depression in college students research paper

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An Exploratory Study of Students with Depression in Undergraduate Research Experiences

• Katelyn M. Cooper
• Logan E. Gin
• M. Elizabeth Barnes
• Sara E. Brownell

*Address correspondence to: Katelyn M. Cooper ( E-mail Address: [email protected] ).

Department of Biology, University of Central Florida, Orlando, FL, 32816

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Biology Education Research Lab, Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ 85281

Depression is a top mental health concern among undergraduates and has been shown to disproportionately affect individuals who are underserved and underrepresented in science. As we aim to create a more inclusive scientific community, we argue that we need to examine the relationship between depression and scientific research. While studies have identified aspects of research that affect graduate student depression, we know of no studies that have explored the relationship between depression and undergraduate research. In this study, we sought to understand how undergraduates’ symptoms of depression affect their research experiences and how research affects undergraduates’ feelings of depression. We interviewed 35 undergraduate researchers majoring in the life sciences from 12 research-intensive public universities across the United States who identify with having depression. Using inductive and deductive coding, we identified that students’ depression affected their motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing in undergraduate research experiences. We found that students’ social connections, experiencing failure in research, getting help, receiving feedback, and the demands of research affected students’ depression. Based on this work, we articulate an initial set of evidence-based recommendations for research mentors to consider in promoting an inclusive research experience for students with depression.

INTRODUCTION

Depression is described as a common and serious mood disorder that results in persistent feelings of sadness and hopelessness, as well as a loss of interest in activities that one once enjoyed ( American Psychiatric Association [APA], 2013 ). Additional symptoms of depression include weight changes, difficulty sleeping, loss of energy, difficulty thinking or concentrating, feelings of worthlessness or excessive guilt, and suicidality ( APA, 2013 ). While depression results from a complex interaction of psychological, social, and biological factors ( World Health Organization, 2018 ), studies have shown that increased stress caused by college can be a significant contributor to student depression ( Dyson and Renk, 2006 ).

Depression is one of the top undergraduate mental health concerns, and the rate of depression among undergraduates continues to rise ( Center for Collegiate Mental Health, 2017 ). While we cannot discern whether these increasing rates of depression are due to increased awareness or increased incidence, it is clear that is a serious problem on college campuses. The percent of U.S. college students who self-reported a diagnosis with depression was recently estimated to be about 25% ( American College Health Association, 2019 ). However, higher rates have been reported, with one study estimating that up to 84% of undergraduates experience some level of depression ( Garlow et al. , 2008 ). Depression rates are typically higher among university students compared with the general population, despite being a more socially privileged group ( Ibrahim et al. , 2013 ). Prior studies have found that depression is negatively correlated with overall undergraduate academic performance ( Hysenbegasi et al. , 2005 ; Deroma et al. , 2009 ; American College Health Association, 2019 ). Specifically, diagnosed depression is associated with half a letter grade decrease in students’ grade point average ( Hysenbegasi et al. , 2005 ), and 21.6% of undergraduates reported that depression negatively affected their academic performance within the last year ( American College Health Association, 2019 ). Provided with a list of academic factors that may be affected by depression, students reported that depression contributed to lower exam grades, lower course grades, and not completing or dropping a course.

Students in the natural sciences may be particularly at risk for depression, given that such majors are noted to be particularly stressful due to their competitive nature and course work that is often perceived to “weed students out”( Everson et al. , 1993 ; Strenta et al. , 1994 ; American College Health Association, 2019 ; Seymour and Hunter, 2019 ). Science course instruction has also been described to be boring, repetitive, difficult, and math-intensive; these factors can create an environment that can trigger depression ( Seymour and Hewitt, 1997 ; Osborne and Collins, 2001 ; Armbruster et al ., 2009 ; Ceci and Williams, 2010 ). What also distinguishes science degree programs from other degree programs is that, increasingly, undergraduate research experiences are being proposed as an essential element of a science degree ( American Association for the Advancement of Science, 2011 ; President’s Council of Advisors on Science and Technology, 2012 ; National Academies of Sciences, Engineering, and Medicine [NASEM], 2017 ). However, there is some evidence that undergraduate research experiences can add to the stress of college for some students ( Cooper et al. , 2019c ). Students can garner multiple benefits from undergraduate research, including enhanced abilities to think critically ( Ishiyama, 2002 ; Bauer and Bennett, 2003 ; Brownell et al. , 2015 ), improved student learning ( Rauckhorst et al. , 2001 ; Brownell et al. , 2015 ), and increased student persistence in undergraduate science degree programs ( Jones et al. , 2010 ; Hernandez et al. , 2018 ). Notably, undergraduate research experiences are increasingly becoming a prerequisite for entry into medical and graduate programs in science, particularly elite programs ( Cooper et al. , 2019d ). Although some research experiences are embedded into formal lab courses as course-based undergraduate research experiences (CUREs; Auchincloss et al. , 2014 ; Brownell and Kloser, 2015 ), the majority likely entail working with faculty in their research labs. These undergraduate research experiences in faculty labs are often added on top of a student’s normal course work, so they essentially become an extracurricular activity that they have to juggle with course work, working, and/or personal obligations ( Cooper et al. , 2019c ). While the majority of the literature surrounding undergraduate research highlights undergraduate research as a positive experience ( NASEM, 2017 ), studies have demonstrated that undergraduate research experiences can be academically and emotionally challenging for students ( Mabrouk and Peters, 2000 ; Seymour et al. , 2004 ; Cooper et al. , 2019c ; Limeri et al. , 2019 ). In fact, 50% of students sampled nationally from public R1 institutions consider leaving their undergraduate research experience prematurely, and about half of those students, or 25% of all students, ultimately leave their undergraduate research experience ( Cooper et al. , 2019c ). Notably, 33.8% of these individuals cited a negative lab environment and 33.3% cited negative relationships with their mentors as factors that influenced their decision about whether to leave ( Cooper et al. , 2019c ). Therefore, students’ depression may be exacerbated in challenging undergraduate research experiences, because studies have shown that depression is positively correlated with student stress ( Hish et al. , 2019 ).

While depression has not been explored in the context of undergraduate research experiences, depression has become a prominent concern surrounding graduate students conducting scientific research. A recent study that examined the “graduate student mental health crisis” ( Flaherty, 2018 ) found that work–life balance and graduate students’ relationships with their research advisors may be contributing to their depression ( Evans et al. , 2018 ). Specifically, this survey of 2279 PhD and master’s students from diverse fields of study, including the biological/physical sciences, showed that 39% of graduate students have experienced moderate to severe depression. Fifty-five percent of the graduate students with depression who were surveyed disagreed with the statement “I have good work life balance,” compared to only 21% of students with depression who agreed. Additionally, the study highlighted that more students with depression disagreed than agreed with the following statements: their advisors provided “real” mentorship, their advisors provided ample support, their advisors positively impacted their emotional or mental well-being, their advisors were assets to their careers, and they felt valued by their mentors. Another recent study identified that depression severity in biomedical doctoral students was significantly associated with graduate program climate, a perceived lack of employment opportunities, and the quality of students’ research training environment ( Nagy et al. , 2019 ). Environmental stress, academic stress, and family and monetary stress have also been shown to be predictive of depression severity in biomedical doctoral students ( Hish et al. , 2019 ). Further, one study found that self-esteem is negatively correlated and stress is positively correlated with graduate student depression; presumably research environments that challenge students’ self-esteem and induce stress are likely contributing to depressive symptoms among graduate students ( Kreger, 1995 ). While these studies have focused on graduate students, and there are certainly notable distinctions between graduate and undergraduate research, the research-related factors that affect graduate student depression, including work–life balance, relationships with mentors, research environment, stress, and self-esteem, may also be relevant to depression among undergraduates conducting research. Importantly, undergraduates in the United States have reported identical levels of depression as graduate students but are often less likely to seek mental health care services ( Wyatt and Oswalt, 2013 ), which is concerning if undergraduate research experiences exacerbate depression.

Based on the literature on the stressors of undergraduate research experiences and the literature identifying some potential causes of graduate student depression, we identified three aspects of undergraduate research that may exacerbate undergraduates’ depression. Mentoring: Mentors can be an integral part of a students’ research experience, bolstering their connections with others in the science community, scholarly productivity, and science identity, as well as providing many other benefits ( Thiry and Laursen, 2011 ; Prunuske et al. , 2013 ; Byars-Winston et al. , 2015 ; Aikens et al. , 2016 , 2017 ; Thompson et al. , 2016 ; Estrada et al. , 2018 ). However, recent literature has highlighted that poor mentoring can negatively affect undergraduate researchers ( Cooper et al. , 2019c ; Limeri et al. , 2019 ). Specifically, one study of 33 undergraduate researchers who had conducted research at 10 institutions identified seven major ways that they experienced negative mentoring, which included absenteeism, abuse of power, interpersonal mismatch, lack of career support, lack of psychosocial support, misaligned expectations, and unequal treatment ( Limeri et al. , 2019 ). We hypothesize negative mentoring experiences may be particularly harmful for students with depression, because support, particularly social support, has been shown to be important for helping individuals with depression cope with difficult circumstances ( Aneshensel and Stone, 1982 ; Grav et al. , 2012 ). Failure: Experiencing failure has been hypothesized to be an important aspect of undergraduate research experiences that may help students develop some the most distinguishing abilities of outstanding scientists, such as coping with failure, navigating challenges, and persevering ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, experiencing failure and the stress and fatigue that often accompany it may be particularly tough for students with depression ( Aldwin and Greenberger, 1987 ; Mongrain and Blackburn, 2005 ). Lab environment: Fairness, inclusion/exclusion, and social support within one’s organizational environment have been shown to be key factors that cause people to either want to remain in the work place and be productive or to want to leave ( Barak et al. , 2006 ; Cooper et al. , 2019c ). We hypothesize that dealing with exclusion or a lack of social support may exacerbate depression for some students; patients with clinical depression react to social exclusion with more pronounced negative emotions than do individuals without clinical depression ( Jobst et al. , 2015 ). While there are likely other aspects of undergraduate research that affect student depression, we hypothesize that these factors have the potential to exacerbate negative research experiences for students with depression.

Depression has been shown to disproportionately affect many populations that are underrepresented or underserved within the scientific community, including females ( American College Health Association, 2018 ; Evans et al. , 2018 ), first-generation college students ( Jenkins et al. , 2013 ), individuals from low socioeconomic backgrounds ( Eisenberg et al. , 2007 ), members of the LGBTQ+ community ( Eisenberg et al. , 2007 ; Evans et al. , 2018 ), and people with disabilities ( Turner and Noh, 1988 ). Therefore, as the science community strives to be more diverse and inclusive ( Intemann, 2009 ), it is important that we understand more about the relationship between depression and scientific research, because negative experiences with depression in scientific research may be contributing to the underrepresentation of these groups. Specifically, more information is needed about how the research process and environment of research experiences may affect depression.

Given the high rate of depression among undergraduates, the links between depression and graduate research, the potentially challenging environment of undergraduate research, and how depression could disproportionately impact students from underserved communities, it is imperative to begin to explore the relationship between scientific research and depression among undergraduates to create research experiences that could maximize student success. In this exploratory interview study, we aimed to 1) describe how undergraduates’ symptoms of depression affect their research experiences, 2) understand how undergraduate research affects students’ feelings of depression, and 3) identify recommendations based on the literature and undergraduates’ reported experiences to promote a positive research experience for students with depression.

This study was done with an approved Arizona State University Institutional Review Board protocol #7247.

In Fall 2018, we surveyed undergraduate researchers majoring in the life sciences across 25 research-intensive (R1) public institutions across the United States (specific details about the recruitment of the students who completed the survey can be found in Cooper et al. (2019c) ). The survey asked students for their opinions about their undergraduate research experiences and their demographic information and whether they would be interested in participating in a follow-up interview related to their research experiences. For the purpose of this study, we exclusively interviewed students about their undergraduate research experiences in faculty member labs; we did not consider students’ experiences in CUREs. Of the 768 undergraduate researchers who completed the survey, 65% ( n = 496) indicated that they would be interested in participating in a follow-up interview. In Spring 2019, we emailed the 496 students, explaining that we were interested in interviewing students with depression about their experiences in undergraduate research. Our specific prompt was: “If you identify as having depression, we would be interested in hearing about your experience in undergraduate research in a 30–60 minute online interview.” We did not define depression in our email recruitment because we conducted think-aloud interviews with four undergraduates who all correctly interpreted what we meant by depression ( APA, 2013 ). We had 35 students agree to participate in the interview study. The interview participants represented 12 of the 25 R1 public institutions that were represented in the initial survey.

Student Interviews

We developed an interview script to explore our research questions. Specifically, we were interested in how students’ symptoms of depression affect their research experiences, how undergraduate research negatively affects student depression, and how undergraduate research positively affects student depression.

We recognized that mental health, and specifically depression, can be a sensitive topic to discuss with undergraduates, and therefore we tried to minimize any discomfort that the interviewees might experience during the interview. Specifically, we conducted think-aloud interviews with three graduate students who self-identified with having depression at the time of the interview. We asked them to note whether any interview questions made them uncomfortable. We also sought their feedback on questions given their experiences as persons with depression who had once engaged in undergraduate research. We revised the interview protocol after each think-aloud interview. Next, we conducted four additional think-aloud interviews with undergraduates conducting basic science or biology education research who identified with having depression to establish cognitive validity of the questions and to elicit additional feedback about any questions that might make someone uncomfortable. The questions were revised after each think-aloud interview until no question was unclear or misinterpreted by the students and we were confident that the questions minimized students’ potential discomfort ( Trenor et al. , 2011 ). A copy of the final interview script can be found in the Supplemental Material.

All interviews were individually conducted by one of two researchers (K.M.C. and L.E.G.) who conducted the think-aloud interviews together to ensure that their interviewing practices were as similar as possible. The interviews were approximately an hour long, and students received a $15 gift card for their participation.

Personal, Research, and Depression Demographics

All student demographics and information about students’ research experiences were collected using the survey distributed to students in Fall 2018. We collected personal demographics, including the participants’ gender, race/ethnicity, college generation status, transfer status, financial stability, year in college, major, and age. We also collected information about the students’ research experiences, including the length of their first research experiences, the average number of hours they spend in research per week, how they were compensated for research, who their primary mentors were, and the focus areas of their research.

In the United States, mental healthcare is disproportionately unavailable to Black and Latinx individuals, as well as those who come from low socioeconomic backgrounds ( Kataoka et al. , 2002 ; Howell and McFeeters, 2008 ; Santiago et al. , 2013 ). Therefore, to minimize a biased sample, we invited anyone who identified with having depression to participate in our study; we did not require students to be diagnosed with depression or to be treated for depression in order to participate. However, we did collect information about whether students had been formally diagnosed with depression and whether they had been treated for depression. After the interview, all participants were sent a link to a short survey that asked them if they had ever been diagnosed with depression and how, if at all, they had ever been treated for depression. A copy of these survey questions can be found in the Supplemental Material. The combined demographic information of the participants is in Table 1 . The demographics for each individual student can be found in the Supplemental Material.

a Students reported the time they had spent in research 6 months before being interviewed and only reported on the length of time of their first research experiences.

b Students were invited to report multiple ways in which they were treated for their depression; other treatments included lifestyle changes and meditation.

c Students were invited to report multiple means of compensation for their research if they had been compensated for their time in different ways.

d Students were asked whether they felt financially stable, particularly during the undergraduate research experience.

e Students reported who they work/worked with most closely during their research experiences.

f Staff members included lab coordinators or lab managers.

g Other focus areas of research included sociology, linguistics, psychology, and public health.

Interview Analysis

The initial interview analysis aimed to explore each idea that a participant expressed ( Charmaz, 2006 ) and to identify reoccurring ideas throughout the interviews. First, three authors (K.M.C., L.E.G., and S.E.B.) individually reviewed a different set of 10 interviews and took detailed analytic notes ( Birks and Mills, 2015 ). Afterward, the authors compared their notes and identified reoccurring themes throughout the interviews using open coding methods ( Saldaña, 2015 ).

Once an initial set of themes was established, two researchers (K.M.C. and L.E.G.) individually reviewed the same set of 15 randomly selected interviews to validate the themes identified in the initial analysis and to screen for any additional themes that the initial analysis may have missed. Each researcher took detailed analytic notes throughout the review of an interview, which they discussed after reviewing each interview. The researchers compared what quotes from each interview they categorized into each theme. Using constant comparison methods, they assigned quotes to each theme and constantly compared the quotes to ensure that each quote fit within the description of the theme ( Glesne and Peshkin, 1992 ). In cases in which quotes were too different from other quotes, a new theme was created. This approach allowed for multiple revisions of the themes and allowed the authors to define a final set of codes; the researchers created a final codebook with refined definitions of emergent themes (the final coding rubric can be found in the Supplemental Material). Once the final codebook was established, the researchers (K.M.C. and L.E.G.) individually coded seven additional interviews (20% of all interviews) using the coding rubric. The researchers compared their codes, and their Cohen’s κ interrater score for these seven interviews was at an acceptable level (κ  =  0.88; Landis and Koch, 1977 ). One researcher (L.E.G.) coded the remaining 28 out of 35 interviews. The researchers determined that data saturation had been reached with the current sample and no further recruitment was needed ( Guest et al. , 2006 ). We report on themes that were mentioned by at least 20% of students in the interview study. In the Supplemental Material, we provide the final coding rubric with the number of participants whose interview reflected each theme ( Hannah and Lautsch, 2011 ). Reporting the number of individuals who reported themes within qualitative data can lead to inaccurate conclusions about the generalizability of the results to a broader population. These qualitative data are meant to characterize a landscape of experiences that students with depression have in undergraduate research rather than to make claims about the prevalence of these experiences ( Glesne and Peshkin, 1992 ). Because inferences about the importance of these themes cannot be drawn from these counts, they are not included in the results of the paper ( Maxwell, 2010 ). Further, the limited number of interviewees made it not possible to examine whether there were trends based on students’ demographics or characteristics of their research experiences (e.g., their specific area of study). Quotes were lightly edited for clarity by inserting clarification brackets and using ellipses to indicate excluded text. Pseudonyms were given to all students to protect their privacy.

The Effect of Depressive Symptoms on Undergraduate Research

We asked students to describe the symptoms associated with their depression. Students described experiencing anxiety that is associated with their depression; this could be anxiety that precedes their depression or anxiety that results from a depressive episode or a period of time when an individual has depression symptoms. Further, students described difficulty getting out of bed or leaving the house, feeling tired, a lack of motivation, being overly self-critical, feeling apathetic, and having difficulty concentrating. We were particularly interested in how students’ symptoms of depression affected their experiences in undergraduate research. During the think-aloud interviews that were conducted before the interview study, graduate and undergraduate students consistently described that their depression affected their motivation in research, their creativity in research, and their productivity in research. Therefore, we explicitly asked undergraduate researchers how, if at all, their depression affected these three factors. We also asked students to describe any additional ways in which their depression affected their research experiences. Undergraduate researchers commonly described five additional ways in which their depression affected their research; for a detailed description of each way students’ research was affected and for example quotes, see Table 2 . Students described that their depression negatively affected their productivity in the lab. Commonly, students described that their productivity was directly affected by a lack of motivation or because they felt less creative, which hindered the research process. Additionally, students highlighted that they were sometimes less productive because their depression sometimes caused them to struggle to engage intellectually with their research or caused them to have difficulty remembering or concentrating; students described that they could do mundane or routine tasks when they felt depressed, but that they had difficulty with more complex and intellectually demanding tasks. However, students sometimes described that even mundane tasks could be difficult when they were required to remember specific steps; for example, some students struggled recalling a protocol from memory when their depression was particularly severe. Additionally, students noted that their depression made them more self-conscious, which sometimes held them back from sharing research ideas with their mentors or from taking risks such as applying to competitive programs. In addition to being self-conscious, students highlighted that their depression caused them to be overly self-critical, and some described experiencing imposter phenomenon ( Clance and Imes, 1978 ) or feeling like they were not talented enough to be in research and were accepted into a lab by a fluke or through luck. Finally, students described that depression often made them feel less social, and they struggled to socially engage with other members of the lab when they were feeling down.

The Effect of Undergraduate Research Experiences on Student Depression

We also wanted to explore how research impacted students’ feelings of depression. Undergraduates described how research both positively and negatively affected their depression. In the following sections, we present aspects of undergraduate research and examine how each positively and/or negatively affected students’ depression using embedded student quotes to highlight the relationships between related ideas.

Lab Environment: Relationships with Others in the Lab.

Some aspects of the lab environment, which we define as students’ physical, social, or psychological research space, could be particularly beneficial for students with depression.

Specifically, undergraduate researchers perceived that comfortable and positive social interactions with others in the lab helped their depression. Students acknowledged how beneficial their relationships with graduate students and postdocs could be.

Marta: “I think always checking in on undergrads is important. It’s really easy [for us] to go a whole day without talking to anybody in the lab. But our grad students are like ‘Hey, what’s up? How’s school? What’s going on?’ (…) What helps me the most is having that strong support system. Sometimes just talking makes you feel better, but also having people that believe in you can really help you get out of that negative spiral. I think that can really help with depression.”

Kelley: “I know that anytime I need to talk to [my postdoc mentors] about something they’re always there for me. Over time we’ve developed a relationship where I know that outside of work and outside of the lab if I did want to talk to them about something I could talk to them. Even just talking to someone about hobbies and having that relationship alone is really helpful [for depression].”

In addition to highlighting the importance of developing relationships with graduate students or postdocs in the lab, students described that forming relationships with other undergraduates in the lab also helped their depression. Particularly, students described that other undergraduate researchers often validated their feelings about research, which in turn helped them realize that what they are thinking or feeling is normal, which tended to alleviate their negative thoughts. Interestingly, other undergraduates experiencing the same issues could sometimes help buffer them from perceiving that a mentor did not like them or that they were uniquely bad at research. In this article, we use the term “mentor” to refer to anyone who students referred to in the interviews as being their mentors or managing their research experiences; this includes graduate students, postdoctoral scholars, lab managers, and primary investigators (PIs).

Abby: “One of my best friends is in the lab with me.  A lot of that friendship just comes from complaining about our stress with the lab and our annoyance with people in the lab. Like when we both agree like, ‘Yeah, the grad students were really off today, it wasn’t us,’ that helps. ‘It wasn’t me, it wasn’t my fault that we were having a rough day in lab; it was the grad students.’ Just being able to realize, ‘Hey, this isn’t all caused by us,’ you know? (…) We understand the stresses in the lab. We understand the details of what each other are doing in the lab, so when something doesn’t work out, we understand that it took them like eight hours to do that and it didn’t work. We provide empathy on a different level.”

Meleana: “It’s great to have solidarity in being confused about something, and it’s just that is a form of validation for me too. When we leave a lab meeting and I look at [another undergrad] I’m like, ‘Did you understand anything that they were just saying?’ And they’re like, ‘Oh, no.’ (…) It’s just really validating to hear from the other undergrads that we all seem to be struggling with the same things.”

Developing positive relationships with faculty mentors or PIs also helped alleviate some students’ depressive feelings, particularly when PIs shared their own struggles with students. This also seemed to normalize students’ concerns about their own experiences.

Alexandra: “[Talking with my PI] is helpful because he would talk about his struggles, and what he faced. A lot of it was very similar to my struggles.  For example, he would say, ‘Oh, yeah, I failed this exam that I studied so hard for. I failed the GRE and I paid so much money to prepare for it.’ It just makes [my depression] better, like okay, this is normal for students to go through this. It’s not an out of this world thing where if you fail, you’re a failure and you can’t move on from it.”

Students’ relationships with others in the lab did not always positively impact their depression. Students described instances when the negative moods of the graduate students and PIs would often set the tone of the lab, which in turn worsened the mood of the undergraduate researchers.

Abby: “Sometimes [the grad students] are not in a good mood. The entire vibe of the lab is just off, and if you make a joke and it hits somebody wrong, they get all mad. It really depends on the grad students and the leadership and the mood that they’re in.”

Interviewer: “How does it affect your depression when the grad students are in a bad mood?”

