés por el bienestar y la salud mental de los alumnos Latinos, y como afecta eso en su deseo
de concluir su carrera.
Primero y, antes de nada, me gustaría darte las gracias por tomarte el tiempo de platicar
conmigo. Tu retroalimentación es esencial y ayudará a formar la manera en que las universidades
apoyan a alumnos Latinos para graduarse.
Esta entrevista no va a durar más de 60 minutos. ¿Esto es aceptable para ti?
Perfecto. Por favor avísame si necesitas tomar una pausa o un receso o inclusive terminar
la entrevista en cualquier momento. A lo largo de esa entrevista, te haré preguntas sobre tus
percepciones de los recursos relacionados a la escuela y los apoyos que te han motivado a querer
terminar tu bachillerato.
Tú eres el experto en este caso, así que no existen las respuestas equivocadas. Estas
entrevistas tienen la intención de querer capturar tu perspectiva. Tu retroalimentación honesta es
vital para poder mejorar como las universidades pueden apoyar a otros alumnos Latinos a que es
gradúen.
Adicionalmente, quisiera preguntarte si me permitirías grabar esta entrevista. Sólo
utilizaré esta grabación para investigaciones y no la compartiré con nadie. ¿Tengo tu
consentimiento para grabar?
Finalmente, me gustaría confirmar que tú hayas recibido la hoja de consentimiento. ¿La
recibiste? Si, sí, ¿has podido revisarla? ¿Qué preguntas tienes?
220

Agradecería si pudieras firmarla y enviármela lo antes posible. Gracias.
¿En qué más te puedo ayudar en este momento? ¿Tienes alguna otra pregunta?
Ahora te compartiré unos detalles esenciales de esta entrevista. Este estudio tiene el visto
bueno ético. Puedo proporcionarte la información de contacto del consejo ético por si tienes
cualquier comentario o duda.
Acuérdate, que eres libre de no querer participar o responder esas preguntas. Toda la
información que me proporciones permanecerá confidencial. No incluiré ningún dato que
permita que otras personas te identifiquen cuando publique el estudio.
Vamos a comenzar si tú estás listo y no tienes preguntas.

Table D1
Spanish Interview Protocol
Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
Cuéntame de tu
experiencia
como alumno
en esta carrera.
¿Cómo te fue en la
escuela? ¿Qué aspectos
de la universidad o
experiencia universitaria
son las más
enriquecedoras? ¿Cuáles
podrían haber sido
mejor? ¿Que los hubiera
hecho mejores? ¿De qué
forma la escuela te pudo
haber apoyado para
terminar tus estudios de
una mejor forma?

1
2
3

Graduation
Feeling of support and
care from the
university
Social cohesion
Acculturative stress
¿De qué forma la
universidad te
proporciona
recursos para
ayudarte a
graduarte?
¿Cuáles son los recursos o
servicios más
enriquecedores?
Cuéntame de una
situación o un momento
que usaste un recurso de
1
2
3
Graduation
Feeling of support and
caring from the
university
Social cohesion
Acculturative stress
221

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
la universidad y te ayudó
a mantenerte enfocado a
permanecer en la
escuela. ¿Por qué te
ayudó a mantenerte
enfocado? Sino utilizaste
uno, ¿cuál hubiera sido
un recurso apropiado
para ti? ¿Qué te hubiera
incitado a buscarlos en
un principio?

¿Quién o qué ha
alimentado tu
enfoque de
permanecer en
la escuela y
ser exitoso en
la escuela?
¿Qué relaciones te han
motivado para graduarte?
¿Cuáles son los
elementos, factores o
relaciones más esenciales
que te impulsan para
terminar tu carrera?
¿Cuáles son las
relaciones dentro de la
universidad (ya sean
profesores, equipo
administrativo, o
miembros de algún
servicio para alumnos)
que hayan influenciado
tu determinación para
terminar tu carrera?

2 Feeling of support and
caring from the
university

Graduation
Social cohesion
Familismo
Religiosity
¿De qué forma te
ayudado en la
escuela
navegar el
estrés que en
algún
momento te ha
hecho
cuestionar si
debieras de
continuar con
tu carrera?

