Global study aims to unpack mental health issues facing university students

11 May 2017 | Jason Bantjes, Christine Lochner, Dan J. Stein and Lian Taljaard

A consortium of international researchers is investigating how prevalent common mental disorders are among undergraduate university students across the globe.

They want to quantify how many students are affected by mental health problems and learn more about the risk factors and trajectory of these disorders.

With this information they will be able to document students’ support needs. This is important because mental illness among university students has become a common problem across the globe.

For example, a study in the US, conducted across 26 university campuses, showed that students experience a wide range of mental health problems. At least 17% suffered from depression. 4.1% had panic disorder, 7.0% had generalised anxiety, 6.3% had suicidal ideation. And 15.3% reported non-suicidal self-injury.

In South Africa, research suggests that as many as 12% of university students experience anything from moderate to severe symptoms of depression. And 15% report moderate to severe symptoms of anxiety. One study found that as many as 24.5% of a large sample of South African students reported some form of suicidal ideation in the two weeks before they were interviewed.

Although rates of psychological distress are high among university students, evidence suggests that only one in six students receive minimally adequate mental health treatment.

Even in high income countries there’s a significant mental health treatment gap. About 24% of students in high income countries receive the care they require. In low and middle income countries the numbers are much more abysmal. Studies show that in low and middle income countries between 8% and 11% of students with mental health problems receive psychological care.

The large mental health treatment gap on university campuses raises questions about whose responsibility it is to take care of students’ psychological well-being. Should it be the department of health, parents or university administrators?

In South Africa most universities have student counselling services staffed by professionals who try to meet the psychological needs of the students who consult them.

But these services are often over subscribed. That forces administrators to curtail the amount of care each student can access. As a result many students cannot access even minimally adequate care to support their ongoing psychological health.

Places of learning

It’s debatable how far universities should be expected to go to take responsibility for students’ mental health. A university is an academic institution. Its primary functions are research, learning and teaching.

But although universities are not in the business of providing health care, they have a responsibility to create optimal conditions for academic success. This entails promoting psychological health.

In the absence of sufficient accessible and affordable public mental health care services in South Africa the burden of providing psychological care to students currently – and perhaps unfairly – falls on universities.

Providing psychological and counselling services to students is expensive. But the costs of not providing psychological care may be even higher. Students who struggle with untreated mental health issues are at risk for academic failure and university drop out, which have costs for universities and ultimately for taxpayers.

However there’s very little data about what exactly university students need when it comes to mental health care and what kinds of services are effective for which students.

A difficult time for young adults

There are several reasons why it’s important to focus on students’ mental health. This developmental period is typically associated with psychological and social challenges.

Students have to negotiate a number of potentially tricky transitions. When most start university they have entered young adulthood. Often they are dealing with changes in family and peer relationships. Some leave home and enter a new social context with an increased opportunity for substance misuse. There’s also an increase in academic pressure and financial concerns.

The stress of dealing with these transitions may contribute to poor psychological functioning and precipitate symptoms of psychopathology.

Young adulthood is also a peak period for the onset of several serious psychological illnesses. This includes psychotic illnesses, depression, anxiety disorders and substance use problems. Left untreated, these disorders can have a serious impact on their development, motivation and attainment. It could lead to university drop outs and academic failure.

There are a number of barriers which prevent students from accessing psychological care. This includes problems like lack of knowledge about mental health issues, stigma and long waiting lists at student counselling centres.

Another problem is that interventions at universities still predominantly rely on traditional approaches to psychotherapy. This is mainly one-on-one talking cures (like individual counselling). This is expensive and it’s not suitable for all students. Researchers in Germany and the Netherlands have developed a number of internet based and e-interventions that could help university students address problems. But these interventions still need to be tested in South Africa.

Filling the gap

Our study, called the Caring Universities project, is addressing this knowledge gap. Researchers from Stellenbosch University and the University of Cape Town are part of a global research effort on more than 11 campuses spanning the US, Belgium, Spain, France, Ireland, Australia, Hong Kong, Portugal and Mexico and South Africa.

Preliminary epidemiological data has already been collected in some countries.

This information will be used to help develop innovative, cost-effective and efficient interventions to promote resilience and reduce psychological distress on university campuses.

As part of the Caring Universities project, the World Student Health Survey will be launched. It will target first year university students at both universities involved in the study. Some third year students will also complete follow up surveys to document the trajectory of mental health problems among senior students.

Ultimately the data that’s collected should filter down to student counselling and support services. It should help university administrators better understand the challenges students face and how resources can be allocated to effectively support them. Hopefully this will help create caring universities that are responsive to students’ mental health care needs.

*Janine Roos, a researcher in the South African Medical Research Council’s Unit on Stress and Anxiety Disorders was part of the team who wrote this article.

Opinion piece by Jason Bantjes, Senior Lecturer in the Psychology Department, Stellenbosch University; Christine Lochner, Co-director of the genetics program at the Research Unit on Anxiety and Stress Disorders , South African Medical Research Council; Dan J. Stein, Professor & Head, Dept of Psychiatry, University of Cape Town and Director of the Research Unit on Risk & Resilience in Mental Disorders, South African Medical Research Council, and Lian Taljaard, PhD candidate in the Department of Psychiatry, Stellenbosch University

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