Towards an evidence‐base for student wellbeing and mental health: Definitions, developmental transitions and data sets

Family Climate as a Mediator of the Relationship between Stress and Life Satisfaction: A Study with Young University Students

BACKGROUND

The family environment has a significant influence on the personality development of young people and their assessment of life satisfaction. Perceived stress is related to life satisfaction, but this relationship is also influenced by the family context. The present study analysed the impact of perceived stress on life satisfaction and the mediating role of family climate in university students.

METHODS

A sample of 920 university students was recruited for this study. The instruments used included the Perceived Stress Scale, the Satisfaction with Life Scale, and the Family Social Climate Scale, and socioeducational information was collected.

RESULTS

The results indicate that perceived stress had a significant and positive effect on both conflictive and violent family climates, while life satisfaction was negatively impacted by these negative family climates. Additionally, supportive and cohesive family climates, along with difficulty expressing feelings and opinions, were found to have significant positive effects on life satisfaction.

CONCLUSIONS

These findings highlight the importance of the family system in shaping individual conditions and how it can regulate the relationship between stress and life satisfaction.

Investigating changes in student mental health and help-seeking behaviour after the introduction of new well-being support services at a UK university

BACKGROUND

Growing numbers of students now seek mental health support from their higher education providers. In response, a number of universities have invested in non-clinical well-being services, but there have been few evaluations of these. This research addresses a critical gap in the existing literature.

AIMS

This study examined the impact of introducing non-clinical well-being advisers on student mental health and help-seeking behaviour at a large UK university.

METHOD

Survey data collected pre-post service introduction in 2018 (n = 5562) and 2019 (n = 2637) measured prevalence of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), and low mental well-being (Warwick-Edinburgh Mental Wellbeing Scale), alongside student support-seeking behaviour. Logistic regression models investigated changes in outcome measures. Administrative data (2014-2020) were used to investigate corresponding trends in antidepressant prescribing at the onsite health service, student counselling referrals and course withdrawal rates.

RESULTS

Adjusted models suggested reductions in students' levels of anxiety (odds ratio 0.86, 95% CI 0.77-0.96) and low well-being (odds ratio 0.84, 95% CI 0.75-0.94) in 2019, but not depression symptoms (odds ratio 1.05, 95% CI 0.93-1.17). Statistical evidence showed reduced student counselling referrals, with antidepressant prescribing and course withdrawal rates levelling off. Student perception of the availability and accessibility of university support improved.

CONCLUSIONS

Our findings suggest a non-clinical well-being service model may improve student perception of support, influence overall levels of anxiety and low well-being, and reduce clinical need. The current study was only able to examine changes over the short term, and a longer follow-up is needed.

University students' access to mental health services: A qualitative study of the experiences of health service professionals through the lens of candidacy in England

OBJECTIVES

In order to develop a better understanding of students' access to mental health services, we explored the experiences of health care professionals interacting with university students with mental health problems.

METHODS

We interviewed 23 professionals working across university advice and counselling services, NHS general practice, crisis, and psychological services in North and East London between June 2022 and January 2023. Our approach drew on reflexive thematic analysis and the principles of abductive analysis. The notion of candidacy - that is, how different needs are deemed deserving of health service attention - was particularly helpful to our understanding of the ongoing phenomenon of interest in the data.

RESULTS

Each student's access to mental health support was highly contingent on the student's dynamic social context and the pressures and organisation of the local health system. Professionals described how different students viewed different needs as deserving of health service attention. Which students reached the professional's service depended on the resources and relationships a student could draw upon, and the service's relative permeability. Once there, what action professionals took was strongly influenced by the professional's service expertise, resource constraints, the relationships the professional's service had with other organisations, the students' wishes, and whether students regarded treatment offers as acceptable.

CONCLUSIONS

Candidacy offers a useful lens to view university students' access to mental health support. Access appears to be an increasingly intricate task for students, given the fragmented service landscape, surging demand for mental health care and challenges of emerging adulthood. Our findings suggest that policy goals to increase use of mental health services are unlikely to improve outcomes for students without policy makers and health systems giving holistic consideration of inter-service relationships and available resources.

