Mental Health and Substance Abuse Among First-Generation Students in Higher Education: Risk and Protective Factors Breadcrumb

 Corresponding author: Chukwudi Precious Chiaginam Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Mental Health and Substance Abuse Among First-Generation Students in Higher Education: Risk and Protective Factors Chukwudi Precious Chiaginam 1, , Mbadugha Adaobi Olivia 2, Ayegbo Mary Olawumi 3, Ugwu Udoka Peace 4, Rosemary Aimkebikhase Aruya 5 and Lilian Chisom Chinwero 6 1 Department of public Administration, Faculty of Social Science, University of Nigeria, Nsukka. Nigeria. 2 Department of Microbiology and Biochemistry, Faculty of Biological sciences, University of Nigeria Nsukka. 3 Department of Health Education, faculty of Education, University of Ibadan. 4 Department of Human kinetics and Health education, faculty of education, University of Nigeria Nsukka. 5 Department of vocational and Technical education, Faculty of education, University of Benin. 6 Science education department, Faculty of education, Enugu state university of science and technology. World Journal of Advanced Research and Reviews, 2025, 28(01), 1158-1180 Publication history: Received on 03 September 2025; revised on 11 October 2025; accepted on 14 October 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.28.1.3497 Abstract First-generation students are a specific phase of higher education, whose parents never completed a university degree, that creates exceptional challenges to elementary education and affects its mental health conditions and substance use practices significantly. This integrative literature review investigates the occurrence, risk factors, and protective factors involved with mental health issues and substance abuse among first generation students across stipulates of the world with specific reference to environments that exist in developing countries. Based on the recent empirical studies, the systematic reviews and policy documents, this article compiles the evidence regarding depression, anxiety, substance use behaviors, and the sociocultural factors that play out the consequences. The results show that first-generation students face higher levels of mental health issues and drug problems than continuing-generation students due to such factors as the financial stress, family support, and academic pressure along with the absence of mental health services. The review can add to the existing literature on the topic of mental health among students, and it is practical because it gives recommended measures that university administrators, policymakers, and all health practitioners interested in ensuring the success of first-generation students should implement. Keyword: Student success; Student affairs; Administration; Student Development theory; Higher Education Leadership; Mental health; Substance abuse 1. Introduction The growth of higher education in the world has brought about unparalleled opportunities to students of various economic statuses to pursue university education. These students include the first-generation learners - those students whose parents did not attain a university degree. The latter students form part of the increasing student remanences of institutions of higher education globally, frequently carrying their distinct advantages, views, and challenges with them and making their experience distinctly different compared to the continuing-generation students (Julius, 2024; LeBouef et al., 2025). Students of the first generation often go through the college setting without the advantage of parental advice on expectations as per academic performance as well as campus atmosphere and facilities. Such deficit in inherited cultural World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1159 capital may worsen the already existing stressors related to the process of adaptation to university life, such as academic pressures, financial overload, and partially academic issues in terms of social integration (Wang and Shah, 2022). Underhandling of these stressors can present in the form of mental health complications, and other adaptive coping strategies such as substance abuse. Mental health issues in university students have become a big social issue in the world in terms of health issues. Studies also show a person high levels of depression, anxiety, and stress-related disorders among university students regardless of their cultural and geographical backgrounds (Obilade et al., 2024; Mekonnen et al., 2024). Nonetheless, it is possible that the psychological health burden is higher for first-generation students that experience the same level of susceptibility due to their socioeconomic status and the absence of previous experience of their family members attending university. It has been recorded that the overlap between first-generation and mental health susceptibility exists in several different countries and school systems. In a large study of the mental and psychological health of college students in various universities in the United States, the Healthy Minds Study includes a substantial indication of depression, anxiety, and psychological distress, with first-generation college students disclosing that their rates are by nearly three to four times greater than those of any other continuing-generation of students (Lipson et al., 2023). Those inequalities harbored even in the context of the equalization of demographic and socioeconomic variables, which may indicate that the first-generation is a status that provides its participants with special vulnerability per se. Another significant issue in the sphere of higher education in the world is substance abuse. Research resources report the high level of substance use in university students, and the prevalence rates are different among universities, regions, and cultures (Ajayi & Oladipo, 2020; Aguocha and Okafor, 2021; DiGuiseppi and Jackson, 2020). The context in which the first-generation status intersects with substance use behaviors is under-researched in most places, even though evidence indicates that such students might be especially susceptible to substance-related issues because of the individual stressors, and their access to support systems might be lower (Swisher & Smith, 2020).1.1 Review Objectives and Significance This literature review aims to: • Examine the prevalence and patterns of mental health problems among first-generation students across diverse educational contexts • Investigate substance abuse behaviors and their correlates within this population • Identify risk factors that increase vulnerability to mental health and substance use problems • Explore protective factors that promote resilience and positive outcomes • Synthesize evidence-based recommendations for interventions and policy development • Highlight gaps in current research and directions for future inquiry It is important to learn about the mental health and substance use experiences of first-generation students because of a number of reasons. To begin with, these students form an ever growing percentage of university populations across all parts of the world and successful performance by these students is central to the goals of social mobility and human capital building. Second, targeting mental health and substance abuse in the early stages of academic career development among these students can avoid negative effects over time, such as academic failure, dropout, persistent health issues, and reduced career opportunities (Swisher and Smith, 2020). Third, solutions that strengthen the achievement of first-generation students will foster equity in postsecondary education and will help to break the intergenerational chain of disadvantaged education. Instructional Theory: Student Development Theory. The current literature review is based on the Student Development Theory which is an extensive framework which describes how students grow, change and mature during the period of higher education. Student Development Theory integrates several theoretical approaches that all help to shed