Abby: “It definitely makes me feel worse. It feels like, again, that I really shouldn’t go ask them for help because they’re just not in the mood to help out. It makes me have more pressure on myself, and I have deadlines I need to meet, but I have a question for them, but they’re in a bad mood so I can’t ask. That’s another day wasted for me and it just puts more stress, which just adds to the depression.”

Additionally, some students described even more concerning behavior from research mentors, which negatively affected their depression.

Julie: “I had a primary investigator who is notorious in the department for screaming at people, being emotionally abusive, unreasonable, et cetera. (…) [He was] kind of harassing people, demeaning them, lying to them, et cetera, et cetera. (…) Being yelled at and constantly demeaned and harassed at all hours of the day and night, that was probably pretty bad for me.”

While the relationships between undergraduates and graduate, postdoc, and faculty mentors seemed to either alleviate or worsen students’ depressive symptoms, depending on the quality of the relationship, students in this study exclusively described their relationships with other undergraduates as positive for their depression. However, students did note that undergraduate research puts some of the best and brightest undergraduates in the same environment, which can result in students comparing themselves with their peers. Students described that this comparison would often lead them to feel badly about themselves, even though they would describe their personal relationship with a person to be good.

Meleana: “In just the research field in general, just feeling like I don’t really measure up to the people around me [can affect my depression]. A lot of the times it’s the beginning of a little spiral, mental spiral. There are some past undergrads that are talked about as they’re on this pedestal of being the ideal undergrads and that they were just so smart and contributed so much to the lab. I can never stop myself from wondering like, ‘Oh, I wonder if I’m having a contribution to the lab that’s similar or if I’m just another one of the undergrads that does the bare minimum and passes through and is just there.’”

Natasha: “But, on the other hand, [having another undergrad in the lab] also reminded me constantly that some people are invested in this and meant to do this and it’s not me. And that some people know a lot more than I do and will go further in this than I will.”

While students primarily expressed that their relationships with others in the lab affected their depression, some students explained that they struggled most with depression when the lab was empty; they described that they did not like being alone in the lab, because a lack of stimulation allowed their minds to be filled with negative thoughts.

Mia: “Those late nights definitely didn’t help [my depression]. I am alone, in the entire building.  I’m left alone to think about my thoughts more, so not distracted by talking to people or interacting with people. I think more about how I’m feeling and the lack of progress I’m making, and the hopelessness I’m feeling. That kind of dragged things on, and I guess deepened my depression.”

Freddy: “Often times when I go to my office in the evening, that is when I would [ sic ] be prone to be more depressed. It’s being alone. I think about myself or mistakes or trying to correct mistakes or whatever’s going on in my life at the time. I become very introspective. I think I’m way too self-evaluating, way too self-deprecating and it’s when I’m alone when those things are really, really triggered. When I’m talking with somebody else, I forget about those things.”

In sum, students with depression highlighted that a lab environment full of positive and encouraging individuals was helpful for their depression, whereas isolating or competitive environments and negative interactions with others often resulted in more depressive feelings.

Doing Science: Experiencing Failure in Research, Getting Help, Receiving Feedback, Time Demands, and Important Contributions.

In addition to the lab environment, students also described that the process of doing science could affect their depression. Specifically, students explained that a large contributor to their depression was experiencing failure in research.

Interviewer: “Considering your experience in undergraduate research, what tends to trigger your feelings of depression?”

Heather: “Probably just not getting things right. Having to do an experiment over and over again. You don’t get the results you want. (…) The work is pretty meticulous and it’s frustrating when I do all this work, I do a whole experiment, and then I don’t get any results that I can use. That can be really frustrating. It adds to the stress. (…) It’s hard because you did all this other stuff before so you can plan for the research, and then something happens and all the stuff you did was worthless basically.”

Julie: “I felt very negatively about myself [when a project failed] and pretty panicked whenever something didn’t work because I felt like it was a direct reflection on my effort and/or intelligence, and then it was a big glaring personal failure.”

Students explained that their depression related to failing in research was exacerbated if they felt as though they could not seek help from their research mentors. Perceived insufficient mentor guidance has been shown to be a factor influencing student intention to leave undergraduate research ( Cooper et al. , 2019c ). Sometimes students talked about their research mentors being unavailable or unapproachable.

Michelle: “It just feels like [the graduate students] are not approachable. I feel like I can’t approach them to ask for their understanding in a certain situation. It makes [my depression] worse because I feel like I’m stuck, and that I’m being limited, and like there’s nothing I can do. So then I kind of feel like it’s my fault that I can’t do anything.”

Other times, students described that they did not seek help in fear that they would be negatively evaluated in research, which is a fear of being judged by others ( Watson and Friend, 1969 ; Weeks et al. , 2005 ; Cooper et al. , 2018 ). That is, students fear that their mentor would think negatively about them or judge them if they were to ask questions that their mentor thought they should know the answer to.

Meleana: “I would say [my depression] tends to come out more in being more reserved in asking questions because I think that comes more like a fear-based thing where I’m like, ‘Oh, I don’t feel like I’m good enough and so I don’t want to ask these questions because then my mentors will, I don’t know, think that I’m dumb or something.’”

Conversely, students described that mentors who were willing to help them alleviated their depressive feelings.

Crystal: “Yeah [my grad student] is always like, ‘Hey, I can check in on things in the lab because you’re allowed to ask me for that, you’re not totally alone in this,’ because he knows that I tend to take on all this responsibility and I don’t always know how to ask for help. He’s like, ‘You know, this is my lab too and I am here to help you as well,’ and just reminds me that I’m not shouldering this burden by myself.”

Ashlyn: “The graduate student who I work with is very kind and has a lot of patience and he really understands a lot of things and provides simple explanations. He does remind me about things and he will keep on me about certain tasks that I need to do in an understanding way, and it’s just because he’s patient and he listens.”

In addition to experiencing failure in science, students described that making mistakes when doing science also negatively affected their depression.

Abby: “I guess not making mistakes on experiments [is important in avoiding my depression]. Not necessarily that your experiment didn’t turn out to produce the data that you wanted, but just adding the wrong enzyme or messing something up like that. It’s like, ‘Oh, man,’ you know? You can get really down on yourself about that because it can be embarrassing.”

Commonly, students described that the potential for making mistakes increased their stress and anxiety regarding research; however, they explained that how other people responded to a potential mistake was what ultimately affected their depression.

Briana: “Sometimes if I made a mistake in correctly identifying an eye color [of a fly], [my PI] would just ridicule me in front of the other students. He corrected me but his method of correcting was very discouraging because it was a ridicule. It made the others laugh and I didn’t like that.”

Julie: “[My PI] explicitly [asked] if I had the dedication for science. A lot of times he said I had terrible judgment. A lot of times he said I couldn’t be trusted. Once I went to a conference with him, and, unfortunately, in front of another professor, he called me a klutz several times and there was another comment about how I never learn from my mistakes.”

When students did do things correctly, they described how important it could be for them to receive praise from their mentors. They explained that hearing praise and validation can be particularly helpful for students with depression, because their thoughts are often very negative and/or because they have low self-esteem.

Crystal: “[Something that helps my depression is] I have text messages from [my graduate student mentor] thanking me [and another undergraduate researcher] for all of the work that we’ve put in, that he would not be able to be as on track to finish as he is if he didn’t have our help.”

Interviewer: “Why is hearing praise from your mentor helpful?”

Crystal: “Because a lot of my depression focuses on everybody secretly hates you, nobody likes you, you’re going to die alone. So having that validation [from my graduate mentor] is important, because it flies in the face of what my depression tells me.”

Brian: “It reminds you that you exist outside of this negative world that you’ve created for yourself, and people don’t see you how you see yourself sometimes.”

Students also highlighted how research could be overwhelming, which negatively affected their depression. Particularly, students described that research demanded a lot of their time and that their mentors did not always seem to be aware that they were juggling school and other commitments in addition to their research. This stress exacerbated their depression.

Rose: “I feel like sometimes [my grad mentors] are not very understanding because grad students don’t take as many classes as [undergrads] do. I think sometimes they don’t understand when I say I can’t come in at all this week because I have finals and they’re like, ‘Why though?’”

Abby: “I just think being more understanding of student life would be great. We have classes as well as the lab, and classes are the priority. They forget what it’s like to be a student. You feel like they don’t understand and they could never understand when you say like, ‘I have three exams this week,’ and they’re like, ‘I don’t care. You need to finish this.’”

Conversely, some students reported that their research labs were very understanding of students’ schedules. Interestingly, these students talked most about how helpful it was to be able to take a mental health day and not do research on days when they felt down or depressed.

Marta: “My lab tech is very open, so she’ll tell us, ‘I can’t come in today. I have to take a mental health day.’ So she’s a really big advocate for that. And I think I won’t personally tell her that I’m taking a mental health day, but I’ll say, ‘I can’t come in today, but I’ll come in Friday and do those extra hours.’ And she’s like, ‘OK great, I’ll see you then.’  And it makes me feel good, because it helps me take care of myself first and then I can take care of everything else I need to do, which is amazing.”

Meleana: “Knowing that [my mentors] would be flexible if I told them that I’m crazy busy and can’t come into work nearly as much this week [helps my depression]. There is flexibility in allowing me to then care for myself.”

Interviewer: “Why is the flexibility helpful given the depression?”

Meleana: “Because sometimes for me things just take a little bit longer when I’m feeling down. I’m just less efficient to be honest, and so it’s helpful if I feel like I can only go into work for 10 hours in a week. It declutters my brain a little bit to not have to worry about all the things I have to do in work in addition the things that I need to do for school or clubs, or family or whatever.”

Despite the demanding nature of research, a subset of students highlighted that their research and research lab provided a sense of stability or familiarity that distracted them from their depression.

Freddy: “I’ll [do research] to run away from those [depressive] feelings or whatever. (…) I find sadly, I hate to admit it, but I do kind of run to [my lab]. I throw myself into work to distract myself from the feelings of depression and sadness.”

Rose: “When you’re sad or when you’re stressed you want to go to things you’re familiar with. So because lab has always been in my life, it’s this thing where it’s going to be there for me I guess. It’s like a good book that you always go back to and it’s familiar and it makes you feel good. So that’s how lab is. It’s not like the greatest thing in the world but it’s something that I’m used to, which is what I feel like a lot of people need when they’re sad and life is not going well.”

Many students also explained that research positively affects their depression because they perceive their research contribution to be important.

Ashlyn: “I feel like I’m dedicating myself to something that’s worthy and something that I believe in. It’s really important because it contextualizes those times when I am feeling depressed. It’s like, no, I do have these better things that I’m working on. Even when I don’t like myself and I don’t like who I am, which is again, depression brain, I can at least say, ‘Well, I have all these other people relying on me in research and in this area and that’s super important.’”

Jessica: “I mean, it just felt like the work that I was doing had meaning and when I feel like what I’m doing is actually going to contribute to the world, that usually really helps with [depression] because it’s like not every day you can feel like you’re doing something impactful.”

In sum, students highlighted that experiencing failure in research and making mistakes negatively contributed to depression, especially when help was unavailable or research mentors had a negative reaction. Additionally, students acknowledged that the research could be time-consuming, but that research mentors who were flexible helped assuage depressive feelings that were associated with feeling overwhelmed. Finally, research helped some students’ depression, because it felt familiar, provided a distraction from depression, and reminded students that they were contributing to a greater cause.

We believe that creating more inclusive research environments for students with depression is an important step toward broadening participation in science, not only to ensure that we are not discouraging students with depression from persisting in science, but also because depression has been shown to disproportionately affect underserved and underrepresented groups in science ( Turner and Noh, 1988 ; Eisenberg et al. , 2007 ; Jenkins et al. , 2013 ; American College Health Association, 2018 ). We initially hypothesized that three features of undergraduate research—research mentors, the lab environment, and failure—may have the potential to exacerbate student depression. We found this to be true; students highlighted that their relationships with their mentors as well as the overall lab environment could negatively affect their depression, but could also positively affect their research experiences. Students also noted that they struggled with failure, which is likely true of most students, but is known to be particularly difficult for students with depression ( Elliott et al. , 1997 ). We expand upon our findings by integrating literature on depression with the information that students provided in the interviews about how research mentors can best support students. We provide a set of evidence-based recommendations focused on mentoring, the lab environment, and failure for research mentors wanting to create more inclusive research environments for students with depression. Notably, only the first recommendation is specific to students with depression; the others reflect recommendations that have previously been described as “best practices” for research mentors ( NASEM, 2017 , 2019 ; Sorkness et al. , 2017 ) and likely would benefit most students. However, we examine how these recommendations may be particularly important for students with depression. As we hypothesized, these recommendations directly address three aspects of research: mentors, lab environment, and failure. A caveat of these recommendations is that more research needs to be done to explore the experiences of students with depression and how these practices actually impact students with depression, but our national sample of undergraduate researchers with depression can provide an initial starting point for a discussion about how to improve research experiences for these students.

Recommendations to Make Undergraduate Research Experiences More Inclusive for Students with Depression

Recognize student depression as a valid illness..

Allow students with depression to take time off of research by simply saying that they are sick and provide appropriate time for students to recover from depressive episodes. Also, make an effort to destigmatize mental health issues.

Undergraduate researchers described both psychological and physical symptoms that manifested as a result of their depression and highlighted how such symptoms prevented them from performing to their full potential in undergraduate research. For example, students described how their depression would cause them to feel unmotivated, which would often negatively affect their research productivity. In cases in which students were motivated enough to come in and do their research, they described having difficulty concentrating or engaging in the work. Further, when doing research, students felt less creative and less willing to take risks, which may alter the quality of their work. Students also sometimes struggled to socialize in the lab. They described feeling less social and feeling overly self-critical. In sum, students described that, when they experienced a depressive episode, they were not able to perform to the best of their ability, and it sometimes took a toll on them to try to act like nothing was wrong, when they were internally struggling with depression. We recommend that research mentors treat depression like any other physical illness; allowing students the chance to recover when they are experiencing a depressive episode can be extremely important to students and can allow them to maximize their productivity upon returning to research ( Judd et al. , 2000 ). Students explained that if they are not able to take the time to focus on recovering during a depressive episode, then they typically continue to struggle with depression, which negatively affects their research. This sentiment is echoed by researchers in psychiatry who have found that patients who do not fully recover from a depressive episode are more likely to relapse and to experience chronic depression ( Judd et al. , 2000 ). Students described not doing tasks or not showing up to research because of their depression but struggling with how to share that information with their research mentors. Often, students would not say anything, which caused them anxiety because they were worried about what others in the lab would say to them when they returned. Admittedly, many students understood why this behavior would cause their research mentors to be angry or frustrated, but they weighed the consequences of their research mentors’ displeasure against the consequences of revealing their depression and decided it was not worth admitting to being depressed. This aligns with literature that suggests that when individuals have concealable stigmatized identities, or identities that can be hidden and that carry negative stereotypes, such as depression, they will often keep them concealed to avoid negative judgment or criticism ( Link and Phelan, 2001 ; Quinn and Earnshaw, 2011 ; Jones and King, 2014 ; Cooper and Brownell, 2016 ; Cooper et al. , 2019b ; Cooper et al ., unpublished data ). Therefore, it is important for research mentors to be explicit with students that 1) they recognize mental illness as a valid sickness and 2) that students with mental illness can simply explain that they are sick if they need to take time off. This may be useful to overtly state on a research website or in a research syllabus, contract, or agreement if mentors use such documents when mentoring undergraduates in their lab. Further, research mentors can purposefully work to destigmatize mental health issues by explicitly stating that struggling with mental health issues, such as depression and anxiety, is common. While we do not recommend that mentors ask students directly about depression, because this can force students to share when they are not comfortable sharing, we do recommend providing opportunities for students to reveal their depression ( Chaudoir and Fisher, 2010 ). Mentors can regularly check in with students about how they’re doing, and talk openly about the importance of mental health, which may increase the chance that students may feel comfortable revealing their depression ( Chaudoir and Quinn, 2010 ; Cooper et al ., unpublished data ).

Foster a Positive Lab Environment.

Encourage positivity in the research lab, promote working in shared spaces to enhance social support among lab members, and alleviate competition among undergraduates.

Students in this study highlighted that the “leadership” of the lab, meaning graduate students, postdocs, lab managers, and PIs, were often responsible for establishing the tone of the lab; that is, if they were in a bad mood it would trickle down and negatively affect the moods of the undergraduates. Explicitly reminding lab leadership that their moods can both positively and negatively affect undergraduates may be important in establishing a positive lab environment. Further, students highlighted how they were most likely to experience negative thoughts when they were alone in the lab. Therefore, it may be helpful to encourage all lab members to work in a shared space to enhance social interactions among students and to maximize the likelihood that undergraduates have access to help when needed. A review of 51 studies in psychiatry supported our undergraduate researchers’ perceptions that social relationships positively impacted their depression; the study found that perceived emotional support (e.g., someone available to listen or give advice), perceived instrumental support (e.g., someone available to help with tasks), and large diverse social networks (e.g., being socially connected to a large number of people) were significantly protective against depression ( Santini et al. , 2015 ). Additionally, despite forming positive relationships with other undergraduates in the lab, many undergraduate researchers admitted to constantly comparing themselves with other undergraduates, which led them to feel inferior, negatively affecting their depression. Some students talked about mentors favoring current undergraduates or talking positively about past undergraduates, which further exacerbated their feelings of inferiority. A recent study of students in undergraduate research experiences highlighted that inequitable distribution of praise to undergraduates can create negative perceptions of lab environments for students (Cooper et al. , 2019). Further, the psychology literature has demonstrated that when people feel insecure in their social environments, it can cause them to focus on a hierarchical view of themselves and others, which can foster feelings of inferiority and increase their vulnerability to depression ( Gilbert et al. , 2009 ). Thus, we recommend that mentors be conscious of their behaviors so that they do not unintentionally promote competition among undergraduates or express favoritism toward current or past undergraduates. Praise is likely best used without comparison with others and not done in a public way, although more research on the impact of praise on undergraduate researchers needs to be done. While significant research has been done on mentoring and mentoring relationships in the context of undergraduate research ( Byars-Winston et al. , 2015 ; Aikens et al. , 2017 ; Estrada et al. , 2018 ; Limeri et al. , 2019 ; NASEM, 2019 ), much less has been done on the influence of the lab environment broadly and how people in nonmentoring roles can influence one another. Yet, this study indicates the potential influence of many different members of the lab, not only their mentors, on students with depression.

Develop More Personal Relationships with Undergraduate Researchers and Provide Sufficient Guidance.

Make an effort to establish more personal relationships with undergraduates and ensure that they perceive that they have access to sufficient help and guidance with regard to their research.

When we asked students explicitly how research mentors could help create more inclusive environments for undergraduate researchers with depression, students overwhelmingly said that building mentor–student relationships would be extremely helpful. Students suggested that mentors could get to know students on a more personal level by asking about their career interests or interests outside of academia. Students also remarked that establishing a more personal relationship could help build the trust needed in order for undergraduates to confide in their research mentors about their depression, which they perceived would strengthen their relationships further because they could be honest about when they were not feeling well or their mentors might even “check in” with them in times where they were acting differently than normal. This aligns with studies showing that undergraduates are most likely to reveal a stigmatized identity, such as depression, when they form a close relationship with someone ( Chaudoir and Quinn, 2010 ). Many were intimidated to ask for research-related help from their mentors and expressed that they wished they had established a better relationship so that they would feel more comfortable. Therefore, we recommend that research mentors try to establish relationships with their undergraduates and explicitly invite them to ask questions or seek help when needed. These recommendations are supported by national recommendations for mentoring ( NASEM, 2019 ) and by literature that demonstrates that both social support (listening and talking with students) and instrumental support (providing students with help) have been shown to be protective against depression ( Santini et al. , 2015 ).

Treat Undergraduates with Respect and Remember to Praise Them.

Avoid providing harsh criticism and remember to praise undergraduates. Students with depression often have low self-esteem and are especially self-critical. Therefore, praise can help calibrate their overly negative self-perceptions.

Students in this study described that receiving criticism from others, especially harsh criticism, was particularly difficult for them given their depression. Multiple studies have demonstrated that people with depression can have an abnormal or maladaptive response to negative feedback; scientists hypothesize that perceived failure on a particular task can trigger failure-related thoughts that interfere with subsequent performance ( Eshel and Roiser, 2010 ). Thus, it is important for research mentors to remember to make sure to avoid unnecessarily harsh criticisms that make students feel like they have failed (more about failure is described in the next recommendation). Further, students with depression often have low self-esteem or low “personal judgment of the worthiness that is expressed in the attitudes the individual holds towards oneself” ( Heatherton et al. , 2003 , p. 220; Sowislo and Orth, 2013 ). Specifically, a meta-analysis of longitudinal studies found that low self-esteem is predictive of depression ( Sowislo and Orth, 2013 ), and depression has also been shown to be highly related to self-criticism ( Luyten et al. , 2007 ). Indeed, nearly all of the students in our study described thinking that they are “not good enough,” “worthless,” or “inadequate,” which is consistent with literature showing that people with depression are self-critical ( Blatt et al. , 1982 ; Gilbert et al. , 2006 ) and can be less optimistic of their performance on future tasks and rate their overall performance on tasks less favorably than their peers without depression ( Cane and Gotlib, 1985 ). When we asked students what aspects of undergraduate research helped their depression, students described that praise from their mentors was especially impactful, because they thought so poorly of themselves and they needed to hear something positive from someone else in order to believe it could be true. Praise has been highlighted as an important aspect of mentoring in research for many years ( Ashford, 1996 ; Gelso and Lent, 2000 ; Brown et al. , 2009 ) and may be particularly important for students with depression. In fact, praise has been shown to enhance individuals’ motivation and subsequent productivity ( Hancock, 2002 ; Henderlong and Lepper, 2002 ), factors highlighted by students as negatively affecting their depression. However, something to keep in mind is that a student with depression and a student without depression may process praise differently. For a student with depression, a small comment that praises the student’s work may not be sufficient for the student to process that comment as praise. People with depression are hyposensitive to reward or have reward-processing deficits ( Eshel and Roiser, 2010 ); therefore, praise may affect students without depression more positively than it would affect students with depression. Research mentors should be mindful that students with depression often have a negative view of themselves, and while students report that praise is extremely important, they may have trouble processing such positive feedback.

Normalize Failure and Be Explicit about the Importance of Research Contributions.

Explicitly remind students that experiencing failure is expected in research. Also explain to students how their individual work relates to the overall project so that they can understand how their contributions are important. It can also be helpful to explain to students why the research project as a whole is important in the context of the greater scientific community.

Experiencing failure has been thought to be a potentially important aspect of undergraduate research, because it may provide students with the potential to develop integral scientific skills such as the ability to navigate challenges and persevere ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, in the interviews, students described that when their science experiments failed, it was particularly tough for their depression. Students’ negative reaction to experiencing failure in research is unsurprising, given recent literature that has predicted that students may be inadequately prepared to approach failure in science ( Henry et al. , 2019 ). However, the literature suggests that students with depression may find experiencing failure in research to be especially difficult ( Elliott et al. , 1997 ; Mongrain and Blackburn, 2005 ; Jones et al. , 2009 ). One potential hypothesis is that students with depression may be more likely to have fixed mindsets or more likely to believe that their intelligence and capacity for specific abilities are unchangeable traits ( Schleider and Weisz, 2018 ); students with a fixed mindset have been hypothesized to have particularly negative responses to experiencing failure in research, because they are prone to quitting easily in the face of challenges and becoming defensive when criticized ( Forsythe and Johnson, 2017 ; Dweck, 2008 ). A study of life sciences undergraduates enrolled in CUREs identified three strategies of students who adopted adaptive coping mechanisms, or mechanisms that help an individual maintain well-being and/or move beyond the stressor when faced with failure in undergraduate research: 1) problem solving or engaging in strategic planning and decision making, 2) support seeking or finding comfort and help with research, and 3) cognitive restructuring or reframing a problem from negative to positive and engaging in self encouragement ( Gin et al. , 2018 ). We recommend that, when undergraduates experience failure in science, their mentors be proactive in helping them problem solve, providing help and support, and encouraging them. Students also explained that mentors sharing their own struggles as undergraduate and graduate students was helpful, because it normalized failure. Sharing personal failures in research has been recommended as an important way to provide students with psychosocial support during research ( NASEM, 2019 ). We also suggest that research mentors take time to explain to students why their tasks in the lab, no matter how small, contribute to the greater research project ( Cooper et al. , 2019a ). Additionally, it is important to make sure that students can explain how the research project as a whole is contributing to the scientific community ( Gin et al. , 2018 ). Students highlighted that contributing to something important was really helpful for their depression, which is unsurprising, given that studies have shown that meaning in life or people’s comprehension of their life experiences along with a sense of overarching purpose one is working toward has been shown to be inversely related to depression ( Steger, 2013 ).