What factors facilitate partnerships between higher education and local mental health services for students? A case study collective

BACKGROUND

Higher education institutions face challenges in providing effective mental health services for diverse student needs. In the UK, discrepancies between healthcare and education service provision create barriers for students and require stronger alignment through partnerships.

OBJECTIVES

This study aimed to identify risks, barriers and enablers to developing service partnerships between universities and the National Health Service (NHS) in England. It investigated existing partnerships and strategies that facilitate effective collaborative working.

DESIGN AND SETTING

A case study approach was employed, including coproduction and stakeholder involvement with staff and service users, to gather information from eight English universities developing regional student mental health hubs. This research received appropriate ethical approval.

PARTICIPANTS

In total, 27 professional staff from counselling, mental health, disability and well-being services participated and represented their respective services.

OUTCOME MEASURES

Descriptive information was collected from service websites, handbooks, reports and 11 focus groups using a standardised data collection template. Inter-rater reliability was used to determine the agreement between coders and finalise focus group themes. EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Standards for Reporting Qualitative Research were adopted.

RESULTS

Using inductive thematic analysis, five themes were identified for developing partnerships: building blocks, facing barriers, achieving positive outcomes, shaping student services and developing coordinated care. Fleiss' kappa showed strong agreement between raters regarding the partnership factors (k=0.84 (95% CI 0.81 to 0.87), p<0.0005). Effective communication, shared understanding and trust were essential. Barriers included restrictions to information sharing and incompatible data infrastructures between services.

CONCLUSIONS

Stronger partnerships between universities and NHS are needed to meet increasing student mental health demands. Addressing barriers and implementing strategies to develop partnerships can enhance student services.

PREREGISTRATION

https://osf.io/u54qk/.

Total Antioxidant Capacity of Saliva and Its Correlation with pH Levels among Dental Students under Different Stressful Conditions

(1) Background: This cross-sectional study conducted at the Faculty of Dental Medicine, Timisoara, Romania, between December 2022 and February 2023 aims to assess salivary total antioxidant capacity and pH levels in dental students experiencing non-stressful and stressful situations and explore potential correlations between these factors. (2) Methods: Saliva samples were collected during two different periods: before an Oral Health course and before the Oral Health exam, under stressful conditions. Ethical principles were followed, and informed consent was obtained. Data on age, gender, health status, drug use, smoking habits, and anxiety levels were recorded. Saliva was collected using the draining method and pH was measured using indicator paper strips. Total antioxidant capacity (TAC) was determined using a commercial assay kit. Statistical analysis involved descriptive statistics, Student's t-test to compare pH and TAC between study groups, and Pearson's correlation coefficient to analyze the correlation between salivary pH and TAC within each group, with p < 0.05 indicating significance. (3) Results: This study involved 80 participants, comprising 26 males and 54 females, all enrolled in the 5th year of the Oral Health course, with ages ranging from 20 to 53 and a mean age of 23.62 (±4.19) years. Pearson's correlation results show a statistically significant negative relationship between the STAI test and TAC during the stress-free period (-0.02 **, N = 80, p < 0.01). (4) Conclusions: There are variations in saliva's antioxidant capacity in response to different stress conditions. Dental students experienced a higher level of stress before academic assessments compared to the non-stress period during the course.

Wellbeing among university students during the COVID-19 pandemic: a systematic review of longitudinal studies

OBJECTIVES

The objectives of this study were to investigate the wellbeing trajectories of university students during the COVID-19 pandemic and identify associated protective factors. Results from the study aimed to inform wellbeing-promotion strategies and crisis-response plans in university settings.

STUDY DESIGN

Systematic review.

METHODS

A review of articles published in English language was conducted in PubMed, PsycINFO, Scopus, Web of Science, and ERIC databases from 1 December 2019 to 15 December 2022. Longitudinal and repeated cross-sectional studies that assessed wellbeing among university students during the COVID-19 pandemic using a validated instrument were included. Article and data extraction were performed by the primary reviewer, with a random subset verified by a second reviewer. Study quality was assessed using the National Institutes of Health 'Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies'.

