Prevalence of depression, anxiety, and post-traumatic stress symptoms among black post-secondary students in North America: A systematic review and meta-analysis.

Abstract

Black post-secondary students in minority contexts face academic pressures and race-related stressors that may elevate risk for mental health difficulties. Although prior research suggests heightened vulnerability, findings on the prevalence of depression, anxiety, and PTSD symptoms are mixed. This study synthesized existing evidence to estimate pooled symptom prevalence among Black post-secondary students in North America and identify associated factors. Following PRISMA 2020 guidelines, systematic searches were conducted in June 2023 and updated in June 2025 across seven databases. The protocol was registered in PROSPERO (CRD42023406838). Eligible studies reported prevalence estimates of depression, anxiety, or PTSD among Black post-secondary students in the United States or Canada. Random-effects meta-analyses using Freeman-Tukey double arcsine transformations estimated pooled prevalence. Subgroup analyses examined differences by race, measure, and publication year. Thirty independent samples from 25 studies were included; none were conducted in Canada. Pooled prevalence estimates were 20.1% for anxiety (95% CI: 12.4-29.2), 22.2% for depression (95% CI: 16.8-28.0), and 19.3% for PTSD (95% CI: 16.9-21.8). No significant differences were observed for depression across racial groups, though students identifying as "other" or multiracial showed slightly higher odds of anxiety. Prevalence did not vary by measurement tool or publication year. Correlates included structural, sociodemographic, psychological, and behavioural factors. Black students experience a substantial burden of depression, anxiety, and PTSD, with pooled symptom prevalence estimates comparable to those of other racial groups. Post-secondary institutions can play a critical role in fostering equitable environments and improving mental health and academic outcomes for Black students.