Towards a health promoting university: descriptive findings on health, wellbeing and academic performance amongst university students in Australia

Abstract

Background: Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental health of university students and other factors which affect academic outcomes particularly for subgroups such as international students. There are few cohort studies of the breadth of issues that can impact on mental health and academic outcomes for both local and international students. We conducted a baseline prevalence survey of students at a large Australian university covering health, academic, and social determinants of wellbeing. The purpose was to inform the university’s new student health and wellbeing framework with a view to follow-up to determine predictors on mental ill-health and academic outcomes in the subsequent year. In this paper we present the baseline prevalence data and report on selected mental health and health care access issues for local and international students. Methods: The entire university population as of April 2019 of over 56,375 students aged 18 or above were invited to complete the online survey. Questions explored eight domains: demographic characteristics, general health and wellbeing, mental health, risk taking behaviours, psychosocial stressors, learning and academic factors, social and cultural environment, and awareness of and access to health and wellbeing services. Records of academic results were also accessed and matched with survey data for a large subset of students providing consent. Results: 14,880 (26.4%) students commenced our survey and were representative of the entire student population on demographic characteristics. Three quarters were aged between 18 to 25 years and one third were international students. Eighty-five percent consented to access their academic records. Similar proportions of local and international students experienced symptoms of a depression or anxiety disorder, however international students were less aware of and less likely to access available health services both inside and external to the university. We also reported on the prevalence of: general lifestyle factors (diet, exercise, amount of daily sleep); risk-taking behaviours (including alcohol, tobacco and other drug use; unprotected sexual activity); psychosocial stressors (financial, intimate partner violence, discrimination, academic stressors, acculturative stress); subjects failed; resilience; social supports; social media use; and health services accessed online. Conclusions: This rigorous and comprehensive examination of the health status of local and international students in a university student population establishes the prevalence of mental health issues and other psychosocial determinants of health and wellbeing, along with academic performance. This study will inform a university-wide student wellbeing framework to guide health and wellbeing promotion and is a baseline for a 12-month follow-up of the cohort.

Characteristics and clinical needs of young tertiary students attending a specialist mood disorders clinic

“…Our findings converge with those of Sanci et al, 6 who found that the proportion of tertiary students reporting severe or moderately severe depression (as indicated by PHQ-9 cut-offs) was higher than among young people in the general population. There may be several reasons as to why tertiary students in this cohort experienced poorer mental health.…”

“…Students experiencing high academic pressure are more likely to report depression and/or anxiety symptoms, while students with poor mental health are more likely to fail subjects, receive lower grades, and discontinue their studies. 6 Respondents to the 2016 Australian National Tertiary Student Wellbeing Survey 8 reported that anxiety, low mood, and feelings of hopelessness impacted their studies to the extent that they were unable to function on some days.…”

“…5 Australian tertiary students aged 15-24 years are more likely to report severe or moderately severe depressive symptoms than non-students in the same agegroup, such that approximately one-third of students enrolled at a large Australian university reported at least moderate depressive symptoms. 6 There are several aspects of tertiary student life that could increase the risk of mental ill-health in young people, such as academic pressure and workload, 7 financial stress, work commitments, transitioning to student life and living away from family for the first time. 1 The available evidence suggests that the relationship between mental ill-health and study outcomes is bidirectional.…”

“…1 The available evidence suggests that the relationship between mental ill-health and study outcomes is bidirectional. 6 That is, the stressors of tertiary study likely increase the risk of poor mental health, while poor mental health makes it harder to effectively respond to these stressors. Students experiencing high academic pressure are more likely to report depression and/or anxiety symptoms, while students with poor mental health are more likely to fail subjects, receive lower grades, and discontinue their studies.…”

“…While previous research has studied the mental health of the broader student population, 6,8,10 tertiary students engaging with the mental health system may have unique challenges and needs that are not captured by surveys, given the relatively unique profile of young people with severe mental health needs. 11 This study examines the characteristics and clinical needs of tertiary students attending a specialist youth mood disorder clinic: the Youth Mood Clinic (YMC).…”