¿Qué servicios dentro de la
escuela jugaron un papel
en eso? ¿Qué figuras
fueron vitales para
mantenerte determinado?
¿Qué te hizo sentir
cómodo para buscarlos y
abrirte? ¿Cómo te
enteraste de ese servicio?
2
3

Mental wellness
Feeling of support and
caring from the
university
Graduation
Social cohesion
Religiosity
Familismo
Acculturative stress
222

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
¿Cómo sabrías si
tus ganas para
terminar tu
carrera están
titubeando?
¿Como sabrías que ya estás
a punto de abandonar la
escuela? ¿Qué harías?
¿Qué tipo de apoyo
buscarías? ¿Qué te hizo
sentir cómodo en buscar
su asistencia?
2
3
Social cohesion
Familismo
Religiosity
Acculturative stress
Cuéntame de una
situación en la
cual tuviste
que
sobrellevar
una situación
estresante que
provocó una
necesidad o un
sentimiento de
tener que
ponerle pausa
a tu educación.
Si utilizaste recursos de la
universidad ¿cómo
estuvo tu experiencia? Si
no lo usaste, ¿por qué?
¿Porque no te sentiste
cómodo? Cuéntame una
situación en la cual
tuviste que sobrellevar
una situación estresante
que provocó una
necesidad o un
sentimiento de tener que
ponerle pausa a tu
educación. Si utilizaste
recursos de la
universidad ¿cómo
estuvo tu experiencia? Si
no lo usaste, ¿por qué?
¿Porque no te sentiste
cómodo en usarlo? ¿Qué
te hubiera incitado a usar
los servicios de la
universidad?
1
2
3
Graduation
Feeling of support and
caring from the
university
Acculturative stress
Algunas
personas
dirían qué les
da pena
utilizar los
recursos de la
universidad
para
mantenerlos
enfocados de
graduarse y
mantener su
bienestar
emocional.
¿Por qué crees que alguien
le daría pena usar los
recursos de la
universidad? ¿Cómo o
que tendría que hacer la
universidad para poder
llegarle a esos
estudiantes y darles la
vuelta a esos retos?
1
2
3

Graduation
Social cohesion
Feeling of support and
caring from the
university
223

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
¿Qué les
dirías?
¿Qué te gustaría
ver que ocurra
para que más
alumnos
puedan tomar
ventaja de los
recursos de la
escuela que
permiten que
los alumnos se
puedan
graduar?
¿Qué ideas tienes sobre los
mensajes que estos
servicios envían a los
alumnos? ¿Cómo te
enteras o servicio? ¿Qué
te provocó o motivo
buscarlo? ¿Compartiste
tu experiencia con
amigos? Si sí, ¿crees que
eso les ayudó a que se
pusieran en contacto con
esos servicios? Si no,
¿qué crees que hubiera
faltado para que más
personas se sientan
cómodas de poder
utilizarlos?

1
2
3

Graduation
Social cohesion
Feeling of support and
caring from the
university

¿Cómo
describirías el
programa ideal
para fomentar
la graduación?
¿Cómo te contactaría este
programa? ¿Qué tipo de
mensajes tendría?
¿Cómo describirías un
programa de retención
ideal? ¿Cómo te
contactaría este
programa? ¿Qué tipo de
mensajes tendría?
Descríbeme el tipo de
persona que trabaja ahí.

2
3
Familismo
Language barriers
Student mental health
Graduation
Feeling of support and
caring from the
university

Si tuvieras que
dejar la
universidad
¿que tendría
que estar
pasando en tu
vida? ¿Qué
pudo haber
hecho en la
universidad
para poder
Hipotéticamente hablando,
¿hubieras buscado
ayuda? ¿Qué recursos
hubieran utilizado? ¿Qué
te hubiera impedido
buscar esa ayuda?
2 Stigma
Graduation
Feeling of support and
caring from the
university
Acculturative stress
224

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
apoyarte una
mejor forma?
Si tuvieras que
elegir los
mejores tres
servicios
escolares que
te ayudaron a
mantenerte
enfocado para
graduarte,
¿cuáles serían?
¿Qué es lo que hacían estos
servicios que fueran tan
especiales? ¿Qué te
provocó buscarlos? ¿Qué
estrategias funcionaron
mejor? ¿Cuáles eran los
menos efectivo? ¿Por
qué te sentiste de esa
forma?
1
2
3
Stigma
Familismo
Language barriers
Motivation to stay in
school
Social cohesion
Familismo
Religiosity.
¿Qué servicio
escolar te
ayuda sentir
que le
importas a la
universidad?
¿El sentir que perteneces te
ayudó a querer
graduarte? ¿Dónde
sientes que perteneces en
esta experiencia
universitaria?