light on cognitive, psychosocial, moral, and identity changes that transpire through the college years. These developmental processes are important to understand why first-generation students are at particular vulnerabilities with regard to mental health and substance abuse because these developmental paths do not continue along the same lines as those of their continuing-generation peers. Student Development Theory came into existence as a result of discovering that, in the previous education systems, there was mainly an attraction to academic learning and yet the holistic development of the students as individuals World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1160 were overlooked. Early theorists like Arthur Chickering, William Perry and Lawrence Kohlberg were pioneering theorists who defined college as a vital developmental stage where significant gain is made in various aspects. An example of such approaches that place developmental tasks is Pietro di Cittato (2019), Seven Vectors of Development by Chickering, which designates horizontal growth challenges, such as competence, emotional regulation, developing autonomy, defining identity, liberating interpersonal, finding purpose, and building integrity. In the case of firstgeneration students, the transmission through these vectors can prove complex due to the absence of family advice and cultural incompatibilities between home and college life as well as the added pressure of making collective, social mobility hopes of their families manifest. The psychosocial aspect of the Student Development Theory is specifically applicable to the issue of mental health of first-generation students. Throughout the time of traditional college, known as late adolescence and transition into emerging adulthood, students contend with several developmental challenges, simultaneously: separating from families without losing meaningful relationships, setting up intimate relationships with classmates, experimenting with identity options, and unifying a cohesive self-concept. The developmental processes of first generation students are usually complexified as a result of increased tension. The force to abandon family and adopt university culture might go against the cultural beliefs about family interdependence and family loyalty. The identity exploration: experiencing trying out various roles, beliefs and values can give rise to guilt when these new ideas do not coincide with family traditions. The ensuing psychological distress caused by these developmental conflicts expresses as anxiety, depression and identity confusion. Student Development Theory Cognitive-Structural theories explain how the cognitions and meaning-making process of students change throughout college. In his scheme of intellectual in ethical growth, William Perry outlines a multi-facet transition between dualistic thought (including knowledge as unconditional and taught by people of authority) and growth and growth and transition through multiplicity and relativism to dedication under relativism. The first generation distant students can first arrive at the university with more dualistic views based on their secondary-school experiences with an emphasis on memorization and obedience to any authority. This epistemological discomfort of the first stage of university education can become especially pronounced when epistemological assumptions are challenged And first-generational students have few templates to handle these intellectual adjustments can find cognitive dissonance particularly sharp. This mental disturbance, although it may be growth-promoting over the long-term involving, introduces severe strain in the short-term, which leads to mental susceptibility. The modern expansion of Student Development Theory focuses more and more on the contribution made by social identities and cultural contexts on the developmental processes. These paradigms acknowledge the fact that old school theory was created with white, middle-income, continuing-generation students in mind and might not accurately reflect the experiences of students belonging to the ribbed groups of people. Among first-generation students, there are complicated interactions between social-class identity with student identity. These are widely the students whose social-class background is subject to social-class transition, between working or low-income backgrounds and an academic setting among middle-class norms and expectations. This shift necessitates a kind of movement that sociologists refer to as code switching the capacity to move between the cultural norms of local communities and university settings. There is the psychological overburden of having to keep switching coding, in addition to the consciousness of the differences in class-based privilege which leads to a sense of marginality, impostor syndrome, and filling in-betweenness leading to an enhanced risk of mental health. The Student Development Theory offers important perspective with which to examine the substance use patterns among the first-generation students. It is developmentally more normative now as a symptom of identity exploration typical of this life cycle to engage in substance experimentation in late adolescence and the onset of adulthood. Nonetheless, among first generation, substance use might have other purposes other than normative experimentation. It can be portrayals of efforts to deal with developmental stress, deal with the cognitive aspect of having the cultural sailing weight, or ease transitional social inclusion into peer groups. Substance use to cope with developmental stress challenges instead of optimal coping through healthy engagement in developmental activities can cause derailment of positive development and result in development of maladaptive patterns that continue into college years and later life. Learning substance use in this developmental context changes the intervention strategies beyond preventive or punitive reactionary responses to more developmental supportive intervention focused on all the underlying troubles faced by students and offering to them healthier strategies of dealing with developmental challenges. World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1161 2. Literature Review Methodology 2.1. Search Strategy and Scope This is a review of literature of the empirical studies, which review rare articles that constitute the recent studies carried on mental health and substance abuse among first-generation university students in higher education. The review utilizes ecological systems approach, taking into account that the student result is constrained by the factors that are in action at all levels including the individual level down to the general factors in society. 2.2. Evidence Base The evidence base includes peer-reviewed research spanning 2013–2025, with emphasis on recent studies (2020– 2025) to capture contemporary trends and emerging issues. Sources encompass: • Empirical studies on mental health among first-generation college students from diverse geographic contexts • Research on substance use patterns and correlates among first-generation students • Systematic reviews and meta-analyses on student mental health • Policy documents and intervention guidelines from international organizations • Studies examining emerging trends including social media influences and pandemic impacts 2.3. Analytical Framework The paradigm of analyzing the study follows the framework of risk-protective according to which the variables that increase the vulnerability to mental health disorders and substance misuse (risk factors) and factors that contribute to resilience and subsequently promote positive outcomes (protective factors) are identified. The paradigm is particularly beneficial in the design of specific interventions because it will methodically detect the barriers that require the redress but also the resources that can be enhanced in the course of upholding first-generation students. 