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.