1
2
3
Feeling of support and
caring from the
university
Social cohesion
Graduation.

225

Appendix A: Survey Draft
Appendix A: Survey Draft
Question Response options (if
close-ended)
RQ Concept being measured
(from emerging
conceptual framework)
How likely are you
to graduate?
1 Extremely unlikely
2 Unlikely
3 Neutral
4 Likely
5 Extremely Likely
1
2
3
Graduation rates
I can count on
someone from the
university to listen
to me in Spanish
when I need to
talk.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

1
2
3
Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
A university staff
member can give
me information in
Spanish or English
to help me
understand a
personal situation.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

3 Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
A university staff
member can give
me good advice
about a crisis
while
understanding I
might feel
embarrassed to
share.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

1 Stigma/ discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
I can count on
someone from the
university to
confide in or talk
to about myself or
my problems
beyond my family
unit.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

1
2
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
The university
environment gives
me access to
someone whose
advice I really
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
1
2
3
Familismo
Social Support

Stigma/discrimination
226

Question Response options (if
close-ended)
RQ Concept being measured
(from emerging
conceptual framework)
want outside of my
family circle.
Emotional/informational,
tangible, affectionate,
and positive social
interaction
The university
environment gives
me access to a
professional to
share my most
private worries and
fears in a way that
does not make me
feel judged.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

1
2
3
Stigma/ discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
The university
resources provide
someone for me to
turn to for
suggestions about
how to deal with a
personal problem
in a way that feels
familiar to me
without feeling
judged.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

2
3
Stigma/ discrimination
Familismo
Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction

The university
provides me access
to someone who
understands my
problems and
background and
can communicate
in my own
language.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

2
3
Language barriers
Emotional/informational,
tangible, affectionate,
and positive social
interaction
I have someone I can
turn to within the
university staff to
help me if I were
considering
leaving school.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

1 Stigma/discrimination
Social Support

Emotional/informational,
tangible, affectionate,
and positive social
interaction
I recognize the
university
resources I would
1 None of the time
2 A little of the time
3 Some of the time
3 Stigma/ discrimination
Emotional/informational,
tangible, affectionate,
227

Question Response options (if
close-ended)
RQ Concept being measured
(from emerging
conceptual framework)
need to tap into if I
needed emotional
support.

4 Most of the time
5 All of the time
and positive social
interaction
I can identify
someone within
the university
network to help
me emotionally if
my family support
system was unable
to do it.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
2
3
Stigma/ discrimination
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
I have someone
within the
university staff to
help me with
academic and
personal stressors
if I were going
through a
challenging time.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
1 Stigma/discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
I can identify
someone within
the university
support services I
feel comfortable
with who shows
they care about me
and my well-being
in my language
and like a family
member.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time

2
3
Familismo
Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
I can identify
university support
services that make
me feel cared for.
1 None of the time
2 A little of the time
3 Some of the time
4 Most of the time
5 All of the time
1
2
3
Familismo
Language barriers
Acculturative stress
Stigma/discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
The university
provides resources
1 None of the time
2 A little of the time
3 Stigma/discrimination
Acculturative stress
228

Question Response options (if
close-ended)
RQ Concept being measured
(from emerging
conceptual framework)
for me to
decompress in a
non-threatening
way when talking
about emotional
issues.

3 Some of the time
4 Most of the time
5 All of the time
Language barriers
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
What are university
resources available
to me that foster
opportunities to
work on my
emotional issues in
a way where I do
not feel judged?
2
3
Stigma/discrimination
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Which university
resources can
adapt to meet my
unique cultural
needs by making
me feel safe to
open up about
internal struggles?
1
2
3
Familismo
Acculturative stress
Language barriers
Stigma/discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction

229

Appendix B: Survey Draft
Appendix B: Survey Draft
Preguntas Opciones de
respuesta
Relación a las
preguntas de
investigación
Concepto que se está
midiendo (derivado del
marco conceptual)
¿Qué tan probable es que
te gradúes de la
Universidad?
1 Extremadamente
improbable
2 Improbable
3 Neutral
4 Probable
5 muy probable

Graduation rates
Yo puedo contar con el
apoyo de alguien de la
universidad que me
escuche en español
cuando tengo que
desahogarme.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

1
2
3
Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Un miembro del equipo
de la universidad me
puede dar información
en inglés o español que
me ayude a entender
una situación personal.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