RESULTS

Of 6651 titles screened without duplicates, 181 underwent full-text review, of which 19 were included in the current study (15 longitudinal and 4 repeated cross-sectional studies, with a total of 19,206 participants). A significant decrease in the wellbeing of university students was observed across studies during the early stages of the pandemic compared to prepandemic times; however, mixed findings were found in later phases of the pandemic, with some studies presenting an improvement in wellbeing, others no change, and two studies finding impairments. Overall, wellbeing was greater among males and was also associated with socioeconomic status, more sleep and physical activity, greater social connectedness, less alcohol use, and less social media activity.

CONCLUSION

The study showed varying wellbeing trajectories across different periods of the COVID-19 pandemic. Results provide relevant information for researchers, public health professionals, and higher education institutions in charge of promoting student wellbeing and crisis preparedness.

PROSPERO REGISTRATION

CRD42022383941.

A study of Irish secondary school student's views on mental health supports in school

OBJECTIVES

An increasing number of young people are experiencing mental health difficulties and schools have been identified as environments that can support them. However, it is unclear how students feel about the current supports in school and whether they are used. The aim of this study is to explore the perceptions of young people in Irish post-primary schools regarding mental health and well-being supports in schools.

METHODS

An online survey was conducted with (n=109) young people to determine the perceptions of mental health and well-being supports in post-primary Irish schools. Using a convenience sampling method, an online survey was distributed via gatekeepers in local youth and sporting groups. Data collection was completed using the Barriers to Seeking Help-brief version (BASH-B) and additional tailored questions.

RESULTS

Qualities like being 'trustworthy' and 'a good listener' were reported as key for adults to be considered a good support in schools. Current mental health and well-being supports were not considered adequate with 65.1% of the participants feeling 'somewhat supported' and 22.9% feeling 'not at all supported'.

CONCLUSIONS

Better advertising of mental health support services should be implemented in schools to promote awareness. This study can inform the development of such services which are urgently needed.

University students' use of mental health services: a systematic review and meta-analysis

BACKGROUND

International estimates suggest around a third of students arrives at university with symptoms indicative of a common mental disorder, many in late adolescence at a developmentally high-risk period for the emergence of mental disorder. Universities, as settings, represent an opportunity to contribute to the improvement of population mental health. We sought to understand what is known about the management of student mental health, and asked: (1) What proportion of students use mental health services when experiencing psychological distress? (2) Does use by students differ across health service types?

METHODS

A systematic review was conducted following PRISMA guidelines using a Context, Condition, Population framework (CoCoPop) with a protocol preregistered on Prospero (CRD42021238273). Electronic database searches in Medline, Embase, PsycINFO, ERIC and CINAHL Plus, key authors were contacted, citation searches were conducted, and the reference list of the WHO World Mental Health International College Student Initiative (WMH-ICS) was searched. Data extraction was performed using a pre-defined framework, and quality appraisal using the Joanna Briggs Institute tool. Data were synthesised narratively and meta-analyses at both the study and estimate level.

RESULTS

7789 records were identified through the search strategies, with a total of 44 studies meeting inclusion criteria. The majority of included studies from the USA (n = 36), with remaining studies from Bangladesh, Brazil, Canada, China, Ethiopia and Italy. Overall, studies contained 123 estimates of mental health service use associated with a heterogeneous range of services, taking highly variable numbers of students across a variety of settings.

DISCUSSION

This is the first systematic quantitative survey of student mental health service use. The empirical literature to date is very limited in terms of a small number of international studies outside of the USA; studies of how services link together, and of student access. The significant variation we found in the proportions of students using services within and between studies across different settings and populations suggests the current services described in the literature are not meeting the needs of all students.

Predicting stress and mental wellbeing among doctoral researchers

BACKGROUND

Although mental health in higher education is increasingly recognised as a public health issue, postgraduate research students are often overlooked. Recent studies indicate a high prevalence of mental distress in this population.