Limitations and Future Directions

This work was a qualitative interview study intended to document a previously unstudied phenomenon: depression in the context of undergraduate research experiences. We chose to conduct semistructured interviews rather than a survey because of the need for initial exploration of this area, given the paucity of prior research. A strength of this study is the sampling approach. We recruited a national sample of 35 undergraduates engaged in undergraduate research at 12 different public R1 institutions. Despite our representative sample from R1 institutions, these findings may not be generalizable to students at other types of institutions; lab environments, mentoring structures, and interactions between faculty and undergraduate researchers may be different at other institution types (e.g., private R1 institutions, R2 institutions, master’s-granting institutions, primarily undergraduate institutions, and community colleges), so we caution against making generalizations about this work to all undergraduate research experiences. Future work could assess whether students with depression at other types of institutions have similar experiences to students at research-intensive institutions. Additionally, we intentionally did not explore the experiences of students with specific identities owing to our sample size and the small number of students in any particular group (e.g., students of a particular race, students with a graduate mentor as the primary mentor). We intend to conduct future quantitative studies to further explore how students’ identities and aspects of their research affect their experiences with depression in undergraduate research.

The students who participated in the study volunteered to be interviewed about their depression; therefore, it is possible that depression is a more salient part of these students’ identities and/or that they are more comfortable talking about their depression than the average population of students with depression. It is also important to acknowledge the personal nature of the topic and that some students may not have fully shared their experiences ( Krumpal, 2013 ), particularly those experiences that may be emotional or traumatizing ( Kahn and Garrison, 2009 ). Additionally, our sample was skewed toward females (77%). While females do make up approximately 60% of students in biology programs on average ( Eddy et al. , 2014 ), they are also more likely to report experiencing depression ( American College Health Association, 2018 ; Evans et al. , 2018 ). However, this could be because women have higher rates of depression or because males are less likely to report having depression; clinical bias, or practitioners’ subconscious tendencies to overlook male distress, may underestimate depression rates in men ( Smith et al. , 2018 ). Further, females are also more likely to volunteer to participate in studies ( Porter and Whitcomb, 2005 ); therefore, many interview studies have disproportionately more females in the data set (e.g., Cooper et al. , 2017 ). If we had been able to interview more male students, we might have identified different findings. Additionally, we limited our sample to life sciences students engaged in undergraduate research at public R1 institutions. It is possible that students in other majors may have different challenges and opportunities for students with depression, as well as different disciplinary stigmas associated with mental health.

In this exploratory interview study, we identified a variety of ways in which depression in undergraduates negatively affected their undergraduate research experiences. Specifically, we found that depression interfered with students’ motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing. We also identified that research can negatively affect depression in undergraduates. Experiencing failure in research can exacerbate student depression, especially when students do not have access to adequate guidance. Additionally, being alone or having negative interactions with others in the lab worsened students’ depression. However, we also found that undergraduate research can positively affect students’ depression. Research can provide a familiar space where students can feel as though they are contributing to something meaningful. Additionally, students reported that having access to adequate guidance and a social support network within the research lab also positively affected their depression. We hope that this work can spark conversations about how to make undergraduate research experiences more inclusive of students with depression and that it can stimulate additional research that more broadly explores the experiences of undergraduate researchers with depression.

Important note

If you or a student experience symptoms of depression and want help, there are resources available to you. Many campuses provide counseling centers equipped to provide students, staff, and faculty with treatment for depression, as well as university-dedicated crisis hotlines. Additionally, there are free 24/7 services such as Crisis Text Line, which allows you to text a trained live crisis counselor (Text “CONNECT” to 741741; Text Depression Hotline , 2019 ), and phone hotlines such as the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can also learn more about depression and where to find help near you through the Anxiety and Depression Association of American website: https://adaa.org ( Anxiety and Depression Association of America, 2019 ) and the Depression and Biopolar Support Alliance: http://dbsalliance.org ( Depression and Biopolar Support Alliance, 2019 ).

ACKNOWLEDGMENTS

We are extremely grateful to the undergraduate researchers who shared their thoughts and experiences about depression with us. We acknowledge the ASU LEAP Scholars for helping us create the original survey and Rachel Scott for her helpful feedback on earlier drafts of this article. L.E.G. was supported by a National Science Foundation (NSF) Graduate Fellowship (DGE-1311230) and K.M.C. was partially supported by a Howard Hughes Medical Institute (HHMI) Inclusive Excellence grant (no. 11046) and an NSF grant (no. 1644236). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF or HHMI.

• Aikens, M. L., Robertson, M. M., Sadselia, S., Watkins, K., Evans, M., Runyon, C. R. , … & Dolan, E. L. ( 2017 ). Race and gender differences in undergraduate research mentoring structures and research outcomes . CBE—Life Sciences Education , 16 (2), ar34. Link ,  Google Scholar
• Aikens, M. L., Sadselia, S., Watkins, K., Evans, M., Eby, L. T., & Dolan, E. L. ( 2016 ). A social capital perspective on the mentoring of undergraduate life science researchers: An empirical study of undergraduate–postgraduate–faculty triads . CBE—Life Sciences Education , 15 (2), ar16. Link ,  Google Scholar
• Aldwin, C., & Greenberger, E. ( 1987 ). Cultural differences in the predictors of depression . American Journal of Community Psychology , 15 (6), 789–813. Medline ,  Google Scholar
• American Association for the Advancement of Science . ( 2011 ). Vision and change in undergraduate biology education: A call to action . Retrieved November 29, 2019, from http://visionandchange.org/files/2013/11/aaas-VISchange-web1113.pdf Google Scholar
• American College Health Association . ( 2018 ). Undergraduate reference group executive summary, Fall 2018 . Retrieved November 29, 2019, from www.acha.org/documents/ncha/NCHA-II_Fall_2018_Reference_Group_Executive_Summary.pdf Google Scholar
• American College Health Association . ( 2019 ). Retrieved November 29, 2019, from NCHA-II_SPRING_2019_UNDERGRADUATE_REFERENCE_GROUP_DATA_REPORT.pdf www.acha.org/documents/ncha/NCHA-II_SPRING_2019_UNDERGRADUATE_REFERENCE_GROUP_DATA_REPORT.pdf Google Scholar
• American Psychiatric Association . ( 2013 ). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing. Google Scholar
• Aneshensel, C. S., & Stone, J. D. ( 1982 ). Stress and depression: A test of the buffering model of social support . Archives of General Psychiatry , 39 (12), 1392–1396. Medline ,  Google Scholar
• Anxiety and Depression Association of America . ( 2019 ). Home page . Retrieved November 29, 2019, from https://adaa.org Google Scholar
• Armbruster, P., Patel, M., Johnson, E., & Weiss, M. ( 2009 ). Active learning and student-centered pedagogy improve student attitudes and performance in introductory biology . CBE—Life Sciences Education , 8 (3), 203–213. Link ,  Google Scholar
• Ashford, S. J. ( 1996 ). Working with doctoral students: Rhythms of Academic Life: Personal Accounts of Careers in Academia . In Front, P. J.Taylor, M. S. (Eds.), Rhythms of Academic Life: Personal Accounts of Careers in Academia (pp. 153–158). Thousand Oaks, CA: Sage. Google Scholar
• Auchincloss, L. C., Laursen, S. L., Branchaw, J. L., Eagan, K., Graham, M., Hanauer, D. I. , … & Rowland, S. ( 2014 ). Assessment of course-based undergraduate research experiences: A meeting report . CBE—Life Sciences Education , 13 (1), 29–40. Link ,  Google Scholar
• Barak, M. E. M., Levin, A., Nissly, J. A., & Lane, C. J. ( 2006 ). Why do they leave? Modeling child welfare workers’ turnover intentions . Children and Youth Services Review , 28 (5), 548–577. Google Scholar
• Bauer, K. W., & Bennett, J. S. ( 2003 ). Alumni perceptions used to assess undergraduate research experience . Journal of Higher Education , 74 (2), 210–230. Google Scholar
• Birks, M., & Mills, J. ( 2015 ). Grounded theory: A practical guide . Thousand Oaks, CA: Sage. Google Scholar
• Blatt, S. J., Quinlan, D. M., Chevron, E. S., McDonald, C., & Zuroff, D. ( 1982 ). Dependency and self-criticism: Psychological dimensions of depression . Journal of Consulting and Clinical Psychology , 50 (1), 113. Medline ,  Google Scholar
• Brown, R. T., Daly, B. P., & Leong, F. T. ( 2009 ). Mentoring in research: A developmental approach . Professional Psychology: Research and Practice , 40 (3), 306. Google Scholar
• Brownell, S. E., Hekmat-Scafe, D. S., Singla, V., Seawell, P. C., Imam, J. F. C., Eddy, S. L. , … & Cyert, M. S. ( 2015 ). A high-enrollment course-based undergraduate research experience improves student conceptions of scientific thinking and ability to interpret data . CBE—Life Sciences Education , 14 (2), ar21. Link ,  Google Scholar
• Brownell, S. E., & Kloser, M. J. ( 2015 ). Toward a conceptual framework for measuring the effectiveness of course-based undergraduate research experiences in undergraduate biology . Studies in Higher Education , 40 (3), 525–544. Google Scholar
• Byars-Winston, A. M., Branchaw, J., Pfund, C., Leverett, P., & Newton, J. ( 2015 ). Culturally diverse undergraduate researchers’ academic outcomes and perceptions of their research mentoring relationships . International Journal of Science Education , 37 (15), 2533–2554. Medline ,  Google Scholar
• Cane, D. B., & Gotlib, I. H. ( 1985 ). Depression and the effects of positive and negative feedback on expectations, evaluations, and performance . Cognitive Therapy and Research , 9 (2), 145–160. Google Scholar
• Ceci, S. J., & Williams, W. M. ( 2010 ). Sex differences in math-intensive fields . Current Directions in Psychological Science , 19 (5), 275–279. Medline ,  Google Scholar
• Center for Collegiate Mental Health . ( 2017 ). Center for Collegiate Mental Health 2017 Annual Report . State College, PA: Penn State Universit. Google Scholar
• Charmaz, K. ( 2006 ). Constructing grounded theory: A practical guide through qualitative research . Thousand Oaks, CA: Sage. Google Scholar
• Chaudoir, S. R., & Fisher, J. D. ( 2010 ). The disclosure processes model: Understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity . Psychological Bulletin , 136 (2), 236. Medline ,  Google Scholar
• Chaudoir, S. R., & Quinn, D. M. ( 2010 ). Revealing concealable stigmatized identities: The impact of disclosure motivations and positive first-disclosure experiences on fear of disclosure and well-being . Journal of Social Issues , 66 (3), 570–584. Medline ,  Google Scholar
• Clance, P. R., & Imes, S. A. ( 1978 ). The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention . Psychotherapy: Theory, Research & Practice , 15 (3), 241. Google Scholar
• Cooper, K. M., Ashley, M., & Brownell, S. E. ( 2017 ). A bridge to active learning: A summer bridge program helps students maximize their active-learning experiences and the active-learning experiences of others . CBE—Life Sciences Education , 16 (1), ar17. Link ,  Google Scholar
• Cooper, K. M., Blattman, J. N., Hendrix, T., & Brownell, S. E. ( 2019a ). The impact of broadly relevant novel discoveries on student project ownership in a traditional lab course turned CURE . CBE—Life Sciences Education , 18 (4), ar57. Link ,  Google Scholar
• Cooper, K. M., & Brownell, S. E. ( 2016 ). Coming out in class: Challenges and benefits of active learning in a biology classroom for LGBTQIA students . CBE—Life Sciences Education , 15 (3), ar37. https://doi.org/10.1187/cbe.16-01-0074 Link ,  Google Scholar
• Cooper, K. M., Brownell, S. E., & Gormally, C. C. ( 2019b ). Coming out to the class: Identifying factors that influence college biology instructor decisions about whether to reveal their LGBQ identity in class . Journal of Women and Minorities in Science and Engineering , 25 (3). Google Scholar
• Cooper, K. M., Downing, V. R., & Brownell, S. E. ( 2018 ). The influence of active learning practices on student anxiety in large-enrollment college science classrooms . International Journal of STEM Education , 5 (1), 23. Medline ,  Google Scholar
• Cooper, K. M., Gin, L. E., Akeeh, B., Clark, C. E., Hunter, J. S., Roderick, T. B. , … & Brownell, S. E. ( 2019c ). Factors that predict life sciences student persistence in undergraduate research experiences . PLoS ONE , 14 (8). https://doi.org/10.1371/journal.pone.0220186 Google Scholar
• Cooper, K. M., Gin, L. E., & Brownell, S. E. ( 2019d ). Diagnosing differences in what introductory biology students in a fully online and an in-person biology degree program know and do regarding medical school admission . Advances in Physiology Education , 43 (2), 221–232. Medline ,  Google Scholar
• Cooper, K. M., Gin, L. E., & Brownell, S. E. ( In press ). Depression as a concealable stigmatized identity: What influences whether students conceal or reveal their depression in undergraduate research experiences? International Journal of STEM Education , ( in press ). Google Scholar
• Depression and Biopolar Support Alliance . ( 2019 ). Home page . Retrieved November 28, 2019, from www.dbsalliance.org Google Scholar
• Deroma, V. M., Leach, J. B., & Leverett, J. P. ( 2009 ). The relationship between depression and college academic performance . College Student Journal , 43 (2), 325–335. Google Scholar
• Dweck, C. S. ( 2008 ). Mindset: The new psychology of success . New York, NY: Random House Digital. Google Scholar
• Dyson, R., & Renk, K. ( 2006 ). Freshmen adaptation to university life: Depressive symptoms, stress, and coping . Journal of Clinical Psychology , 62 (10), 1231–1244. Medline ,  Google Scholar
• Eddy, S. L., Brownell, S. E., & Wenderoth, M. P. ( 2014 ). Gender gaps in achievement and participation in multiple introductory biology classrooms . CBE—Life Sciences Education , 13 (3), 478–492. https://doi.org/10.1187/cbe.13-10-0204 Link ,  Google Scholar
• Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. ( 2007 ). Prevalence and correlates of depression, anxiety, and suicidality among university students . American Journal of Orthopsychiatry , 77 (4), 534–542. Medline ,  Google Scholar
• Elliott, R., Sahakian, B. J., Herrod, J. J., Robbins, T. W., & Paykel, E. S. ( 1997 ). Abnormal response to negative feedback in unipolar depression: Evidence for a diagnosis specific impairment . Journal of Neurology, Neurosurgery & Psychiatry , 63 (1), 74–82. Medline ,  Google Scholar
• Eshel, N., & Roiser, J. P. ( 2010 ). Reward and punishment processing in depression . Biological Psychiatry , 68 (2), 118–124. Medline ,  Google Scholar
• Estrada, M., Hernandez, P. R., & Schultz, P. W. ( 2018 ). A longitudinal study of how quality mentorship and research experience integrate underrepresented minorities into STEM careers . CBE—Life Sciences Education , 17 (1), ar9. Link ,  Google Scholar
• Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T., & Vanderford, N. L. ( 2018 ). Evidence for a mental health crisis in graduate education . Nature Biotechnology , 36 (3), 282. Medline ,  Google Scholar
• Everson, H. T., Tobias, S., Hartman, H., & Gourgey, A. ( 1993 ). Test anxiety and the curriculum: The subject matters . Anxiety, Stress, and Coping , 6 (1), 1–8. Google Scholar
• Flaherty, C. ( 2018 ). New study says graduate students’ mental health is a “crisis.” Retrieved November 29, 2019, from www.insidehighered.com/news/2018/03/06/new-study-says-graduate-students-mental-health-crisis Google Scholar
• Forsythe, A., & Johnson, S. ( 2017 ). Thanks, but no-thanks for the feedback . Assessment & Evaluation in Higher Education , 42 (6), 850–859. Google Scholar
• Garlow, S. J., Rosenberg, J., Moore, J. D., Haas, A. P., Koestner, B., Hendin, H., & Nemeroff, C. B. ( 2008 ). Depression, desperation, and suicidal ideation in college students: Results from the American Foundation for Suicide Prevention College Screening Project at Emory University . Depression and Anxiety , 25 (6), 482–488. Medline ,  Google Scholar
• Gelso, C. J., & Lent, R. W. ( 2000 ). Scientific training and scholarly productivity: The person, the training environment, and their interaction . In Brown, S. D.Lent, R. W. (Eds.), Handbook of counseling psychology (pp. 109–139). Hoboken, NJ: John Wiley & Sons Inc. Google Scholar
• Gilbert, P., Baldwin, M. W., Irons, C., Baccus, J. R., & Palmer, M. ( 2006 ). Self-criticism and self-warmth: An imagery study exploring their relation to depression . Journal of Cognitive Psychotherapy , 20 (2), 183. Google Scholar
• Gilbert, P., McEwan, K., Bellew, R., Mills, A., & Gale, C. ( 2009 ). The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm . Psychology and Psychotherapy: Theory, Research and Practice , 82 (2), 123–136. Medline ,  Google Scholar
• Gin, L. E., Rowland, A. A., Steinwand, B., Bruno, J., & Corwin, L. A. ( 2018 ). Students who fail to achieve predefined research goals may still experience many positive outcomes as a result of CURE participation . CBE—Life Sciences Education , 17 (4), ar57. Link ,  Google Scholar
• Glesne, C., & Peshkin, A. ( 1992 ). Becoming qualitative researchers: An introduction . London, England, UK: Longman. Google Scholar
• Grav, S., Hellzèn, O., Romild, U., & Stordal, E. ( 2012 ). Association between social support and depression in the general population: The HUNT study, a cross-sectional survey . Journal of Clinical Nursing , 21 (1–2), 111–120. Medline ,  Google Scholar
• Guest, G., Bunce, A., & Johnson, L. ( 2006 ). How many interviews are enough? An experiment with data saturation and variability . Field Methods , 18 (1), 59–82. Google Scholar
• Hancock, D. R. ( 2002 ). Influencing graduate students’ classroom achievement, homework habits and motivation to learn with verbal praise . Educational Research , 44 (1), 83–95. Google Scholar
• Hannah, D. R., & Lautsch, B. A. ( 2011 ). Counting in qualitative research: Why to conduct it, when to avoid it, and when to closet it . Journal of Management Inquiry , 20 (1), 14–22. Google Scholar
• Heatherton, T. F., & Wyland, C. L. ( 2003 ). Assessing self-esteem . In Lopez, S. J.Snyder, C. R. (Eds.), Positive psychological assessment: A handbook of models and measures (pp. 219–233). Washington, DC: American Psychological Association. https://doi.org/10.1037/10612-014 . Google Scholar
• Henderlong, J., & Lepper, M. R. ( 2002 ). The effects of praise on children’s intrinsic motivation: A review and synthesis . Psychological Bulletin , 128 (5), 774. Medline ,  Google Scholar
• Henry, M. A., Shorter, S., Charkoudian, L., Heemstra, J. M., & Corwin, L. A. ( 2019 ). FAIL is not a four-letter word: A theoretical framework for exploring undergraduate students’ approaches to academic challenge and responses to failure in STEM learning environments . CBE—Life Sciences Education , 18 (1), ar11. Link ,  Google Scholar
• Hernandez, P. R., Woodcock, A., Estrada, M., & Schultz, P. W. ( 2018 ). Undergraduate research experiences broaden diversity in the scientific workforce . BioScience , 68 (3), 204–211. Google Scholar
• Hish, A. J., Nagy, G. A., Fang, C. M., Kelley, L., Nicchitta, C. V., Dzirasa, K., & Rosenthal, M. Z. ( 2019 ). Applying the stress process model to stress–burnout and stress–depression relationships in biomedical doctoral students: A cross-sectional pilot study . CBE—Life Sciences Education , 18 (4), ar51. Link ,  Google Scholar
• Howell, E., & McFeeters, J. ( 2008 ). Children’s mental health care: Differences by race/ethnicity in urban/rural areas . Journal of Health Care for the Poor and Underserved , 19 (1), 237–247. Medline ,  Google Scholar
• Hysenbegasi, A., Hass, S. L., & Rowland, C. R. ( 2005 ). The impact of depression on the academic productivity of university students . Journal of Mental Health Policy and Economics , 8 (3), 145. Medline ,  Google Scholar
• Ibrahim, A. K., Kelly, S. J., Adams, C. E., & Glazebrook, C. ( 2013 ). A systematic review of studies of depression prevalence in university students . Journal of Psychiatric Research , 47 (3), 391–400. Medline ,  Google Scholar
• Intemann, K. ( 2009 ). Why diversity matters: Understanding and applying the diversity component of the National Science Foundation’s broader impacts criterion . Social Epistemology , 23 (3–4), 249–266. Google Scholar
• Ishiyama, J. ( 2002 ). Does early participation in undergraduate research benefit social science and humanities students? College Student Journal , 36 (3), 381–387. Google Scholar
• Jenkins, S. R., Belanger, A., Connally, M. L., Boals, A., & Durón, K. M. ( 2013 ). First-generation undergraduate students’ social support, depression, and life satisfaction . Journal of College Counseling , 16 (2), 129–142. Google Scholar
• Jobst, A., Sabass, L., Palagyi, A., Bauriedl-Schmidt, C., Mauer, M. C., Sarubin, N. , … & Zill, P. ( 2015 ). Effects of social exclusion on emotions and oxytocin and cortisol levels in patients with chronic depression . Journal of Psychiatric Research , 60 , 170–177. Medline ,  Google Scholar
• Jones, K. P., & King, E. B. ( 2014 ). Managing concealable stigmas at work: A review and multilevel model . Journal of Management , 40 (5), 1466–1494. Google Scholar
• Jones, M. T., Barlow, A. E., & Villarejo, M. ( 2010 ). Importance of undergraduate research for minority persistence and achievement in biology . Journal of Higher Education , 81 (1), 82–115. Google Scholar
• Jones, N. P., Papadakis, A. A., Hogan, C. M., & Strauman, T. J. ( 2009 ). Over and over again: Rumination, reflection, and promotion goal failure and their interactive effects on depressive symptoms . Behaviour Research and Therapy , 47 (3), 254–259. Medline ,  Google Scholar
• Judd, L. L., Paulus, M. J., Schettler, P. J., Akiskal, H. S., Endicott, J., Leon, A. C. , … & Keller, M. B. ( 2000 ). Does incomplete recovery from first lifetime major depressive episode herald a chronic course of illness? American Journal of Psychiatry , 157 (9), 1501–1504. Medline ,  Google Scholar
• Kahn, J. H., & Garrison, A. M. ( 2009 ). Emotional self-disclosure and emotional avoidance: Relations with symptoms of depression and anxiety . Journal of Counseling Psychology , 56 (4), 573. Google Scholar
• Kataoka, S. H., Zhang, L., & Wells, K. B. ( 2002 ). Unmet need for mental health care among US children: Variation by ethnicity and insurance status . American Journal of Psychiatry , 159 (9), 1548–1555. Medline ,  Google Scholar
• Kreger, D. W. ( 1995 ). Self-esteem, stress, and depression among graduate students . Psychological Reports , 76 (1), 345–346. Medline ,  Google Scholar
• Krumpal, I. ( 2013 ). Determinants of social desirability bias in sensitive surveys: A literature review . Quality & Quantity , 47 (4), 2025–2047. Google Scholar
• Landis, J. R., & Koch, G. G. ( 1977 ). An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers . Biometrics , 33 (2), 363–374. Medline ,  Google Scholar
• Laursen, S., Hunter, A.-B., Seymour, E., Thiry, H., & Melton, G. ( 2010 ). Undergraduate research in the sciences: Engaging students in real science . Hoboken, NJ: Wiley. Google Scholar
• Limeri, L. B., Asif, M. Z., Bridges, B. H., Esparza, D., Tuma, T. T., Sanders, D. , … & Maltese, A. V. ( 2019 ). “Where’s my mentor?” Characterizing negative mentoring experiences in undergraduate life science research . CBE—Life Sciences Education , 18 (4), ar61. Link ,  Google Scholar
• Link, B. G., & Phelan, J. C. ( 2001 ). Conceptualizing stigma . Annual Review of Sociology , 27 (1), 363–385. Google Scholar
• Luyten, P., Sabbe, B., Blatt, S. J., Meganck, S., Jansen, B., De Grave, C. , … & Corveleyn, J. ( 2007 ). Dependency and self-criticism: Relationship with major depressive disorder, severity of depression, and clinical presentation . Depression and Anxiety , 24 (8), 586–596. Medline ,  Google Scholar
• Mabrouk, P. A., & Peters, K. ( 2000 ). Student perspectives on undergraduate research (UR) experiences in chemistry and biology . CUR Quarterly , 21 (1), 25–33. Google Scholar
• Maxwell, J. A. ( 2010 ). Using numbers in qualitative research . Qualitative Inquiry , 16 (6), 475–482. Google Scholar
• Mongrain, M., & Blackburn, S. ( 2005 ). Cognitive vulnerability, lifetime risk, and the recurrence of major depression in graduate students . Cognitive Therapy and Research , 29 (6), 747–768. Google Scholar
• Nagy, G. A., Fang, C. M., Hish, A. J., Kelly, L., Nicchitta, C. V., Dzirasa, K., & Rosenthal, M. Z. ( 2019 ). Burnout and mental health problems in biomedical doctoral students . CBE—Life Sciences Education , 18 (2), ar27. Link ,  Google Scholar
• National Academies of Sciences, Engineering, and Medicine (NASEM) . ( 2017 ). Undergraduate research experiences for STEM students: Successes, challenges, and opportunities . Washington, DC: National Academies Press. https://doi.org/10.17226/24622 Google Scholar
• NASEM . ( 2019 ). The science of effective mentorship in STEMM . Washington, DC: National Academies Press. Retrieved November 29, 2019, from www.nap.edu/download/25568 Google Scholar
• Osborne, J., & Collins, S. ( 2001 ). Pupils’ views of the role and value of the science curriculum: A focus-group study . International Journal of Science Education , 23 (5), 441–467. https://doi.org/10.1080/09500690010006518 Google Scholar
• Porter, S. R., & Whitcomb, M. E. ( 2005 ). Non-response in student surveys: The role of demographics, engagement and personality . Research in Higher Education , 46 (2), 127–152. Google Scholar
• President’s Council of Advisors on Science and Technology . ( 2012 ). Engage to excel: Producing one million additional college graduates with degrees in science, Technology, Engineering, and mathematics . Washington, DC: U.S. Government Office of Science and Technology. Google Scholar
• Prunuske, A. J., Wilson, J., Walls, M., & Clarke, B. ( 2013 ). Experiences of mentors training underrepresented undergraduates in the research laboratory . CBE—Life Sciences Education , 12 (3), 403–409. Link ,  Google Scholar
• Quinn, D. M., & Earnshaw, V. A. ( 2011 ). Understanding concealable stigmatized identities: The role of identity in psychological, physical, and behavioral outcomes . Social Issues and Policy Review , 5 (1), 160–190. Google Scholar
• Rauckhorst, W. H., Czaja, J. A., & Baxter Magolda, M. ( 2001 ). Measuring the impact of the undergraduate research experience on student intellectual development . Snowbird, UT: Project Kaleidoscope Summer Institute. Google Scholar
• Saldaña, J. ( 2015 ). The coding manual for qualitative researchers . Thousand Oaks, CA: Sage. Google Scholar
• Santiago, C. D., Kaltman, S., & Miranda, J. ( 2013 ). Poverty and mental health: How do low-income adults and children fare in psychotherapy? Journal of Clinical Psychology , 69 (2), 115–126. Medline ,  Google Scholar
• Santini, Z. I., Koyanagi, A., Tyrovolas, S., Mason, C., & Haro, J. M. ( 2015 ). The association between social relationships and depression: A systematic review . Journal of Affective Disorders , 175 , 53–65. Medline ,  Google Scholar
• Schleider, J., & Weisz, J. ( 2018 ). A single-session growth mindset intervention for adolescent anxiety and depression: 9-month outcomes of a randomized trial . Journal of Child Psychology and Psychiatry , 59 (2), 160–170. Medline ,  Google Scholar
• Seymour, E., & Hewitt, N. M. ( 1997 ). Talking about leaving: Why undergraduates leave the sciences . Westview Press. Google Scholar
• Seymour, E., & Hunter, A.-B. ( 2019 ). Talking about leaving revisited . New York, NY: Springer. Google Scholar
• Seymour, E., Hunter, A.-B., Laursen, S. L., & DeAntoni, T. ( 2004 ). Establishing the benefits of research experiences for undergraduates in the sciences: First findings from a three-year study . Science Education , 88 (4), 493–534. Google Scholar
• Smith, D. T., Mouzon, D. M., & Elliott, M. ( 2018 ). Reviewing the assumptions about men’s mental health: An exploration of the gender binary . American Journal of Men’s Health , 12 (1), 78–89. Medline ,  Google Scholar
• Sorkness, C. A., Pfund, C., Ofili, E. O., Okuyemi, K. S., Vishwanatha, J. K., Zavala, M. E. , … & Deveci, A. ( 2017 ). A new approach to mentoring for research careers: The National Research Mentoring Network . BMC Proceedings , 11 , 22. Medline ,  Google Scholar
• Sowislo, J. F., & Orth, U. ( 2013 ). Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies . Psychological Bulletin , 139 (1), 213. Medline ,  Google Scholar
• Steger, M. F. ( 2013 ). Experiencing meaning in life: Optimal functioning at the nexus of well-being, psychopathology, and spirituality . In Wong, P. T. P. (Ed.), The human quest for meaning (pp. 211–230). England, UK: Routledge. Google Scholar
• Strenta, A. C., Elliott, R., Adair, R., Matier, M., & Scott, J. ( 1994 ). Choosing and leaving science in highly selective institutions . Research in Higher Education , 35 (5), 513–547. Google Scholar
• Text Depression Hotline . ( 2019 ). Crisis text line . Retrieved November 29, 2019, from www.crisistextline.org/depression Google Scholar
• Thiry, H., & Laursen, S. L. ( 2011 ). The role of student–advisor interactions in apprenticing undergraduate researchers into a scientific community of practice . Journal of Science Education and Technology , 20 (6), 771–784. Google Scholar
• Thompson, J. J., Conaway, E., & Dolan, E. L. ( 2016 ). Undergraduate students’ development of social, cultural, and human capital in a networked research experience . Cultural Studies of Science Education , 11 (4), 959–990. Google Scholar
• Trenor, J. M., Miller, M. K., & Gipson, K. G. ( 2011 ). Utilization of a think-aloud protocol to cognitively validate a survey instrument identifying social capital resources of engineering undergraduates . 118th American Society for Engineering Education Annual Conference and Exposition, Vancouver, BC, Canada . Google Scholar
• Turner, R. J., & Noh, S. ( 1988 ). Physical disability and depression: A longitudinal analysis . Journal of Health and Social Behavior , 29 (1), 23–37. Medline ,  Google Scholar
• Watson, D., & Friend, R. ( 1969 ). Measurement of social-evaluative anxiety . Journal of Consulting and Clinical Psychology , 33 (4), 448. Medline ,  Google Scholar
• Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., & Liebowitz, M. R. ( 2005 ). Empirical validation and psychometric evaluation of the Brief Fear of Negative Evaluation Scale in patients with social anxiety disorder . Psychological Assessment , 17 (2), 179. Medline ,  Google Scholar
• World Health Organization . ( 2018 ). Depression . Retrieved November 29, 2019, from www.who.int/news-room/fact-sheets/detail/depression Google Scholar
• Wyatt, T., & Oswalt, S. B. ( 2013 ). Comparing mental health issues among undergraduate and graduate students . American Journal of Health Education , 44 (2), 96–107. Google Scholar
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Submitted: 4 November 2019 Revised: 24 February 2020 Accepted: 6 March 2020