3 Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Un miembro del equipo
de la universidad o
afiliado a la
universidad me puede
dar un buen consejo de
cómo manejar una
crisis y entender que
me podría dar pena
compartirle mi
situación.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

1 Stigma/ discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Puedo contar con alguien
del equipo de la
universidad para
platicarle de mí mismo
o mis problemas fuera
de mi núcleo familiar.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

1
2
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
El entorno universitario
me da acceso a alguien
que me oriente y de
1 Nunca
2 Casi nunca
3 Ocasionalmente
1
2
3
Familismo
Social Support

230

Preguntas Opciones de
respuesta
Relación a las
preguntas de
investigación
Concepto que se está
midiendo (derivado del
marco conceptual)
consejos fuera de mi
núcleo familiar.
4 La mayor parte del
tiempo
5 Todo el tiempo

Stigma/discrimination
Emotional/informational,
tangible, affectionate,
and positive social
interaction

El entorno universitario
me da acceso a un
profesional que me
permite compartirle
mis miedos y
preocupaciones más
privadas de una forma
que no me hace sentir
juzgado/a.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

1
2
3
Stigma/ discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Los recursos
universitarios me
proporcionan acceso a
alguien en quien puedo
confiar para pedirles
consejos de cómo
manejar una situación
personal de una forma
que se siente conocida
y que no me sienta
juzgado/a.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

2
3
Stigma/ discrimination
Familismo
Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction

La universidad me
proporciona el acceso a
para poder conversar
con alguien que
entiende mis problemas
y perfil en mi propio
idioma.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

2
3
Language barriers
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Yo tengo a alguien en el
que puedo confiar
dentro del equipo de la
universidad que me
ayudaría si estuviera
considerando dejar la
escuela.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

1 Stigma/discrimination
Social Support

Emotional/informational,
tangible, affectionate,
and positive social
interaction
Yo identifico los recursos
universitarios que
necesitaría utilizar si
1 Nunca
2 Casi nunca
3 Ocasionalmente
3 Stigma/ discrimination
Emotional/informational,
tangible, affectionate,
231

Preguntas Opciones de
respuesta
Relación a las
preguntas de
investigación
Concepto que se está
midiendo (derivado del
marco conceptual)
necesito el apoyo
emocional.
4 La mayor parte del
tiempo
5 Todo el tiempo
and positive social
interaction
Yo puedo identificar a
alguien dentro de la red
de la universidad para
apoyarme
emocionalmente si mi
sistema familiar no
pudiese hacerlo.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

2
3
Stigma/ discrimination
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Yo cuento con alguien
dentro de la red de la
universidad que me
ayuda a manejar el
estrés académico y
personal,
especialmente si estoy
pasando por un
momento difícil.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

1 Stigma/discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Yo puedo identificar a
alguien dentro de los
servicios de apoyo para
alumnos en la red
universitaria con el que
me sienta cómodo
porque muestran
interés en mi bienestar,
se comunica en mi
idioma y me trata como
un miembro de la
familia.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo

2
3
Familismo
Acculturative stress
Language barriers
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
Puedo identificar
servicios de apoyo al
alumno dentro de la
universidad que me
hacen sentir valorado y
que pertenezco.
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo
1
2
3
Familismo
Language barriers
Acculturative stress
Stigma/discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
La universidad me
proporciona recursos
que me permiten
1 Nunca
2 Casi nunca
3 Ocasionalmente
3 Stigma/discrimination
Acculturative stress
Language barriers
232

Preguntas Opciones de
respuesta
Relación a las
preguntas de
investigación
Concepto que se está
midiendo (derivado del
marco conceptual)
desahogarme de una
forma segura cuando
hablo de temas
emocionales.
4 La mayor parte del
tiempo
5 Todo el tiempo

Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
¿Cuáles son los recursos
universitarios
disponibles que
fomentan las
oportunidades de
trabajar en mis temas
emocionales de una
forma que no me hace
sentir juzgado/a?
2
3
Stigma/discrimination
Familismo
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction
¿Qué recursos
universitarios se
adaptan a mis
necesidades culturales
particulares y me hacen
sentirme seguro/a de
abrirme a comentar mis
problemas personales?
1 Nunca
2 Casi nunca
3 Ocasionalmente
4 La mayor parte del
tiempo
5 Todo el tiempo
1
2
3
Familismo
Acculturative stress
Language barriers
Stigma/discrimination
Social Support
Emotional/informational,
tangible, affectionate,
and positive social
interaction