AIMS

This study assesses the experience of doctoral researchers and identifies factors influencing mental wellbeing and perceived stress.

METHODS

A cross-sectional study examined how key demographic, individual and contextual factors related to stress and mental wellbeing in a sample of 431 doctoral researchers in the United Kingdom.

RESULTS

Respondents gave positive reports about their supervisory relationship and identified feeling confidently prepared for their work. Family support, good general health, sleep and low levels of self-depreciation predicted stronger mental wellbeing and lower levels of stress. Students who were confident about their future career and felt well prepared for their studies were less stressed and those who were achievement orientated had better mental wellbeing.

CONCLUSIONS

Focused attention on exploring career options and building confidence may help reduce stress among doctoral researchers. Taking steps to tackle the imposter phenomenon may help further. These could include addressing fear of failure, improving confidence in research ability and clarifying the role of doctoral researchers within the wider academic community.

Uncertainty, Existential Immobility and Well-Being: Experiences of Women Seeking Asylum in Norway

In recent years, European countries have made their asylum systems increasingly stricter. Norway has been no exception, taking additional measures to tighten its asylum system to make it less attractive to seek asylum. How does the asylum procedure and living in asylum centres influence psychosocial well-being and, in turn, the prospects of incorporation into a new society? This article identifies the main challenges that a group of women face while seeking asylum and living in asylum centres in Norway, and it explores the influence that these challenges have on their mental health and well-being. To do this, it draws on ethnographic fieldwork conducted during approximately one year (2017-2018) with nine women-of different nationalities, ages and backgrounds-living in asylum centres in Norway. The analysis shows five main elements of the Norwegian asylum and reception system that result in the main challenges that the women deal with during their wait in the asylum centres. These elements are the wait and uncertainty around their asylum application coupled with the inability to influence their circumstances, the limitations to engage in meaningful activities as well as the financial and mobility limitations imposed by the Norwegian authorities. The interconnections of these five elements make the women often feel powerless, unable to influence their circumstances and feel stuck in the present, unable to plan their future, thus, experiencing high levels of uncertainty and existential immobility (Hage 2009). This, in turn, leads to frustration, apathy and even depression in the women, which can have a negative effect on their future incorporation into the Norwegian society.

Understanding university student priorities for mental health and well‐being support: A mixed‐methods exploration using the person‐based approach

Poor student well-being at UK universities is overstretching institutional support services, highlighting a need for effective new resources. Despite extensive literature on mental health and well-being interventions, students' engagement with support remains unexplored. The study aimed to understand students' experience of engagement with well-being support, identify their well-being needs and form concrete recommendations for future intervention design and delivery. The Person-Based Approach to intervention design was followed to centralise users' experience, in turn maximising acceptability and effectiveness of resources. An online survey (N = 52) was followed by three focus groups (N = 14). Survey data were analysed descriptively, and reflexive thematic analysis was performed on qualitative data. Mixed-methods data integration produced four key student priorities for well-being resources - ease of access, inclusive and preventative approach, sense of community and a safe space, and applying skills to real-life contexts. Five actionable guiding principles for intervention design were produced through consultation with expert stakeholders. This work helps understand why and how students engage with support at university. The resulting recommendations can inform future intervention development, leading to more acceptable, engaging and effective student well-being resources.

“Seeing and Being Seen” or Just “Seeing” in a Smart Classroom Context When Videoconferencing: A User Experience-Based Qualitative Research on the Use of Cameras

This research examines the form in which undergraduates use video cameras during videoconferencing class sessions in a Smart Classroom context and, more specifically, the reasons why a considerable number of students opt to turn off their cameras when videoconferencing during the sessions while others keep them on. The study was carried out in an institution that had previously switched from face-to-face teaching to an Emergency Remote Teaching solution, initially adopted in 2019–2020 to cope with the COVID-19 pandemic restrictions. Findings suggest that using cameras when videoconferencing is associated with increasing and enhancing the interaction between the student and the rest of the class, although not all students agreed with this conclusion. In addition, having the video cameras switched fomented socialization and improved the overall online learning experience for students. However, the surveyed students pointed out diverse negative elements, such as why they had to turn on their personal cameras, privacy concerns, and limitations derived from the available technology infrastructure, in addition to other factors such as distractions, anxiety, and cognitive load. This work discusses how these elements can influence the well-being and the user experience of the students, both positively and negatively.

