University students face significant mental health challenges, including anxiety, depression, and stress, which may negatively impact their academic performance and overall well-being. This narrative review explores the important role of university support services in addressing these challenges. Services such as on-campus counselling, wellness programs, and peer support initiatives are vital in providing professional guidance, coping strategies, and fostering a supportive environment. It also highlights barriers to accessing these services, including stigma, long wait times, and cultural or socioeconomic factors, which can affect students from seeking help. Innovative approaches like digital platforms, teletherapy, and holistic wellness programs can enhance accessibility and engagement. The review identifies research gaps, particularly regarding the long-term impacts of mental health services on academic success. Recommendations emphasize the importance of culturally competent care, collaboration with faculty and staff, and ongoing evaluation to improve service delivery. By prioritizing mental health services and adopting innovative strategies, universities can better support their students, reduce stigma, and promote help-seeking behaviours. This review calls for institutions to expand and improve their mental health programs to meet their students' diverse and growing needs.

Background and Objectives: Psychiatric symptoms and multidimensional impulsivity may be associated with the clinical and functional heterogeneity of substance use disorders (SUDs), but evidence from Saudi Arabian treatment populations remains limited. This study examined concurrent associations with a study-specific aggregate of Addiction Severity Index (ASI-5) interviewer severity ratings. Materials and Methods: This cross-sectional study included 204 adults receiving inpatient detoxification or residential rehabilitation services in Najran, Saudi Arabia. The seven ASI interviewer ratings were summed as an aggregate score. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS), and impulsiveness using the Barratt Impulsiveness Scale-11 (BIS-11). Analyses included age- and sex-adjusted analyses of covariance, false-discovery-rate correction, bootstrap Spearman correlations, an a priori multivariable model with HC3 robust confidence intervals, and sensitivity analyses addressing content overlap, multicollinearity, influential observations, functional form, and the bounded outcome distribution. Results: The mean age was 34.4 ± 7.3 years; 78.9% were male. The aggregate score was 26.33 ± 4.15. It correlated strongly with BPRS total (ρ = 0.874, 95% CI 0.827–0.908) and moderately with BIS-11 total (ρ = 0.590, 95% CI 0.494–0.669). In the primary model (adjusted R² = 0.864), age, BPRS total, motor impulsiveness, and non-planning impulsiveness were conditional correlates of greater aggregate burden; male sex was inversely associated, and polysubstance use was not. BPRS remained associated after exclusion of the ASI psychiatric domain. Separate impulsivity-domain and BIS-11 total models, 5000-resample bootstrap analysis, median regression, and fractional-logit analysis retained the principal psychiatric and impulsivity directions. The polysubstance coefficient varied across sensitivity models. Conclusions: Psychiatric symptom burden and selected impulsivity dimensions were concurrently associated with higher study-specific aggregate ASI interviewer severity scores. Integrated psychiatric and impulsivity assessment may help characterize patients with greater concurrent multidomain clinical burden; the aggregate score should not be interpreted as a validated global severity or prediction measure.