The mental health of university students in South Africa: Results of the national student survey

Background: We estimate 30-day prevalence of 11 common mental disorders among a representative sample of university students in South Africa and explore disparities in student mental health across historically segregated institutions and marginalised groups. Methods: Cross-sectional data collected in self-report surveys of students (n = 28,268) from 17 universities were weighted to adjust for differences in survey responses. Poisson regression was used to estimate risk ratios (RRs). Results: Prevalence estimates were highest (21.0-24.5 %) for two anxiety disorders (social anxiety disorder, PTSD) and two disruptive behavior disorders (eating disorder, ADHD). Prevalence estimates were higher for any anxiety disorder (37.1 %) and any disruptive behavior disorder (38.7 %) than for any mood disorder (16.3 %) or any substance use disorder (6.6 %). Prevalence estimates varied significantly by historical segregation status of institutions (F3 = 221.6, p < .001), with prevalence consistently highest in Historically White Institutions (HWIs). Across all institutions, risk of any disorder was lower among oldest than younger students (RR = 0.7, 95%CI = 0.7-0.8), and elevated among gender non-conforming (RR = 1.3, 95%CI = 1.1-1.4), female (RR = 1.2, 95%CI = 1.1-1.2), and sexual minority (RR = 1.2, 95%CI = 1.2-1.3) students. Black students attending HWIs had elevated risk of any disorder relative to White students. Limitations: Reliance on self-report measures together with relatively low and variable response rates across institutions limit generalizability of results. Conclusions: Modest risks associated with sociodemographic factors suggest a need to focus on mental health of female, gender nonconforming and sexual minority students at all universities along with Black students attending HWIs.

Automated summary

This study estimated the 30-day prevalence of 11 common mental disorders among university students in South Africa and found disparities in student mental health across historically segregated institutions and marginalized groups. Anxiety disorders and disruptive behavior disorders had the highest prevalence rates. Sociodemographic factors such as age, gender, gender non-conforming identity, and race significantly influenced the risk of mental disorders.