The impact of the COVID-19 pandemic on student mental health and wellbeing in UK university students: a multiyear cross-sectional analysis

BACKGROUND

Ongoing concern for the unique mental health challenges faced by university students has been magnified by the disruption of the global COVID-19 pandemic since March 2020.

AIMS

This study aimed to investigate changes in mental health and wellbeing outcomes for UK university students since the pandemic began, and to examine whether more vulnerable groups were disproportionately impacted.

METHODS

Students at a UK university responded to anonymous online cross-sectional surveys in 2019 (N = 2637), 2020 (N = 3693), and 2021 (N = 2772). Students completed measures of depression, anxiety and subjective wellbeing (SWB). Multivariable logistic regression models investigated associations of survey year and sociodemographic characteristics with mental health and SWB.

RESULTS

Compared to 2019, fewer students showed high levels of depression and anxiety symptoms in 2020. However, there was evidence of worsened levels of anxiety and SWB in 2021 compared to 2019. Interaction effects indicated that students from a Black, Asian or minority ethnicity background and students previously diagnosed with a mental health difficulty showed improved outcomes in 2021 compared to previous years.

CONCLUSIONS

There is a need for sector-wide strategies including preventative approaches, appropriate treatment options for students already experiencing difficulties and ongoing monitoring post-pandemic.

Key questions: research priorities for student mental health

BACKGROUND

The high prevalence of mental distress among university students is gaining academic, policy and public attention. As the volume of research into student mental health increases, it is important to involve students to ensure that the evidence produced can translate into meaningful improvements.

AIMS

For the first time, we consult UK students about their research priorities on student mental health.

METHOD

This priority setting exercise involved current UK university students who were asked to submit three research questions relating to student mental health. Responses were aggregated into themes through content analysis and considered in the context of existing research. Students were involved throughout the project, including inception, design, recruitment, analysis and dissemination.

RESULTS

UK university students (N = 385) submitted 991 questions, categorised into seven themes: epidemiology, causes and risk factors, academic factors and work-life balance, sense of belonging, intervention and services, mental health literacy and consequences. Across themes, respondents highlighted the importance of understanding the experience of minority groups.

CONCLUSIONS

Students are interested in understanding the causes and consequences of poor mental health at university, across academic and social domains. They would like to improve staff and students' knowledge about mental health, and have access to evidence-based support. Future research should take a broad lens to evaluate interventions; considering how services are designed and delivered, and investigating institutional and behavioural barriers to accessibility, including how this varies across different groups within the student population.

Determinants of wellbeing in university students: The role of residential status, stress, loneliness, resilience, and sense of coherence

Maintaining wellbeing in university students is a government priority, but robust evidence has been lacking. Higher wellbeing is associated with better mental and physical health, higher self-esteem, self-efficacy, and effective coping strategies. This study aimed to identify, through an online survey in 2018, key determinants of wellbeing amongst a sample of 574 (65.5% female) students across all levels of study at a university in the UK. Most respondents (526 (91.8%)) reported feeling unusually stressed or overwhelmed at university. Residential students reported higher loneliness and number of stressors than commuter students, and postgraduate students reported higher wellbeing, resilience, and sense of coherence, and lower perceived stress and loneliness. Hierarchical regression analyses showed that 71.8% of the variance in wellbeing was predicted by a model containing demographics (age/gender, level of study, number of stressors), psychosocial variables, and perceived stress, with perceived stress, sense of coherence, loneliness, and resilience the strongest predictors. The findings suggest that interventions designed to improve resilience and sense of coherence, and reduce loneliness and perceived stress are likely to be effective in enhancing wellbeing in a student population.