2.4. Limitations It is noteworthy that there are a number of restrictions, which are worth being considered. First of all, the definition of first-generation students in national contexts and the educational system varies considerably, which makes crosscultural comparisons dangerous. Secondly, the heterogeneity of this cohort, which spans the socio-economic status, ethnicity, race, religious affiliation as well as cultural background, suggests that extra-polations might not be generalized to all groups. Third, research studies of substance use risk are probably underestimated over the real immediate data because of stigmatization, legal consequences, and social desirability error. Lastly, the likely overrepresentation of published data sources by high income countries of which the United States is the greatest example limits the diversity of our conclusions to less affluent or structurally separate environments. 3. Mental Health Among First-Generation Students: Global Evidence 3.1. Prevalence and Patterns of Mental Health Problems As the most recent international studies show, the levels of mental health issues faced by first-generation college students are systematically higher, in comparison with those of continuing-generation students. Healthy Minds Study implies that first-generation students have significantly higher depression rates (30 vs. 24) and levels of anxiety (35 vs. 29), plus levels of psychological distress (Lipson et al., 2023). Even when these differences are corrected on the basis of demographic and socioeconomic factors, the differences are significant, indicating that the first-generation status provides an exclusive vulnerability, regardless of family income and other background factors. A systematic review by Smith and colleagues (2023) presents common patterns in mental health profile of the firstgeneration students of the university in various international contexts. High levels of depression, anxiety, impostor syndrome, and academic stress have been reported in the review documents. It also highlights how cultural and family norms should impact students and points out that, as many members of the first generation student find they pressured by academic success, they continue to maintain connections with their own communities and often support their families by sending money or emotional help. A study conducted in sub-Saharan African has shockingly identified high prevalence of mental illnesses amongst university students. Julius (2024) conducted a systematic review of mental health among students in this area, as a World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1162 result of which 3560% of the participants had clinically significant problems. A notably high rate is seen among medical students who provide an over-achieving group of learners including a significant proportion of first-generation learners. Once systematic reviews have shown that the level of depression in African medical students is between 2835 (Mekonnen et al., 2024; Pitua et al., 2024), which is very high and significantly higher than the overall population rates. 3.2. The Transition Period: It is a Critical Vulnerability University transition is a transition that becomes especially pivotal in the process involving mental health of firstgeneration students. According to Wang and Shah (2022), these students face more challenges in terms of this transition, with higher stress levels, homesickness, and indecision in terms of their academic ability. Parental experience of higher education is usually wanting, which leads to the rise of less parental influence in helping the transition through institutional structures, the understanding of academic demands, and the institutional support services, which exacerbates mental health challenges. The first-generation students have their unique vulnerabilities that get triggered during transition period. They are also more likely to have a culture shock because they are exposed to educational environments that are significantly contrasting to the ones associated with the home communities (LeBouef et al., 2025). This dislocation can be through sense of alienation, lack of confidences as to where they belong in their university, and anxiety on whether they can achieve in a new environment. The most prevalent mental health issues include aphasia, thyroid disorders, post-traumatic stress disorder, and bipolar disorder, among others.<|human|>4.3 Widespread Mental Health Problems There are aphasia, thyroid illness, posttraumatic stress disorder, and bipolar disorder, among others. One of the main mental health issues in the first-generation students around the world is depression. The recurring findings of empirical studies testify to the accumulation of a higher severity of depressive symptoms and major depressive disease in this population segment (Obilade et‛ al., 2024; Lipson et‛ al., 2023). Depressive symptomatology is usually characterized by inert levels of sustained sadness, anhedonia, change in sleep and appetite, inability to focus properly and ideation of worthlessness or hopelessness. In the case of university students depression significantly affects academic performance in terms of staying in school, poor concentration and loss of the motivation to study. First-generation students are also on the high list of anxiety disorders such as generalized anxiety disorder, social anxiety, and test anxiety. Such individuals often develop anxiety associated with performance at school, financial instability, anticipations of family acceptance, relationships with a sense of belongingness at school (Lipson et al., 2023). The duration of such worry may cause a disruption of normal life activities, school performance, and living in general. The side effect is imposter syndrome, which is a constant manager feeling inferior intellectually, even in perfectly competent situations (Smith et al., 2023). Students with imposter syndrome tend to believe that they got into university by chance and not merit, and may be living with the fear of being found out as wanting. It builds up a state of chronic anxiety, lowers the self-esteem, and may preclude engagement in classroom activities, seeking help, or seeking or exploiting opportunities to which they have the necessary qualifications. Stress related disorders are an index of the aggregate pressure of various pressures exerted over the psychological resources of students. First star students are also facing stressors such as academic demands, financial difficulties, family life, pressures of socializing and doubts on future employment post graduation. Once shock turn into a chronic and unpleasable state, it can be shown not only psychologically (distress, frustration, anxiety, etc.) but also physically (innocuous studies such as headache, stomachache, fatigue, etc.). 3.3. Academic Consequence of Mental Health Problems Mental health disorders have vital negative implications on educational performance of students in the first generation. Studies have always shown that depression, anxiety, and stress are associated with worse grade point averages, higher chances of course failure, and overall high risk of academic withdrawal (Smith et al., 2023; Idoko and Nwankwo, 2023). Mental health impediments might contribute with these students to other risk elements, including poor academic preparation, financial pressure and a lack of adequate support systems, to increase chances of academic hardship. The connection between academic performance and mental health is two-way. Mental issues suppress cognition, motivation, and energy therefore triggering academic problems. Academic difficulties, on the other hand, might contribute to the evolution of mental illness conditions increasing the feeling of incompetence, the disappointment of not meeting the demands of the family, and the perception threat of future opportunities. The result of this cyclic World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1163 movement may trap the student in a software that is hard to dig out unless the right measures and interventions are taken in good time. 3.4. Snowballs to Mental