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Public Health Approaches to Promoting University Students’ Mental Health: A Global Perspective

  • Global Mental Health (BN Gaynes, Section Editor)
  • Published:
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Abstract

Purpose of Review

Provide a critical overview of recent global advances in student mental health from a public health perspective, highlighting key challenges and gaps in the literature.

Recent Findings

Mental disorders and suicidality are common among university students globally. However, there is a significant treatment gap even though evidence-based treatments are available. To overcome barriers to treatment, public health interventions should be conceptualized within a developmental paradigm that takes cognizance of the developmental tasks of young adulthood.

Summary

Traditional one-on-one treatment approaches will not be a cost-effective or sustainable way to close the treatment gap among students. A range of evidence-based interventions is available to promote students’ mental health; however, novel approaches are needed to scale up services and adapt intervention delivery to suit student specific contexts. Digital interventions and peer-to-peer interventions could be a cost-effective way to scale-up and expand the range of services.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Duffy A, Saunders KEA, Malhi GS, Patten S, Cipriani A, McNevin SH, et al. Mental health care for university students: a way forward? Lancet Psychiatry. [Internet]. Elsevier; 2019 [cited 2022 Jul 31];6:885–7. Available from: http://www.thelancet.com/article/S2215036619302755/fulltext.

  2. Storrie K, Ahern K, Tuckett A. A systematic review: Students with mental health problems—a growing problem. Int J Nurs Pract. [Internet]. John Wiley & Sons, Ltd; 2010 [cited 2022 Jul 31];16:1–6. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-172X.2009.01813.x.

  3. Auerbach RP, Mortier P, Bruffaerts R, Alonso J, Benjet C, Cuijpers P, et al. WHO World mental health surveys international college student project: prevalence and distribution of mental disorders. J Abnorm Psychol. [Internet]. 2018 [cited 2019 May 30];127:623–38. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/abn0000362.

  4. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) Surveys*. Epidemiol Psychiatr Sci. [Internet]. Cambridge University Press; 2009 [cited 2022 Jul 31];18:23–33. Available from: https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/abs/global-burden-of-mental-disorders-an-update-from-the-who-world-mental-health-wmh-surveys/FCE4DE10C9FB1A9FFDDDBA3C5264F445.

  5. Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, et al. Mental disorders among college students in the World Health Organization World Mental Health Surveys Psychol Med. [Internet]. 2016;46:2955–70. Available from: https://www.cambridge.org/core/product/identifier/S0033291716001665/type/journal_article.

  6. Peltzer K, Pengpid S. Association between tobacco use, depression, and anxiety: a cross-national study among university students from 30 low- and middle-income countries. J Psychol Afr. 2017;27:483–7.

    Article  Google Scholar 

  7. Peltzer K, Pengpid S. Correlates of illicit drug use among university students in Africa and the Caribbean. J Psychol Afr. 2016;26:390–3.

    Article  Google Scholar 

  8. Harrer M, Adam SH, Messner EM, Baumeister H, Cuijpers P, Bruffaerts R, et al. Prevention of eating disorders at universities: a systematic review and meta-analysis. Int J Eat Disord. [Internet]. John Wiley & Sons, Ltd; 2020 [cited 2022 Jan 25];53:813–33. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/eat.23224.

  9. Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry [Internet]. 2015;39:503–11. Available from: https://doi.org/10.1007/s40596-014-0205-9.

  10. Yi S, Peltzer K, Pengpid S, Susilowati IH. Prevalence and associated factors of illicit drug use among university students in the association of southeast Asian nations (ASEAN). Subst Abuse Treat Prev Policy. 2017;12:1–7.

    Article  Google Scholar 

  11. Cranford JA, Eisenberg D, Serras AM. Substance use behaviors, mental health problems, and use of mental health services in a probability sample of college students. Addict Behav. [Internet]. Pergamon; 2009 [cited 2018 Jul 2];34:134–45. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0306460308002554.

  12. • Sheldon E, Simmonds-Buckley M, Bone C, Mascarenhas T, Chan N, Wincott M, et al. Prevalence and risk factors for mental health problems in university undergraduate students: a systematic review with meta-analysis. J Affect Disord. Elsevier; 2021;287:282–92. This article is a meta-analysis of the prevalence and risk factors for common mental disorders among university students.

  13. Paula W de, Breguez GS, Machado EL, Meireles AL. Prevalence of anxiety, depression, and suicidal ideation symptoms among university students: a systematic review / Prevalência de sintomas ansiedade, depressão e ideação suicida entre estudantes universitários: uma revisão sistemática. Braz J Health Rev. [Internet]; 2020 [cited 2022 Sep 24];3:8739–56. Available from: https://www.brazilianjournals.com/ojs/index.php/BJHR/article/view/13518.