233

Appendix C: In-Depth Interview
Hello, my name is Adriana Merlo. It will be my pleasure to interview you today. My
current research project with USC’s doctoral program looks at the relationship between Latinx
students’ perceptions of student support services, their perception of the university and if it
makes them feel cared for, and the key support systems that empower students to graduate from
a 4-year institution.
Firstly, I would like to thank you for taking the time to talk with me. Your feedback is
essential and will help shape the way colleges support Latinx students in completing their
undergraduate programs.
This interview will last no more than 60 minutes. Would that be acceptable?
Great. Please let me know if you need a break or stop at any time.
During this interview, I will ask you a few questions about your perceptions of the
school-related resources and the university-driven supports that motivate you to finish your
undergraduate degree.
You are the expert here, so there are no wrong answers. These interviews aim to hear
from you and capture your point of view. Your honest feedback is vital to improving how
colleges can support Latinx students’ graduation rates.
Also, would you let me record this call? I will only use the recording for my research. I
will not share it with anyone. Do I have your consent to record?
Lastly, I would like to confirm that you have received a participant consent form. Is that
correct? If so, did you review it? What questions do you have? I would appreciate it if you could
sign it and send it back as soon as possible.

234

Thank you. What else can I help you with at this time? Do you have any follow-up
questions?
Next, I will share with you some essential details about the interview.
This study has obtained ethical clearance. I can provide you with contact information for
the interview at the end of the study if you have any comments or concerns.
Remember, you are free not to participate or respond to any questions. All information
you provide will remain confidential, and no individuals will be identified when the data is
published. Let’s begin if you are all set and have no more questions.

Table C1
English Interview Protocol
Interview questions Potential probes RQ addressed Key concept addressed
Tell me about your
experiences as an
undergraduate.
How was school for you? What
aspects of the college
experience were the most
enriching? Which ones
could’ve been better? What
would have made them
better? How could the school
have better supported you to
stay motivated to finish
school?
1
2
3
Graduation
Feeling of support and
care from the
university
Social cohesion
Acculturative stress
How has the school
provided
resources to
support
managing your
stress to continue
your education?
What are the most enriching
services/resources? Tell me
about a time you used a
school-wide service, and it
helped you on your journey
toward graduation. How
come? If you didn’t use one,
what would have been a great
one for you? What would
have prompted you to seek
them out?
1
2
3
Graduation
Feeling of support and
caring from the
university
Social cohesion
Acculturative stress
235

Interview questions Potential probes RQ addressed Key concept addressed
What/who has fed
your desire to
graduate?
What relationships have
influenced your desire to stay
in school? What are the most
essential
elements/factors/relationships
that keep you focused on
graduation? What school-
related relationships (Faculty,
staff, or support service team
members) influenced your
desire to finish your degree?
2 Feeling of support and
caring from the
university

Graduation
Social cohesion
Familismo
Religiosity
How has the school
helped you
navigate
stressors that
made you
question whether
you stay in
school?
What institutions within the
school played a role? Which
figures were vital in keeping
you focused on graduation
when times were tough?
What made you feel
comfortable to reach out to
them and open up? How did
you find out about these
services?
2
3

Mental wellness
Feeling of support and
caring from the
university
Graduation
Social cohesion
Religiosity
Familismo
Acculturative stress
What are the
triggers that alert
you to an
intolerable stress
level that could
risk you
dropping out?
What would you do? From
whom would you seek help?
What made you feel
comfortable to seek out their
assistance?
2
3
Social cohesion
Familismo
Religiosity
Acculturative stress
Tell me about a
situation when
you had to
overcome a
stressful situation
that provoked a
sense of needing
to pause your
education.
If you used school resources,
how was your experience? If
you didn’t, what led you to
shy away from those service?
What could have prompted you
to seek them out?
1
2
3
Graduation
Feeling of support and
caring from the
university
Acculturative stress
Some people
would say they
are embarrassed
to use college
resources to keep
them supported
to stay in school.
What do you think would make
someone embarrassed or shy
of using school services?
How could the school
overcome these challenges to
reach these students?
1
2
3
Graduation
Social cohesion
Feeling of support and
caring from the
university
236

Interview questions Potential probes RQ addressed Key concept addressed
What would you
say to them?
What would you
like to see
happen so more
students can take
advantage of
school resources
that help students
graduate?
What ideas do you have around
the messages these school
services send out to the
student body? How did you
find out about these services?
What prompted you to seek
them out? Did you share your
experience with your friends?
If so, were more students
inspired to use these
services? If not, what would
have made you more
comfortable in letting people
know about them?
1
2
3
Graduation
Social cohesion
Feeling of support and
caring from the
university