Health Care Even in areas where mental health care exists, first-generation students find numerous barriers to obtaining mental health care. Stigma is a powerful discouragement in a wide range of cultural settings, and the mental health conditions are often framed as evidence of individual infirmity, spiritual inadequacy, or even family dishonor (Fadele and Afolabi, 2595; World Health Organization, 2512). Therefore, students can be afraid of getting help and can provoke judgment or discrimination, as well as cause damage to their reputation. Another barrier is lack of level of knowledge concerning the state of mental health and existing services. A high portion of first-generation students have limited mental-health literacylacking of awareness of mental health illnesses, their treatment, and the proper referral resources. Without parental direction to handle resources available in campus, students can be left unaware of the guidance provided on campus by the counseling centers or how to approach the services. Students may be put off by the cost of care, especially in situations where consultations require some fee or when the student needs to seek the service of personal care providers. Even the smaller expenses can be prohibitive to the firstgeneration students who can often be attracted into lower-income backgrounds. Besides, the fear of family resource drain needed to treat someone experiencing mental health can give rise to guilt and unwillingness. The cultural differences affect the help-seeking behavior of heterogeneous environments. Mental health conditions in most cultural milieus are handled through a spiritual or traditional perception that may be incompatible with the Western psychological models. Such students can choose to deal with traditional healers or religious counselors instead of institutional university counseling services, or can not understand their experiences to be enough of problem of clinical psychopathological concern. Table 1 Prevalence Estimates of Mental Health Conditions Among First-Generation and General University Student Populations Condition First-Generation Students General Student Population Population Studied Reference Depression 30-45% 24-35% Multi-institutional samples Lipson et al., 2023; Smith et al., 2023 Anxiety 35-40% 29-33% Multi-institutional samples Lipson et al., 2023 Imposter Syndrome 60-70% 40-50% University samples Smith et al., 2023 Any Mental Health Problem 45-60% 35-45% University students (Africa) Julius, 2024 Stress-Related Disorders 40-55% 30-45% University students Obilade et al., 2024 Note: Prevalence estimates vary based on assessment tools, sampling methods, specific populations, and cultural contexts. First-generation students consistently show higher rates than continuing-generation peers. 4. Substance Use Among First-Generation Students 4.1. Prevalence and Patterns The first generation status in relation to the use of substances is complicated and multidimensional. Empirical observations indicate subtle trends that are not consistent among substances, cultures and developmental processes. Swisher and Smith (2020) used longitudinal analysis of substance-use trajectories between firstand continuinggeneration students; it was noted that the former students choose less substance in their entry to university, but after that, their trends were steeper. More to the point, underuse of substances was associated with a decline in graduation World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1164 rate among this group of students, suggesting that substance-related issues are one of the factors that can lead to academic attrition among the first-generation students. The contextual fields and motivation of substance use in first generation students vary largely in comparison to their continuing-generations student. Vasiliou et‛al. (2024) reinforced the importance of contextualizing substance use in college students, as in the case of first-generation students the contexts typically include relief of academic stress, formation of social connection in a group, dealing with feelings of alienation, and alleviating anxiety due to the impact of the financial or family obligations. Studies documenting rates of substance -use among university students are thoroughly diversified geographically. A study in sub-Saharan Africa has found 30-60 percent university students endorsed use of alcohol, 15-35 percent use of cannabis and 10-25 percent use of prescription opioids (Ajayi and Oladipo, 2020; Aguocha and Okafor, 2021; Olanrewaju and Adegoke, 2022). Although there is no particular comparatively lower data on first-generation students in this respect, foreign literature indicates that such a group faces specific weaknesses. 4.2. Substances that are usually used in various contexts. Alcohol is the drug that can be described as the most frequently used drug among college students worldwide, and it can involve the occasional drinking to the problematic issues. Alcohol can also be taken as a form of stress relief, market entry and coping with academic stress by first-generation students (DiGuiseppi and Jackson, 2020). The social milieus of drinking including the party, social events, and peer affiliation could have special effects on first-generation students who are in need of belonging to new institutional environments of universities. Cannabis is a drug that is commonly used by university students in many different cultural settings, yet the legal status and attitudes are quite different. Some users mention the motives of reducing stress, as a sleeping tool, a source of recreational pleasure, and curiosity (Aguocha and Okafor, 2021). Getting under the pressure of seeking social acceptance among specific groups requiring cannabis normalization, first-generation students may be pressed to use it. Prescription drugs, including stimulants, opioids, and tranquilizers, are a growing problem of abuse among university students. To improve academic success, improve attention, and decrease the sleep requirement in exam sessions, prescription stimulants are frequently utilized (Idoko and Nwankwo, 2023). Medical and health-science students might have an easier time accessing such substances. In other situations, especially in developing countries, prescription drugs, so opioids, could be sold without a prescription, and thus there was easy access and increased risk (Olanrewaju and Adegoke, 2022; Oweibia et al., 2025). Ethanol consumption, including smoking cigarettes and other dispositions, is still quite common even after long-term health-consciousness education. In some cases, the use of tobacco by a first-generation student may initiate or increase in university as social adaptation or stress reduction. 4.3. Risk Factors for Substance Use Among First-Generation Students First-generation students face multiple risk factors that may increase vulnerability to substance use: • Academic stress represents a primary driver of substance use across contexts. The pressure to succeed academically, combined with concerns about disappointing family and anxiety about future employment, can create overwhelming stress that students attempt to manage through substance use (Idoko & Nwankwo, 2023). For first-generation students who often feel they are carrying their families' hopes and aspirations, academic pressure may be particularly intense. Some students turn to prescription stimulants to enhance focus and academic performance, while others use alcohol or cannabis to manage anxiety and decompress from academic demands. • Peer influence plays a significant role in substance use initiation and continuation across all student populations, but may have particular salience for first-generation students (DiGuiseppi & Jackson, 2020; Ajayi & Oladipo, 2020). First-generation students may be especially susceptible to peer influence as they navigate unfamiliar university social environments and seek acceptance and belonging. When substance use is normalized within peer groups, students may feel pressure to participate to fit in or avoid social