  14. Mortier P, Auerbach RP, Alonso J, Bantjes J, Benjet C, Cuijpers P, et al. Suicidal thoughts and behaviors among first-year college students: results from the WMH-ICS project. J Am Acad Child Adolesc Psychiatry. Elsevier; 2018;57:263-273.e1.

  15. Mortier P, Cuijpers P, Kiekens G, Auerbach RP, Demyttenaere K, Green JG, et al. The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychol Med. [Internet]. Cambridge University Press; 2018 [cited 2018 Dec 15];48:554–65. Available from: https://www.cambridge.org/core/product/identifier/S0033291717002215/type/journal_article.

  16. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Üstün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. [Internet]. NIH Public Access; 2007 [cited 2022 Sep 21];20:359. Available from: /pmc/articles/PMC1925038/.

  17. Alonso J, Vilagut G, Mortier P, Auerbach RP, Bruffaerts R, Cuijpers P, et al. The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative. Int J Methods Psychiatr Res. [Internet]. John Wiley & Sons, Ltd; 2019 [cited 2022 Jan 26];28:e1750. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/mpr.1750.

  18. McGorry PD, Purcell R, Goldstone S, Amminger GP. Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Curr Opin Psychiatry. [Internet]. 2011 [cited 2022 Sep 21];24:301–6. Available from: https://journals.lww.com/co-psychiatry/Fulltext/2011/07000/Age_of_onset_and_timing_of_treatment_for_mental.8.aspx.

  19. Hawton K, Saunders KEA, O’Connor RC. Self-harm and suicide in adolescents. The Lancet Elsevier. 2012;379:2373–82.

    Article  Google Scholar 

  20. Conley CS, Kirsch AC, Dickson DA, Bryant FB. Negotiating the transition to college: developmental trajectories and gender differences in psychological functioning, cognitive-affective strategies, and social well-being. Emerg Adulthood. 2014;2:195–210.

    Article  Google Scholar 

  21. Keeling S. Advising the millennial generation NACADA Journal. 2003;23:30–6.

    Google Scholar 

  22. Syed M. Emerging adulthood. Arnett JJ, editor. Oxford University Press; 2015.

  23. McLafferty M, Lapsley CR, Ennis E, Armour C, Murphy S, Bunting BP, et al. Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland. PLoS One. 2017;12:1299–307.

    Article  Google Scholar 

  24. Limone P, Toto GA. Factors that predispose undergraduates to mental issues: a cumulative literature review for future research perspectives. Front Public Health. Frontiers Media S.A.; 2022;10:213.

  25. Campbell F, Blank L, Cantrell A, Baxter S, Blackmore C, Dixon J, et al. Factors That Influence Mental health of university and college students in the UK: a rapid review. 2022 [cited 2022 Sep 22]; Available from: https://europepmc.org/article/PPR/PPR491515.

  26. Li W, Dorstyn DS, Jarmon E. Identifying suicide risk among college students: a systematic review. [Internet]. Routledge; 2019 [cited 2022 Sep 20];44:450–8. Available from: https://www.tandfonline.com/doi/abs/10.1080/07481187.2019.1578305.

  27. Russell K, Allan S, Beattie L, Bohan J, MacMahon K, Rasmussen S. Sleep problem, suicide and self-harm in university students: a systematic review. Sleep Med Rev W.B. Saunders; 2019;44:58–69.

  28. Stein DJ. Is there a “mosquito net” for anxiety and mood disorders? Curr Psychiatry Rep. [Internet]. Curr Psychiatry Rep; 2009 [cited 2022 Oct 2];11:264–5. Available from: https://pubmed.ncbi.nlm.nih.gov/19635233/.

  29. Brewer ML, van Kessel G, Sanderson B, Naumann F, Lane M, Reubenson A, et al. Resilience in higher education students: a scoping review. [Internet]. Routledge; 2019 [cited 2022 Oct 2];38:1105–20. Available from: https://www.tandfonline.com/doi/abs/10.1080/07294360.2019.1626810.

  30. Bruffaerts R, Mortier P, Auerbach RP, Alonso J, Hermosillo De la Torre AE, Cuijpers P, et al. Lifetime and 12-month treatment for mental disorders and suicidal thoughts and behaviors among first year college students. Int J Methods Psychiatr Res. [Internet]. John Wiley & Sons, Ltd; 2019 [cited 2019 Feb 8];e1764. Available from: http://doi.wiley.com/10.1002/mpr.1764.

  31. • Dunley P, Papadopoulos A. Why is it so hard to get help? Barriers to help-seeking in postsecondary students struggling with mental health issues: A scoping review. Int J Ment Health Addict. 2019 Jun;17(3):699-715. Available from: https://link.springer.com/article/10.1007/s11469-018-0029-z. This scoping review provides key insights into the barriers students face to accessing mental health care.