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Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis

Affiliations.

• 1 Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
• 2 Wuhan Center for Disease Control and Prevention, Wuhan, China.
• PMID: 35297041
• DOI: 10.1111/jcpp.13606

Background: To evaluate the global prevalence of depression and anxiety symptoms among college students and potential associated factors.

Methods: PubMed and Web of Science were searched from their inception to March 28, 2021. Random-effects models were used to calculate the pooled prevalence of depression and anxiety. Subgroup analyses were conducted to explore potential heterogeneity. Egger's and Begg's test were used to assess publication bias.

Results: A total of 64 studies with 100,187 individuals were included in the present meta-analysis. The pooled prevalence of depression and anxiety symptoms among college students was 33.6% (95% confidence interval [CI] 29.3%-37.8%) and 39.0% (95% CI, 34.6%-43.4%), respectively. The highest prevalence of depression symptoms was found in Africa region (40.1%, 95% CI 12.3-67.9%), lower middle-income countries (42.5%, 95% CI 28.6-56.3%), and medical college students (39.4%, 95% CI 29.3-49.6%). For the prevalence of anxiety symptoms, the highest was observed in North America (48.3%, 95% CI 37.4-59.2%), lower middle-income countries (54.2%, 95% CI 35.0-73.4%), medical college students (47.1%, 95% CI 35.1-59.1%) and identified by Beck Anxiety Inventory (BAI) (49.1%, 95% CI 31.0-43.0%). Besides, the prevalence of depression symptoms (35.9%, 95% CI 20.2-51.7%) and anxiety symptoms (40.7%, 95% CI 39.5-42.0%) was higher in studies conducted after the coronavirus disease 2019 (COVID-19) outbreak.

Conclusions: Our study suggests that a lot of college students experience depression and anxiety symptoms and clarifies factors that are related to these mental disorders. Effective prevention and intervention strategies for mental disorders should be developed among college students.

Keywords: Depression; anxiety; college students; global prevalence; risk factors.

© 2022 Association for Child and Adolescent Mental Health.

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• Commentary: The global prevalence of depression and anxiety symptoms among college students and its influencing factors - a commentary on Li et al. (2022). Zhang H, Wang D. Zhang H, et al. J Child Psychol Psychiatry. 2022 Nov;63(11):1231-1233. doi: 10.1111/jcpp.13660. Epub 2022 Jun 28. J Child Psychol Psychiatry. 2022. PMID: 35764310

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ORIGINAL RESEARCH article

Depression and academic engagement among college students: the role of sense of security and psychological impact of covid-19.

• College of Social Sciences, Shenzhen University, Shenzhen, China

Background: The negative consequences of depression in college students have garnered global attention, especially in relation to academic achievement during the COVID-19 pandemic, which need critical assessment.

Aim: This study investigated whether a sense of security mediated the relationship between depression and academic engagement among college students during the pandemic and whether the moderating psychological impact of COVID-19 has a moderating effect on this relationship.

Methods: In this cross-sectional study, we recruited 466 college students from 30 provincial-level administrative regions in China via the Internet and used established scales to measure depression, academic engagement, a sense of security, and the psychological impact of COVID-19. The mediating and moderating effects were tested using the bootstrap method.

Results: Depression was found to negatively influence academic engagement, with a sense of security partially mediating this relationship. Moreover, the psychological impact of COVID-19 was shown to have a moderating effect on this mediating process.

Conclusion: This study could aid in crafting pertinent strategies to mitigate the adverse effects of depression on learning amid unexpected public health crises and foster better mental health among college students.

1. Introduction

The COVID-19 pandemic, an unprecedented public health crisis, not only posed a grave threat to people's physical safety, but also cast a significant shadow on their mental wellbeing ( 1 , 2 ). This was particularly detrimental to those already in a fragile psychological state, such as those suffering from depression, which exacerbated their condition ( 3 ). College students, who are a high-risk group for depression, faced significant challenges during the ongoing waves of the virus ( 4 ), with a rapid global rise in depressive symptoms reported among young adults, typically those with lower resilience to psychological stress ( 5 ). This deterioration in mental health is a cause of concern, and the question of how to intervene and reduce the negative psychological aftermath following such pandemic events has become a focal point of research. Analysis of depression among college students is often tied to their academic commitment, which is central to their lives ( 6 ). Academic struggles caused by depression may, in turn, impact mental health, potentially exacerbating anxiety and depressive states, thus creating a vicious cycle ( 7 ). Some college students feel hopeless and distressed, often exhibiting confusion and avoidance in their studies ( 8 ). Investigating the mechanisms by which depression affects college students' academic engagement is of paramount importance. Not only can it provide fresh insights for more effective interventions targeting student depression, but it can also improve student learning, thus laying a solid foundation for promoting students' mental health and academic progress.

Depression is an emotional disorder characterized by frequent experiences of intense feelings such as pain, emptiness, and hopelessness ( 9 – 12 ). It often disrupts people's mental states and leads to an array of difficulties in their studies and lives, with severe cases resulting in self-harm and other harmful consequences ( 13 ). As an unprecedented public health crisis, the pandemic caused an incalculable disruption to students' lives and studies, coupled with increased uncertainty about their future, which increased their susceptibility to depression ( 14 ). For students with a predisposition to depression or a history of illness, the pandemic undoubtedly acted as an adverse stimulus, potentially leading to heightened feelings of despair and sorrow ( 15 ). During the pandemic, home isolation measures may have confined students to a single space for extended periods, preventing them from engaging in outdoor activities, possibly heightening their feelings of repression and irritability, and triggering more frequent depressive episodes ( 16 ). With the pandemic having increased the prevalence of depression, understanding the mechanisms through which depression affects academic engagement can provide a reference for better targeted interventions. Such interventions would not only be beneficial in addressing students' academic problems, but also in promoting their mental health.

Academic engagement refers to the interest or enthusiasm that students hold toward their studies, coupled with the time and energy they dedicate to learning ( 17 – 19 ). Pandemic-related pressures burdened students in dealing with issues in terms of academic setbacks, lifestyle inconveniences, and future uncertainties ( 20 ). These pressures not only brought about distress among the student population, but also potentially affected students' academic engagement ( 21 ) given the unprecedented number of issues arising during the pandemic ( 22 ). For instance, some students reported increased fatigue during study sessions, whereas others experienced diminished interest in learning, even to the point of actively avoiding it ( 23 ). The interplay between mental health issues and learning problems became evident during this pandemic ( 24 ), with both a rapid increase in the number of students exhibiting symptoms of depression and a noticeable decline in their academic engagement compared with pre-pandemic levels ( 25 ).

Investigating the mechanisms affecting academic engagement and identifying the variables that could serve as mediators or moderators during the pandemic can aid in understanding the complex interplay between depression and other factors under such novel circumstances. Determining the mediating or moderating mechanisms is likely to provide a more profound theoretical understanding of depression issues faced by adolescents, especially from an educational perspective, which is likely to be beneficial for formulating effective interventions.

Some students grappled with the profound grief of losing friends and family to COVID-19, coupled with significant setbacks in their academic and personal lives ( 26 ), which could potentially exacerbate depressive states. The pandemic drastically reduced students' interest in outdoor activities and social interactions, leading to extended periods of emptiness and loneliness ( 27 ). Additionally, economic support for college students was severely affected by the pandemic, with some students' family financial circumstances deteriorating rapidly ( 28 ). In addition to dealing with boredom due to social isolation and an uncertain future, the modes of learning for these students underwent considerable changes. Online learning became the dominant mode of emergency education worldwide. However, this abrupt shift in learning modalities left many students feeling lost, thereby intensifying their anxiety ( 29 ). This situation may have led to an increased prevalence of depressive disorders, making students more susceptible to mental health issues ( 30 ), which, in turn, may have exacerbated their already difficult predicaments. Therefore, it is imperative to study depression-related issues, particularly how depression influences academic engagement, and determine appropriate interventions.

Academic engagement reflects the level and willingness of students to invest in various learning resources ( 31 ), often involving a strong desire for knowledge, proficiency in applying various effective learning strategies, and a sense of achievement in their studies. These qualities may positively contribute to mental health ( 32 ). However, during the pandemic, students' academic engagement was severely affected ( 33 ). Students faced the challenges of online, home-based, and isolated learning due to substantial changes in their learning environments ( 34 ). Discomforting feelings, including anxiety and unease, may have dampened students' enthusiasm for learning, making it difficult for them to concentrate and causing them to lose interest in their studies ( 35 ).

Depression may influence students' academic engagement through three potential pathways. During the pandemic, college students may have experienced serious psychological distress, particularly negative emotions and feelings of hopelessness triggered by depressive symptoms ( 36 ), leading to a lack of interest and an inability to gain a sense of achievement in their studies ( 37 ). The pandemic forced students to change their learning methods in a short period, and educators may have struggled to provide sufficient support through new online teaching methods, leading to potential learning burnout due to adaptation difficulties in the online learning environment ( 38 ). Some students may have significantly altered their lifestyles due to the pandemic, such as indulging in Internet use and excessively focusing on negative news about the pandemic, intensifying their negative feelings toward the pandemic ( 39 ), which could in turn have make it more difficult for them to concentrate on their studies. Therefore, it can be conjectured that college students' academic engagement may have been more influenced by depression during the pandemic.

A sense of security refers to the affirmative and positive sensations related to experiences of trustworthiness, reliability, and tranquility that arise due to one's active ability to tackle issues, have a comprehensive understanding of individuals or events, and to effectively engage with familiar environments ( 40 – 43 ). Among college students, insecurity is a common psychological issue ( 44 ), stemming from their lack of experience in dealing with external environments and their perceived lack of sufficient ability and resources to resolve multiple complex problems ( 45 ). Particularly during the pandemic, college students faced unprecedented events such as health threats, disruptions in their learning status, and future employment difficulties, which could have made them feel helpless ( 46 ). Under these circumstances, many students may have experienced feelings of insecurity. Among students who already had poor psychological conditions or emotional disorders, this insecurity could have potentially exacerbated their psychological issues ( 47 ), thereby severely affecting their regular learning.

During the pandemic, a sense of security among college students may have served as a mediating variable between depression and academic engagement. First, depression among college students could have potentially increased the frequency of feelings of insecurity ( 48 ). Depression is often characterized by excessive pessimism toward external matters, which can trigger worry or even panic. Moreover, long-term experiences of insecurity can negatively impact mental health, leading to increased negativity and suppression ( 49 ). Hence, there may be a strong correlation between depression and sense of security. For some students, insecurity stems mainly from the uncertainty and risks of the external environment, requiring them to expend more energy dealing with threats and risks, making it difficult to concentrate on academic challenges ( 50 ). Other students may feel insecure because of inadequacies or difficulties in their academic abilities, which may have led to potential stagnation in their learning during the pandemic, thereby exacerbating academic problems ( 51 ). These factors foster anxiety rather than enthusiasm in learning, potentially leading to a reluctance to learn. Therefore, there may be a correlation between students' sense of security and academic engagement ( 52 ). While depression in college students may have been directly linked to academic engagement during the pandemic, it may also have influenced academic engagement through feelings of insecurity, which involve distinct and intense negative emotional experiences that often directly affect students' life status and learning behavior ( 53 ). Students' depression may further amplify their feelings of insecurity, which may negatively impact their academic engagement. Based on these considerations, we inferred that a sense of security might serve as a mediator between depression and academic engagement.

The psychological impact of COVID-19 refers to psychological problems, such as distress and avoidance, caused by the pandemic ( 54 , 55 ). The pandemic disrupted people's normal lives, causing some to have strong emotional reactions ( 56 ), with prolonged negative psychological effects as well as sometimes triggering anorexia, frequent nightmares, and insomnia ( 57 ). Some college students may have been prone to feelings of panic and evasion as well as a strong aversion to pandemic-related matters ( 58 ). Such increased psychological stress likely posed more challenges to their academic pursuits ( 59 ).

When the psychological impact of COVID-19 was high, college students' psychological states and normal learning may have been affected. Their mental health already faced many challenges, especially for those with depression who were struggling with emotional regulation ( 60 ). Excessive worry about the pandemic might have induced more feelings of insecurity, thereby impacting academic engagement ( 61 ). Furthermore, the psychological impact of COVID-19 may not only have potentially increased the psychological pressure on students but also affected academic engagement by diminishing learning motivation and draining energy, leading to student fatigue or a sense of futility toward studying ( 62 ). From this perspective, the psychological impact of COVID-19 may have moderated the mediating effect of a sense of security between depression and academic engagement.

Previous research has reported an association between depression and academic engagement ( 63 , 64 ). While academic engagement may be adversely affected by depression directly ( 65 , 66 ), it has also been reported that this relationship is contingent on specific conditions, suggesting the existence of mediating variables ( 67 ). Further studies are needed to improve understanding of the association between these factors.

Existing research has reported an association between depression and a sense of security, with individuals in depressed groups being more prone to feelings of insecurity ( 68 – 70 ). Academic performance is strongly correlated with student insecurity ( 71 , 72 ). Individuals experiencing insecurity have been found to have their energy and interest in learning negatively affected ( 73 , 74 ). Furthermore, while insecurity has been reported to mediate between psychological problems and learning ( 75 ), further investigation is required to establish whether a sense of security acted as a mediator between depression and academic engagement during the pandemic.

The psychological effects of COVID-19 could potentially have become a risk factor ( 76 – 78 ), possibly exacerbating adverse emotional effects ( 79 , 80 ), and negatively affecting students' learning ( 38 , 81 , 82 ). These studies suggest that the psychological impact of COVID-19 may have served as a moderating variable.

Based on an analysis of previous related research and to help ensure better targeted interventions for depression and enhance the mental wellbeing of college students, we considered it of fundamental importance to investigate how depression affected academic engagement among college students during the COVID-19 pandemic and whether a sense of security played a mediating role under the conditions of the pandemic. Additionally, while the psychological impact of COVID-19 could potentially have acted as a moderator in this mediating relationship, this area remains relatively unexplored in existing research; therefore, we also investigated this factor. The three hypotheses of this study are as follows:

Hypothesis 1. Depression can negatively predict college students' academic engagement.

Hypothesis 2. A sense of security in college students mediated the relationship between depression and academic engagement.

Hypothesis 3. The psychological impact of COVID-19 moderated the relationship between depression and academic engagement.

The research hypothesis model diagram is shown in Figure 1 .

Figure 1 . Research hypothesis model diagram.

2.1. Process and participants of the survey

2.1.1. design.

This study focused on college students aged 18 years and older studying in China. This study adopted a cross-sectional design to assess the current state and associations of variables in a single time point. The sample was composed of currently enrolled, full-time college students from diverse academic disciplines across China. Inclusion criteria were: being a college student, being 18 years of age or older, currently residing in China, and being willing to participate in an online survey. Exclusion criteria included: students who were not currently enrolled, those under the age of 18, those who did not currently reside in China, and those who did not provide informed consent to participate. However, during the pandemic period in China, it was challenging to conduct offline surveys of college students from different regions across the country. Convenience sampling was therefore adopted. College students were recruited using various online platforms. College students viewed recruitment information online and voluntarily participated in the survey, with participation covering multiple regions.

2.1.2. Procedure

The survey was conducted in December 2022 when normal life was affected in China due to the ongoing COVID-19 pandemic. Prior to conducting the survey, our institution conducted an ethical review and approved the study. A professional online questionnaire research platform was used to recruit college students from 30 provinces across China. We provided the participants with informed consent forms and participation was dependent on these being completed. A total of 471 people completed the questionnaire, five of whom were excluded because their response time was <3 min, and 466 questionnaires were retained. The questionnaire included four scales and collected basic demographic information. Monte Carlo analysis revealed that the sample size needed to exceed 232 for 0.8 statistical power ( 83 ). Therefore, the sample size was adequate.

