Mental Disorders among university students in Australia: web-based cross-sectional survey

Purpose: To identify variables associated with common mental disorders in an Australian university population. Background: A systematic literature review was conducted to identify research on prevalence and risk factors associated with depression, anxiety, eating and alcohol disorders in university students. The review identified 1200 studies of which 36 met our inclusion criteria. Depression and anxiety disorders were identified as the most prevalent disorders in this group. The main risk factors reported for student mental disorders were: being a woman, being homosexual or bisexual, growing up in a family with low socio-economic status, current financial difficulty and being a man for alcohol disorders. Methods: We invited all Australian based students from a large public university (N=24,209) to participate in a web-based Student Mental Health Survey. Outcome measures included the Primary Health Questionnaire depression, anxiety, and eating disorders modules, and the Alcohol Use Disorders Identification Test. Explanatory variables of interest included gender, age, year of study, degree type, financial means, parental education, domestic/international status and sexual orientation. Multiple logistic regression analysis was used to estimate independent associations with the four outcomes. Results: Complete responses were received from 6044 students (25%). Proportions reporting depression, anxiety, eating disorders and harmful drinking were 8%, 13%, 14% and 8% respectively, while 30% had at least one of these disorders. The groups with the highest rates of disorder were women, 25–34 year olds, students on low income, and homosexual or bisexual students. Parental education was not associated with disorder, and nor was an international/domestic status. Conclusions: This is the first study examining mental disorders in a population-based university sample in Australia. Groups in particular need are women, students on low incomes and homosexual or bisexual students. Given increasing student numbers and participation of students from lower socio-economic backgrounds, policy is urgently needed to promote better mental health in the population, to routinely identify vulnerable students, and to intervene early. A national longitudinal study examining mental health across multiple institutions with oversampling of high risk groups is recommended based on the findings and limitations of this study. There is also need for further research and development of electronic programs which are cost-effective and preventative in nature, as a first response in a stepped care approach to mental health on campuses.