  32. Lui JC, Sagar-Ouriaghli I, Brown JSL. Barriers and facilitators to help-seeking for common mental disorders among university students: a systematic review. [Internet]. Taylor & Francis; 2022 [cited 2022 Sep 23];1–9. Available from: https://www.tandfonline.com/doi/abs/10.1080/07448481.2022.2119859.

  33. Bantjes J, Saal W, Lochner C, Roos J, Auerbach RP, Mortier P, et al. Inequality and mental healthcare utilisation among first-year university students in South Africa. Int J Ment Health Syst. [Internet]. 2020;14:5. Available from: https://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-0339-y.

  34. Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. The Lancet. [Internet]. Elsevier; 2016 [cited 2022 Sep 21];387:2423–78. Available from: http://www.thelancet.com/article/S0140673616005791/fulltext.

  35. Chung WW, Hudziak JJ. The transitional age brain: “the best of times and the worst of times”. Child Adolesc Psychiatr Clin. 2017 Apr 1;26(2):157-75. Available from: http://www.childpsych.theclinics.com/article/S1056499316301304/fulltext.

  36. Duffy A, Saunders KEA, Malhi GS, Patten S, Cipriani A, McNevin SH, et al. Mental health care for university students: a way forward? Lancet Psychiatry. [Internet]. Elsevier Ltd; 2019 [cited 2022 Sep 21];6:885–7. Available from: http://www.thelancet.com/article/S2215036619302755/fulltext.

  37. •• Cuijpers P, Miguel C, Ciharova M, Aalten P, Batelaan N, Salemink E, Spinhoven P, Struijs S, de Wit L, Gentili C, Ebert D. Prevention and treatment of mental health and psychosocial problems in college students: An umbrella review of meta-analyses. Clin Psychol.: Sci Pract. 2021 Sep;28(3):229. Available from: https://doi.org/10.1037/cps0000030. This article provides a review of reviews examine interventions to prevent and treat common mental health problems among students.

  38. Gaiotto EMG, Trapé CA, Campos CMS, Fujimori E, de Almeida Carrer FC, Nichiata LYI, et al. Response to college students’ mental health needs: a rapid review. Rev Saude Publica. [Internet]. Faculdade de Saúde Pública da Universidade de São Paulo; 2022 [cited 2022 Sep 21];55. Available from: http://www.scielo.br/j/rsp/a/3g8cn4H3vvgcsCcm8GSdRRg/?format=html&lang=en.

  39. Ruzek JI, Brymer MJ, Jacobs AK, Layne CM, Vernberg EM, Watson PJ. Psychological First Aid J Ment Health Couns. [Internet]. Allen Press; 2007 [cited 2022 Sep 21];29:17–49. Available from: https://meridian.allenpress.com/jmhc/article/29/1/17/83350/Psychological-First-Aid.

  40. El-Den S, Moles R, Choong HJ, O’Reilly C. Mental health first aid training and assessment among university students: a systematic review. J Am Pharm Assoc. Elsevier; 2020;60:e81–95.

  41. Reis AC, Saheb R, Moyo T, Smith C, Sperandei S. The impact of mental health literacy training programs on the mental health literacy of university students: a systematic review. Prev Sci. [Internet]. Springer; 2022 [cited 2022 Sep 22];23:648–62. Available from: https://link.springer.com/article/10.1007/s11121-021-01283-y.

  42. Tay JL, Tay YF, Klainin-Yobas P. Effectiveness of information and communication technologies interventions to increase mental health literacy: a systematic review. Early Interv Psychiatry. [Internet]. John Wiley & Sons, Ltd; 2018 [cited 2022 Sep 22];12:1024–37. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/eip.12695.

  43. Worsley JD, Pennington A, Corcoran R. Supporting mental health and wellbeing of university and college students: a systematic review of review-level evidence of interventions. PLoS One. [Internet]. Public Library of Science; 2022 [cited 2022 Sep 21];17:e0266725. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266725.

  44. John NM, Page O, Martin SC, Whittaker P. Impact of peer support on student mental wellbeing: a systematic review. Med Ed Publish. F1000 Research Ltd; 2018;7:170.

  45. Ali K, Farrer L, Gulliver A, Griffiths KM. Online peer-to-peer support for young people with mental health problems: a systematic review. JMIR Ment Health. 2015;2(2):e19. [Internet]. JMIR Mental Health; 2015 [cited 2022 Oct 1];2:e4418. Available from: https://mental.jmir.org/2015/2/e19.

  46. Barnett P, Arundell LL, Saunders R, Matthews H, Pilling S. The efficacy of psychological interventions for the prevention and treatment of mental health disorders in university students: a systematic review and meta-analysis. J Affect Disord Elsevier. 2021;280:381–406.

