The 2023 Annual Report summarizes data contributed to CCMH during the 2022-2023 academic year, beginning July 1, 2022 and ending on June 30, 2023. De-identified data were contributed by 195 college and university counseling centers, describing 185,114 unique college students seeking mental health treatment, 4,817 clinicians, and 1,259,380 appointments. In this year's Annual Report, CCMH investigated if experiences of discrimination or unfair treatment based on six identities are associated with mental health concerns and symptom improvement at college counseling centers. Findings revealed a strong relationship between discrimination and increased general distress, social isolation, and suicidal thoughts at the beginning of treatment. In fact, experiences of discrimination demonstrated associations with symptoms equivalent to most clinical variables that have been historically collected by clinicians (i.e., history of suicide attempts, history of counseling). Moreover, counseling centers were shown to effectively treat student clients with experiences of discrimination, as they demonstrated commensurate improvement in symptoms of distress, social isolation, and suicidal ideation during services as students with no discrimination.