How would you
describe an ideal
graduation
support
program?
How would this support reach
out to you? What kind of
messages would it have?
Describe to me the kind of
people working there.
2
3
Familismo
Language barriers
Student mental health
Graduation
Feeling of support and
caring from the
university
What conditions or
circumstances of
life would
prompt you to
leave your
college?
What could the school have
done to support you best?
Hypothetically speaking,
would you have asked for
help? If so, what resources
would you have used? If not,
what would have held you
back from doing so?
2 Stigma
Graduation
Feeling of support and
caring from the
university
Acculturative stress
If you had to pick
the top three
school services
that helped you
keep support you
to stay in school,
what would they
be?
What was so special about
these services? What led you
to seek them out? What
strategies worked best?
Which ones were least
effective? How come you felt
this way?
1
2
3
Stigma
Familismo
Language barriers
Motivation to stay in
school
Social cohesion
Familismo
Religiosity.
What school
service helps you
feel that you are
cared for by the
university?
How did they make you feel
cared for?
1
2
3
Feeling of support and
caring from the
university
Social cohesion
Graduation.

237

Appendix D: Entrevista Profunda
Hola, mi nombre es Adriana Merlo. Será mi placer llevar a cabo esta entrevista hoy. Mi
proyecto investigación actual con el programa de doctorado de la Universidad de Southern
California intenta explorar la relación entre la percepción de los servicios de apoyo académico, el
interés por el bienestar y la salud mental de los alumnos Latinos, y como afecta eso en su deseo
de concluir su carrera.
Primero y, antes de nada, me gustaría darte las gracias por tomarte el tiempo de platicar
conmigo. Tu retroalimentación es esencial y ayudará a formar la manera en que las universidades
apoyan a alumnos Latinos para graduarse.
Esta entrevista no va a durar más de 60 minutos. ¿Esto es aceptable para ti?
Perfecto. Por favor avísame si necesitas tomar una pausa o un receso o inclusive terminar
la entrevista en cualquier momento. A lo largo de esa entrevista, te haré preguntas sobre tus
percepciones de los recursos relacionados a la escuela y los apoyos que te han motivado a querer
terminar tu bachillerato.
Tú eres el experto en este caso, así que no existen las respuestas equivocadas. Estas
entrevistas tienen la intención de querer capturar tu perspectiva. Tu retroalimentación honesta es
vital para poder mejorar como las universidades pueden apoyar a otros alumnos Latinos a que es
gradúen.
Adicionalmente, quisiera preguntarte si me permitirías grabar esta entrevista. Sólo
utilizaré esta grabación para investigaciones y no la compartiré con nadie. ¿Tengo tu
consentimiento para grabar?
Finalmente, me gustaría confirmar que tú hayas recibido la hoja de consentimiento. ¿La
recibiste? Si, sí, ¿has podido revisarla? ¿Qué preguntas tienes?
238

Agradecería si pudieras firmarla y enviármela lo antes posible. Gracias.
¿En qué más te puedo ayudar en este momento? ¿Tienes alguna otra pregunta?
Ahora te compartiré unos detalles esenciales de esta entrevista. Este estudio tiene el visto
bueno ético. Puedo proporcionarte la información de contacto del consejo ético por si tienes
cualquier comentario o duda.
Acuérdate, que eres libre de no querer participar o responder esas preguntas. Toda la
información que me proporciones permanecerá confidencial. No incluiré ningún dato que
permita que otras personas te identifiquen cuando publique el estudio.
Vamos a comenzar si tú estás listo y no tienes preguntas.

Table D1
Spanish Interview Protocol
Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
Cuéntame de tu
experiencia
como alumno
en esta carrera.
¿Cómo te fue en la
escuela? ¿Qué aspectos
de la universidad o
experiencia universitaria
son las más
enriquecedoras? ¿Cuáles
podrían haber sido
mejor? ¿Que los hubiera
hecho mejores? ¿De qué
forma la escuela te pudo
haber apoyado para
terminar tus estudios de
una mejor forma?

