Even before the pandemic, university students were at high risk of developing mental health problems. Transitioning to adulthood is already a period of heightened vulnerability, and for students, this can be combined with added stressors such as living away from home, financial hardship and changing social relationships.
The COVID pandemic enforced massive and rapid changes in the way we lived our lives. For university students, campuses closed down, courses shifted online, exams were cancelled, part-time jobs in the hospitality sector disappeared, and socialising was highly restricted.
Some students found themselves unable to return home due to travel restrictions, and many were living in accommodation that wasn’t suited to studying online. As the pandemic restrictions continued, concerns increased about the longer-term effects on job prospects.
In this context, Rosie Allen and colleagues at the University of Bolton sought to investigate the mental health effects of the pandemic on UK university students over time. To do this, they asked students to complete online questionnaires about psychological distress, general anxiety and “flourishing” (an aspect of wellbeing: specifically, thriving and feeling satisfied with one’s life) four times between May 2020 and May 2021.
They found that on average across the students who took part for the duration of the study (554 students, mostly female), psychological distress increased during the first six months of the study.
Anxiety was highest at the beginning (May 2020), and somewhat lower one year later (May 2021). It’s worth bearing in mind that for most students, May is likely to be a period of heightened anxiety as it tends to be when exams and other significant assessments take place. Anxiety was lowest in July 2020 – probably because this was during the summer holiday and soon after initial pandemic restrictions were eased.
Flourishing declined over the course of the whole year.
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These results suggest, as the authors conclude, that the pandemic has had a negative and ongoing effect on wellbeing among UK university students. This is generally consistent with other studies in the UK and elsewhere. However, it’s important to consider that the study has a number of limitations, which the authors acknowledge.
First, the students who took part were recruited through Prolific, an online research platform which people can sign up to and get paid to participate in studies. Researchers can use the platform to recruit registered users to take part in their studies.
In this study, university students on Prolific were offered a small financial incentive to take part (£1.25 per time point). This is called a convenience sample, and means the participants may not be representative of the general population of students. So the extent to which we can assume these findings apply nationally is limited.
Second, we don’t know very much about the students who took part. Age is reported and so is “gender” (male or female only) – but not important contextual variables such as level of study (for example, undergraduate or postgraduate), socioeconomic status, gender identity, sexual orientation, ethnicity, and so on. Given that certain groups are disproportionately vulnerable to mental health problems, it’s important to take these factors into account in making sense of the findings.
Third, many students who took part in the study in May 2020 had stopped completing the questionnaires by May 2021, with only one-third of the original sample staying the course. Notably, male students were more likely to drop out, so most participants who were recruited and retained in this study were female.
Finally, and perhaps most importantly for the conclusions drawn, this study was initiated once pandemic restrictions were in place. Without knowing about the participants’ mental health before COVID, we can’t be sure whether the pandemic caused a deterioration in their mental health.
The authors do make comparisons with average pre-pandemic scores in psychological distress, anxiety and flourishing from other research, but this isn’t as strong as comparing the same participants’ scores before and during the pandemic.
However, other UK university student studies which did include pre-pandemic data have also reported decreases in wellbeing and increases in distress.
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Allen and her colleagues looked at average scores across the participants, rather than at changes within individuals over time. But we know the experience of the pandemic was not the same for everyone.
For instance, another study showed that postgraduate students who were younger, female, had caring responsibilities and were shielding tended to have more severe symptoms of depression and anxiety. This highlights the importance of considering individual circumstances, and the need to go beyond aggregate trends, to understand who is more vulnerable and in what ways.
Mental health problems are associated with a range of negative outcomes. For university students, these include lower grades and higher dropout rates.
This study, consistent with many others, reminds us that university students are a particularly vulnerable group. We need to make sure there is a range of mental health help on offer, that students know about this, and that help is available when they seek it, rather than having to wait.
We also need to think about systemic solutions, and how we can create mentally healthy universities in which students can flourish. How can we ease the financial burden they face? How can we manage the academic pressure? We need to work with students to design solutions that work for them.
Dr Maria Loades (Advanced Fellowship, 302929) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.