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Background  Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years.    Methods  Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models.    Results  With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males.    Conclusions  Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12889-021-10622-1.

Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019