Numerous research studies have investigated the mental health concerns and needs of college students. However, there is a need for additional research to understand the unique presenting mental health concerns of first-generation college students at university counseling centers in the US. The current study was a non-experimental exploratory research study that utilized secondary data analysis to examine and compare the sociodemographic profiles, mental health needs, and presenting problems of first-generation students compared to their non-first-generation peers at university counseling centers (UCCs) in the US. In Part One of the study, comparisons were drawn between first-generation and non-first-generation collegiate clients on key demographic and clinical outcomes. These results revealed that first-generation collegiate clients presented to UCCs with significantly higher mental health needs and higher suicidality risk as compared to non-first-generation collegiate clients. Furthermore, results showed that first-generation students who presented to UCCs were significantly more likely to hold oppressed identities as compared to non-first-generation collegiate clients. In Part Two of the study, a hierarchical regression analysis was conducted to investigate generational status as a predictor of general distress as well as emotional support and help from family as a moderating variable between generational status and general distress. Results of the regression analysis showed that generational status was found to not be a significant predictor of general distress. Additionally, while emotional support and help from family was found to be a significant independent predictor of general distress, it was not found to be a moderator between generational status and general distress. Future research will need to continue investigating first-generation mental health concerns and intersecting oppressed identities as well as the relationship between generational status, family support, and distress. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]