Background: Mental health service is underutilized in the United States. Adolescent and young adults, including college students, are especially unlikely to seek professional help for mental illness. This issue presents a concern, because signs and symptoms commonly appear during this part of growth and development. Purpose: The Health Belief Model (HBM) was used to explore perceptions about mental illness and mental health service utilization and self-medication among college students who may or may not have a history of mental illness. Methods: A survey exploring HBM constructs and self-medicating behaviors was distributed to a population of university undergraduate students ages 18-24. A concurrent focus group of mental health care providers investigated practitioner perceptions of mental health care utilization. Results of both were analyzed for common themes. Results: Sociocultural concerns and challenges navigating through the system were the primary perceived barriers to accessing mental health services. Primary care providers were reported as a vital cue to action. Alcohol, marijuana, and prescription medications were the most frequent and preferred substances used for self-medication. Translation to Health Education Practice: The most apparent theme is the need for education and continuing school partnerships. Doing so can offer diagnosis and treatment and foster personal and social skill development.