Purpose <p>This study aims to examine the perceptions, beliefs, and attitudes that affect help-seeking behaviors among college students with a diagnosis of psychosis.</p> Methods <p>Cross-sectional 2015–2024 national survey data from the Healthy Minds Study (HMS) were used to examine antipsychotic medication use, therapy/counseling utilization, and informal support engagement in the past 12 months among 2,819 U.S. college students with a diagnosis of psychosis. Descriptive statistics and adjusted logistic regression models were used to examine students’ help-seeking behaviors.</p> Results <p>Approximately four-in-ten students with a diagnosis of psychosis reported antipsychotic medication use, eight-in-ten reported therapy/counseling utilization, and eight-in-ten reported engaging in informal supports. Eight-in-ten students agreed or strongly agreed that they needed help for their mental health in the past 12 months. As perceived need for help decreased, the use of antipsychotic medication, therapy/counseling, and engagement with informal supports also generally decreased. The belief that medication or therapy/counseling would not be helpful for mental health was generally associated with lower use of medication and therapy/counseling.</p> Conclusions <p>Therapy and/or counseling in this population is highly utilized. A majority of students strongly agreed or agreed that they needed help for their mental health; however, six in ten students did not meet current recommended treatment guidelines for combined antipsychotic medication and therapy. High identified need for help and low service utilization, especially of antipsychotic medication, may indicate barriers to access.</p>