Burnt Out and Dropping Out: A Comparison of the Experiences of Autistic and Non-autistic Students During the COVID-19 Pandemic

Autistic students are more likely to drop out of university, while facing both challenges and opportunities within university environments. This study compared the experiences of autistic and non-autistic current United Kingdom students, in terms of thoughts about dropping out, burnout, mental health and coping, during the COVID-19 pandemic. Burnout was of particular interest as this is a relatively unexamined phenomenon for autistic students. Seventy autistic and 315 non-autistic students, completed a mixed methods questionnaire with standardized measures of burnout (personal and academic), mental health (depression, stress, and anxiety), and coping styles (adaptive and maladaptive). We also included qualitative questions about dropping out and COVID-19 experiences. We found autistic participants experienced higher rates of burnout and mental health symptoms and were more likely to have thought about dropping out. Reasons given for thinking about dropping out, for both groups, focused on poor mental well-being, doubts about university, and academic challenges. For autistic participants, further analyses did not identify specific predictors of thinking about dropping out, but for non-autistic participants, this was predicted by maladaptive coping styles and academic burnout. Academic and personal burnout predicted one another for autistic students, and age, maladaptive coping, autistic characteristics, stress, and anxiety additionally predicted burnout for non-autistic students. Similarities in experiences during the pandemic were noted, with both groups experiencing negative social implications, difficulties adjusting to emergency online learning, and poorer psychological well-being. Moving forward from COVID-19, universities must find ways to enhance both academic and social support, to enable equal opportunity within Higher Education for autistic students.

Developing a national database for higher education student counselling services: the importance of collaborations

Student counselling services are at the forefront of providing mental health support to Irish Higher Education students. Since 1996, the Psychological Counsellors in Higher Education in Ireland (PCHEI) association, through their annual survey collection, has collected aggregate data for the sector. However, to identify national trends and effective interventions, a standardised non-aggregate sectoral approach to data collection is required. The Higher Education Authority funded project, 3SET, builds on the PCHEI survey through the development of a national database. In this paper, we outline the steps followed in developing the database, identify the parties involved at each stage and contrast the approach taken to the development of similar databases. Important factors shaping the development have been the autonomy of counselling services, compliance with General Data Protection Regulation, and the involvement of practitioners. This is an ongoing project with the long-term sustainability of the database being a primary objective.

Components of psychosocial health

Purpose

“Psychosocial health” is a new term to comprehend the already established factors involved in mental health and psychological well-being. The term has not been specifically defined and explained within the framework of psychology.

Design/methodology/approach

The study proposed and validated a new model of psychosocial health. Principal component analysis, exploratory factor analysis and confirmatory factor analysis were conducted by involving a total of 4,086 participants.

Findings

Psychosocial health was interpreted as the “sexual, emotional, social, environmental, cognitive, religious, moral and spiritual satisfaction” of a person. The proposed model of psychosocial health was statistically validated. The additional findings revealed significantly higher levels of psychosocial health in women and significant inverse correlations between psychosocial health and age.

Originality/value

The current paper provided a comprehensive picture of psychosocial health from a psychological perspective and presented a statistically reliable tool for measuring psychosocial health.

"Pandemic Dreams are Susceptible to Priming and Unrelated to COVID-19 Exposure"

"Surveys that have recruited participants through social media and news websites have led researchers and clinicians to conclude that the COVID-19 pandemic has precipitated a parallel pandemic of nightmares that reflect pandemic-induced psychological distress. Many of these surveys were administered to participants who intentionally opted into research knowing that the investigators were soliciting pandemic dream reports. This investigation surveyed 193 college students who were blind to the purpose of the study to assess the prevalence of pandemic dreams and to determine if the wording of the questions could shape responses. Fewer than half could recall a dream. Reports were brief, susceptible to priming, and unrelated to personal SARS-CoV-2/COVID-19 exposure. Although this sample was not truly random, it is probably more representative of the US population than those recruited through thematic websites. Clinicians should be aware of problems inherent in survey research and understand how their words can shape client responses."

