Mental Health and COVID-19 in University Students: Findings from a Qualitative, Comparative Study in Italy and the UK

Changes in Rates of Special Considerations in Higher Education Applications Pre- and During the COVID-19 Pandemic in Victoria, Australia

BACKGROUND AND AIMS

Since the onset of the COVID-19 pandemic, a significant rise in mental ill health has been observed globally in young people, particularly those in their final years of secondary school. Students' negative experiences coincide with a critical transitional period which can disrupt milestones in social and educational development. This study aimed to use innovative population-level data to map the impact of the pandemic on students entering higher education.

METHODS

Pre-pandemic (2019/2020) and pandemic (2020/2021) tertiary education application data were obtained from the Victorian Tertiary Admissions Centre. Prevalence of applications for special consideration related to mental ill health were compared between cohorts across various geographical areas and applicant demographic subgroups. Relative risk regression models were used to understand the role of different risk factors.

RESULTS

Rates of mental health-related special consideration applications increased by 38% among all applications (pre-pandemic: 7.8%, n = 56 916; pandemic: 10.8%, n = 58 260). Highest increases were observed among students in areas with both extended and close-quarter lockdown experiences, and areas impacted by 2019/2020 black summer bushfires. The increases were higher among Year 12 students and students with other special consideration needs (e.g., physical condition, learning disability). Slightly higher increases were observed in areas with higher socio-economic status, which may potentially be related to inequality in mental health service access.

CONCLUSION

As consequences of mental health difficulties and academic disruption in youth can be long lasting, it is critical to establish a mental health support framework both in and outside of higher education to facilitate young people's recovery from the pandemic.

Stress, Coping, and Adjustment of International Students during COVID-19: A Quantitative Study

The COVID-19 pandemic in 2020 caused unexpected and unprecedented disruptions worldwide. University students, especially international students, underwent unique challenges during this volatile era. This secondary quantitative data analysis study aimed to investigate the experiences, stress, adjustment, and ways of coping of university students during the COVID-19 pandemic. Data from 112 international university students and 112 domestic American university students were included in the statistical analyses. The differences in Student Adaptation to College Questionnaire (SACQ), Ways of Coping Questionnaire (WAYS), COVID-19-related questionnaire, and Perceived Stress Scale (PSS) between international and domestic students were analyzed using independent samples t-tests. Multiple regression models predicting PSS by SACQ, WAYS, and COVID-19-related questionnaire subscales were estimated for international and domestic students separately. The results showed that international students and American students did not report significant differences in their university adjustment, usage of coping strategy, and perceived stress level during the peak of the pandemic. Additionally, American students reported more factors impacting their perceived stress than international students. Implications of the findings as well as limitations and future directions were discussed.

The Relationship Between Stressful Life Events and Depressive Symptoms in College Students: mediation by Parenting Style and Gender's Moderating Effect

Aim

Stressful life events have a significant impact on the mental health of college students. Depression, as a prevalent psychological issue, has garnered attention in the field of college student mental health and is closely linked to it. Additionally, parenting style is identified as an important factor influencing the development of college students' mental health. Therefore, this study aims to explore the relationship between these three factors.

Methods

A total of 8079 first-year college students from two medical universities in Shandong Province, China were surveyed. The Beck Depression Inventory was utilized to evaluate depressive symptoms among the college students, while the Adolescent Self-rating Life Events Checklist and the Egna Minnen Beträfande Uppfostran were employed to gather data. Subsequently, the SPSS macro program PROCESS was utilized to analyze both the mediating and moderating effects. All statistical analyses were conducted using SPSS 26.0.

Results

The study found a detection rate of 6.3% for depressive symptoms among college students. The correlation analysis of this study showed that the stressful life events of college students were significantly positively correlated with depressive symptoms (r=0.261, p< 0.01). Each dimension of parenting style was associated with depressive symptoms in different degrees and directions. At the same time, parenting styles of all sizes play a partial mediating role between stressful life events and depressive symptoms in college students, gender plays a crucial regulatory role in this mediation.

