COVID-19 and common mental disorders among university students in South Africa

Jason Bantjes; Sonja Swanevelder; Esme Jordaan; Nancy A. Sampson; Maria V. Petukhova; Christine  Lochner; Dan J.  Stein; Ronald C. Kessler

doi:10.17159/sajs.2023/13594

Authors

Jason Bantjes 1.Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; 2.Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa https://orcid.org/0000-0002-3626-9883
Sonja Swanevelder Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa https://orcid.org/0000-0003-0885-3190
Esme Jordaan Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa https://orcid.org/0000-0002-0361-3473
Nancy A. Sampson Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Maria V. Petukhova Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Christine Lochner SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa https://orcid.org/0000-0002-4766-3704
Dan J. Stein 1.SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa; 2.Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa https://orcid.org/0000-0001-7218-7810
Ronald C. Kessler Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA

DOI:

https://doi.org/10.17159/sajs.2023/13594

Keywords:

COVID-19, university students, South Africa, depression, anxiety, suicidal ideation

Abstract

COVID-19 has had far-reaching economic, social and health consequences, with vulnerable groups disproportionally affected. Even before the COVID-19 pandemic, concern was expressed about university students’ mental health, with global data suggesting students are more vulnerable than the general population to mental disorders. Yet, it is unclear what the pandemic’s impact has been on the mental health of students in South Africa. We examined the impact of COVID-19 on first-year students at two universities in South Africa by analysing changes in the prevalence and age-of-onset of three common mental disorders (namely major depressive episode, generalised anxiety disorder, and suicidal ideation) before and during the pandemic, and comparing these to changes between 2015 and 2017. Our analysis of cross-sectional survey data collected in 2015, 2017 and 2020 shows no clear or consistent pattern of increases in prevalence of common mental disorders following the start of the pandemic. Lifetime prevalence rates of common mental disorders among students have been steadily increasing since 2015, and where increases before and during COVID-19 were observed, they are not consistently larger than increases between 2015 and 2020. No significant changes were observed in the 12-month prevalence of common mental disorders before and during COVID-19, except for an increase in prevalence of depression at one institution, and a decrease in suicidal ideation at the other. Findings suggest that in the context of ongoing adversity and disruptions on South African university campuses in recent years, COVID-19 may be just one more stressor local students face and that its impact on student mental health may not have been as marked in South Africa compared to other regions.

Significance:

This study is the first to explore COVID-19’s impact on university students’ mental health in South Africa, using data collected before and during the pandemic.
High rates of psychopathology confirm the need for sustainable campus-based interventions to support student well-being.
Rates of mental disorders among students have been increasing since 2015, and increases observed in 2020 were no larger than those observed in prior years.
In the context of disruptions on university campuses in recent years, COVID-19 is just one more stressor for students, and its impact may not have been as marked in South Africa compared to other regions.