Assertive skills: a comparison of two group interventions with Brazilian university students

The improvement or acquisition of socioemotional skills contributes to the academic and personal adaptation of university students. The way students think about themselves and others influence their social skills and well-being. Considering the importance of social competence for professional practice in the face of new social realities, the university must invest in programs that promote the socio-emotional development of students. This study compared the effects of interventions based on Rational Emotive Behavior Therapy and Psychoeducation on assertive skills and subjective well-being. This study involved 25 undergraduate students of a public university. The students were randomly allocated to three groups, including the Control group, and they were evaluated by means of questionnaires, inventories, scales, and written evaluation of the group process. The program consisted of 10 meetings and a 6-week follow-up. Irrational beliefs were reduced and their assertive skills’ scores increased in the post-intervention and follow-up evaluations, regardless of the group. Only verbal reports from participants indicated an increase in well-being. The students’ written reports after the end of the meetings indicate that the two forms of intervention were evaluated as promoting change by the students. One of the limitations of the study is the size of the groups. Despite the very small sample size, the study highlights that developing a set of flexible beliefs is fundamental to the exercise of assertiveness.

Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis

BACKGROUND

Effective targeting of services requires that we establish which undergraduates are at increased risk of mental health problems at university. We aimed to conduct a systematic review and meta-analysis of the prevalence and risk factors for mental health problems in undergraduates.

METHODS

We searched MEDLINE, PsycInfo, EMBASE and the Cochrane Central Register. Eligible studies were assessed using the Quality of Prognostic Studies checklist and narratively synthesised. Pooled prevalence of depression and suicide-related outcomes, and associated risk factors (odds ratios) were estimated using random-effects meta-analyses.

RESULTS

Sixty-six eligible studies of varying quality were included in a narrative synthesis. The pooled prevalence of depression (eight studies; 13,790 participants) was 25% (95% CI 17%, 35%) and the pooled prevalence of suicide-related outcomes (four studies; 2,586 participants) was 14% (95% CI 0%, 44%). Thirteen studies contributed to meta-analytic syntheses of 12 depression-related and four suicide-related risk factors. Presenting with a current mental health problem, negative rumination, parent separation, experiences of sexual harassment and parental depression significantly predicted depression outcomes. Childhood adversity, baseline mental health problems and financial difficulties significantly predicted suicide-related outcomes.

LIMITATIONS

Student mental health is a heterogeneous research area and is hampered by the use of imprecise terms, both for describing risk factors and mental health outcomes. These inconsistencies limit the extent to which datasets can be meaningfully synthesised.

CONCLUSIONS

This review evidences the importance of a range of risk factors for poor undergraduate mental health. Interventions should be developed to target modifiable risk factors and prevent poor mental health outcomes. Systematic review registration: PROSPERO registration CRD42019144927.

Student mental health and well-being: Overview and Future Directions

The mental health of third-level students is of major societal concern with the gap between the demand for services and supports offered at crisis level. In Ireland, similar to elsewhere, colleges have responded to this need in vastly differing ways, with student counselling services available to all institutions, and student health departments and sessional psychiatry in some of the larger institutions, with none operating as a single multidisciplinary service. There is an increasing recognition for a more systematised approach, with the establishment of International Networks, Charters and Frameworks. These advocate for a whole institutional approach to student mental health, in addition to the development of an integrated system of supports with effective pathways to appropriate care. This paper, by members of the Youth and Student Special Interest Group of the College of Psychiatrists of Ireland, contextualises student mental health currently and describes future directions for this emerging field. It is a call to action to develop a structure that supports the needs of students with mental health problems across the full range of the spectrum from mild to severe.

Effectiveness of providing university students with a mindfulness-based intervention to increase resilience to stress: 1-year follow-up of a pragmatic randomised controlled trial

Background

There is concern that increasing demand for student mental health services reflects deteriorating student well-being. We designed a pragmatic, parallel, single-blinded randomised controlled trial hypothesising that providing mindfulness courses to university students would promote their resilience to stress up to a year later. Here we present 1-year follow-up outcomes.