Conclusion

Stressful life events experienced by college students have a significant impact on their mental health. Early intervention through positive parenting styles from parents may prove to be beneficial in promoting the development of good mental health among college students.

Understanding University Students' Perspectives towards Digital Tools for Mental Health Support: A Cross-country Study

Background

Organisational and individual barriers often prevent university students from seeking mental health support. Digital technologies are recognised as effective in managing psychological distress and as a source of health-related information, thus representing useful options to address mental health needs in terms of accessibility and cost-effectiveness. However, university students' experiences and perspectives towards such interventions are little known.

Objectives

We thus aimed to expand the existing base of scientific knowledge, focusing on this special population.

Methods

Data were from the qualitative component of "the CAMPUS study", longitudinally assessing the mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts using the framework approach.

Results

An explanatory model was derived from five themes identified across 33 interviews (15 for Italy, 18 for the UK). Students perceived that social media, apps, and podcasts could deliver relevant mental health content, ranging from primary to tertiary prevention. Wide availability and anonymity were perceived as advantages that make tools suitable for preventive interventions, to reduce mental health stigma, and as an extension of standard treatment. These goals can be hindered by disadvantages, namely lower efficacy compared to face-to-face contact, lack of personalisation, and problematic engagement. Individual and cultural specificities might influence awareness and perspectives on the use of digital technologies for mental health support.

Conclusion

Although considering some specific features, digital tools could be a useful instrument to support the mental health needs of students. Since personal contact remains crucial, digital tools should be integrated with face-to-face interventions through a multi-modal approach.

How Social Support Affects Resilience in Disadvantaged Students: The Chain-Mediating Roles of School Belonging and Emotional Experience

This study aims to utilize data from the Programme for International Student Assessment (PISA), 2018, conducted in four provinces and cities in China, to investigate the impact of social support on the resilience of disadvantaged students. It specifically focuses on the chain-mediated effects of school belonging and emotional experiences. To achieve this, the study selected 2997 disadvantaged students as participants and employed path analysis to examine the mediating effects. The results indicate that teacher support, parental support, school belonging, and positive emotional experiences significantly positively influence the resilience of disadvantaged students, while fear of failure significantly negatively affects resilience. Additionally, teacher and parental support indirectly impact the resilience of disadvantaged students through the chain-mediated effects of school belonging and positive emotional experiences. Similarly, teacher and parental support also influence the resilience of disadvantaged students through the chain-mediated effects of school belonging and fear of failure. To enhance the resilience development of disadvantaged students, it is recommended that teachers and parents provide active attention and support to these students. Simultaneously, there should be increased focus on the psychological well-being of disadvantaged students by strengthening their mental health education.

Impact of the COVID-19 Pandemic on the Use of Antidepressants by Young Adults in the ASL TO4 Regione Piemonte (Italy)

The association between younger age and poorer mental health during the COVID-19 pandemic has been documented. Whether these changes were associated with a change in antidepressant (AD) use is not well understood. This study aimed to estimate the impact of the COVID-19 pandemic on AD use by young adults in the ASL TO4 Regione Piemonte (Italy). The impact of the pandemic on the weekly prevalence of AD users was assessed using interrupted time-series analysis with autoregressive integrated moving average models. A total of 1071 subjects (18-22 years with ≥1 AD dispensation) were included in the study. The observed prevalence was lower than the predicted value for several weeks after the introduction of the lockdown. However, it was consistently higher than the predicted values from week 134. The maximum difference between observed and predicted values (25 subjects per 10,000 young adults) was found at week 170. Changes in AD use were observed in both genders and were more pronounced for selective serotonin reuptake inhibitors. In conclusion, the impact of the COVID-19 pandemic on the mental health of young adults is likely to be significant in the coming years, which may place a future burden on pharmaceutical public health and community health.

