Effects of COVID-19 on College Students’ Mental Health in the United States: Interview and Survey Studies
TimeFriday, April 1612:30pm - 12:50pm EDT
LocationPatient Safety Research and Initiatives
Keywords: COVID-19; pandemic; college student; mental health; stress; anxiety; self-management
The COVID-19 pandemic has had a negative impact on mental health on a massive scale. Whether through confinement, reducing access to resources, changes in finances, or death of friends and family. However, not all sectors of the population will be affected the same, so it is important to investigate the impact on already vulnerable populations, especially in this period of isolation.
College students are one of these vulnerable populations. About 1 in 3 college students screen for at least one mental health problem (Auerbach et al., 2018). Suicide is the second most frequent cause of death for this group (Oswalt et al., 2018) but only 1 in 5 students who commit suicide ever contacted their institutions counseling services (Shuchman, 2007). It is important to understand the specific challenges these students face, the impact on their mental health, and how they are adapting, to inform policy.
Two studies were carried out. One consisted of virtual semi structured interviews and the other a survey emailed to all students. 195 students were interviewed to understand the pandemic’s impact on their mental health and wellbeing. An email invitation and link were sent to undergraduate and graduate students at Texas A&M University to complete the COVID-19 survey, 2031 students completed the survey. Frequencies and percentages were reported for all items, thematic analysis was used for qualitative data.
195 students participated in one-on-one semi structured interviews via zoom. The interview consisted of the following…
1. Orally administration of 10 item perceived stress scale (PSS-10)
Example Item: “In the past month, how often have you felt upset because of something that happened unexpectedly?”
2. Inquiry to overall change in their mental health
a. Example Item: “Did your overall stress or anxiety, increase, decrease or remain the same after the ongoing pandemic?”
3. Follow-up questions based on their response.
Example Probe: “Can you elaborate as to why it increased?”
4. Questions about specific changes
a. Example question: “Have there been any changes to your sleeping patterns?”
b. Example participant response: “Yes”
c. Example Probe: “How severe on a scale of 0 to 3, 0 being none, 1 being mild, 2 being moderate, and 3 being severe”
d. Example participant response: “Three!”
e. Example Probe: “Can you elaborate on that?”
f. Example Participant Response: “Because right now I'm back in Thailand and because of the time zone differences and one of my classes requiring me to attend a zoom session and that means I have to wake up at 2am to attend to class during my sleep time”
Invitation and link to complete the survey was distributed to all students and consisted of the following…
1. PHQ-9 & GAD-7 assessments for assessing depression and anxiety symptomology, respectively.
a. Example Prompt: “Over the last 2 weeks, how often have you been bothered by any of the following problems? (response: Not at all, Several days, More than half the days, or Nearly everyday)”
i. Feeling nervous, anxious, or on edge.
ii. Not being able to stop or control worrying.
2. Multiple-choice questions regarding stress and stressors across academic, health, and living and lifestyle categories.
a. Example Prompt: “In the past month, what level of fear, worry, and/or changes have you experienced related to any of the following? (response: None, Mild, Moderate, or Severe)”
b. Example Category: Academic Related
i. Example Question: “In the past month, what level of fear, worry, and/or changes have you experienced related to academics? (response: none/mild/moderate/severe)
3. Multiple-choice and open-ended questions regarding coping mechanisms
a. Example multiple-choice question: “Have you been using any mobile applications or features on existing apps for managing stress, anxiety, or depression related to the ongoing COVID-19 pandemic? (response: yes or no)” ○
b. Example open-ended question: “If yes, please mention the app(s) in the space below”
Of the 195 students, 138 (71%) indicated increased stress and anxiety due to the COVID-19 outbreak. Multiple stressors were identified that contributed to the increased levels of stress, anxiety, and depressive thoughts among students. These included fear and worry about their own health and that of their loved ones (177/195, 91% reported negative impacts of the pandemic), difficulty in concentrating (173/195, 89%), disruptions to sleeping patterns (168/195, 86%), decreased social interactions due to physical distancing (167/195, 86%), and increased concerns on academic performance (159/195, 82%). To cope with stress and anxiety, participants have sought support from others and helped themselves by adopting either negative or positive coping mechanisms.
Among the 2031 participants, 960 (48.14%) showed a moderate-to-severe level of depression, 775 (38.48%) showed a moderate-to-severe level of anxiety, and 336 (18.04%) had suicidal thoughts. Most participants indicated that their stress/anxiety levels had increased during the pandemic. Less than half of the participants (43.25%) indicated that they were able to cope adequately with the stress related to the current situation.
College students are struggling. There was high prevalence of stress, depression, and anxiety symptoms. Students identified a myriad of stressors dealing with academic performance, financial security, social relationships, and health. Most students did not feel they were able to adequately cope with the situation, many adopting maladaptive coping techniques. These findings highlight the urgent need to develop interventions and preventive strategies to address the mental health of college students.