1
2
3

Graduation
Feeling of support and
care from the
university
Social cohesion
Acculturative stress
¿De qué forma la
universidad te
proporciona
recursos para
ayudarte a
graduarte?
¿Cuáles son los recursos o
servicios más
enriquecedores?
Cuéntame de una
situación o un momento
que usaste un recurso de
1
2
3
Graduation
Feeling of support and
caring from the
university
Social cohesion
Acculturative stress
239

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
la universidad y te ayudó
a mantenerte enfocado a
permanecer en la
escuela. ¿Por qué te
ayudó a mantenerte
enfocado? Sino utilizaste
uno, ¿cuál hubiera sido
un recurso apropiado
para ti? ¿Qué te hubiera
incitado a buscarlos en
un principio?

¿Quién o qué ha
alimentado tu
enfoque de
permanecer en
la escuela y
ser exitoso en
la escuela?
¿Qué relaciones te han
motivado para graduarte?
¿Cuáles son los
elementos, factores o
relaciones más esenciales
que te impulsan para
terminar tu carrera?
¿Cuáles son las
relaciones dentro de la
universidad (ya sean
profesores, equipo
administrativo, o
miembros de algún
servicio para alumnos)
que hayan influenciado
tus determinación para
terminar tu carrera?

2 Feeling of support and
caring from the
university

Graduation
Social cohesion
Familismo
Religiosity
¿De qué forma te
ayudado en la
escuela
navegar el
estrés que en
algún
momento te ha
hecho
cuestionar si
debieras de
continuar con
tu carrera?

¿Qué servicios dentro de la
escuela jugaron un papel
en eso? ¿Qué figuras
fueron vitales para
mantenerte determinado?
¿Qué te hizo sentir
cómodo para buscarlos y
abrirte? ¿Cómo te
enteraste de ese servicio?
2
3

Mental wellness
Feeling of support and
caring from the
university
Graduation
Social cohesion
Religiosity
Familismo
Acculturative stress
240

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
¿Cómo sabrías si
tus ganas para
terminar tu
carrera están
titubeando?
¿Como sabrías que ya estás
a punto de abandonar la
escuela? ¿Qué harías?
¿Qué tipo de apoyo
buscarías? ¿Qué te hizo
sentir cómodo en buscar
su asistencia?
2
3
Social cohesion
Familismo
Religiosity
Acculturative stress
Cuéntame de una
situación en la
cual tuviste
que
sobrellevar
una situación
estresante que
provocó una
necesidad o un
sentimiento de
tener que
ponerle pausa
a tu educación.
Si utilizaste recursos de la
universidad ¿cómo
estuvo tu experiencia? Si
no lo usaste, ¿por qué?
¿Porque no te sentiste
cómodo? Cuéntame una
situación en la cual
tuviste que sobrellevar
una situación estresante
que provocó una
necesidad o un
sentimiento de tener que
ponerle pausa a tu
educación. Si utilizaste
recursos de la
universidad ¿cómo
estuvo tu experiencia? Si
no lo usaste, ¿por qué?
¿Porque no te sentiste
cómodo en usarlo? ¿Qué
te hubiera incitado a usar
los servicios de la
universidad?
1
2
3
Graduation
Feeling of support and
caring from the
university
Acculturative stress
Algunas
personas
dirían qué les
da pena
utilizar los
recursos de la
universidad
para
mantenerlos
enfocados de
graduarse y
mantener su
bienestar
emocional.
¿Por qué crees que alguien
le daría pena usar los
recursos de la
universidad? ¿Cómo o
que tendría que hacer la
universidad para poder
llegarle a esos
estudiantes y darles la
vuelta a esos retos?
1
2
3

Graduation
Social cohesion
Feeling of support and
caring from the
university
241

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
¿Qué les
dirías?
¿Qué te gustaría
ver que ocurra
para que más
alumnos
puedan tomar
ventaja de los
recursos de la
escuela que
permiten que
los alumnos se
puedan
graduar?
¿Qué ideas tienes sobre los
mensajes que estos
servicios envían a los
alumnos? ¿Cómo te
enteras o servicio? ¿Qué
te provocó o motivo
buscarlo? ¿Compartiste
tu experiencia con
amigos? Si sí, ¿crees que
eso les ayudó a que se
pusieran en contacto con
esos servicios? Si no,
¿qué crees que hubiera
faltado para que más
personas se sientan
cómodas de poder
utilizarlos?

1
2
3

Graduation
Social cohesion
Feeling of support and
caring from the
university

¿Cómo
describirías el
programa ideal
para fomentar
la graduación?
¿Cómo te contactaría este
programa? ¿Qué tipo de
mensajes tendría?
¿Cómo describirías un
programa de retención
ideal? ¿Cómo te
contactaría este
programa? ¿Qué tipo de
mensajes tendría?
Descríbeme el tipo de
persona que trabaja ahí.

