The purpose of this study was to develop a profile of at-risk 5th-year students by assessing the relationships between heavy alcohol use and mental health issues, on academic performance in 5th-year students. This secondary analysis study used the National College Health Assessment (NCHA) datasets from survey years Fall 2000- Spring 2008. Using the Social Cognitive Theory as the conceptual framework, the outcome variable was C/D/F GPA in 5th-year college students. The independent variables were Alcohol Use and Mental Health Issues. T-tests, one-way ANOVA, and chi-square analysis were used to determine differences in groups. Logistic regression and Structural Equation Modeling were used to determine predictors of lower GPA in 5th-year students. The results indicate that 5th-year students are a distinct group from 1st- 4th-year college students in terms of increased alcohol use and increased prevalence of mental health issues. Alcohol use; experience of moderate and severe mental health symptoms; experiences of Bulimia, Depression, and Substance Abuse; and Mental Health Consequences were significant predictors of C/D/F GPA in 5th-year college students. Targeted policies and programs aimed at the unique profile of 5th-year college students should address 5th-year college students' alcohol use behaviors as well as mental health.