    Article  Google Scholar 

  47. Stein DJ, Hartford A. Health-policy approaches for problematic Internet use: lessons from substance use disorders. Curr Opin Behav Sci. Elsevier; 2022;46:101151.

  48. Bhat S. Effects of social media on mental health: a review. Article in Int J Indian Psychol. [Internet]. 2016 [cited 2022 Oct 3]; Available from: http://www.ijip.in.

  49. Sharma MK, John N, Sahu M. Influence of social media on mental health: a systematic review. Curr Opin Psychiatry. [Internet]. Lippincott Williams and Wilkins; 2020 [cited 2022 Oct 3];33:467–75. Available from: https://journals.lww.com/co-psychiatry/Fulltext/2020/09000/Influence_of_social_media_on_mental_health__a.7.aspx.

  50. Lattie EG, Lipson SK, Eisenberg D. Technology and college student mental health: challenges and opportunities. Front Psychiatry. 2019 Apr 15;10:246.

  51. Hadler NL, Bu P, Winkler A, Alexander AW. College student perspectives of telemental health: a review of the recent literature. Curr Psychiatry Rep. 2021 23:2. [Internet]. Springer; 2021 [cited 2022 Sep 22];23:1–8. Available from: https://link.springer.com/article/10.1007/s11920-020-01215-7.

  52. •• Lattie EG, Adkins EC, Winquist N, Stiles-Shields C, Wafford QE, Graham AK. Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: systematic review. J Med Internet Res. 2019;21(7):e12869. [Internet]. Available from: https://www.jmir.org/2019/7/e12869. This article provides a systematic review of the use of technology to treat common student mental health problems.

  53. Melcher J, Hays R, Torous J. Digital phenotyping for mental health of college students: a clinical review. Evid Based Ment Health. 2020 Nov 1;23(4):161-6. Available from: https://ebmh.bmj.com/content/23/4/161.

  54. Barbosa NS, Veloso LUP, Ferraz MMM, Monteiro CF de S, de Carvalho KG, Lima AC de BS. Interventions for the prevention of suicidal behavior in colleges: integrative review / Intervenções para prevenção do comportamento suicida em universitários: revisão integrativa. Revista de Pesquisa Cuidado é Fundamental Online. Universidade Federal do Estado do Rio de Janeiro UNIRIO; 2021;13:1193–8.

  55. Breet E, Matooane M, Tomlinson M, Bantjes J. Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice. BMC Public Health. [Internet]. 2021;21:1116. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11124-w.

  56. Cecchin HFG, Murta SG, de Macedo EOS, Moore RA. Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness. Psicol Reflex Crit. [Internet]. Springer; 2022 [cited 2022 Sep 21];35. Available from: /pmc/articles/PMC9294115/.

  57. Wolitzky-Taylor K, LeBeau RT, Perez M, Gong-Guy E, Fong T. Suicide prevention on college campuses: what works and what are the existing gaps? A systematic review and meta-analysis. [Internet]. Taylor & Francis; 2019 [cited 2022 Sep 20];68:419–29. Available from: https://www.tandfonline.com/doi/abs/10.1080/07448481.2019.1577861.

  58. Bowersox NW, Jagusch J, Garlick J, Chen JI, Pfeiffer PN. Peer-based interventions targeting suicide prevention: a scoping review. Am J Community Psychol. [Internet]. John Wiley & Sons, Ltd; 2021 [cited 2022 Sep 23];68:232–48. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/ajcp.12510.

  59. Khadijah S, Hanik EN. A Systematic Review of Early Intervention for Suicide Prevention among College Students. Int J Psychosocial Rehab. 2020;24(7):9226-32. Available from: https://www.psychosocial.com/article/PR270918/19319/.

  60. Braciszewski JM. Digital Technology for Suicide Prevention. Adv Psychiatry Behav Health. 2021 Sep 1;1(1):53-65.

  61. Conrad R. Legal and ethical challenges in the psychiatric treatment of college students. Curr Psychiatry Rep. 2020 22:9. [Internet]. Springer; 2020 [cited 2022 Sep 21];22:1–4. Available from: https://link.springer.com/article/10.1007/s11920-020-01168-x.

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Funding

The work reported herein was made possible through funding by the South African Medical Research Council (SAMRC) through its Division of Research Capacity Development under the MCSP (awarded to Jason Bantjes and Xanthe Hunt). This research was also funded by the SAMRC Unit on Risk & Resilience in Mental Disorders. The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the SAMRC.

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Correspondence to Dan J. Stein.

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Bantjes, J., Hunt, X. & Stein, D.J. Public Health Approaches to Promoting University Students’ Mental Health: A Global Perspective. Curr Psychiatry Rep 24, 809–818 (2022). https://doi.org/10.1007/s11920-022-01387-4

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