Methods

University of Cambridge students without severe mental illness or crisis were randomised (1:1, remote software-generated random numbers), to join an 8-week mindfulness course adapted for university students (Mindfulness Skills for Students (MSS)), or to mental health support as usual (SAU).

Results

We randomised 616 students; 53% completed the 1-year follow-up questionnaire. Self-reported psychological distress and mental well-being improved in the MSS arm for up to 1 year compared to SAU (p<0.001). Effects were smaller than during the examination period. No significant differences between arms were detected in the use of University Counselling Service and other support resources, but there was a trend for MSS participants having milder needs. There were no differences in students’ workload management; MSS participants made more donations. Home practice had positive dose–response effects; few participants meditated. No adverse effects related to self-harm, suicidality or harm to others were detected.

Conclusion

Loss to follow-up is a limitation, but evidence suggests beneficial effects on students’ average psychological distress that last for at least a year. Effects are on average larger at stressful times, consistent with the hypothesis that this type of mindfulness training increases resilience to stress.

Trial registration number

ACTRN12615001160527.

Improving Mental Health Help-Seeking Behaviours for Male Students: A Framework for Developing a Complex Intervention

Men are less likely to seek help for mental health difficulties and this process is often used to help explain the disproportionally higher suicide rates compared to women. Furthermore, university students are often regarded as a vulnerable population group with a lower propensity to seek help. Thus, male students are a very high-risk group that is even more reluctant to seek help for mental health difficulties, placing them at high risk of suicide. Often, student mental health problems are highlighted in the media, but very few evidence-based solutions specifically designed for male students exist. The current paper seeks to provide a comprehensive framework about how to better design mental health interventions that seek to improve male students' willingness to access psychological support. The Medical Research Council's (MRC's) framework for developing a complex intervention was used to develop an intervention relevant to male students. In this paper, previous help-seeking interventions and their evaluation methods are first described, secondly, a theoretical framework outlining the important factors male students face when accessing support, and thirdly, how these factors can be mapped onto a model of behaviour change to inform the development of an evidence-based intervention are discussed. Finally, an example intervention with specific functions and behaviour change techniques is provided to demonstrate how this framework can be implemented and evaluated. It is hoped that this framework can be used to help reduce the disparity between male and female students seeking mental health support.

Counselling and psychotherapy post-COVID-19

We consider how the prolonged, complex and uncertain aftermath of the COVID‐19 crisis will present challenges and opportunities for counselling and psychotherapy. Increased mental strain on populations, individuals and professionals is likely to be compounded by further constraints in therapeutic resources. Nevertheless, emerging needs and priorities will offer ground for systems thinking in linking the application of a range of therapeutic frameworks, theories to address global challenges, integration of counselling and psychotherapy into new sectors, service models for the most vulnerable, use of digital approaches, support mechanisms for professionals and interdisciplinary research.

What worries first-year students? Psychometric properties of the Student Worry Scale

The transition to university can be stressful for first-year university students. Despite the fact where the feeling of worry is a shared symptom by various mental health issues, there is a lack of studies that investigate into this matter. As worry is a domain-specific construct, there is a need for a valid and reliable measure of worry specifically for university students. Hence, this study aimed to evaluate the psychometric properties of the Student Worry Scale (SWS), particularly in terms of its validity and reliability. For this purpose, the current study recruited a sample of 295 first-year students to evaluate the psychometric properties of SWS. Exploratory factor analysis yielded a five-factor structure of SWS, which explained 55.7% of the total variance. The yielded five factors were general worries, financial-related concerns, significant other's well-being, academic concerns, and social adequacy concerns. Inter-correlations between the five factors were all significant (r ranged between 0.395 and 0.625). The SWS demonstrated good internal consistency in this study (Cronbach's alpha ranged between 0.786 and 0.941). Overall, the SWS is psychometrically evidenced to be a reliable and valid content-based worry measure specifically for university students.