Background: Almost a third of college students experience significant mental health concerns, but many do not receive adequate services. This study investigated barriers to mental health services among college students screened in a student health center primary care service. Method: Students (N = 1662) presenting for primary care completed mental health screenings and a barrier measure in the student health center of a university. Latent class analysis created barrier profiles. Results: Three barrier profiles were identified (none, logistical, all barriers). Profiles related to gender (p < 0.001), with logistical/all barrier profiles more likely amongst female students. No significant difference found by race. Students with higher depression scores were more likely to report logistical barriers than no barriers (p < 0.001). Conclusion: Programs must address multiple barriers to successfully engage students in treatment. Tailored interventions, including in primary care, should assess and respond to individual barriers, not just common ones.