Financial and sleeping difficulties are key mental health risk indicators in university students

The findings will be valuable to higher education institutions in identifying those students at higher risk of developing mental health issues, and will help to inform policies and interventions aimed at preventing these issues.

The study, published today (26 July) in the journal BJPsychOpen, is based on a survey of 895 university students and 547 young adults who were not in higher education taken between July and September 2020, with 201 of those university students also followed-up after 6 months. The research was funded by the University of Warwick's Pro-Vice Chancellor (Research) COVID Research Programme Award and supported by the Warwick Health Global Research Priorities.

Analysis of their responses showed several consistent factors linked to high levels of poor mental health at the end of the first lockdown in the UK: age, previous mental health conditions, carer status, worse-off financial status and increased sleep irregularity and difficulty.

When they compared the responses of university students to those from non-students of a similar age, there were no significant differences between the two groups in mental health symptoms, except for a higher substance misuse risk found in non-students.

When recontacting a subset of students who responded between January -- March 2021, the researchers found that increased financial difficulties and difficulty sleeping would consistently predict poorer mental health. They also found that there was a reduction in mental health symptoms over time, with the percentage of students reporting symptoms of anxiety reduced from 72.1% to 59.3% over six months, and for depression it was reduced from 69.8% to 61.4%. The researchers suggest that this could be due to students adapting to some symptoms as the pandemic evolved, though some symptoms were more ingrained.

The demographic profile of the study participants is comparable to the profile of the student population in the UK, suggesting that the findings would be of use to universities across the country.

Intervention and prevention measures available for each group may be applied to both populations for greater generalisability.

Lead author Professor Nicole Tang, from the University's Department of Psychology and Co-Lead of the University Health GRP Mental Health theme, said: "There is a wealth of information generated by this study that universities can utilise to inform policies, prevention and intervention strategies. Whilst there are markers of mental health issues that we cannot change, for example, age, a history of mental health conditions, and being a carer, we can use them to identify individuals at risk and provide enhanced support.

"Some of the indicators of future mental health issues are things that we can act on, for example, a worsened financial situation, reduced physical activity and increased sleep difficulties. Within the university system, there are established bursary programmes and infrastructure for promoting sports and activities. There are also proven-effective treatments on acute and chronic insomnia that can be applied to help students better regulate their sleep, in the midst of overwhelming stress and a loss of normal routine.

"What is also interesting is that the study shows mental health is a multidimensional concept, and can be seen as a profile of different symptoms, which appear to respond to the pandemic experience differently."

Dr Hannah Friend, Director of Wellbeing and Safeguarding at the University of Warwick, said: "Research is a critical component of Warwick's Wellbeing Strategy. This study reinforces the importance of utilising our research expertise to better inform what we do, and specifically to further define our priorities and objectives on Prevention and Early Intervention. I'm delighted that we are successfully joining up research and practice in a whole organisation approach to wellbeing."

Dr Elaine Lockhart, Chair of the Royal College of Psychiatrists Faculty of Child and Adolescent Psychiatry, said: "While this research highlights the current pressures facing students' wellbeing and mental health, it also highlights the need for continued support to mental health services in and outside university settings. However, those who develop more acute mental health problems must be able to access specialist services for diagnosis and evidence-based treatment. With life returning to some degree of normality, students still face the worry of the pandemic and its economic consequences."