exclusion. • DiGuiseppi and Jackson (2020) demonstrated that peer norms significantly influence substance use behaviors among first-generation students. These students often navigate conflicting social contexts—the norms of their family and home community versus those of the university peer environment. This navigation can create vulnerability to substance use as a means of social integration or belonging. World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1165 • Mental health problems are closely intertwined with substance use in bidirectional relationships. Students experiencing depression, anxiety, or overwhelming stress may turn to substances as a form of self-medication (Obilade et al., 2024). Alcohol may be used to reduce anxiety, cannabis to help with sleep or mood, and stimulants to overcome depression-related lethargy. Simultaneously, substance use can worsen mental health by disrupting sleep, altering brain chemistry, creating additional life stressors, and interfering with healthy coping mechanisms. • Financial stress affects many first-generation students, who often come from lower-income backgrounds and may lack adequate financial support. Paradoxically, while students may lack funds for tuition and basic needs, substance use may still occur, either through inexpensive substances or through sharing within peer networks (Aguocha & Okafor, 2021). Financial stress also creates vulnerability to substance use as a coping mechanism for the anxiety and worry associated with economic insecurity. • Social media influence represents an emerging risk factor. Agberotimi (2025) documented that exposure to substance-reference content on social media platforms is associated with more positive attitudes toward substance use and higher rates of actual use among university students. Social media may normalize substance use, create perceptions that use is more common than it actually is, and provide information about how and where to obtain substances. First-generation students, who may turn to social media for information and social connection, could be particularly vulnerable to these influences. • Substance availability significantly influences use patterns across contexts. In settings where substances are readily accessible through multiple channels—local markets, pharmacies, peers, off-campus vendors—rates of use tend to be higher (Aguocha & Okafor, 2021). The ease of obtaining substances, particularly prescription medications that should require prescriptions but are available over-the-counter in some contexts, facilitates use and experimentation. • Limited parental monitoring distinguishes first-generation students from continuing-generation peers. Without parental experience of university life, families may have difficulty providing appropriate guidance and monitoring regarding substance use risks. Students may feel they can hide substance use from parents who do not understand university environments, or may lack the parental warnings about substance risks that continuing-generation students might receive. 4.4. Consequences of Substance Use Substance use has multiple negative consequences for first-generation students: • Academic impairment is consistently documented across studies. Substance use is associated with reduced class attendance, difficulty concentrating, declining grades, and increased risk of academic failure (Idoko & Nwankwo, 2023; Swisher & Smith, 2020). The longitudinal research by Swisher and Smith (2020) found that substance use was associated with lower graduation rates specifically among first-generation students, suggesting that academic consequences may be particularly severe for this population. For first-generation students, academic difficulties related to substance use can derail the educational opportunity they and their families have sacrificed to achieve. • Health consequences range from acute effects (intoxication, overdose risk, injuries, risky sexual behavior) to chronic problems (addiction, organ damage, mental health deterioration). Different substances carry different risk profiles, but all pose potential health harms, particularly with heavy or prolonged use. • Mental health deterioration can result from substance use, creating or worsening depression, anxiety, and other conditions. The cyclical relationship between mental health problems and substance use can create a downward spiral difficult to escape without intervention. Substance use may provide temporary relief from psychological distress but ultimately worsens underlying mental health conditions. • Financial problems arise from spending money on substances rather than educational and basic needs. For students already experiencing financial strain, substance-related expenses can exacerbate economic difficulties and force difficult choices between educational necessities and substance acquisition. Additionally, academic consequences of substance use (failed courses requiring retakes, delayed graduation) create longer-term financial costs. • Social and legal consequences include damaged relationships with family and peers, involvement in risky behaviors, and potential legal problems related to possession or use of illegal substances. These consequences can have lasting impacts on students' futures, including employment prospects, professional licensure eligibility, and immigration status in some contexts. • Interference with identity development and future planning represents a less obvious but important consequence. Substance use during the critical developmental period of young adulthood can interfere with the identity exploration, goal clarification, and future planning that should characterize this life stage. For first- World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1166 generation students navigating complex identity negotiations between home and university cultures, substance use may further complicate healthy identity development. Table 2 Substance Use Prevalence and Motivations Among First-Generation University Students Substance Category Estimated Prevalence Primary Motivations Specific Vulnerability for FGS Alcohol 30-60% (any use); 1025% (problematic) Social integration, stress relief, peer bonding, recreation Pressure to fit in; lack of family guidance about moderate use; stress from academic/financial burden Cannabis 15-35% Stress management, sleep aid, recreation, curiosity Self-medication for anxiety; peer pressure; perceived as "safer" option Prescription Stimulants 5-20% (higher among high-stress majors) Academic enhancement, focus, exam preparation Intense pressure to succeed; inadequate preparation creating need for performance aids; perception as "just studying harder" Prescription Opioids 8-25% (varies by region/availability) Pain relief, stress management, euphoria Self-medication for stress; easy availability in some contexts; lack of education about addiction risks Tobacco 15-30% Social integration, stress relief, routine/habit Social bonding mechanism; stress from multiple pressures; cultural norms in some contexts FGS = First-Generation Students 4.5. The Intersection of Mental Health and Substance Use The relationship between mental health problems and substance use is complex and bidirectional, creating particular challenges for first-generation students. Many students who struggle with mental health conditions turn to substances as a form of self-medication, attempting to alleviate symptoms of depression, anxiety, or stress through substance use (Obilade et al., 2024). Simultaneously, substance use can worsen mental health by disrupting sleep, altering brain chemistry, creating additional life stressors, and interfering with healthy coping mechanisms. This co-occurrence creates particular challenges for intervention. Addressing only substance use without treating underlying mental health conditions often results in relapse, as students continue to experience the psychological distress that motivated substance use initially. Conversely, mental health treatment may be ineffective if active substance use continues, as substances interfere with treatment and may worsen symptoms. Integrated approaches that simultaneously address both mental health and substance use are needed but are rarely available in university settings, particularly in resource-limited contexts. 