2
3
Familismo
Language barriers
Student mental health
Graduation
Feeling of support and
caring from the
university

Si tuvieras que
dejar la
universidad
¿que tendría
que estar
pasando en tu
vida? ¿Qué
pudo haber
hecho en la
universidad
para poder
Hipotéticamente hablando,
¿hubieras buscado
ayuda? ¿Qué recursos
hubieran utilizado? ¿Qué
te hubiera impedido
buscar esa ayuda?
2 Stigma
Graduation
Feeling of support and
caring from the
university
Acculturative stress
242

Preguntas de la
entrevista
Preguntas para expandir
respuestas
Pregunta de
investigación
Concepto
apoyarte una
mejor forma?
Si tuvieras que
elegir los
mejores tres
servicios
escolares que
te ayudaron a
mantenerte
enfocado para
graduarte,
¿cuáles serían?
¿Qué es lo que hacían estos
servicios que fueran tan
especiales? ¿Qué te
provocó buscarlos? ¿Qué
estrategias funcionaron
mejor? ¿Cuáles eran los
menos efectivo? ¿Por
qué te sentiste de esa
forma?
1
2
3
Stigma
Familismo
Language barriers
Motivation to stay in
school
Social cohesion
Familismo
Religiosity.
¿Qué servicio
escolar te
ayuda sentir
que le
importas a la
universidad?
¿El sentir que perteneces te
ayudó a querer
graduarte? ¿Dónde
sientes que perteneces en
esta experiencia
universitaria?

1
2
3
Feeling of support and
caring from the
university
Social cohesion
Graduation.

Abstract (if available)

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Analyzing effects of institutional design on student success outcomes between 2-year and 4-year institutions

PDF

Improving student-athlete mental health services: addressing the mental health needs of college student-athletes

PDF

Belonging matters: exploring the impact of social connectedness on the academic success of immigrant and refugee children in the American school system

PDF

Unlocking the potential: improving persistence and graduation of Black female students at select historically Black colleges and universities: a case study

PDF

The consequences of stereotype threat on Black and Latinx students in science and engineering

PDF

Facilitators for the advancement of Hispanic/Latinx employees in corporate security

PDF

Factors related to transfer and graduation in Latinx community college students

PDF

Adolescent mental health services in Nevada: assessing the perspectives of families

PDF

Addressing degree completion among Latinx working adults

PDF

The continuous failure of Continuous Improvement: the challenge of implementing Continuous Improvement in low income schools

PDF

Evaluation of mental health support and needs for emergency department providers

PDF

Addressing the underrepresentation of women in undergraduate science, technology, engineering, and math: a focus on African American and Hispanic women in community college and university programs

PDF

Institutional diversity's impact on Latinx students' self-efficacy and sense of belonging

PDF

Addressing the education debt: how community college educators utilize culturally relevant pedagogy to support Black and Latinx student success

PDF

Addressing financial barriers to college completion through community cultural wealth

PDF

Échale ganas: the transition experiences of first-generation Latinx students and their parents to college

PDF

The effects social determinants of health have on the higher prevalence of diabetes in low socioeconomic status Hispanics compared to non-Hispanic Whites

PDF

The barriers and challenges associated with mental health help-seeking behaviors of police officers in the United States: a descriptive study

PDF

Assessing mental health barriers faced by Air Force law enforcement veterans

PDF

The effects of technology on the mathematical achievement of Black and Latinx students

Asset Metadata

Creator Merlo, Adriana (author)

Core Title The relationship between Latinx undergraduate students’ mental health and college graduation rates

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2023-08

Publication Date 08/21/2023

Defense Date 07/26/2023

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag college graduation,college graduation rates,Graduation,Latinx,Latinx mental health,Latinx undergraduates,Mental Health,OAI-PMH Harvest,undergraduates

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Crew, Rudolph (committee chair), Ott, Maria (committee member), Trahan, Donald (committee member)

Creator Email adrianamerlo1@gmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113298448

Unique identifier UC113298448

Identifier etd-MerloAdria-12272.pdf (filename)

Legacy Identifier etd-MerloAdria-12272

Document Type Dissertation

Format theses (aat)

Rights Merlo, Adriana

Internet Media Type application/pdf

Type texts

Source 20230821-usctheses-batch-1086 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu