Abstract
Although there is growing interest in mental health problems in university students there is limited understanding of the scope of need and determinants to inform intervention efforts. To longitudinally examine the extent and persistence of mental health symptoms and the importance of psychosocial and lifestyle factors for student mental health and academic outcomes. Undergraduates at a Canadian university were invited to complete electronic surveys at entry and completion of their first year. The baseline survey measured important distal and proximal risk factors and the follow-up assessed mental health and well-being. Surveys were linked to academic grades. Multivariable models of risk factors and mental health and academic outcomes were fit and adjusted for confounders. In 1530 students surveyed at entry to university 28% and 33% screened positive for clinically significant depressive and anxiety symptoms respectively, which increased to 36% and 39% at the completion of first year. Over the academic year, 14% of students reported suicidal thoughts and 1.6% suicide attempts. Moreover, there was persistence and overlap in these mental health outcomes. Modifiable psychosocial and lifestyle factors at entry were associated with positive screens for mental health outcomes at completion of first year, while anxiety and depressive symptoms were associated with lower grades and university well-being. Clinically significant mental health symptoms are common and persistent among first-year university students and have a negative impact on academic performance and well-being. A comprehensive mental health strategy that includes a whole university approach to prevention and targeted early-intervention measures and associated research is justified.
Highlights
There is growing interest in mental health problems in university students there is limited understanding of the scope of need and determinants to inform intervention efforts
University student populations are changing and more closely reflect the general population in terms of risk factors and rates of psychopathology, in part driven by increasing enrolment and widening access.[8,9]
In adjusted models, depressive symptoms remained associated with decreases in cumulative grade point average (GPA); whereas anxiety symptoms appeared associated with increases in cumulative GPA
Summary
The transition to university coincides with a critical developmental period during which young people are expected to separate from family and take on increased responsibility for regulating their sleep, daily schedules and lifestyle; all while the brain is undergoing accelerated growth and shows increased sensitivity to stress.[1]. Recent reports from varied higher education institutions and associations in both Canada and the UK have highlighted a substantial disparity between the increasing need for university student mental health support and available resources.[8,9,12] Yet, there are little reliable data to inform the extent of mental health need in the transition to and over the course of university study or to identify salient targets for the development of evidence-informed preventive and early-intervention strategies
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