5. Risk Factors: A Multi-Level Framework 5.1. Individual-Level Risk Factors • Pre-existing mental health conditions create vulnerability to both mental health problems and substance use during university. Students entering higher education with histories of depression, anxiety, trauma, or other mental health conditions are at elevated risk for recurrence or worsening during the stressful transition period. • Academic preparation gaps affect many first-generation students who may arrive from secondary schools that provided inadequate preparation for university-level work. Students from under-resourced schools may lack foundational knowledge in key subjects, have limited academic literacy, and possess inadequate study skills for university demands (Wang & Shah, 2022). These preparation gaps create academic struggles that can quickly overwhelm students, triggering stress, anxiety, and potential substance use as coping mechanisms. World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1173 • Increasing professional staffing through creative partnerships with mental health training programs (social work, psychology, counseling), utilizing advanced trainees to expand service capacity under supervision. Graduate programs can establish practicum placements, benefiting both institutions and trainee development. • Implementing the Mental Health Gap Action Programme (mhGAP) protocols can enable non-specialist healthcare providers to deliver mental health interventions (World Health Organization, 2019). Training campus health center staff, student affairs professionals, and peer counselors in mhGAP approaches can extend mental health support beyond limited specialized counselors (Ali et al., 2022; Keynejad et al., 2021). • Group therapy and support groups represent efficient uses of counselor time while providing peer support benefits. Groups can be organized around specific issues (depression, anxiety, substance use recovery) or populations (first-generation students, academic stress, grief and loss). • Crisis intervention and safety planning must be prioritized given the potential severity of mental health crises. Establishing 24/7 crisis support through phone lines (potentially shared across multiple universities to manage costs) and clear protocols for responding to students in crisis can save lives. • Culturally responsive services are essential for effectiveness. Mental health services must be delivered in ways that respect diverse cultural values, address spiritual dimensions of wellbeing, involve families appropriately, and overcome stigma. Hiring counselors from diverse backgrounds and providing ongoing cultural competency training supports this goal. • Stepped-care models match intervention intensity to need, ensuring efficient use of limited resources. Students with mild symptoms can receive brief interventions or guided self-help, while more intensive services are reserved for those with severe problems. 7.5. Substance Abuse Prevention and Treatment Comprehensive substance abuse prevention should address multiple levels of influence: • Environmental prevention includes reducing substance availability through enforcement of policies regarding on-campus substance use, working with local authorities regarding illegal sales to students, and limiting alcohol marketing near campus. • Normative reeducation addresses misperceptions about peer substance use through social norms campaigns that communicate actual (typically lower) use rates. Students often overestimate peer substance use, and correcting these misperceptions can reduce use. • Skills-based education teaches refusal skills, decision-making, stress management, and alternative coping strategies. Education should be interactive and acknowledge the real pressures students face. • Policy development and enforcement includes clear policies regarding substance use, consistent enforcement, and emphasis on treatment rather than purely punitive responses. Policies should balance accountability with compassion and recognition that substance use often reflects underlying struggles. • Screening and brief intervention programs can identify students with emerging substance problems before they become severe. Training healthcare providers, counselors, and even faculty advisors to conduct brief screening and provide motivational feedback can facilitate early intervention (Vest et al., 2021). • Treatment services for students with substance use disorders are often severely limited. Institutions should develop partnerships with specialized treatment providers, establish referral pathways, and consider implementing on-campus recovery support services. Recovery support could include: • Collegiate recovery programs providing community, support, and resources for students in recovery (Vest et al., 2021) • Substance-free housing options where students in recovery can live in supportive environments • Peer recovery support training students in recovery to support others • Integration with academic support recognizing that students in recovery may need academic accommodations 7.6. Academic Support and Success Initiatives Comprehensive academic support services are essential for first-generation student success: World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1174 • Tutoring programs in high-risk courses, utilizing peer tutors and embedded tutoring models • Writing centers providing individualized feedback on academic writing • Supplemental instruction offering structured group study sessions led by successful students • Academic skills workshops teaching note-taking, test preparation, time management, and learning strategies • Summer bridge programs for incoming first-generation students, providing intensive academic preparation before the regular term begins • Faculty development should educate faculty about first-generation student experiences, challenges, and needs. Training can help faculty recognize struggling students, make appropriate referrals, create inclusive classroom environments, and serve as effective mentors. Faculty should understand that asking for help is difficult for many first-generation students and should proactively offer support. 7.7. Financial Support Strategies • Targeted scholarships for first-generation students can reduce financial stress while signaling institutional commitment to these students' success. Even modest scholarship amounts can significantly impact student wellbeing by reducing work hours or providing emergency funds. • Emergency assistance funds should be established to help students facing unexpected financial crises that threaten their ability to continue enrollment. Rapid-response grants for emergencies (medical needs, family crises, unexpected fees) can prevent situations that would otherwise force withdrawal. • Financial literacy education helps students manage limited resources effectively, avoid debt traps, and plan for long-term financial wellbeing. Programming should address budgeting, banking, avoiding predatory lending, understanding student loans, and financial planning. • Work-study and on-campus employment provides income while keeping students connected to campus. Priority in work-study placement should be given to first-generation students with financial need. 7.8. Policy and Systems-Level Changes Institutional policy development should prioritize first-generation student success through: • Collecting and analyzing data on first-generation student outcomes to identify disparities and evaluate interventions • Establishing specific goals for first-generation student retention, graduation rates, and wellbeing indicators • Allocating resources specifically for first-generation student support • Creating accountability mechanisms and regular assessment of progress Cross-sector collaboration can leverage resources