2.1.3. Sample characteristics

Of the final 466 questionnaire respondents included in this study, 355 were female, 111 were male, with ages ranging from 18 to 32 years (average, 21.1 ± 1.97 years), and comprising 381 undergraduates (81.76%), 76 master's students (16.31%), and 9 doctoral students (1.93%).

2.2. Measurement

Depression was assessed using a scale developed by Spitzer et al. ( 84 ). The Chinese version of this scale has proven reliable ( 85 ). A 4-point Likert scale is used to score each of the nine items in the scale, such as “Over the past 2 weeks, have you experienced a loss of appetite or overeating?,” where a higher total score indicates a greater level of depression. In this study, the Cronbach's α coefficient was 0.85, the McDonald's omega coefficient was 0.885, and the Kaiser-Meyer-Olkin (KMO) coefficient was 0.885.

Academic engagement was evaluated using a scale developed by Schaufeli et al. ( 86 ). The reliability of the Chinese version of this scale has been verified ( 87 ). This scale includes nine items, such as “Does your study inspire you?,” rated on a 7-point Likert scale, with a higher score reflecting higher levels of academic engagement. In this study, the Cronbach's α coefficient was 0.93, the McDonald's omega coefficient was 0.945, and the KMO coefficient was 0.932.

A sense of security was measured using a scale developed by Cong and An ( 87 ). The reliability of this scale in its Chinese version has been verified ( 88 ). The scale consists of 16 items, for instance, “Do you often feel unlucky?,” scored on a 4-point Likert scale, where a higher cumulative score signifies a stronger sense of security. The Cronbach's alpha, McDonald's omega, and KMO coefficients for this study were 0.881, 0.901, and 0.866, respectively.

The psychological impact of COVID-19 was measured using a scale developed by Vanaken et al. ( 89 ). The reliability of this scale has been verified ( 90 ). This scale includes 15 items, such as “Have you had dreams about the pandemic in the past week?,” rated on a 5-point Likert scale, with the interpretation being that a higher total score indicates a greater psychological impact of COVID-19. The Cronbach's alpha, McDonald's omega, and KMO coefficients for this study were 0.872, 0.894, and 0.898, respectively. For the questionnaire used in this study, we computed the composite reliability (CR) index, which came out to be 0.875, indicating a high degree of validity. We also carried out a confirmatory factor analysis, and found that the Parsimony Goodness of Fit Index (PGFI) was 0.586, the Parsimony Normed Fit Index (PNFI) was 0.625, the Parsimony Comparative Fit Index (PCFI) was 0.645, and the Standardized Root Mean Square Residual (SRMR) was 0.091. These model fit indices reflect a good overall fit of the model.

2.3. Data analysis

The scores of the college students on the four scales of academic engagement, depression, sense of security, and the psychological impact of COVID-19 were tallied, and their means ( M ) and standard deviations ( SD ) were calculated. Pearson's correlation coefficients were used to analyze the correlations. Given that the sample size was >300, kurtosis and skewness values were used to estimate the multivariate normal distribution. To test the moderated mediation effect, we used Model 14 of the microprocess plugin developed by Hayes ( 91 ) for the mediation analysis and moderation effect. A moderated mediation effect can be considered when the bootstrap confidence interval excludes zero.

A normality test was conducted on the data of the four variables: academic engagement, depression, a sense of security, and the psychological impact of COVID-19. The skewness values were 0.426, −0.166, −0.008, and 0.170, respectively, and the kurtosis values were −0.326, −0.523, −0.162, and −0.134 respectively, indicating that all the variables conformed to a normal distribution. In addition to the skewness and kurtosis assessments, visual inspection of the histograms also confirmed the normal distribution, further substantiating that all four variables exhibited essential normality. Analysis of the correlations among the four variables revealed a negative correlation between depression and academic engagement (r = −0.457, p < 0.01) and a negative correlation with a sense of security (r = −0.258, p < 0.01). A significant correlation was also found between a sense of security and academic engagement (r = 0.297, p < 0.01). The specifications are listed in Table 1 .

Table 1 . Correlation analysis of the four variables.

Regression analysis showed that depression could significantly negatively affect a sense of security (B = −0.5669, t = −5.7535, p < 0.001). A sense of security (B = 0.1741, t = 0.0379, p < 0.001) and depression (B = −0.8084, t = −9.7212, p < 0.001) significantly affected academic engagement (R 2 = 0.2430, F = 74.3092, p < 0.001). These results suggest that depression negatively affected academic engagement and that this relationship was mediated by a sense of security. Furthermore, depression (B = −1.028, t = −11.969, p < 0.001), a sense of security (B = −0.246, t = −1.893, p = 0.059), the psychological impact of COVID-19 (B = −0.267, t = −1.446, p = 0.149), and the interaction between a sense of security and the psychological impact of COVID-19 (B = 0.012, t = 3.419, p < 0.001) significantly affected academic engagement (R 2 = 0.317, F = 53.4556, p < 0.001). The test results of the mediated model with moderation proposed in this study are shown in Figure 2 . In this model, the interaction between a sense of security and the psychological impact of COVID-19 was significant (95% confidence interval [CI] = [0.0051,0.0191]), indicating that a sense of security and academic engagement were moderated by the psychological impact of COVID-19 (See Table 2 ).

Figure 2 . Test results of the mediator model with moderation. *** p < 0.001.

Table 2 . Summary of regression models.

When analyzing the moderating effect of the psychological impact of COVID-19, it was found that at a low level of impact ( M – 1 SD ) with an effect value of −0.042 and 95%CI = [−0.110,0.010], there was no mediation. However, the mediation was significant at both M and high M levels ( M + 1 SD ) in relation to the psychological impact of COVID-19, with effect values of −0.098 and −0.154, and 95%CIs of [−0.168, −0.042] and [−0.251, −0.068], respectively (See Table 3 ). Therefore, the mediating role of a sense of security varied at different levels in terms of the psychological impact of COVID-19, indicating moderated mediation.

Table 3 . Results of the conditional indirect effect.

Simple slope analysis revealed that under high levels of the psychological impact of COVID-19, as the level of depression increased, the level of academic engagement was noticeably poorer compared to the group with low levels (See Figure 3 ). This finding indicates that the psychological impact of COVID-19 significantly moderated the mediating role of depression and academic engagement.

Figure 3 . Mediating moderating effect between depression and academic engagement.

4. Discussion

This study found that depression negatively influenced college students' academic engagement during the COVID-19 pandemic, with a sense of security playing a mediating role and the psychological impact of COVID-19 having a moderating effect. As a result of these findings, hypothesis 1 and hypothesis 3 were both supported, and hypothesis 2 was partially supported. Notably, theoretical understanding of how depression affects college students in the context of sudden public health crises has been strengthened by this new insight into the relationship between depression and academic engagement.

This study found that college students' depression was negatively associated with academic engagement, supporting the first hypothesis, which accords with previous studies reporting that college students' depression affects their academic engagement ( 92 , 93 ). However, in this study conducted during the pandemic, college students' depression was found to have a stronger effect on academic engagement. This finding implies that, in the context of new environmental variables, the risk factors for college students' depression affecting academic engagement are likely to be exacerbated, such as psychological difficulties, academic challenges, and financial issues, which could intensify this relationship ( 94 ).

Several factors may explain why depression negatively affects college students' academic engagement. First, depression severely affects students' psychological and emotional states ( 95 ). This emotional instability and the frequent experience of low mood can compromise learning effectiveness ( 35 ) and significantly undermine academic self-efficacy in the long run ( 96 ). Second, an enthusiastic attitude toward learning is crucial for academic engagement ( 97 ). Depression can lead to a loss of interest in learning and doubts about its importance, especially during crises such as the pandemic when students faced an uncertain future, further diminishing their enthusiasm for learning ( 98 ). Additionally, students had to deal with sudden shifts to online learning, prolonged Internet usage, and an inability to consult teachers face-to-face. Among those with depression, these substantial learning challenges and unprecedented pressures could have become overwhelming, possibly leading to avoidance or refusal to learn ( 99 ). Depression among college students during the pandemic could have intensified, significantly affecting their sleep quality and mental states and making it difficult for them to concentrate on academic issues ( 100 ). Therefore, students' academic engagement was more likely to be significantly affected by depression, with the pandemic having a further exacerbating effect.

This study found that under certain levels of psychological impact of COVID-19, a sense of security partially mediated the relationship between depression and academic engagement, partially confirming the second hypothesis. Previous research has suggested that depression may influence feelings of insecurity ( 101 ), which aligns with the results of the present study. This study also found a correlation between college students' sense of security and academic engagement, further corroborating previous studies ( 102 , 103 ).

Symptoms of depression in college students usually form over a long period owing to the combined influence of various factors, and their impact on students' learning and life may require other elements to unfold further ( 104 , 105 ). Depression in college students is often characterized by significant emotional issues ( 106 ), which alter their perceptions of and attitudes toward their surroundings. During the pandemic, students exhibiting depressive symptoms were more likely to worry about their personal safety and future prospects ( 107 ), which negatively affected their passion for learning. Students' heightened sense of insecurity during the pandemic indicates that they faced challenges in terms of adapting and problem-solving, which may have disrupted their learning mindset. In the complex pandemic environment, college students required a calm and stable mindset for academic engagement ( 108 ). The greater insecurity induced by depression imposed enormous pressure on some of them, preventing them from focusing on their studies ( 109 ). Importantly, depression makes students more susceptible to perceived threats. When students are highly anxious and fearful, learning is not a priority in their subconscious, especially during crises such as the pandemic when they had to divide their attention ( 110 ). Consequently, the psychological resources that can be allocated to learning naturally decrease, thereby affecting academic engagement.

This study found that depression and academic engagement in college students were moderated by the psychological impact of COVID-19, thereby verifying the third hypothesis. There was a greater likelihood that depression would affect academic engagement among those who experienced a high level of psychological impact from COVID-19, supporting previous findings ( 111 – 114 ). This finding suggests that in college students with depression, sudden major public health crises may further disrupt mental states; therefore, along with routine depression interventions, it is crucial to address heightened emotional stress due to crises such as the pandemic.

There are several key reasons why the psychological impact of COVID-19 mediated the relationship between depression and academic engagement. First, the psychological impact of COVID-19 involved short-term and intense negative emotions ( 115 ). These types of emotion could have amplified negative feelings among depressed college students, causing them to experience more anxiety and pressure, which depleted their energy for learning. Second, among those experiencing strong pandemic-related stress, their ability to regulate emotions may have been significantly affected ( 116 ), with emotional dysregulation becoming more severe. This outcome could have weakened their ability to manage their feelings of insecurity, thereby reducing their enthusiasm for learning. Good cognitive abilities are necessary for academic engagement. In groups that reacted excessively to the pandemic, their cognitive abilities might have been further weakened ( 117 ), thus exacerbating the negative influence of depression on academic engagement.

4.1. Main contributions

This study provides novel theoretical insights. First, it was found that college students' sense of security partially mediated the relationship between depression and academic engagement. The degree to which COVID-19 impacted students psychologically was also found to moderate this mediating effect. This study offers a fresh perspective on the mechanisms underlying the interaction between depression and learning among college students. Second, the analysis of the psychological impact of COVID-19 provides new evidence for understanding depression-related issues during major public health crises. Finally, this study enhances understanding of the mechanisms underlying the negative effects of depression, which can help generate new ideas for the development of better targeted intervention strategies.

4.2. Practical implications

In accordance with the findings of this study, during critical events such as the COVID-19 pandemic, the mental health support for college students should be brought to the forefront. It has been observed that during such severe public health crises, not only does the prevalence of depression among college students significantly rise, but mental health of already depressed individuals is further impacted. Hence, a concerted effort to educate college students about their mental health, as well as the provision of timely psychological counseling support, becomes vital. Firstly, in the face of the pandemic, institutions should ramp up their psychological aid services to assist students in handling the mental pressures triggered by the crisis. This would include proffering counseling and targeted assistance, incorporating both individual and group psychological therapies. Secondly, educational institutions should proactively disseminate pandemic-centric mental health education. This can take the form of online mental health seminars, aimed at enlightening students about the psychological repercussions of the pandemic, equipping them with methods to assuage the mental stress incited by the situation, and instructing them on preserving their academic engagement amidst these arduous circumstances. Additionally, fostering tighter collaboration between an institution's mental health services department and its basic academic units can be beneficial. This partnership, expressed through the organization of relevant activities, can boost students' psychological resilience, enhance their mental health literacy, and arm them with the tactics to effectively navigate through similar crises. Moreover, the institutions bear the responsibility of ensuring a secure environment for the students' living and learning needs. For those students whose in-person learning has been obstructed due to the pandemic, schools should guarantee a safe, stable online platform to ensure the seamless continuation of their studies. It would also be advantageous to schedule frequent online social events, allowing students to experience the warmth and support of their community, even while confined at home. Lastly, and most importantly, institutions need to create an exhaustive protocol to manage student mental health crises during public health emergencies. This could entail setting up mental health records, offering active interventions for students grappling with depression during ordinary times, and emphasizing the provision of psychological counseling services, online learning resources, and flexible academic policies in the event of sudden public health emergencies. In doing so, institutions can secure students' sense of safety and academic involvement during crises, thereby mitigating the potential risks associated with depression. This study uncovered that the academic engagement of college students was severely challenged during the pandemic. This necessitates focused interventions to ensure these students receive additional attention and assistance, fostering a supportive learning environment that diminishes feelings of insecurity and encourages active academic involvement. It underlines that during unexpected public health crises, students should be offered counseling and specific assistance to address their psychological needs. Overall, these steps can significantly contribute to the mitigation of adverse effects on learning due to depression and foster better mental health among college students.

4.3. Limitations

This study had some limitations. The data collected in the research were derived from self-reporting, which may have resulted in bias as students may have avoided providing truthful responses due to perceived social conformity constraints. Future studies should employ multiple data collection methods to obtain more comprehensive and accurate datasets. All participants in this study were from China and, because of cultural differences, the findings may not be generalizable to other cultures. Further validation of these findings in other countries is warranted. This study used convenience sampling. Although a wide range of students from different regions was recruited online to increase the breadth of the sample, future studies should employ more systematic sampling methods for a more accurate representation of Chinese college students. Female participants constituted a large proportion of the investigation, which might have introduced some bias. Future studies could control for the gender ratio of the participants. In addition to a sense of security and the psychological impact of COVID-19, other factors and mechanisms may have been involved in terms of the relationship between depression on student engagement, which should be explored further in future studies. In addition, the investigation was cross-sectional; therefore, causal inferences could not be made, suggesting the need for experimental or longitudinal research designs in future investigations.

5. Conclusion

This study revealed that during the COVID-19 pandemic, depression among college students negatively affected their academic engagement. A sense of security partially mediated this relationship, with the psychological impact of COVID-19 found to moderate this mediating effect. Furthermore, the indirect negative effect of depression on academic engagement through a sense of security was found to be stronger in students who experienced a higher psychological impact from COVID-19. These findings provide new insights into the mechanisms through which depression affects academic engagement among college students and new evidence of the negative impact of depression on students. This study can help inform the development of more effective intervention strategies during crisis events such as the pandemic that can reduce the negative effects of depression and promote students' academic engagement.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving human participants were reviewed and approved by Academic Committee of Shenzhen University's College of Social Sciences. The patients/participants provided their written informed consent to participate in this study.

Author contributions

YT responsible for the execution of the methodology, securing the required funding, and drafting the original document. WH conducts formal analysis, provides review and editing of the manuscript, and manages the project. The investigation aspect has seen contributions from both YT and WH.

Shenzhen Academy of Social Sciences (SZ2022C001), Guangdong Education Science Planning Leading Group Office (2022GXJK077), and Shenzhen Education Science Planning Leading Group Office (dwzz22171) provided funding.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

1. Lou H, Chen J, Liu P. The impact of adolescents' health motivation on the relationship among mental stress, physical exercise, and stress symptoms during COVID-19: a dual moderation model. Front Public Health. (2023) 11:1164184. doi: 10.3389/fpubh.2023.1164184

PubMed Abstract | CrossRef Full Text | Google Scholar

2. Wen J, Zou L, Wang Y, Liu YF Li WJ, Liu ZW, et al. The relationship between personal-job fit and physical and mental health among medical staff during the two years after COVID-19 pandemic: emotional labor and burnout as mediators. J Affect Disord. (2023) 327:416–24. doi: 10.1016/j.jad.2023.02.029

3. Wang JQ, Xu MD Li XT, Ni YT, A. Latent class analysis of hopelessness in relation to depression and trauma during the COVID-19 pandemic in China. J Affect Disord. (2023) 329:81–7. doi: 10.1016/j.jad.2023.02.077

4. Zhao Y, Qu DY, Chen SY, Chi XL. Network analysis of internet addiction and depression among Chinese college students during the COVID-19 pandemic: a longitudinal study. Comput Human Behav. (2023) 138:107424. doi: 10.1016/j.chb.2022.107424

5. Egbert AR, Karpiak S, Havlik R, Cankurtaran S. Global occurrence of depressive symptoms during the COVID-19 pandemic. J Psychosom Res. (2023) 166:145. doi: 10.1016/j.jpsychores.2022.111145

6. Wang Y, Zhang S, Liu XG, Shi HY, Deng XY. Differences in central symptoms of anxiety and depression between college students with different academic performance: a network analysis. Front Psychol. (2023) 14:1071936. doi: 10.3389/fpsyg.2023.1071936

7. Altavini CS, Asciutti APR, Santana GL, Solis ACO, Andrade LH, Oliveira LG, et al. Suicide ideation among brazilian college students: relationship with academic factors, mental health, and sexual abuse. J Affect Disord. (2023) 329:324–34. doi: 10.1016/j.jad.2023.02.112

8. Turana Y, Primatanti PA, Sukarya WS, Wiyanto M, Duarsa ABS, Wratsangka R, et al. Impact on medical education and the medical student's attitude, practice, mental health, after one year of the COVID-19 pandemic in Indonesia. Front Educ. (2022) 7:898. doi: 10.3389/feduc.2022.843998

CrossRef Full Text | Google Scholar

9. Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. (2011) 35:537–55. doi: 10.1016/j.neubiorev.2010.06.006

10. Hasler G, Drevets WC, Manji HK, Charney DS. Discovering endophenotypes for major depression. Neuropsychopharmacology. (2004) 29:1765–81. doi: 10.1038/sj.npp.1300506

11. Rosenstrom T, Jokela M. Reconsidering the definition of major depression based on collaborative psychiatric epidemiology surveys. J Affect Disord. (2017) 207:38–46. doi: 10.1016/j.jad.2016.09.014

12. Zhang K, Yao YT, Hashimoto K. Ketamine and its metabolites: potential as novel treatments for depression. Neuropharmacology. (2023) 222:109305. doi: 10.1016/j.neuropharm.2022.109305

13. Arun P, Ramamurthy P, Thilakan P. Indian medical students with depression, anxiety, and suicidal behavior: why do they not seek treatment? Indian J Psychol Med. (2022) 44:10–6. doi: 10.1177/0253717620982326

14. Liu LL, Chen JB, Liang SW, Yang WW, Peng XD, Cai CC, et al. Impact of family functioning on mental health problems of college students in china during COVID-19 pandemic and moderating role of coping style: a longitudinal study. BMC Psychiatry. (2023) 23:9. doi: 10.1186/s12888-023-04717-9

15. Kim K, Jeong H, Lee J. COVID-19 Related fear, risk perceptions, and behavioral changes according to level of depression among nursing students. Int J Environ Res Public Health. (2022) 19:814. doi: 10.3390/ijerph19084814

16. Shi CY, Wang SJ, Tang QH, Liu XP Li Y. Cross-Lagged relationship between anxiety, depression, and sleep disturbance among college students during and after collective isolation. Front Public Health. (2022) 10:862. doi: 10.3389/fpubh.2022.1038862

17. Fredricks JA, Blumenfeld PC, Paris AH. School engagement: potential of the concept, state of the evidence. Rev Educ Res. (2004) 74:59–109. doi: 10.3102/00346543074001059

18. Nagy RP, Martin AJ, Collie RJ. Disentangling motivation and engagement: exploring the role of effort in promoting greater conceptual and methodological clarity. Front Psychol. (2022) 13:717. doi: 10.3389/fpsyg.2022.1045717

19. Steinhardt F, Dolva AS, Jahnsen R, Ullenhag A. Exploring two subdimensions of participation, involvement and engagement: a scoping review. Scand J Occup Ther. (2022) 29:441–63. doi: 10.1080/11038128.2021.1950207

20. Wang JX, Yang CH, Wang JZ, Sui XL, Sun W, Wang Y. Factors affecting psychological health and career choice among medical students in eastern and western region of china after COVID-19 pandemic. Front Public Health. (2023) 11:108136. doi: 10.3389/fpubh.2023.1081360

21. Thompson Z, Yoon H, Booth P. Dispersed assessment: a novel approach to enhancing student engagement during and beyond COVID-19. Int J Manage Educ. (2023) 21:811. doi: 10.1016/j.ijme.2023.100811

22. Al-Khresheh M. Virtual classrooms engagement among jordanian efl students during the pandemic of COVID-19 period. Cogent Educ. (2023) 10:898. doi: 10.1080/2331186X.2023.2188989

23. Ghislieri C, Sanseverino D, Dolce V, Spagnoli P, Manuti A, Ingusci E, et al. Emotional exhaustion and engagement in higher education students during a crisis, lessons learned from COVID-19 experience in Italian universities. Soc Sci Basel. (2023) 12:q09. doi: 10.3390/socsci12020109

24. Rafsanjani MA, Wijaya PA, Baskara A, Wahyudi HD. Mental health and learning achievement during the COVID-19 outbreak: a lesson from online learning among indonesian college students. Obrazovanie I Nauka-Education and Science. (2023) 25:155–73. doi: 10.17853/1994-5639-2023-3-155-173

25. Liu SH, Zou SQ, Zhang D, Wang XY, Wu XC. Problematic internet use and academic engagement during the COVID-19 lockdown: the indirect effects of depression, anxiety, and insomnia in early, middle, and late adolescence. J Affect Disord. (2022) 309:9–18. doi: 10.1016/j.jad.2022.04.043

26. Wickramasinghe A, Essen B, Surenthirakumaran R, Axemo P. Prevalence of depression among students at a Sri Lankan University: a study using the patient health questionnaire-9 (Phq-9) during the COVID-19 pandemic. BMC Public Health. (2023) 23:15427. doi: 10.1186/s12889-023-15427-y

27. Quarta S, Levante A, Garcia-Conesa MT, Lecciso F, Scoditti E, Carluccio MA, et al. Assessment of Subjective well-being in a cohort of university students and staff members: association with physical activity and outdoor leisure time during the COVID-19 pandemic. Int J Environ Res Public Health. (2022) 19:787. doi: 10.3390/ijerph19084787

28. Peng P, Hao YZ, Liu YH, Chen SB, Wang YF, Yang Q, et al. The prevalence and risk factors of mental problems in medical students during COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord. (2023) 321:167–81. doi: 10.1016/j.jad.2022.10.040

29. Wang Y, Wang R, Lu JJ. Exploring the impact of university student engagement on junior faculty's online teaching anxiety and coping strategies during COVID-19. Educ Sci. (2022) 12:664. doi: 10.3390/educsci12100664

30. Yuan LL, Lu L, Wang XH, Qu M, Gao YQ, Pan BC. Comorbid anxiety and depressive symptoms and the related factors among international medical students in China During COVID-19 pandemic: a cross-sectional study. BMC Psychiatry. (2023) 23:4638. doi: 10.1186/s12888-023-04638-7

31. Vizoso C, Rodriguez C, Arias-Gundin O. Coping, academic engagement and performance in university students. High Educ Res Develop. (2018) 37:1515–29. doi: 10.1080/07294360.2018.1504006

32. Zhao H, Liu XX Qi CH. “Want to learn” and “can learn”: influence of academic passion on college students' academic engagement. Front Psychol. (2021) 12:7822. doi: 10.3389/fpsyg.2021.697822

33. Busonera A, Lampis J, Cataudella S. Starting university at the time of COVID-19: psychoemotional adjustment of a group of italian students. J Adult Develop . 23:1–12. doi: 10.1007/s10804-023-09444-9

