The aims of the current thesis include 1) identifying the rates and types of USEs among university students in Northern Ireland, 2) identifying the associations between USEs, mental health outcomes and alcohol use, 3) assessing gender differences of USEs and how this relates to mental health outcomes and alcohol use, 4) examining whether social support and coping strategies are a mediator in the relationship between USE with mental health outcomes and alcohol use, and 5) exploring the understanding of sexual consent and alcohol use among university students in Northern Ireland. A sequential mixed methods research design was implemented. A systematic review was undertaken to identify prevalence rates of USEs and the impacts of such (i.e., mental health and alcohol use). Following this, a quantitative data collection was utilised in the form of a survey design to collect data on USEs, mental health outcomes and alcohol use. Results suggest that rates for USEs among university students in Northern Ireland were high and indicated that USEs were associated with mental health outcomes. In addition, coping strategies and social support acted as mediators in the relationships between USEs and, mental health and alcohol use. Finally, qualitative methods using focus groups were utilised to explore the understanding of sexual consent and alcohol use among university students in Northern Ireland. The key findings were (a) university students clearly indicated when consent has not been given and when it has been withdrawn, (b) alcohol does not cause USEs, but rather perpetrators use alcohol to excuse their behaviour, (c) students do not believe that their university and the police service respond adequately to disclosures of USEs nor do they support survivors, and (d) expressed the need for education on sexual consent and alcohol use in primary and secondary schools, and universities.