Changes in mental health across the COVID-19 pandemic for local and international university students in Australia: a cohort study

Abstract

Purpose Previous research has indicated that university students experienced substantial mental health issues during the global COVID-19 pandemic, but few studies have considered changes relative to pre-pandemic levels across population groups. Hence, the aim of this study was to compare changes in mental health and associated stressors across the pandemic for international and local university students studying in Australia. Methods In a cohort of 4407 university students, we assessed depression (Patient Health Questionnaire 2), anxiety (Generalized Anxiety Disorder-2), social support (Medical Outcomes Study—Social Support Survey), inability to afford food, fear of partner, and experiences of discrimination, both pre-pandemic (April–May 2019) and during the pandemic (September–October 2020). Change in prevalence between local and international students were estimated with logistic regression, adjusting for baseline factors. Results Compared to local students, international students experienced an increase in probable major depression (odds ratio (OR) 1.43, 95% Confidence Interval (CI) 1.23, 1.66), low social support (OR 2.63, 95% CI 2.23, 3.11), inability to afford food (OR 5.21, 95% CI 3.97, 6.83) race-based discrimination (OR 2.21, 95% CI 1.82, 2.68) and fear of partner (OR 3.46, 95% CI 2.26, 5.13). Interaction analyses indicated that these issues were more likely to be experienced by students living outside their country of origin, inclusive of international students based in Australia (depression p value interaction term 0.02). Conclusion The pandemic had a substantial negative impact on international students, particularly those living outside of their country of origin during the pandemic. The inequalities exacerbated by the pandemic were present prior to the pandemic and are likely to continue post-pandemic without action. Interventions to build the supports for international students need to be urgently explored.

International and domestic university students’ mental health over the course of the COVID-19 pandemic in Germany: Comparison between 2020, 2021, and 2022

“…This was not surprising when considering that international students leave their families and social support systems behind when moving to the host country [ 11 ]. Lower social support among international students in our sample is consistent with previous findings [ 29 , 36 – 38 ]. Moreover, language barriers, lack of knowledge of the host country’s health care system, and stigma associated with mental health services may hinder help-seeking [ 39 ].…”

“…Regardless of the timepoint, international students presented more depressive symptoms and perceived stress, lower perceived social support and resilience, but higher levels of self-efficacy compared to domestic students. These results corroborate previous findings indicating that while domestic students had their mental health worsened by the COVID-19 pandemic, international students were less affected as they had already poorer mental health outcomes from the beginning [ 11 , 29 ]. Among international students, mean scores of depressive symptoms reflected clinically relevant depressive symptoms for all timepoints, whereas domestic students presented a mean score indicating clinically relevant depressive symptoms only in 2021.…”

“…Despite the common-shared burdens of the COVID-19 pandemic that domestic and international students faced, international students presented overall poorer mental health outcomes compared to domestic students. For example, in Australia, international students reported race-based discrimination during the COVID-19 pandemic [ 29 ]. Concerns about visa status and consequent disruption of studies were reported by international students in the US [ 42 ].…”

Building a Multi-layered Support System for Students in Psychological Distress: Insights from Indonesian Faculty Members

“…Although our data was collected prior to the pandemic and we are now in the post-pandemic era, this issue remains pertinent. Several studies have indicated a decline in student well-being post-pandemic, especially among economically disadvantaged students even before the pandemic (Paton et al, 2023), as well as international students or those who had to live apart from their families during lockdown (Russell et al, 2023). In other words, the role of educational institutions in ensuring a smooth recovery and readjustment to university life may be even more critical at present.…”

Psychometric properties of a new instrument for the measurement of the perceived quality of distance learning during the coronavirus disease 2019 (COVID-19) pandemic

“…Although numerous studies have been conducted on the psychological impact of the COVID-19 pandemic on university students, only a small number of them have specifically investigated the psychological effects resulting from the mandatory use of DL during the COVID-19 lockdown ( Cao et al, 2020 ; Irawan et al, 2020 ; Russell et al, 2023 ).…”