34. Gabrovec B, Selak S, Crnkovic N, Cesar K, Sorgo A. Perceived satisfaction with online study during COVID-19 lockdown correlates positively with resilience and negatively with anxiety, depression, and stress among slovenian postsecondary students. Int J Environ Res Public Health. (2022) 19:7024. doi: 10.3390/ijerph19127024

35. Wang QL, Kou ZY, Du YF, Wang K, Xu YH. Academic procrastination and negative emotions among adolescents during the COVID-19 pandemic: the mediating and buffering effects of online-shopping addiction. Front Psychol. (2022) 12:505. doi: 10.3389/fpsyg.2021.789505

36. Giovenco D, Shook-Sa BE, Hutson B, Buchanan L, Fisher EB, Pettifor A. Social isolation and psychological distress among Southern us college students in the Era of COVID-19. PLoS One. (2022) 17:e0279485. doi: 10.1371/journal.pone.0279485

37. Morris ME, Kuehn KS, Brown J, Nurius PS, Zhang H, Sefidgar YS, et al. College from home during COVID-19: a mixed-methods study of heterogeneous experiences. PLoS One. (2021) 16:e251580. doi: 10.1371/journal.pone.0251580

38. Wong WLL, Yuen KWA. Online learning stress and Chinese College students' academic coping during COVID-19: the role of academic hope and academic self-efficacy. J Psychol. (2023) 157:95–120. doi: 10.1080/00223980.2022.2148087

39. Marciano L, Ostroumova M, Schulz PJ, Camerini AL. Digital media use and adolescents' mental health during the COVID-19 pandemic: a systematic review and meta-analysis. Front Public Health . (2022) 9:7938. doi: 10.3389/fpubh.2021.793868

40. Murray SL. Regulating the risks of closeness—a relationship-specific sense of felt security. Curr Dir Psychol Sci. (2005) 14:74–8. doi: 10.1111/j.0963-7214.2005.00338.x

41. Carnelley KB, Rowe AC. Priming a sense of security: what goes through people's minds? J Soc Pers Relat. (2010) 27:253–61. doi: 10.1177/0265407509360901

42. Jakubiak BK, Feeney BC, A. Sense of security: touch promotes state attachment security. Soc Psychol Personal Sci. (2016) 7:745–53. doi: 10.1177/1948550616646427

43. Nowicki GJ, Slusarska B, Tucholska K, Naylor K, Chrzan-Rodak A, Niedorys B. The severity of traumatic stress associated with COVID-19 pandemic, perception of support, sense of security, and sense of meaning in life among nurses: research protocol and preliminary results from poland. Int J Environ Res Public Health. (2020) 17:491. doi: 10.3390/ijerph17186491

44. Berger E, Larsen J, Freudenberg N, Jones HE. Food insecurity associated with educational disruptions during the COVID-19 pandemic for college students and the role of anxiety and depression. J Am Coll Health. (2022) 20:3115. doi: 10.1080/07448481.2022.2093115

45. Maynard M, Meyer SB, Perlman CM, Kirkpatrick SI. Experiences of food insecurity among undergraduate students: “you can't starve yourself through school.” Canad J High Educ . (2018) 48:130–48. doi: 10.47678/cjhe.v48i2.188121

46. Hu YX, Ye BJ, Tan JW. Stress of COVID-19, anxiety, economic insecurity, and mental health literacy: a structural equation modeling approach. Front Psychol. (2021) 12:709. doi: 10.3389/fpsyg.2021.707079

47. Sundermeir SM, Wolfson JA, Bertoldo J, Gibson DG, Agarwal S, Labrique AB. Food insecurity is adversely associated with psychological distress, anxiety and depression during the COVID-19 pandemic. Prevent Med Rep. (2021) 24:1574. doi: 10.1016/j.pmedr.2021.101547

48. Coakley KE, Cargas S, Walsh-Dilley M, Mechler H. Basic needs insecurities are associated with anxiety, depression, and poor health among university students in the State of New Mexico. J Community Health. (2022) 47:454–63. doi: 10.1007/s10900-022-01073-9

49. McKenney EE, Brunwasser SM, Richards JK, Day TC, Kofner B, McDonald RG, et al. Repetitive negative thinking as a transdiagnostic prospective predictor of depression and anxiety symptoms in neurodiverse first-semester college students. Autism in Adulthood. (2023) 22:78. doi: 10.1089/aut.2022.0078

50. Brownfield N, Quinn S, Bates G, Thielking M. What Is Eating gilbert's grades? examining the impact of food insecurity and psychological distress on weighted average marks within a sample of Australian University Students. J Furth High Educ. (2023) 21:203. doi: 10.1080/0309877X.2023.2176203

51. Umeda M, Kim Y, Park SW, Chung EH, Ullevig SL. Food insecurity and academic function among college students during the COVID-19 pandemic: a moderating role of the first-generation college student status. J Am Coll Health. (2023) 23:1–7. doi: 10.1080/07448481.2023.2185076

52. Igboeli CC, Nnamdi O, Obi IE, Okafor O. School insecurity and students academic engagement in Nigeria public University. COOU J Educ Res. (2021) 2:19–24.

Google Scholar

53. Gahan E, Farooqui S, Leung CW. “You feel out of place”: a photovoice study of the impact of food insecurity on college students. Health Equity. (2022) 6:67. doi: 10.1089/heq.2022.0067

54. Safwan J, Halat DH, Akel M, Younes S, Rahal M, Mourad N, et al. The impact of COVID-19 on the mental health of lebanese pharmacists: a national cross-sectional study. Front Public Health. (2023) 11:840. doi: 10.3389/fpubh.2023.1156840

55. Serafini G, Parmigiani B, Amerio A, Aguglia A, Sher L, Amore M. The psychological impact of COVID-19 on the mental health in the general population. Qjm-an Int J Med. (2020) 113:529–35. doi: 10.1093/qjmed/hcaa201

56. Ali AM, Al-Amer R, Kunugi H, Stanculescu E, Taha SM, Saleh MY, et al. The Arabic version of the impact of event scale-revised: psychometric evaluation among psychiatric patients and the general public within the context of COVID-19 outbreak and quarantine as collective traumatic events. J Pers Med. (2022) 12:681. doi: 10.3390/jpm12050681

57. Ahmad S, Masood S, Khan NZ, Badruddin IA., Ompal, Ahmadian A, et al. Analysing the impact of COVID-19 pandemic on the psychological health of people using fuzzy Mcdm. Methods Operat Res Perspect. (2023) 10:263. doi: 10.1016/j.orp.2022.100263

58. Xu FM, Huang L. Impacts of stress response and negative emotion on mental health of college students during the COVID-19 Outbreak. Front Psychiatry. (2022) 12:78461. doi: 10.3389/fpsyt.2021.784661

59. Carrion AJ, Ridley A, Rasaki AA, Journee B, McCants TA. Impact of COVID-19 on the academic performance and mental health of hbcu pharmacy students. Currents in pharmacy teaching & learning. (2023) 15:123–9. doi: 10.1016/j.cptl.2023.02.017

60. Chaudhuri A, Paul S, Saha E. A comparative study to assess mental health literacy, impact of event, depression, anxiety, and stress levels of medical and other students during the second wave of the COVID-19 pandemic. J Scientific Soc. (2022) 49:35–9. doi: 10.4103/jss.jss_143_21

61. Tapia V, Isralowitz EB, Deng K, Nguyen NT, Young M, Como DH, et al. Exploratory analysis of college students' occupational engagement during COVID-19. J Occupat Sci. (2022) 29:545–61. doi: 10.1080/14427591.2022.2101021

62. Clark RM, Besterfield-Sacre M, Dickerson S, Gau D. Impact of COVID-19 on engineering students in the middle phases of the pandemic: academic motivation, valued college experiences, and stress. Int J Eng Educ. (2023) 39:30–47.

63. Hjiej G, El Idrissi FE, Janfi T, Bouhabs M, Hnaifi H, Belakbyer H, et al. Distant education in moroccan medical schools following COVID-19 outbreak at the early phase of lockdown: were the students really engaged? Scientific African . (2022) 15:e01087. doi: 10.1016/j.sciaf.2021.e01087

64. McEwan RC, Downie R. Patterns of academic success and engagement among college students with psychiatric disabilities. J College Stud Psychother. (2019) 33:257–72. doi: 10.1080/87568225.2018.1483216

65. Bang H, Won D, Park S. School engagement, self-esteem, and depression of adolescents: the role of sport participation and volunteering activity and gender differences. Child Youth Serv Rev. (2020) 113:105012. doi: 10.1016/j.childyouth.2020.105012

66. Fiorilli C, De Stasio S, Di Chiacchio C, Pepe A, Salmela-Aro K. School burnout, depressive symptoms and engagement: their combined effect on student achievement. Int J Educ Res. (2017) 84:1–12. doi: 10.1016/j.ijer.2017.04.001

67. Gao F, Mei Q, Guo C. Relationship between depression and student engagement of senior high school students and the mediating role of resilience. Revista Argentina de Clinica Psicologica. (2020) 29:14. doi: 10.24205/03276716.2020.3

68. Cortes-Garcia L, Takkouche B, Rodriguez-Cano R, Senra C. Mediational mechanisms involved in the relation between attachment insecurity and depression: a meta-analysis. J Affect Disord. (2020) 277:706–26. doi: 10.1016/j.jad.2020.08.082

69. Fowler JC, Allen JG, Oldham JM, Frueh BC. Exposure to interpersonal trauma, attachment insecurity, and depression severity. J Affect Disord. (2013) 149:313–8. doi: 10.1016/j.jad.2013.01.045

70. Reeder N, Tolar-Peterson T, Bailey RH, Cheng W-H, Evans MW Jr. Food insecurity and depression among us adults: nhanes 2005–2016. Nutrients. (2022) 14:3081. doi: 10.3390/nu14153081

71. Martinez SM, Frongillo EA, Leung C, Ritchie L. No food for thought: food insecurity is related to poor mental health and lower academic performance among students in California's public university system. J Health Psychol. (2020) 25:1930–9. doi: 10.1177/1359105318783028

72. Van Woerden I, Hruschka D, Bruening M. Food insecurity negatively impacts academic performance. J Public Affairs. (2019) 19:e1864. doi: 10.1002/pa.1864

73. Lavrijsen J, Soenens B, Vansteenkiste M, Verschueren K. When insecure self-worth drains students' energy: academic contingent self-esteem and parents' and teachers' perceived conditional regard as predictors of school burnout. J Youth Adolescence. (2023) 52:810–25. doi: 10.1007/s10964-023-01749-y

74. Perez-Felkner L, Ford JR, Zhao T, Anthony M Jr, Harrison JA, Rahming SG. Basic needs insecurity among doctoral students: what it looks like and how to address it. About Campus. (2020) 24:18–24. doi: 10.1177/1086482219899649

75. Liu Y, Li D, Jia J, Zhou Y, Zhao L, Wang Y, et al. Perceived school climate and problematic internet use among chinese adolescents: psychological insecurity and negative peer affiliation as mediators. Psychol Addict Behav. (2021) 35:113. doi: 10.1037/adb0000684

76. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: systematic review of the current evidence. Brain Behav Immun. (2020) 89:531–42. doi: 10.1016/j.bbi.2020.05.048

77. Penninx BW, Benros ME, Klein RS, Vinkers CH. How COVID-19 shaped mental health: from infection to pandemic effects. Nat Med. (2022) 28:2027–37. doi: 10.1038/s41591-022-02028-2

78. Park C, Fuller MM, Echevarria TM, Nguyen K, Perez D, Masood H, et al. A participatory study of college students' mental health during the first year of the COVID-19 pandemic. Front Public Health. (2023) 11:6865. doi: 10.3389/fpubh.2023.1116865

79. Orozco MFS, de Gonzalez WYE, Marin NP, Hernandez JRC, Hernandez-Cabanillas JC, Acosta IO, et al. Depression and opinion of dental students regarding the hybrid learning model during the COVID-19 pandemic. Bmc Psychol. (2023) 11:78. doi: 10.1186/s40359-023-01157-8

80. Sotelo JCE. Depression and aggressiveness in the context of COVID-19: impact of the pandemic on university students. Revista San Gregorio. (2023) 53:185–99. doi: 10.36097/rsan.v0i53.2143

81. Yang LS, Liu ZY, Shi SN, Dong Y, Cheng HTJ. The Mediating role of perceived stress and academic procrastination between physical activity and depressive symptoms among Chinese college students during the COVID-19 pandemic. Int J Environ Res Public Health. (2023) 20:10733. doi: 10.3390/ijerph20010773

82. Ikbar RR, Amit N, Subramaniam P, Ibrahim N. Relationship between self-efficacy, adversity quotient, COVID-19-related stress and academic performance among the undergraduate students: a protocol for a systematic review. PLoS One. (2022) 17:12. doi: 10.1371/journal.pone.0278635

83. Schoemann AM, Boulton AJ, Short SD. Determining power and sample size for simple and complex mediation models. Soc Psychologic Personal Sci. (2017) 8:379–86. doi: 10.1177/1948550617715068

84. Spitzer RL, Kroenke K, Williams JBW, Patient Hlth Questionnaire P. Validation and utility of a self-report version of prime-md - the phq primary care study. Jama. (1999) 282:1737–44. doi: 10.1001/jama.282.18.1737

85. Zhao YJ, Zhang SF Li W, Zhang L, Guo T, Cheung T, et al. Associations between depressive symptoms and quality of life among residents of wuhan, china during the later stage of the COVID-19 pandemic: a network analysis. J Affect Disord. (2022) 318:456–64. doi: 10.1016/j.jad.2022.08.104

86. Schaufeli WB, Bakker AB, Salanova M. The measurement of work engagement with a short questionnaire—a cross-national study. Educ Psychol Meas. (2006) 66:701–16. doi: 10.1177/0013164405282471

87. Mou QX, Zhuang J, Gao YX, Zhong YQ, Lu QY, Gao F, et al. The relationship between social anxiety and academic engagement among Chinese college students: a serial mediation model. J Affect Disord. (2022) 311:247–53. doi: 10.1016/j.jad.2022.04.158

88. Cao L. The relationship between adjustment and mental health of Chinese freshmen: the mediating effect of security and the moderating effect of gender. Front Public Health. (2022) 10:16329. doi: 10.3389/fpubh.2022.916329

89. Vanaken L, Scheveneels S, Belmans E, Hermans D. Validation of the impact of event scale with modifications for COVID-19 (Ies-COVID19). Front Psychiatry. (2020) 11:738. doi: 10.3389/fpsyt.2020.00738

90. Am KU, Jackson D, Massey D, Wynaden D, Grant J, West C, et al. The mental health impact of COVID-19 on Pre-registration nursing students in Australia: findings from a national cross-sectional study. J Adv Nurs. (2023) 79:581–92. doi: 10.1111/jan.15478

91. Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach . NewYork, NY: Guilford publications (2017).

92. Hysenbegasi A, Hass SL, Rowland CR. The impact of depression on the academic productivity of University students. J Ment Health Policy Econ. (2005) 8:145–51.

PubMed Abstract | Google Scholar

93. Grøtan K, Sund ER, Bjerkeset O. Mental health, academic self-efficacy and study progress among college students–the shot study, Norway. Front Psychol. (2019) 10:45. doi: 10.3389/fpsyg.2019.00045

94. Haikalis M, Doucette H, Meisel MK, Birch K, Barnett NP. Changes in college student anxiety and depression from pre-to during-COVID-19: perceived stress, academic challenges, loneliness, and positive perceptions. Emerg Adulthood. (2022) 10:534–45. doi: 10.1177/21676968211058516

95. Meeks K, Peak AS, Dreihaus A. Depression, anxiety, and stress among students, faculty, and staff. J Am Coll Health. (2023) 71:348–54. doi: 10.1080/07448481.2021.1891913

96. Strasser K, Arias P, Alessandri F, Turner P, Villarroel T, Aldunate CP, et al. Adolescents' academic self-efficacy and emotions during the COVID-19 pandemic: a latent profile analysis of family and school risk factors. School Psychol. (2022) 22:523. doi: 10.1037/spq0000523

97. Chen L, Bae SR, Battista C, Qin S, Chen T, Evans TM, et al. Positive attitude toward math supports early academic success: behavioral evidence and neurocognitive mechanisms. Psychol Sci. (2018) 29:390–402. doi: 10.1177/0956797617735528

98. Sverdlik A, Hall NC, Vallerand RJ. Doctoral students and COVID-19: exploring challenges, academic progress, and well-being. Educat Psychol. (2022) 22:1–16. doi: 10.1080/01443410.2022.2091749

99. Mohammed TF, Gin LE, Wiesenthal NJ, Cooper KM. The experiences of undergraduates with depression in online science learning environments. Cbe-Life Sci Educ. (2022) 21:228. doi: 10.1187/cbe.21-09-0228

100. Archibald P, Lopez-Humphreys M, Rosenthal K. COVID-19 stressors and effects related to depression with american university students. Soc Work Ment Health. (2022). doi: 10.1080/15332985.2022.2162835

101. Diamond KK, Stebleton MJ, delMas RC. Exploring the relationship between food insecurity and mental health in an undergraduate student population. J Stud Affairs Res Pract. (2020) 57:546–60. doi: 10.1080/19496591.2019.1679158

102. Cockerham M, Camel S, James L, Neill D. Food insecurity in baccalaureate nursing students: a cross-sectional survey. J Profession Nurs. (2021) 37:249–54. doi: 10.1016/j.profnurs.2020.12.015

103. Scotta AV, Cortez MV, Miranda AR. Insomnia Is associated with worry, cognitive avoidance and low academic engagement in argentinian university students during the COVID-19 social isolation. Psychol Health Med. (2022) 27:199–214. doi: 10.1080/13548506.2020.1869796

104. Saravanan C, Subhashini G, A. Systematic review on the prevalence of depression and its associated factors among international university students. Curr Psychiatr Res Rev. (2021) 17:13–25. doi: 10.2174/2666082217666210426110208

105. AlJaber MI. The prevalence and associated factors of depression among medical students of Saudi Arabia: a systematic review. J Fam Medi Primary Care. (2020) 9:2608–14. doi: 10.4103/jfmpc.jfmpc_255_20

106. O'Hara RE, Armeli S, Boynton MH, Tennen H. Emotional stress-reactivity and positive affect among college students: the role of depression history. Emotion. (2014) 14:193–202. doi: 10.1037/a0034217

107. Kibbey MM, Fedorenko EJ, Farris SG. Anxiety, depression, and health anxiety in undergraduate students living in initial us outbreak “hotspot” during COVID-19 pandemic. Cogn Behav Ther. (2021) 50:409–21. doi: 10.1080/16506073.2020.1853805

108. Lei XC. The impact of emotion management ability on learning engagement of college students during COVID-19. Front Psychol. (2022) 13:6766. doi: 10.3389/fpsyg.2022.967666

109. DeBate R, Himmelgreen D, Gupton J, Heuer JN. Food insecurity, well-being, and academic success among college students: implications for post covid-19 pandemic programming. Ecol Food Nutr. (2021) 60:564–79. doi: 10.1080/03670244.2021.1954511

110. Zhang Y, Tao SM, Qu Y, Mou XY, Gan H, Zhou PF, et al. The correlation between lifestyle health behaviors, coping style, and mental health during the COVID-19 pandemic among college students: two rounds of a web-based Study. Front Public Health. (2023) 10:1560. doi: 10.3389/fpubh.2022.1031560

111. Saleh A, Almutairi A, Almutairi A, Alrashedi A, Almutairi M. The psychological and academic impact of COVID-19 among students of college of medicine in Saudi Arabia 2020-2021. J Res Med Dental Sci. (2021) 9:212–23. doi: 10.21474/IJAR01/14661

112. Ewid M, Amal Y, Billah SMB, Kalou Y, Zitoun OA, Alnaser AR, et al. Impact of the COVID-19 pandemic on the psychological status of undergraduate medical students in saudi arabia: a cross-sectional double-scale study. Medicine. (2023) 102:14. doi: 10.1097/MD.0000000000033487

113. Gomez-Garcia G, Ramos-Navas-Parejo M. de la Cruz-Campos JC, Rodriguez-Jimenez C. Impact of COVID-19 on university students: an analysis of its influence on psychological and academic factors. Int J Environ Res Public Health. (2022) 19:1610. doi: 10.3390/ijerph191610433

114. Atlam E, Ewis A, Abd El-Raouf MM, Ghoneim O, Gad I, A new approach in identifying the psychological impact of COVID-19 on university student's academic performance. Alexandria Eng J. (2022) 61:5223–33. doi: 10.1016/j.aej.2021.10.046

115. Thompson L., Christian C. “It just broke me”: exploring the psychological impact of the COVID-19 pandemic on academics. Bmc Psychology. (2022) 10:1008. doi: 10.1186/s40359-022-01008-y

116. Albani A, Ambrosini F, Mancini G, Passini S, Biolcati R. Trait emotional intelligence and self-regulated learning in university students during the COVID-19 pandemic: the mediation role of intolerance of uncertainty and COVID-19 perceived stress. Pers Individ Dif. (2023) 23:203. doi: 10.1016/j.paid.2022.111999

117. Buelow MT, Wirth JH, Kowalsky JM. Poorer decision making among college students during the COVID-19 pandemic: evidence for “pandemic-brain.” J Am Coll Health . (2023) 21:189. doi: 10.1080/07448481.2023.2186129

Keywords: academic engagement, college students, COVID-19, depression, psychological impact of COVID-19, sense of security

Citation: Tang Y and He W (2023) Depression and academic engagement among college students: the role of sense of security and psychological impact of COVID-19. Front. Public Health 11:1230142. doi: 10.3389/fpubh.2023.1230142

Received: 28 May 2023; Accepted: 24 July 2023; Published: 04 August 2023.

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Copyright © 2023 Tang and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Weiguang He, hwg@szu.edu.cn

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Student mental health is in crisis. Campuses are rethinking their approach

Amid massive increases in demand for care, psychologists are helping colleges and universities embrace a broader culture of well-being and better equipping faculty to support students in need

Vol. 53 No. 7 Print version: page 60

• Mental Health

By nearly every metric, student mental health is worsening. During the 2020–2021 school year, more than 60% of college students met the criteria for at least one mental health problem, according to the Healthy Minds Study, which collects data from 373 campuses nationwide ( Lipson, S. K., et al., Journal of Affective Disorders , Vol. 306, 2022 ). In another national survey, almost three quarters of students reported moderate or severe psychological distress ( National College Health Assessment , American College Health Association, 2021).

Even before the pandemic, schools were facing a surge in demand for care that far outpaced capacity, and it has become increasingly clear that the traditional counseling center model is ill-equipped to solve the problem.

“Counseling centers have seen extraordinary increases in demand over the past decade,” said Michael Gerard Mason, PhD, associate dean of African American Affairs at the University of Virginia (UVA) and a longtime college counselor. “[At UVA], our counseling staff has almost tripled in size, but even if we continue hiring, I don’t think we could ever staff our way out of this challenge.”

Some of the reasons for that increase are positive. Compared with past generations, more students on campus today have accessed mental health treatment before college, suggesting that higher education is now an option for a larger segment of society, said Micky Sharma, PsyD, who directs student life’s counseling and consultation service at The Ohio State University (OSU). Stigma around mental health issues also continues to drop, leading more people to seek help instead of suffering in silence.

But college students today are also juggling a dizzying array of challenges, from coursework, relationships, and adjustment to campus life to economic strain, social injustice, mass violence, and various forms of loss related to Covid -19.

As a result, school leaders are starting to think outside the box about how to help. Institutions across the country are embracing approaches such as group therapy, peer counseling, and telehealth. They’re also better equipping faculty and staff to spot—and support—students in distress, and rethinking how to respond when a crisis occurs. And many schools are finding ways to incorporate a broader culture of wellness into their policies, systems, and day-to-day campus life.

“This increase in demand has challenged institutions to think holistically and take a multifaceted approach to supporting students,” said Kevin Shollenberger, the vice provost for student health and well-being at Johns Hopkins University. “It really has to be everyone’s responsibility at the university to create a culture of well-being.”