University students' psychological distress during the COVID-19 pandemic: A structural equation model of the role of resource loss and gain

Using the Conservation of Resources (COR) theory, we aimed to determine whether university students' loss and gain in resources during the pandemic mediated the relationships between COVID-19 exposure/concern and depression and anxiety. In 2021, 7013 Israeli university students completed online questionnaires. We assessed the data using structural equation modeling. We found that resource loss was directly related to concern (β = 0.32, p < 0.001). Depression and anxiety were both directly related to loss of resources (depression: β = 0.75, p < 0.001; anxiety: β = 0.69, p < 0.001) and concern (depression: β = 0.06, p < 0.001; anxiety: β = 0.12, p < 0.001). Resource loss had an indirect effect on the relationships between concern and depression (β = 0.24, p < 0.001) and concern and anxiety (β = 0.22, p < 0.001). COR theory may help explain the mechanisms behind university students' mental health during the pandemic and provides a framework to better understand preparedness for future pandemics, epidemics, and major disasters. Governments and universities should help prevent the loss of resources during future emergencies.

Spanish media coverage of youth mental health issues during the COVID-19 pandemic

BACKGROUND

The media portrayal of mental health is relevant in shaping the population's attitudes towards mental disorders. However, there is little information about the representation of young mental health issues in the Spanish-language press, especially in the context of the COVID-19 pandemic. The general objective of this study was to analyse the tone and content of Spanish newspaper articles about mental disorders in youth during the COVID-19 pandemic.

METHODS

We collected media articles from the 10 most read news sources over a 6 month period (January-June 2021). These articles were coded for content using a standardised codebook, followed by an inductive thematic analysis. A total of 205 news items were evaluated.

RESULTS

Results showed that the majority of the news items had an overall positive tone (68.3%), only 5.4% were stigmatising and only 7.3% were related to violence. However, few articles offered help seeking information (6%), adolescents were rarely quoted (14%) and children were never quoted. Substantial differences are described in terms of age, gender and disorder. The thematic analysis led to three emergent themes: (i) violence and victimisation; (ii) the COVID-19 pandemic; and (iii) technology and social media.

CONCLUSIONS

The percentage of news in the Spanish media that refer to young people's mental health in a stigmatising way or in a way associated with violence is very low. Furthermore, the COVID-19 pandemic may have promoted more positive discussion about youth mental health. However, major challenges remain to be addressed, as patients are seldom quoted, very few articles offer help-seeking information, and a narrative of victimisation without appropriate discussion of resilience regularly occurs.

Stress, Anxiety, and Depression Levels among University Students: Three Years from the Beginning of the Pandemic

BACKGROUND

Three years after the outbreak of the COVID-19 pandemic, psychological distress among college students remains increased. This study assesses stress, anxiety, and depression levels among students of the Aristotle University of Thessaloniki by the end of the third year of the pandemic (November 2022), revealing demographic characteristics and probable stressors.

METHODS

A questionnaire was distributed in November 2022 via the academic students' e-mails. The evaluation was performed with the DASS21 survey tool. The correlation analysis and the effect size calculation were performed with the t-test.

RESULTS

The majority of participants were undergraduates, on their first or second academic year, female students (67%), age of 18 to 21, unmarried or single (91%), and vaccinated against COVID-19 infection (83.4%). Severely increased levels of stress, anxiety, and depression (21.3%, 23.3%, and 25.1%, respectively) were measured. The normal and mild levels of stress, anxiety, and depression were 64.0%, 66.5%, and 57.2%, respectively. Female and younger students were at a higher risk of extremely severe stress, anxiety and depression prevalence (ORs up to 2.07, p-Values < 0.00001). Participants who were receiving psychological or psychiatric treatment exhibited severe stress, anxiety, and depression levels (ORs above 2.9, p-Values < 0.00001).

CONCLUSIONS

Despite the undeniable withdrawal of the COVID-19 pandemic, the community of the Aristotle University of Thessaloniki presents high stress, anxiety, and depression levels, similar to those reported during the first year of the pandemic (November 2020). Stressors and risk factors were according to the reported literature and previous studies on Greek students. Academic psychological support offices should consider the students' "profile" in order to evaluate properly the potential risk for emotional and psychological distress. Evidence suggest that new technology (virtual reality, tele-psychiatry or tele-support apps and sessions) should also be implemented in universities.