Waning mental health and resilience in the post-secondary student population is a growing concern across North American institutions, these concerns have only been compounded further by the added stressors associated with the COVID-19 pandemic. Transitioning into post-secondary brings with it a variety of interpersonal and intrapersonal challenges that often reciprocally influence each other (e.g., moving away from existing social support networks, forming new relationships, increased responsibility, and financial independence, increased academic expectations, etc.). Successful adaptation to such challenges is equally influenced by demographic (e.g., impacts of gender, sexuality, ethnicity, and socioeconomic status) and institutional factors (e.g., the provision and efficacy of health-related services and programming on campus). A thorough literature review and synthesis was conducted examining post-secondary student mental health. Attention was given to post-secondary mental health, help seeking, demographic, and institutional characteristics. The scope of this literature review focused on the North American context. Future directions for research and practice are drawn from the findings. Institutions need to focus on initiatives intended to improve campus climate and service utilization amongst their students. Health care providers, administrators, and educators are challenged to provide evidence-based, health-related services that meet the unique needs of their student population.