The university years are a critical time period when students experience the challenging transition into adulthood. Although student years are characterized by positive experiences and personal growth, it is also a peak period for the onset of many common mental disorders, including mood, anxiety, and substance use disorders.
The high prevalence of these conditions is significant not only because of the distress and disability it causes, but also because it is associated with reduced academic performance. It is for this reason that universities should take note of their students' mental health and their risk for common mental disorders – so that they can perform optimally during this important developmental period.
With this in mind, the South African MRC Unit on Risk and Resilience in Mental Disorders in the Department of Psychiatry has been working with a range of universities and colleges around the world on a mental health survey project aimed at keeping track of students' mental health and the risks they face.
Professor Christine Lochner from the MRC Unit on Risk and Resilience in Mental Disorders said that in South Africa, researchers at the MRC Unit, a cross-university unit of Stellenbosch Universities (SU) of and the University of Cape Town (UCT), have been working together with international mental health experts at McLean Hospital (Columbia University, USA); Harvard Medical School (Harvard University, USA) and KU Leuven University (Belgium) on the WHO World Mental Health Surveys International College Student Project (WMH-ICS).
The WMH-ICS Initiative is designed to “generate accurate epidemiological data … for the treatment of mental, substance and behavioural disorders among college students worldwide; to implement and evaluate web-based interventions for the prevention and treatment of these disorders; and disseminate the evidence-based interventions found to be effective using a continuous quality improvement approach designed to prevent degradation of these interventions in dissemination and successively to improve targeting of interventions using precision medicine procedures," says Lochner.
“There have been a number of important publications based on data collected by the WMH-ICS, with Dr Ron Kessler from Harvard Medical School as the senior author on many of these. Locally, the work is done collaboratively at SU and UCT, with me, Dr Jason Bantjes (Psychology, SU) and Professor Dan Stein (Psychiatry, UCT) and Ms Janine Roos from the Mental Health Information Centre (MHIC) as leading researchers," Lochner explained. (For more information, see www.mentalhealthsa.org.za).
Lochner cited the latest paper published in BMC Public Health which was focused on the prevalence and sociodemographic correlates of Common Mental Disorders (CMDs) among 1st year students in SA (and at SU and UCT specifically).
The study investigated the prevalence and sociodemographic correlates of lifetime and 12-month CMDs among university students in SA with a particular focus on vulnerability among students in historically excluded and marginalized segments of the population.
Data was collected through self-report measures in an online survey of first-year students registered at the two universities – UCT and SU. They were assessed for CMDs with previously-validated screening scales.
The research concluded that, “despite advances to promote greater social inclusion in post-apartheid South Africa, students who identify as female, students with atypical sexual orientations and students with disabilities are nonetheless at increased risk of CMDs."
The study found, among other things, that a total of 38,5% respondents reported at least one lifetime CMD, the most common being major depressive disorder (24,7%). “Twelve-month prevalence of any CMD was 31,5% with generalized anxiety disorder being the most common (20,8%). The median age of onset for any disorder was 15 years, suggesting that most of the CMDs has its onset during adolescence already. Female students, students who reported an atypical sexual orientation and students with disabilities were at significantly higher risk of any lifetime or 12-month disorder and internalizing disorders such as depression and generalised anxiety disorder, whereas male gender, identifying as white and reporting an atypical sexual orientation were associated with elevated risk of externalizing disorders such as alcohol use disorder or substance use disorder. Older age, atypical sexual orientation and disability were associated with elevated risk of bipolar spectrum disorder."
Lochner said the research highlighted the need for universities to be alert to student mental health. She stressed that students have many opportunities to find help for mental challenges. “It would be important, however, to extend the reach and if needed, adjust the format of some of the existing services and break down barriers to treatment-seeking going forward," she said. Some of these issues have already been addressed and published on by the researchers and should be taken notice of by all tertiary institutions.