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Tertiary education students experience higher levels of distress and mental disorder than both the general population and their age matched peers, requiring targeted mental health support.
In high income nations, mental health problems are the greatest health challenges faced by younger people. This is because medical health problems tend to affect people more as they age (here), whereas most mental health problems start by age 25 years (here). In Australia, suicide was the most common cause of death for people aged 15–44 years for the period 2019–2021 (here). Data for 2022 from the Australian Bureau of Statistics are still being finalised, but early indications suggest that the rate of suicide in Australia climbed by around 2.5% compared with 2021 (here).
Aside from suicide-related mortality, mental health problems are also associated with longer term reduced functioning and quality of life, including educational attainment, social and familial relationships, workplace productivity and career outcomes, physical health, and life expectancy (here). Mental disorders are responsible for 25% of the global burden of disease (here) and are projected to cost US$6 trillion annually by the year 2030 (here).
The challenges facing tertiary students
As a group, tertiary education students experience higher levels of distress and mental disorder than both the general population (here) and their age matched peers not attending university (here). Tertiary education students face unique stressors compared to non-students, including increased academic demands, changed living arrangements and potential financial stressors from relocating to begin their studies, formation of new social connections, and adjusting to new roles in their family and society (here).
Along with suicide-related mortality, mental health problems in tertiary students are associated with reduced tertiary student academic achievement and greater student drop-out rates (here), resulting in wasted resources. This wastage contributes to the economic costs of poor mental health for tertiary students and society.
Studies have demonstrated that the coronavirus disease 2019 (COVID-19) pandemic has increased the levels of mental distress and disorder in the general population (here and here) as well as in tertiary students (here). Our study published in the Journal of Clinical Psychology (here) also found that levels of distress in Australian tertiary students was higher during the pandemic than before the pandemic.
The need for prevention
The high levels of mental disorder across both general and tertiary student populations suggest that Australia’s mental health system is not able to adequately meet the needs of the population. Greater emphasis needs to be placed on preventive measures that will help individuals stay healthy rather than treating people once they are unwell. This strategy is already incorporated into medical health models but has not seen wide implementation with mental health policy.
It is not difficult to imagine that rates of heart disease- and lung cancer-related deaths in Australia would be much higher if not for public health campaigns aimed at combating these problems. Given that young people also pay tax, or will do once they finish their studies, it seems fair that public health campaigns should aim to manage the health issues affecting them.
Although mental health issues are under-researched compared with medical health problems (here), it has been shown that the majority of anxiety and depressive disorders begin after a period of subclinical distress and develop into serious mental illness over time (here and here) in the same way that many serious medical health problems develop. This indicates that effective preventive mental health campaigns should help to relieve the high rates of mental disorder associated with the COVID-19 pandemic (here) as well as future disasters.
The Resilience Portfolio Model
A potentially useful framework for addressing mental health challenges comes in the form of the Resilience Portfolio Model (here). This intuitive model states that individuals can improve their overall level of mental health by performing practices that reduce stress and improve wellbeing. This model is based on previous research that found that stressors have a cumulative effect on mental health (here). The Resilience Portfolio Model extends this idea by stating that mental health depends not only on the stressors being faced by the individual but also on the resources that are available to them and the behaviours employed by the individual.
Our systematic review of mental health interventions conducted with tertiary students (here) used the Resilience Portfolio Model to identify practices that improve the mental health of tertiary students after stressful events. It found that paying attention to the present moment, engaging in personally meaningful and enjoyable activities, positive relations with others, exercise, humour, and acceptance of difficult circumstances were effective for relieving negative mental health symptoms. However, this is not an exhaustive list and efforts to uncover more of these factors are ongoing.
In terms of implementation, health interventions aiming to improve the mental health of tertiary students could use the practices listed above. Rather than involving demographic or systemic factors over which individuals have little control, these interventions are behaviours that individuals can employ themselves. The interventions themselves are cost-effective to employ, with arguably the biggest cost being that of paying health professionals to dispense the information to students. However, given that preventive mental health campaigns save money by reducing the need for clinical services in both tertiary students (here) and the general population (here), implementing these strategies with tertiary students would likely save money for both individuals and public institutions in the longer term.
David Tuck is a research assistant at Monash University’s Faculty of Medicine, Nursing and Health Sciences.
If this article has caused you or someone you know distress, please contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 46 36.
Further resources for medical practitioners who need support:
Doctors’ Health in Queensland: https://dhq.org.au/
Doctors’ Health New South Wales: https://doctorshealth.org.au/
Victorian Doctors’ Health Program: https://vdhp.org.au/
Doctors’ Health Advisory Service Western Australia: https://www.dhaswa.com.au/
Doctors’ Health South Australia: https://doctorshealthsa.com.au/
Drs4Drs Tasmania: https://www.ama.com.au/drs4drs/tas
Drs4Drs ACT: https://www.ama.com.au/drs4drs/act
Doctors’ Health Northern Territory: https://doctorshealthnt.com.au/confidential-support
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