Poster #2 - Parity vs. Privilege: Do State Mental Health Parity Laws Improve First-Gen Academic Outcomes?

• In Event: Saturday Poster Luncheon

Abstract

Introduction: The mental health crisis among U.S. college students has reached record highs; data from 2021–2022 indicates that 44% of students reported depression, 37%  anxiety, and 15% experienced severe suicidal ideation. Despite this growing burden, a significant "treatment gap" persists, with nearly 60% of students who have a mental health problem receiving no services. Mental health parity laws (federally enacted Mental Health Parity and Addiction Equity Act (MHPAEA)) —which mandate that insurance coverage for mental health be equal to medical/surgical benefits—aim to close this gap by removing financial barriers to accessibility. However, their impact on academic persistence and success remains under-evaluated.

Research Question: This study investigates the causal impact of state-level mental health parity laws on unmet needs and academic outcomes (GPA and college retention). Specifically, it asks:To what extent do state parity laws reduce unmet mental health needs and improve academic outcomes among college students?Does the impact of these laws differ for first-generation college students (FGCS), who often face distinct structural and financial barriers?

Data:  The study utilizes seven waves of individual-level data from the Healthy Minds Study (2017–2024), a dataset covering over 600 U.S. institutions with more than 630,000 observations. To categorize the policy environment, the analysis classifies state laws into Full Parity and Partial Parity categories. Currently, 35 states have enacted comprehensive mandates requiring full equality in coverage. Approximately 8 states maintain limited or partial mandates that only cover specific conditions (does not cover substance abuse) or provide restricted protections. Approximately 8 states do not have any parity laws in effect. After cleaning the dataset, my analysis focuses on data from 49 states and 610,008 observations.

Research Methodology: I utilize a triple difference-in-differences (DDD) design, utilizing the staggered implementation of state-level parity laws to identify causal effects. This model accounts for state and year fixed effects while focusing on the interaction between policy adoption and student status (FGCS vs. continuing-generation). In this study, the triple difference in difference will be conducted to differentiate among students with self-reported mental health burden (primary) and without self-reported mental health burden (placebo).Results/Findings:  Descriptive analysis from the 2017–2024 period reveals that unmet mental health needs are strongly associated with academic disadvantage. Unmet mental health needs disproportionately impact first-generation students (FGCS). While those with unmet mental health needs are 7 percentage points more likely to drop out of college (p<.01), FGCS with unmet mental health needs are 18 percentage points more likely to drop out of college (p < .05). This nearly threefold vulnerability identifies untreated mental health as a primary driver of the widening higher education equity gap.

Conclusion/Implications These findings suggest that while state parity laws are intended to improve access, the "unmet need" pathway remains a primary driver of academic inequity, particularly for FGCS. Policy interventions must move beyond simple insurance mandates to include institutional support to implement existing policies to ensure that legislative progress translates into substantive academic equity.

Author

• Marzuka Ahmad Radia, University at Albany
  Presenting Author