beyond individual institutions: • Partnerships with local mental health providers for expanded treatment capacity • Collaboration with community organizations serving youth and families • Engagement with government agencies addressing substance abuse and mental health • Inter-institutional partnerships for resource-sharing and collaborative programming National and international policy advocacy is needed to address systemic barriers. Higher education leaders should advocate for: • Increased government investment in higher education and student support services • Mental health parity in insurance coverage • Substance abuse prevention and treatment funding • Recognition of first-generation students as a priority population in educational policy • Research funding to better understand first-generation student needs across diverse contexts World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1175 Table 5 Implementation Framework for First-Generation Student Support Intervention Level Target Population Key Interventions Expected Outcomes Timeline Universal Prevention (All Students) Entire student body Mental health literacy campaigns; Substance abuse prevention; Wellness programming; Stress management workshops Increased awareness; Reduced stigma; Enhanced coping skills; Prevention of problems Immediate/Ongoing Selective Prevention (AtRisk Groups) Firstgeneration students, lowincome students, students in high-stress programs First-generation student programs; Enhanced academic advising; Financial support; Peer mentoring; Family engagement Improved retention; Better academic outcomes; Enhanced wellbeing; Stronger support networks Short-term (1-2 years) Indicated Prevention (Early Warning Signs) Students with emerging mental health or substance use concerns Screening and brief intervention; Early counseling; Academic support; Case management Problem resolution before escalation; Prevention of academic impact; Reduced need for intensive treatment Medium-term (2-3 years) Treatment (Significant Problems) Students with diagnosable mental health or substance use disorders Expanded counseling services; Group therapy; Substance use treatment; Crisis intervention; Academic accommodations; Recovery support Symptom reduction; Continued enrollment; Academic progress; Recovery and wellbeing Medium to Longterm (2-5 years) Systems/Infrastructure Institutionwide Policy development; Service expansion; Training programs; Data systems; Partnerships; Resource allocation Sustainable support systems; Improved institutional capacity; Evidence-based practice; Accountability Long-term (3-5+ years) 8. Challenges to Implementation 8.1. Resource Constraints The most significant challenge to implementing comprehensive support for first-generation students is limited financial and human resources. Many universities face chronic underfunding, with inadequate budgets for basic operations, let alone expansion of support services (Fadele & Afolabi, 2024). Mental health staffing is particularly limited, with World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1176 counselor-to-student ratios far exceeding recommended standards in many institutions. Implementing comprehensive recommendations requires creative resource mobilization, prioritization, and efficiency strategies. 8.2. Stigma and Cultural Barriers Mental health stigma remains powerful across many societies, creating barriers to help-seeking even when services are available (World Health Organization, 2022). Students fear judgment, discrimination, or being labeled negatively if they acknowledge mental health problems. Families may discourage mental health treatment, viewing psychological problems as spiritual issues or signs of weakness. Overcoming stigma requires sustained public education, engagement of cultural and religious leaders, and careful messaging that resonates with diverse values. 8.3. Limited Mental Health Infrastructure Beyond institutional resources, broader societal mental health systems face critical limitations in many contexts, including severe workforce shortages, inadequate facilities, limited insurance coverage, and fragmented service delivery (Fadele & Afolabi, 2024; World Health Organization, 2022). This means institutions cannot simply refer students to community providers, as such providers may not exist or may be inaccessible. Institutions must either develop internal capacity or create innovative partnerships to address this gap. 8.4. Data and Evidence Gaps Research specifically examining first-generation students in diverse cultural and geographic contexts remains limited, creating evidence gaps about the magnitude of problems, specific risk and protective factors in different contexts, and effectiveness of interventions. Implementing interventions often requires adaptation from evidence developed in different contexts, with careful evaluation to determine whether approaches are effective locally. 8.5. Competing Institutional Priorities Administrators face multiple competing demands, and student mental health and substance abuse may not be viewed as priorities compared to academic quality, physical infrastructure, research productivity, or fiscal sustainability. Advocacy is needed to elevate these issues on institutional agendas, demonstrating that student wellbeing is foundational to academic success and institutional mission. 8.6. Defining and Identifying First-Generation Students Definitional inconsistencies across institutions and nations create challenges for research, policy, and programming. Some definitions focus on whether parents attended any university, while others specify degree completion. Some include students whose parents attended university in other countries. These definitional variations affect who is identified as first-generation and served by targeted programs. 8.7. Sustainability of Interventions Many support programs begin with grant funding or special initiatives but lack sustainable funding for continuation. Creating lasting change requires embedding support for first-generation students into institutional budgets and structures rather than relying on temporary funding. 9. Implications for Student Development Theory and Practice 9.1. Reconceptualizing Student Development Traditional student development theories often assume students enter university with certain forms of capital— cultural, social, and economic—that may not reflect first-generation students' realities. Theories of identity development, psychosocial development, and cognitive development must be reconsidered in light of first-generation students' unique experiences. • Cultural capital deficits should be reframed not as student deficiencies but as institutional failures to provide accessible information and support. Rather than expecting students to arrive with knowledge of university systems, institutions must actively teach this knowledge. World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1177 • Multiple identities and identity conflict characterize many first-generation students who navigate between home and university cultures. Student development practice must recognize and support this navigation rather than expecting assimilation to dominant university culture. • Non-linear development pathways may characterize first-generation students whose development is shaped by financial interruptions, family obligations, and other factors that continuing-generation students may not experience. Traditional stage-based theories may not adequately describe these experiences. 