Higher caseloads, creative solutions

The number of students seeking help at campus counseling centers increased almost 40% between 2009 and 2015 and continued to rise until the pandemic began, according to data from Penn State University’s Center for Collegiate Mental Health (CCMH), a research-practice network of more than 700 college and university counseling centers ( CCMH Annual Report , 2015 ).

That rising demand hasn’t been matched by a corresponding rise in funding, which has led to higher caseloads. Nationwide, the average annual caseload for a typical full-time college counselor is about 120 students, with some centers averaging more than 300 students per counselor ( CCMH Annual Report , 2021 ).

“We find that high-caseload centers tend to provide less care to students experiencing a wide range of problems, including those with safety concerns and critical issues—such as suicidality and trauma—that are often prioritized by institutions,” said psychologist Brett Scofield, PhD, executive director of CCMH.

To minimize students slipping through the cracks, schools are dedicating more resources to rapid access and assessment, where students can walk in for a same-day intake or single counseling session, rather than languishing on a waitlist for weeks or months. Following an evaluation, many schools employ a stepped-care model, where the students who are most in need receive the most intensive care.

Given the wide range of concerns students are facing, experts say this approach makes more sense than offering traditional therapy to everyone.

“Early on, it was just about more, more, more clinicians,” said counseling psychologist Carla McCowan, PhD, director of the counseling center at the University of Illinois at Urbana-Champaign. “In the past few years, more centers are thinking creatively about how to meet the demand. Not every student needs individual therapy, but many need opportunities to increase their resilience, build new skills, and connect with one another.”

Students who are struggling with academic demands, for instance, may benefit from workshops on stress, sleep, time management, and goal-setting. Those who are mourning the loss of a typical college experience because of the pandemic—or facing adjustment issues such as loneliness, low self-esteem, or interpersonal conflict—are good candidates for peer counseling. Meanwhile, students with more acute concerns, including disordered eating, trauma following a sexual assault, or depression, can still access one-on-one sessions with professional counselors.

As they move away from a sole reliance on individual therapy, schools are also working to shift the narrative about what mental health care on campus looks like. Scofield said it’s crucial to manage expectations among students and their families, ideally shortly after (or even before) enrollment. For example, most counseling centers won’t be able to offer unlimited weekly sessions throughout a student’s college career—and those who require that level of support will likely be better served with a referral to a community provider.

“We really want to encourage institutions to be transparent about the services they can realistically provide based on the current staffing levels at a counseling center,” Scofield said.

The first line of defense

Faculty may be hired to teach, but schools are also starting to rely on them as “first responders” who can help identify students in distress, said psychologist Hideko Sera, PsyD, director of the Office of Equity, Inclusion, and Belonging at Morehouse College, a historically Black men’s college in Atlanta. During the pandemic, that trend accelerated.

“Throughout the remote learning phase of the pandemic, faculty really became students’ main points of contact with the university,” said Bridgette Hard, PhD, an associate professor and director of undergraduate studies in psychology and neuroscience at Duke University. “It became more important than ever for faculty to be able to detect when a student might be struggling.”

Many felt ill-equipped to do so, though, with some wondering if it was even in their scope of practice to approach students about their mental health without specialized training, Mason said.

Schools are using several approaches to clarify expectations of faculty and give them tools to help. About 900 faculty and staff at the University of North Carolina have received training in Mental Health First Aid , which provides basic skills for supporting people with mental health and substance use issues. Other institutions are offering workshops and materials that teach faculty to “recognize, respond, and refer,” including Penn State’s Red Folder campaign .

Faculty are taught that a sudden change in behavior—including a drop in attendance, failure to submit assignments, or a disheveled appearance—may indicate that a student is struggling. Staff across campus, including athletic coaches and academic advisers, can also monitor students for signs of distress. (At Penn State, eating disorder referrals can even come from staff working in food service, said counseling psychologist Natalie Hernandez DePalma, PhD, senior director of the school’s counseling and psychological services.) Responding can be as simple as reaching out and asking if everything is going OK.

Referral options vary but may include directing a student to a wellness seminar or calling the counseling center to make an appointment, which can help students access services that they may be less likely to seek on their own, Hernandez DePalma said. Many schools also offer reporting systems, such as DukeReach at Duke University , that allow anyone on campus to express concern about a student if they are unsure how to respond. Trained care providers can then follow up with a welfare check or offer other forms of support.

“Faculty aren’t expected to be counselors, just to show a sense of care that they notice something might be going on, and to know where to refer students,” Shollenberger said.

At Johns Hopkins, he and his team have also worked with faculty on ways to discuss difficult world events during class after hearing from students that it felt jarring when major incidents such as George Floyd’s murder or the war in Ukraine went unacknowledged during class.

Many schools also support faculty by embedding counselors within academic units, where they are more visible to students and can develop cultural expertise (the needs of students studying engineering may differ somewhat from those in fine arts, for instance).

When it comes to course policy, even small changes can make a big difference for students, said Diana Brecher, PhD, a clinical psychologist and scholar-in-residence for positive psychology at Toronto Metropolitan University (TMU), formerly Ryerson University. For example, instructors might allow students a 7-day window to submit assignments, giving them agency to coordinate with other coursework and obligations. Setting deadlines in the late afternoon or early evening, as opposed to at midnight, can also help promote student wellness.

At Moraine Valley Community College (MVCC) near Chicago, Shelita Shaw, an assistant professor of communications, devised new class policies and assignments when she noticed students struggling with mental health and motivation. Those included mental health days, mindful journaling, and a trip with family and friends to a Chicago landmark, such as Millennium Park or Navy Pier—where many MVCC students had never been.

Faculty in the psychology department may have a unique opportunity to leverage insights from their own discipline to improve student well-being. Hard, who teaches introductory psychology at Duke, weaves in messages about how students can apply research insights on emotion regulation, learning and memory, and a positive “stress mindset” to their lives ( Crum, A. J., et al., Anxiety, Stress, & Coping , Vol. 30, No. 4, 2017 ).

Along with her colleague Deena Kara Shaffer, PhD, Brecher cocreated TMU’s Thriving in Action curriculum, which is delivered through a 10-week in-person workshop series and via a for-credit elective course. The material is also freely available for students to explore online . The for-credit course includes lectures on gratitude, attention, healthy habits, and other topics informed by psychological research that are intended to set students up for success in studying, relationships, and campus life.

“We try to embed a healthy approach to studying in the way we teach the class,” Brecher said. “For example, we shift activities every 20 minutes or so to help students sustain attention and stamina throughout the lesson.”

Creative approaches to support

Given the crucial role of social connection in maintaining and restoring mental health, many schools have invested in group therapy. Groups can help students work through challenges such as social anxiety, eating disorders, sexual assault, racial trauma, grief and loss, chronic illness, and more—with the support of professional counselors and peers. Some cater to specific populations, including those who tend to engage less with traditional counseling services. At Florida Gulf Coast University (FGCU), for example, the “Bold Eagles” support group welcomes men who are exploring their emotions and gender roles.

The widespread popularity of group therapy highlights the decrease in stigma around mental health services on college campuses, said Jon Brunner, PhD, the senior director of counseling and wellness services at FGCU. At smaller schools, creating peer support groups that feel anonymous may be more challenging, but providing clear guidelines about group participation, including confidentiality, can help put students at ease, Brunner said.

Less formal groups, sometimes called “counselor chats,” meet in public spaces around campus and can be especially helpful for reaching underserved groups—such as international students, first-generation college students, and students of color—who may be less likely to seek services at a counseling center. At Johns Hopkins, a thriving international student support group holds weekly meetings in a café next to the library. Counselors typically facilitate such meetings, often through partnerships with campus centers or groups that support specific populations, such as LGBTQ students or student athletes.

“It’s important for students to see counselors out and about, engaging with the campus community,” McCowan said. “Otherwise, you’re only seeing the students who are comfortable coming in the door.”

Peer counseling is another means of leveraging social connectedness to help students stay well. At UVA, Mason and his colleagues found that about 75% of students reached out to a peer first when they were in distress, while only about 11% contacted faculty, staff, or administrators.

“What we started to understand was that in many ways, the people who had the least capacity to provide a professional level of help were the ones most likely to provide it,” he said.

Project Rise , a peer counseling service created by and for Black students at UVA, was one antidote to this. Mason also helped launch a two-part course, “Hoos Helping Hoos,” (a nod to UVA’s unofficial nickname, the Wahoos) to train students across the university on empathy, mentoring, and active listening skills.

At Washington University in St. Louis, Uncle Joe’s Peer Counseling and Resource Center offers confidential one-on-one sessions, in person and over the phone, to help fellow students manage anxiety, depression, academic stress, and other campus-life issues. Their peer counselors each receive more than 100 hours of training, including everything from basic counseling skills to handling suicidality.

Uncle Joe’s codirectors, Colleen Avila and Ruchika Kamojjala, say the service is popular because it’s run by students and doesn’t require a long-term investment the way traditional psychotherapy does.

“We can form a connection, but it doesn’t have to feel like a commitment,” said Avila, a senior studying studio art and philosophy-neuroscience-psychology. “It’s completely anonymous, one time per issue, and it’s there whenever you feel like you need it.”

As part of the shift toward rapid access, many schools also offer “Let’s Talk” programs , which allow students to drop in for an informal one-on-one session with a counselor. Some also contract with telehealth platforms, such as WellTrack and SilverCloud, to ensure that services are available whenever students need them. A range of additional resources—including sleep seminars, stress management workshops, wellness coaching, and free subscriptions to Calm, Headspace, and other apps—are also becoming increasingly available to students.

Those approaches can address many student concerns, but institutions also need to be prepared to aid students during a mental health crisis, and some are rethinking how best to do so. Penn State offers a crisis line, available anytime, staffed with counselors ready to talk or deploy on an active rescue. Johns Hopkins is piloting a behavioral health crisis support program, similar to one used by the New York City Police Department, that dispatches trained crisis clinicians alongside public safety officers to conduct wellness checks.

A culture of wellness

With mental health resources no longer confined to the counseling center, schools need a way to connect students to a range of available services. At OSU, Sharma was part of a group of students, staff, and administrators who visited Apple Park in Cupertino, California, to develop the Ohio State: Wellness App .

Students can use the app to create their own “wellness plan” and access timely content, such as advice for managing stress during final exams. They can also connect with friends to share articles and set goals—for instance, challenging a friend to attend two yoga classes every week for a month. OSU’s apps had more than 240,000 users last year.

At Johns Hopkins, administrators are exploring how to adapt school policies and procedures to better support student wellness, Shollenberger said. For example, they adapted their leave policy—including how refunds, grades, and health insurance are handled—so that students can take time off with fewer barriers. The university also launched an educational campaign this fall to help international students navigate student health insurance plans after noticing below average use by that group.

Students are a key part of the effort to improve mental health care, including at the systemic level. At Morehouse College, Sera serves as the adviser for Chill , a student-led advocacy and allyship organization that includes members from Spelman College and Clark Atlanta University, two other HBCUs in the area. The group, which received training on federal advocacy from APA’s Advocacy Office earlier this year, aims to lobby public officials—including U.S. Senator Raphael Warnock, a Morehouse College alumnus—to increase mental health resources for students of color.

“This work is very aligned with the spirit of HBCUs, which are often the ones raising voices at the national level to advocate for the betterment of Black and Brown communities,” Sera said.

Despite the creative approaches that students, faculty, staff, and administrators are employing, students continue to struggle, and most of those doing this work agree that more support is still urgently needed.

“The work we do is important, but it can also be exhausting,” said Kamojjala, of Uncle Joe’s peer counseling, which operates on a volunteer basis. “Students just need more support, and this work won’t be sustainable in the long run if that doesn’t arrive.”

Further reading

Overwhelmed: The real campus mental-health crisis and new models for well-being The Chronicle of Higher Education, 2022

Mental health in college populations: A multidisciplinary review of what works, evidence gaps, and paths forward Abelson, S., et al., Higher Education: Handbook of Theory and Research, 2022

Student mental health status report: Struggles, stressors, supports Ezarik, M., Inside Higher Ed, 2022

Before heading to college, make a mental health checklist Caron, C., The New York Times, 2022

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Depression, Anxiety, Loneliness Are Peaking in College Students

Photo by Cydney Scott 

Nationwide study, co-led by BU researcher Sarah Ketchen Lipson, reveals a majority of students say mental health has impacted their academic performance

Kat j. mcalpine.

A survey by a Boston University researcher of nearly 33,000 college students across the country reveals the prevalence of depression and anxiety in young people continues to increase, now reaching its highest levels, a sign of the mounting stress factors due to the coronavirus pandemic, political unrest, and systemic racism and inequality. 

“Half of students in fall 2020 screened positive for depression and/or anxiety,” says Sarah Ketchen Lipson , a Boston University mental health researcher and a co–principal investigator of the nationwide survey , which was administered online during the fall 2020 semester through the Healthy Minds Network. The survey further reveals that 83 percent of students said their mental health had negatively impacted their academic performance within the past month, and that two-thirds of college students are struggling with loneliness and feeling isolated—an all-time high prevalence that reflects the toll of the pandemic and the social distancing necessary to control it.

Lipson, a BU School of Public Health assistant professor of health law, policy, and management, says the survey’s findings underscore the need for university teaching staff and faculty to put mechanisms in place that can accommodate students’ mental health needs.

“Faculty need to be flexible with deadlines and remind students that their talent is not solely demonstrated by their ability to get a top grade during one challenging semester,” Lipson says.

She adds that instructors can protect students’ mental health by having class assignments due at 5 pm, rather than midnight or 9 am, times that Lipson says can encourage students to go to bed later and lose valuable sleep to meet those deadlines.

Especially in smaller classroom settings, where a student’s absence may be more noticeable than in larger lectures, instructors who notice someone missing classes should reach out to that student directly to ask how they are doing. 

“Even in larger classes, where 1:1 outreach is more difficult, instructors can send classwide emails reinforcing the idea that they care about their students not just as learners but as people, and circulating information about campus resources for mental health and wellness,” Lipson says. 

And, crucially, she says, instructors must bear in mind that the burden of mental health is not the same across all student demographics. “Students of color and low-income students are more likely to be grieving the loss of a loved one due to COVID,” Lipson says. They are also “more likely to be facing financial stress.” All of these factors can negatively impact mental health and academic performance in “profound ways,” she says.

At a higher level within colleges and universities, Lipson says, administrators should focus on providing students with mental health services that emphasize prevention, coping, and resilience. The fall 2020 survey data revealed a significant “treatment gap,” meaning that many students who screen positive for depression or anxiety are not receiving mental health services.

“Often students will only seek help when they find themselves in a mental health crisis, requiring more urgent resources,” Lipson says. “But how can we create systems to foster wellness before they reach that point?” She has a suggestion: “All students should receive mental health education, ideally as part of the required curriculum.”

It’s also important to note, she says, that rising mental health challenges are not unique to the college setting—instead, the survey findings are consistent with a broader trend of declining mental health in adolescents and young adults. “I think mental health is getting worse [across the US population], and on top of that we are now gathering more data on these trends than ever before,” Lipson says. “We know mental health stigma is going down, and that’s one of the biggest reasons we are able to collect better data. People are being more open, having more dialogue about it, and we’re able to better identify that people are struggling.”

The worsening mental health of Americans, more broadly, Lipson says, could be due to a confluence of factors: the pandemic, the impact of social media, and shifting societal values that are becoming more extrinsically motivated (a successful career, making more money, getting more followers and likes), rather than intrinsically motivated (being a good member of the community). 

The crushing weight of historic financial pressures is an added burden. “Student debt is so stressful,” Lipson says. “You’re more predisposed to experiencing anxiety the more debt you have. And research indicates that suicidality is directly connected to financial well-being.” 

With more than 22 million young people enrolled in US colleges and universities, “and with the traditional college years of life coinciding with the age of onset for lifetime mental illnesses,” Lipson stresses that higher education is a crucial setting where prevention and treatment can make a difference.

One potential bright spot from the survey was that the stigma around mental health continues to fade. The results reveal that 94 percent of students say that they wouldn’t judge someone for seeking out help for mental health, which Lipson says is an indicator that also correlates with those students being likely to seek out help themselves during a personal crisis (although, paradoxically, almost half of students say they perceive that others may think more poorly of them if they did seek help).

“We’re harsher on ourselves and more critical of ourselves than we are with other people—we call that perceived versus personal stigma,” Lipson says. “Students need to realize, your peers are not judging you.”

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first of all, excellent writing! This report is extremely triggering for a few reasons. Obviously students are NOT okay at the moment, now confirmed by the student. But what does the university do about it? They micro-manage EVERY aspect of students’ life to mitigate Covid risk. Here, tell me why the university took away household table seating in the dining hall? That was one of the ONLY places on campus where students can eat with each other and actually see their friends’ faces. What type of modeling was used to make this decision and its impact on covid spread on campus. Same thing for the green badge, was there a statistical difference in case before and after students have to walk around showing that? The university’s policies are simply incentivizing off-campus, more dangerous gatherings because the university won’t facilitate anything like that on campus. Oh, and the university response? ‘you’re doing great sweetie’ type of deal – absolutely ridiculous. I know BU can’t keep this up much longer, they are losing far too much money because of Covid and less students on campus – there will be a reckoning. Students, stand up.

BU will acknowledge this but then still won’t do anything to actually help.

Great, but this school is doing absolutely nothing to help it

I appreciate this article because I feel that the issue of mental health isn’t talked about enough amongst students and just college culture in general. I don’t see any concerns coming from college faculty, at least clearly. It’s so important to talk about mental health, especially during a pandemic.

This article is definitely going in the right direction. That being said, as the other comments have also mentioned, BU needs to do MUCH more than just publishing an article telling students, “well, at least you aren’t alone.” If 83% of your student body reports their mental health affects their school work, then if not for them, at least change something for the benefit of the school’s name. To put it bluntly, this does not look good. Also referencing BU’s response to sexual harassment, BU now has a track record of acknowledging issues that significantly impact its students in an article or maybe a speech to only do NOTHING about it. Please, I implore the school to act. Act or we will.

We know mental health stigma is going down

Actually, we know support for those taught and teaching that prejudice is diminishing, though that does not mean by any stretch of the imagination it is not still being taught. It continues to be taught (often resolutely) at Boston University. The above sentence is one manner in which it continues to be taught, Passive Reference. It is also actively taught.  “Perceived stigma” is another interesting Passive Reference, directed prejudices are intended by their directors to be perceived. “perceived” stigma is an obfuscation of the process whereby it is perceived.  It surprises me, that so many women, eschewing “the stigma” of rape, continue to declare “the stigma” of mental illnesses. Sometimes history does not inform us. A few years ago 5 students died by suicide at a Canadian college, blamed was “the stigma” of mental illnesses, not those conveying it. When a young man at U Penn died by suicide it prompted his sister to set up a now national organization protesting “the stigma” of mental illnesses, not those conveying it. National organizations abound conveying “the stigma” of mental illnesses to eagerly awaiting audiences. Publications abound, but to my knowledge not one single publication directly addresses how it is taught or who teaches it.  Nor, to my knowledge is there a campus in the US, or any English speaking country, where someone is given guidance on how to address those directing it. Whom to approach. How to resolve it. [email protected] offers no such guidance. I invite each of you to return to 1972, when a small group of personally empowered women said, “Stop directing the term stigma at rape, you have done enough harm” and take that lesson to heart: We stopped.

And I invite [email protected] to take a role in bringing about that change. 

Harold A Maio, retired mental health editor

Wow – so what is BU doing about this when we have pleaded with admin and offered so many ideas and solutions to helping here since September 2020?

The silence is deafening BU.

The Well Being Project is stagnate.

The Dean is silent.

The provost says students are happy based on some survey they did just before holidays when students knew they were going home.

The Director of Mental Health says appts for mental health are down – that’s the sign everything is fine?

We are hearing the opposite and many students have just lost their faith in support from BU as well as just returning home for LFA where they have a support system.

Where are the social in person safe activities outside and inside?

Where are the RAs and their weekly activities and support of their residents or are they just there to write students up?

Where are the self-care tips and resources offered daily to students?

Where in the daily MANDATORY self-check survey of their health – are any questions about their emotional well being including their mood, stress levels, sleep and appetite?

Where is the support for faculty who are seeing these issues and trying to reach out?

Where are the therapy dogs from pre-pandemic we asked for weekly or biweekly to come outside and offer unconditional emotional support during this tough time?

Where are some campus wide concerts or comedy relief concert paid for by BU – virtually or outside so students have anything to look forward to? If it’s down to money / the $70,000 Tuition or should cover some of it or funds from housing since many were not reimbursed when they returned home for support.

Where is any work with this amazing wise resource Dr. Lipson to take any of her guidance since last summer instead of just posting it here?

Is anyone listening to the isolation and pain of so many terriers? I have heard troubling stories for months since we began our BU Parent group that is NOT monitored by the Deans office unlike others. I have helped refer and counsel families worried if they speak up there might be some retaliation. There is no retaliation just a deaf ear to making any changes to improve morale and well being of our terriers during a pandemic. And then posting this article is the ultimate hutzpah when no one has listened to Dr.Lipson / your own shining star about these issues.

Why not shine as you have with COVID testing? What if this were your family member feeling isolated and disillusioned with their dreams at BU with no outreach from BU except an occasional ZOOM message.

BU can do so much better and be the example for the rest of the nation. Why test so stringently if you will not allow any safe activities except for favorites like sports teams and band members?

Terriers are ZOOMED OUT. Don’t wait for a suicide or more depression to appear in students. It’s almost too late to be proactive / but you can try and we ask that you try hard. Be an example for other colleges.

We are not giving up on being heard. We are parents who care and love BU and know it can do better.

A lot of good points made – I wanted to touch upon when you mentioned that appointments for mental health are apparently down. As a student actively seeking mental health resources, my experience is that it has been extremely difficult to even schedule any sort of mental health appointments or counseling; we are unable to make an appointment online or in-person anymore, and the only information we are given is a phone number to call (the Behavioral Medicine number). I find this frustrating as many of us need more than just a phone conversation to help – even a zoom meeting would be helpful, but why aren’t there zoom appointments for SHS like there are for almost every other service on campus (e.g., pre-professional advising, financial aid, etc.)? I’ve noticed that the loneliness and isolation is affecting not only me but my roommates as well, who have stronger support systems and more friends on campus than I do – we’ve all been lacking motivation to do any of our work and they’ve mentioned that they feel like they need a break (spring break canceled due to pandemic concerns). Even some of my professors seem burnt out – forgetting class, getting behind on their syllabus, etc. In my opinion, BU should be more proactive in giving students resources instead of making it difficult to find said resources. Lastly, I wanted to add that I understand a lot of services are probably very different now due to the pandemic, but a single “wellness week” and emails about it do not do much to actually help students – I find it comparable to “self care” where the self care is just drinking wine and putting on a skincare mask and pushing all your real problems aside.

I agree with those who are asking for BU to do more to support students. I’m a faculty member who is trying to do my best to support my students. I’m more than willing to give extensions, modify assignments, and lower my expectations this semester. I’m checking in on students who miss class to make sure they’re okay. I’m trying to cut as much material as I can while still meeting my course learning objectives. At the same time, I don’t think it’s fair to expect faculty to do everything when it comes to students’ wellbeing. I’ve been in meetings where faculty were asked (both implicitly and explicitly) to help students make friends and socialize during class. I know faculty who are doing this in their courses (and I applaud them for their efforts), but shouldn’t Res Life and other staff at BU be providing opportunities for students to safely socialize? Sure, it’s cold, but certainly BU can be creative and think of ways to encourage students to get out of their dorms and make friends. Faculty are struggling too, and BU’s administration can help us by helping our students.

This is an excellent article, and though not surprising, it is shocking that the BU administration has not done anything to remedy this mental health crises. This is a mental health pandemic happening and it should be as high of a priority for BU as the trying to control the virus. If BU doesn’t step up and come up with a plan to address this then our students will suffer for years to come. This should have happened months ago. You can’t have a healthy individual/society if you are only concerned with physical health. It has to be a holistic approach.