9.2. Implications for Student Affairs Administration • Organizational structure should explicitly include first-generation student support in student affairs portfolios. Whether through dedicated offices or embedded responsibilities across departments, institutions must clearly assign accountability for first-generation student success. • Professional development for student affairs staff should include training on first-generation student experiences, challenges, and effective support strategies. All staff who interact with students should understand the unique needs of this population. • Assessment and accountability systems should track first-generation student outcomes separately, identifying disparities and evaluating the effectiveness of interventions. Data should drive continuous improvement in programs and services. • Collaboration across divisions is essential, as first-generation student success requires coordination among academic affairs, student affairs, enrollment management, and finance. Silos must be broken down to create comprehensive support. 9.3. Leadership Responsibilities • Higher education leadership at all levels—department chairs, deans, vice presidents, presidents—must prioritize first-generation student success. This includes: • Articulating vision and values that explicitly commit to first-generation student success and equity • Allocating resources to support programs and services for first-generation students • Creating accountability through inclusion of first-generation student success metrics in strategic plans and leadership evaluation • Modeling inclusive practices in interactions with students, faculty, and staff • Advocating externally for policies and funding that support first-generation students 10. Future Research Directions Future research must address critical gaps in understanding first-generation students' mental health and substance use experiences across diverse contexts. More research is needed examining first-generation students in Latin America, Asia, Africa, and the Middle East, as most published research originates from high-income English-speaking nations. Comparative international studies could identify universal patterns while illuminating context-specific factors shaped by educational systems, cultural values, economic conditions, and mental health infrastructure. Research examining intersectionality—how first-generation status interacts with race/ethnicity, gender, sexual orientation, disability, religion, and immigration status—would reveal unique patterns of risk and resilience not captured by examining firstgeneration status alone. Longitudinal research following students from entry through graduation and into postgraduate outcomes would illuminate developmental trajectories, identify critical intervention points, and reveal longterm impacts of university experiences. Rigorous evaluation of intervention effectiveness through randomized controlled trials, quasi-experimental designs, and careful program evaluation would strengthen the evidence base for practice. Research on protective factors and resilience processes, family systems and dynamics, technology and social media influences, and long-term impacts of the COVID-19 pandemic would further inform understanding and guide evidence-based interventions tailored to first-generation students' unique needs and strengths. 11. Conclusion First-generation students in higher education face substantial challenges related to mental health and substance abuse. These students navigate academic environments without the benefit of familial guidance about university systems and culture, often while experiencing financial stress, academic preparation gaps, and social integration difficulties. The World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1178 confluence of these risk factors creates vulnerability to mental health problems including depression, anxiety, and stress-related disorders, as well as substance use as a maladaptive coping mechanism. The evidence synthesized in this literature review reveals concerning patterns across diverse contexts. Research consistently documents elevated mental health challenges among first-generation students compared to continuinggeneration peers (Lipson et al., 2023; Wang & Shah, 2022; Smith et al., 2023). Studies from multiple world regions demonstrate high rates of both mental health problems and substance use among university students generally, with first-generation students facing unique additional vulnerabilities (Ajayi & Oladipo, 2020; Aguocha & Okafor, 2021; Obilade et al., 2024; Mekonnen et al., 2024). However, this review also highlights substantial protective factors and resilience among first-generation students. These students possess remarkable determination, strong academic motivation, and cultural strengths that can buffer against adversity. With appropriate support, first-generation students not only survive university but thrive, going on to successful careers and serving as role models for their communities. Addressing the mental health and substance abuse challenges facing first-generation students requires comprehensive, multi-level interventions operating across ecological levels. Universal prevention programs can increase awareness and promote healthy coping strategies for all students. Targeted support programs specifically designed for first-generation students can address their unique needs and strengthen protective factors. Enhanced mental health and substance abuse services can provide treatment for students experiencing significant problems. Systems-level changes in policy, resource allocation, and institutional culture can create environments that support rather than undermine firstgeneration student success. Implementation will require overcoming substantial challenges including resource constraints, stigma, limited mental health infrastructure, and competing institutional priorities. However, the cost of inaction—in terms of human potential lost, families disappointed, and societal development hindered—far exceeds the investment required to provide appropriate support. The success of first-generation students is not only a matter of individual wellbeing but also a critical issue of educational equity and social justice. These students often represent their families' and communities' hopes for social mobility and improved life circumstances. Supporting their mental health and preventing substance abuse is essential to honoring those hopes and ensuring that higher education serves as a pathway to opportunity rather than a source of overwhelming stress and struggle. For student affairs professionals and higher education leaders, supporting first-generation students must be recognized as a core institutional responsibility. This requires moving beyond token acknowledgment of diversity to substantive investment in programs, services, and policies that address the unique challenges these students face. It requires datadriven assessment of first-generation student outcomes, accountability for improving those outcomes, and continuous refinement of approaches based on evidence. Ultimately, the goal is not simply to help first-generation students survive university, but to enable them to thrive—to experience the intellectual growth, personal development, and career preparation that higher education should provide to all students. Achieving this goal requires sustained commitment, adequate resources, evidence-based practice, and genuine institutional prioritization of equity and student success. The research synthesized in this review provides a foundation for action. The evidence clearly documents both the challenges facing first-generation students and the protective factors that can be strengthened. The pathways forward are known, even if implementation remains challenging. What is required now is the institutional will and societal commitment to translate knowledge into action, ensuring that all students, regardless of whether their parents attended university, have the opportunity to succeed in higher education and beyond. Compliance with ethical standards Disclosure of conflict of interest There’s no conflict of interest between the authors. World Journal of Advanced Research and Reviews, 2025, 28(01),1158-1180 1179 References [1] Lipson, S. K., Eisenberg, D., & Broman-Fulks, J. (2023). Mental health among first-generation college students: Findings from the Healthy Minds Study (2018–2021). Journal of American College Health. [2] Wang, W., & Shah, A. (2022). 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