Nice article I hope all instructors read this article I am one of the students sometimes fell a depression and live in the anxiety that is effectives on my life and do not have the energy to do anything particularly during what we live now

First, I would like to focus on the positive and thank BU mental health staff for being there for my son when he was in urgent need of mental health support back in the Fall semester. My call was answered right away and my son was able to speak with a professional with in 15 minutes. I was very impressed and relieved. They were there when we needed them.

On the other hand, I’m hearing from my son and all of his friends that the academic culture of rigor for the sake of rigor, grade deflation and the purposeful weeding out of students from core classes rather than supporting and helping each student succeed, not only continues but has been increased during COVID. These students have a sense that professors are concerned about online cheating so have ramped the rigor to address this. Not sure if this is real or perceived and I’m sure this is not going on in all classes as I also heard examples of supportive professors, but this is definitely a theme I am hearing from students. This style of academics is known to be outdated and ineffective, yet it continues, even at a higher level, during a pandemic.

I’m hoping this feedback can serve helpful to administration.

THANK YOU!!!! As a college student, who has survived the past year with a 4.0, attending full-time to obtain my degree in IT. I am struggling for the first time. After technology issues that set me behind four days, I really thought my instructors would understand. One of my instructors couldn’t care less. The workload is beyond overwhelming, her curriculum seems almost cruel. I graduate next month and I feel like I am losing my mind. I already suffer from severe anxiety, so the level I’m at now is almost debilitating. I have been obtaining degrees since 1998, and familiar with online learning. I’ve never had issues. This morning I received an email from her reminding me of the due date, in all bold caps, followed by some !!!! … She made it clear she is not available on the weekend, but expects us to be flexible. So my dilemma is this, I am failing my coding class now, but I don’t feel that I should be financially responsible to pay for having to retake it, as well as have it impact my financial aid and scholarships I receive for my academic performance.

Hi. I’m a BU alumna, a college professor, and mom to 4 college-aged sons. WONDERING… Do students feel there is explicit and implicit prejudice against college students as “purveyors of COVID?” I think this adds to the discomfort or enjoyment of being a college student and part of a university community. Thoughts? Thanks!

I notice that the students like to complain on here. One thing that university researchers on mental health have a difficult time assessing is knowing the familial support system (or lack thereof) students come into university life with. Psychologists will affirm that this plays a huge role in the mental health of students, at any age. Just as elementary through high schools today are expected to be the emotional, parental, physical, educational, and social supporter of each student, so too are universities being given this sort of expectation. Don’t get me wrong…I believe in striving for mental health and making resources available on campuses. However, within the communities of students – whether their friends or family – we have to realize that the internal conversation around mental health for many cultures is either non-existent or looked down upon. We can sing mental health from the rooftops all day long and hope that students are listening…..and I hope they do.

ECT/Electroshock use has been on the rise last 5 years or so and not just used for depression nor as a last resort. No FDA testing ever done of devices used or the procedure itself. Increase risk for suicide following as many cannot find help for their repeated brain injuries after consenting to this. Lawsuits taking place in the US and England around these damages covered up. See site ectjustice to learn more. Please speak out on social media so others are made aware of the truth of this practice.

People shouldn’t hesitate to ask for psychological help. I think it’s one of the main problems why people struggle mentally. Maybe, it’s a matter of self-critique, and society says sometimes that we should be strong… But when someone gets in an emotional crisis, only a professional can help. And I also never see when students/educators judge their peers/colleagues if someone contacted mental health support. I looked through the list of different affordable mental health services across English-speaking countries – https://ivypanda.com/blog/mental-health-resources – I was shocked how many problems we can have, and how many professionals exist to help with them. Maybe, it may be helpful to others too. Let’s take care of ourselves.

I tried to find the source for “83 %” of college students say their performance was negatively affected by mental health. Did you just pull that number out of thin air? I tried to go through everything I could and could not find this number anywhere in any actual published writing.

Please see page six of the report, the pie chart listed under Academic Impairment.

I think you just made up certain elements of this article and they actually have 0 foundation whatsoever. It has led me down a rabbit hole of attempting to try to find the published support for some of the claims you make. Including the 83 % figure. If you’re going to write articles that will be heavily referenced (which this is, because other idiots went on to quote this article), you should at least get the facts straight.

Please see page 6 of the report, the pie chart listed under Academic Impairment: https://healthymindsnetwork.org/wp-content/uploads/2021/02/HMS-Fall-2020-National-Data-Report.pdf

That is a misrepresentation of the data, in my opinion. Including students who reported mental health impacting their academic performance 1-2 days out of the week is insufficient to be grouped in with 83% of students. The way it is presented in this article makes it seem much more drastic than that. It should say, “28% of students felt 1-2 days out of the week had been negatively impacted by their mental health in the past month..” and report the other percentages. Not combined into one group and twisted in a sensationalistic way. I was attempting to use this information for a research paper of my own and was sent down a rabbit hole trying to find a source. Other people have cited this article, and that is your responsibility as a researcher.

Reading it because to help a friend with his assignment. He studies in FAST, Islamabad, Pakistan. If anyone of his class fellows are here, good luck to you

It is 3:12 in the morning and I just got off the phone with son. He called because he was riddled with anxiety and suffering with loneliness and a seeming inability to form meaningful connections. This is his first year at BU. He loves the University; However, in addition to the rigorous academic challenges, he is crushed by the seeming inability to form connections with others. This, on so many levels, surprises me. He is intelligent, interesting, friendly, handsome and well rounded. Upon my introduction to the University’s logistical layout, I was immediately aware that it not appear easily conducive to meeting people… As opposed to a smaller private college if you will. Clearly, BU had an obligation to address the many challenges brought about as a result of Covid. Understandable, but perhaps a bit extreme, ie: The students not being allowed to eat or congregate. Regardless, what I also observed is that there are few, if any, common rooms.. areas for students to hang out, play board games, ping pong, darts, tell jokes, b.s. and share common concerns. Or My point being, there should be multiple places (Besides sneaking into local clubs, or drinking Alone in your dorm) where kids can go..day or night. Organized events as well, aside from sports. As aforementioned, my son also found it very challenging and frustrating to contact a counselor through your service. When you do, the schedules are booked…… I have been heartbroken. Nonetheless, the consistent voice if encouragement. I want more from the school. I, like all others noted before me. More social emotional support. More access to social opportunities. More professors understanding and working with the challenges our children are struggling to navigate. In closing, it’s not just a BU crisis. I listen to very similar difficulties from many other University families…. PLEASE be more proactive. PLEASE care PLEASE help It is imperative and essential to a successful college experience and outcome. Thank you. And thank you all aforementioned

very very nice

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• Published: 13 July 2021

Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students

• Emily N. Satinsky 1 ,
• Tomoki Kimura 2 ,
• Mathew V. Kiang 3 , 4 ,
• Rediet Abebe 5 , 6 ,
• Scott Cunningham 7 ,
• Hedwig Lee 8 ,
• Xiaofei Lin 9 ,
• Cindy H. Liu 10 , 11 ,
• Igor Rudan 12 ,
• Srijan Sen 13 ,
• Mark Tomlinson 14 , 15 ,
• Miranda Yaver 16 &
• Alexander C. Tsai 1 , 11 , 17  

Scientific Reports volume  11 , Article number:  14370 ( 2021 ) Cite this article

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• Epidemiology
• Health policy
• Quality of life

University administrators and mental health clinicians have raised concerns about depression and anxiety among Ph.D. students, yet no study has systematically synthesized the available evidence in this area. After searching the literature for studies reporting on depression, anxiety, and/or suicidal ideation among Ph.D. students, we included 32 articles. Among 16 studies reporting the prevalence of clinically significant symptoms of depression across 23,469 Ph.D. students, the pooled estimate of the proportion of students with depression was 0.24 (95% confidence interval [CI], 0.18–0.31; I 2  = 98.75%). In a meta-analysis of the nine studies reporting the prevalence of clinically significant symptoms of anxiety across 15,626 students, the estimated proportion of students with anxiety was 0.17 (95% CI, 0.12–0.23; I 2  = 98.05%). We conclude that depression and anxiety are highly prevalent among Ph.D. students. Data limitations precluded our ability to obtain a pooled estimate of suicidal ideation prevalence. Programs that systematically monitor and promote the mental health of Ph.D. students are urgently needed.

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Introduction.

Mental health problems among graduate students in doctoral degree programs have received increasing attention 1 , 2 , 3 , 4 . Ph.D. students (and students completing equivalent degrees, such as the Sc.D.) face training periods of unpredictable duration, financial insecurity and food insecurity, competitive markets for tenure-track positions, and unsparing publishing and funding models 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 —all of which may have greater adverse impacts on students from marginalized and underrepresented populations 13 , 14 , 15 . Ph.D. students’ mental health problems may negatively affect their physical health 16 , interpersonal relationships 17 , academic output, and work performance 18 , 19 , and may also contribute to program attrition 20 , 21 , 22 . As many as 30 to 50% of Ph.D. students drop out of their programs, depending on the country and discipline 23 , 24 , 25 , 26 , 27 . Further, while mental health problems among Ph.D. students raise concerns for the wellbeing of the individuals themselves and their personal networks, they also have broader repercussions for their institutions and academia as a whole 22 .

Despite the potential public health significance of this problem, most evidence syntheses on student mental health have focused on undergraduate students 28 , 29 or graduate students in professional degree programs (e.g., medical students) 30 . In non-systematic summaries, estimates of the prevalence of clinically significant depressive symptoms among Ph.D. students vary considerably 31 , 32 , 33 . Reliable estimates of depression and other mental health problems among Ph.D. students are needed to inform preventive, screening, or treatment efforts. To address this gap in the literature, we conducted a systematic review and meta-analysis to explore patterns of depression, anxiety, and suicidal ideation among Ph.D. students.

Flowchart of included articles.

The evidence search yielded 886 articles, of which 286 were excluded as duplicates (Fig.  1 ). An additional nine articles were identified through reference lists or grey literature reports published on university websites. Following a title/abstract review and subsequent full-text review, 520 additional articles were excluded.

Of the 89 remaining articles, 74 were unclear about their definition of graduate students or grouped Ph.D. and non-Ph.D. students without disaggregating the estimates by degree level. We obtained contact information for the authors of most of these articles (69 [93%]), requesting additional data. Three authors clarified that their study samples only included Ph.D. students 34 , 35 , 36 . Fourteen authors confirmed that their study samples included both Ph.D. and non-Ph.D. students but provided us with data on the subsample of Ph.D. students 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 . Where authors clarified that the sample was limited to graduate students in non-doctoral degree programs, did not provide additional data on the subsample of Ph.D. students, or did not reply to our information requests, we excluded the studies due to insufficient information (Supplementary Table S1 ).

Ultimately, 32 articles describing the findings of 29 unique studies were identified and included in the review 16 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 (Table 1 ). Overall, 26 studies measured depression, 19 studies measured anxiety, and six studies measured suicidal ideation. Three pairs of articles reported data on the same sample of Ph.D. students 33 , 38 , 45 , 51 , 53 , 56 and were therefore grouped in Table 1 and reported as three studies. Publication dates ranged from 1979 to 2019, but most articles (22/32 [69%]) were published after 2015. Most studies were conducted in the United States (20/29 [69%]), with additional studies conducted in Australia, Belgium, China, Iran, Mexico, and South Korea. Two studies were conducted in cross-national settings representing 48 additional countries. None were conducted in sub-Saharan Africa or South America. Most studies included students completing their degrees in a mix of disciplines (17/29 [59%]), while 12 studies were limited to students in a specific field (e.g., biomedicine, education). The median sample size was 172 students (interquartile range [IQR], 68–654; range, 6–6405). Seven studies focused on mental health outcomes in demographic subgroups, including ethnic or racialized minority students 37 , 41 , 43 , international students 47 , 50 , and sexual and gender minority students 42 , 54 .

In all, 16 studies reported the prevalence of depression among a total of 23,469 Ph.D. students (Fig.  2 ; range, 10–47%). Of these, the most widely used depression scales were the PHQ-9 (9 studies) and variants of the Center for Epidemiologic Studies-Depression scale (CES-D, 4 studies) 63 , and all studies assessed clinically significant symptoms of depression over the past one to two weeks. Three of these studies reported findings based on data from different survey years of the same parent study (the Healthy Minds Study) 40 , 42 , 43 , but due to overlap in the survey years reported across articles, these data were pooled. Most of these studies were based on data collected through online surveys (13/16 [81%]). Ten studies (63%) used random or systematic sampling, four studies (25%) used convenience sampling, and two studies (13%) used multiple sampling techniques.

Pooled estimate of the proportion of Ph.D. students with clinically significant symptoms of depression.

The estimated proportion of Ph.D. students assessed as having clinically significant symptoms of depression was 0.24 (95% confidence interval [CI], 0.18–0.31; 95% predictive interval [PI], 0.04–0.54), with significant evidence of between-study heterogeneity (I 2  = 98.75%). A subgroup analysis restricted to the twelve studies conducted in the United States yielded similar findings (pooled estimate [ES] = 0.23; 95% CI, 0.15–0.32; 95% PI, 0.01–0.60), with no appreciable difference in heterogeneity (I 2  = 98.91%). A subgroup analysis restricted to the studies that used the PHQ-9 to assess depression yielded a slightly lower prevalence estimate and a slight reduction in heterogeneity (ES = 0.18; 95% CI, 0.14–0.22; 95% PI, 0.07–0.34; I 2  = 90.59%).

Nine studies reported the prevalence of clinically significant symptoms of anxiety among a total of 15,626 Ph.D. students (Fig.  3 ; range 4–49%). Of these, the most widely used anxiety scale was the 7-item Generalized Anxiety Disorder scale (GAD-7, 5 studies) 64 . Data from three of the Healthy Minds Study articles were pooled into two estimates, because the scale used to measure anxiety changed midway through the parent study (i.e., the Patient Health Questionnaire-Generalized Anxiety Disorder [PHQ-GAD] scale was used from 2007 to 2012 and then switched to the GAD-7 in 2013 40 ). Most studies (8/9 [89%]) assessed clinically significant symptoms of anxiety over the past two to four weeks, with the one remaining study measuring anxiety over the past year. Again, most of these studies were based on data collected through online surveys (7/9 [78%]). Five studies (56%) used random or systematic sampling, two studies (22%) used convenience sampling, and two studies (22%) used multiple sampling techniques.

Pooled estimate of the proportion of Ph.D. students with clinically significant symptoms of anxiety.

The estimated proportion of Ph.D. students assessed as having anxiety was 0.17 (95% CI, 0.12–0.23; 95% PI, 0.02–0.41), with significant evidence of between-study heterogeneity (I 2  = 98.05%). The subgroup analysis restricted to the five studies conducted in the United States yielded a slightly lower proportion of students assessed as having anxiety (ES = 0.14; 95% CI, 0.08–0.20; 95% PI, 0.00–0.43), with no appreciable difference in heterogeneity (I 2  = 98.54%).

Six studies reported the prevalence of suicidal ideation (range, 2–12%), but the recall windows varied greatly (e.g., ideation within the past 2 weeks vs. past year), precluding pooled estimation.

Additional stratified pooled estimates could not be obtained. One study of Ph.D. students across 54 countries found that phase of study was a significant moderator of mental health, with students in the comprehensive examination and dissertation phases more likely to experience distress compared with students primarily engaged in coursework 59 . Other studies identified a higher prevalence of mental ill-health among women 54 ; lesbian, gay, bisexual, transgender, and queer (LGBTQ) students 42 , 54 , 60 ; and students with multiple intersecting identities 54 .

Several studies identified correlates of mental health problems including: project- and supervisor-related issues, stress about productivity, and self-doubt 53 , 62 ; uncertain career prospects, poor living conditions, financial stressors, lack of sleep, feeling devalued, social isolation, and advisor relationships 61 ; financial challenges 38 ; difficulties with work-life balance 58 ; and feelings of isolation and loneliness 52 . Despite these challenges, help-seeking appeared to be limited, with only about one-quarter of Ph.D. students reporting mental health problems also reporting that they were receiving treatment 40 , 52 .

Risk of bias

Twenty-one of 32 articles were assessed as having low risk of bias (Supplementary Table S2 ). Five articles received one point for all five categories on the risk of bias assessment (lowest risk of bias), and one article received no points (highest risk). The mean risk of bias score was 3.22 (standard deviation, 1.34; median, 4; IQR, 2–4). Restricting the estimation sample to 12 studies assessed as having low risk of bias, the estimated proportion of Ph.D. students with depression was 0.25 (95% CI, 0.18–0.33; 95% PI, 0.04–0.57; I 2  = 99.11%), nearly identical to the primary estimate, with no reduction in heterogeneity. The estimated proportion of Ph.D. students with anxiety, among the 7 studies assessed as having low risk of bias, was 0.12 (95% CI, 0.07–0.17; 95% PI, 0.01–0.34; I 2  = 98.17%), again with no appreciable reduction in heterogeneity.

In our meta-analysis of 16 studies representing 23,469 Ph.D. students, we estimated that the pooled prevalence of clinically significant symptoms of depression was 24%. This estimate is consistent with estimated prevalence rates in other high-stress biomedical trainee populations, including medical students (27%) 30 , resident physicians (29%) 65 , and postdoctoral research fellows (29%) 66 . In the sample of nine studies representing 15,626 Ph.D. students, we estimated that the pooled prevalence of clinically significant symptoms of anxiety was 17%. While validated screening instruments tend to over-identify cases of depression (relative to structured clinical interviews) by approximately a factor of two 67 , 68 , our findings nonetheless point to a major public health problem among Ph.D. students. Available data suggest that the prevalence of depressive and anxiety disorders in the general population ranges from 5 to 7% worldwide 69 , 70 . In contrast, prevalence estimates of major depressive disorder among young adults have ranged from 13% (for young adults between the ages of 18 and 29 years in the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions III 71 ) to 15% (for young adults between the ages of 18 and 25 in the 2019 U.S. National Survey on Drug Use and Health 72 ). Likewise, the prevalence of generalized anxiety disorder was estimated at 4% among young adults between the ages of 18 and 29 in the 2001–03 U.S. National Comorbidity Survey Replication 73 . Thus, even accounting for potential upward bias inherent in these studies’ use of screening instruments, our estimates suggest that the rates of recent clinically significant symptoms of depression and anxiety are greater among Ph.D. students compared with young adults in the general population.

Further underscoring the importance of this public health issue, Ph.D. students face unique stressors and uncertainties that may put them at increased risk for mental health and substance use problems. Students grapple with competing responsibilities, including coursework, teaching, and research, while also managing interpersonal relationships, social isolation, caregiving, and financial insecurity 3 , 10 . Increasing enrollment in doctoral degree programs has not been matched with a commensurate increase in tenure-track academic job opportunities, intensifying competition and pressure to find employment post-graduation 5 . Advisor-student power relations rarely offer options for recourse if and when such relationships become strained, particularly in the setting of sexual harassment, unwanted sexual attention, sexual coercion, and rape 74 , 75 , 76 , 77 , 78 . All of these stressors may be magnified—and compounded by stressors unrelated to graduate school—for subgroups of students who are underrepresented in doctoral degree programs and among whom mental health problems are either more prevalent and/or undertreated compared with the general population, including Black, indigenous, and other people of color 13 , 79 , 80 ; women 81 , 82 ; first-generation students 14 , 15 ; people who identify as LGBTQ 83 , 84 , 85 ; people with disabilities; and people with multiple intersecting identities.

Structural- and individual-level interventions will be needed to reduce the burden of mental ill-health among Ph.D. students worldwide 31 , 86 . Despite the high prevalence of mental health and substance use problems 87 , Ph.D. students demonstrate low rates of help-seeking 40 , 52 , 88 . Common barriers to help-seeking include fears of harming one’s academic career, financial insecurity, lack of time, and lack of awareness 89 , 90 , 91 , as well as health care systems-related barriers, including insufficient numbers of culturally competent counseling staff, limited access to psychological services beyond time-limited psychotherapies, and lack of programs that address the specific needs either of Ph.D. students in general 92 or of Ph.D. students belonging to marginalized groups 93 , 94 . Structural interventions focused solely on enhancing student resilience might include programs aimed at reducing stigma, fostering social cohesion, and reducing social isolation, while changing norms around help-seeking behavior 95 , 96 . However, structural interventions focused on changing stressogenic aspects of the graduate student environment itself are also needed 97 , beyond any enhancements to Ph.D. student resilience, including: undercutting power differentials between graduate students and individual faculty advisors, e.g., by diffusing power among multiple faculty advisors; eliminating racist, sexist, and other discriminatory behaviors by faculty advisors 74 , 75 , 98 ; valuing mentorship and other aspects of “invisible work” that are often disproportionately borne by women faculty and faculty of color 99 , 100 ; and training faculty members to emphasize the dignity of, and adequately prepare Ph.D. students for, non-academic careers 101 , 102 .

Our findings should be interpreted with several limitations in mind. First, the pooled estimates are characterized by a high degree of heterogeneity, similar to meta-analyses of depression prevalence in other populations 30 , 65 , 103 , 104 , 105 . Second, we were only able to aggregate depression prevalence across 16 studies and anxiety prevalence across nine studies (the majority of which were conducted in the U.S.) – far fewer than the 183 studies included in a meta-analysis of depression prevalence among medical students 30 and the 54 studies included in a meta-analysis of resident physicians 65 . These differences underscore the need for more rigorous study in this critical area. Many articles were either excluded from the review or from the meta-analyses for not meeting inclusion criteria or not reporting relevant statistics. Future research in this area should ensure the systematic collection of high-quality, clinically relevant data from a comprehensive set of institutions, across disciplines and countries, and disaggregated by graduate student type. As part of conducting research and addressing student mental health and wellbeing, university deans, provosts, and chancellors should partner with national survey and program institutions (e.g., Graduate Student Experience in the Research University [gradSERU] 106 , the American College Health Association National College Health Assessment [ACHA-NCHA], and HealthyMinds). Furthermore, federal agencies that oversee health and higher education should provide resources for these efforts, and accreditation agencies should require monitoring of mental health and programmatic responses to stressors among Ph.D. students.

Third, heterogeneity in reporting precluded a meta-analysis of the suicidality outcomes among the few studies that reported such data. While reducing the burden of mental health problems among graduate students is an important public health aim in itself, more research into understanding non-suicidal self-injurious behavior, suicide attempts, and completed suicide among Ph.D. students is warranted. Fourth, it is possible that the grey literature reports included in our meta-analysis are more likely to be undertaken at research-intensive institutions 52 , 60 , 61 . However, the direction of bias is unpredictable: mental health problems among Ph.D. students in research-intensive environments may be more prevalent due to detection bias, but such institutions may also have more resources devoted to preventive, screening, or treatment efforts 92 . Fifth, inclusion in this meta-analysis and systematic review was limited to those based on community samples. Inclusion of clinic-based samples, or of studies conducted before or after specific milestones (e.g., the qualifying examination or dissertation prospectus defense), likely would have yielded even higher pooled prevalence estimates of mental health problems. And finally, few studies provided disaggregated data according to sociodemographic factors, stage of training (e.g., first year, pre-prospectus defense, all-but-dissertation), or discipline of study. These factors might be investigated further for differences in mental health outcomes.

Clinically significant symptoms of depression and anxiety are pervasive among graduate students in doctoral degree programs, but these are understudied relative to other trainee populations. Structural and clinical interventions to systematically monitor and promote the mental health and wellbeing of Ph.D. students are urgently needed.

This systematic review and meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach (Supplementary Table S3 ) 107 . This study was based on data collected from publicly available bibliometric databases and did not require ethical approval from our institutional review boards.

Eligibility criteria

Studies were included if they provided data on either: (a) the number or proportion of Ph.D. students with clinically significant symptoms of depression or anxiety, ascertained using a validated scale; or (b) the mean depression or anxiety symptom severity score and its standard deviation among Ph.D. students. Suicidal ideation was examined as a secondary outcome.

We excluded studies that focused on graduate students in non-doctoral degree programs (e.g., Master of Public Health) or professional degree programs (e.g., Doctor of Medicine, Juris Doctor) because more is known about mental health problems in these populations 30 , 108 , 109 , 110 and because Ph.D. students face unique uncertainties. To minimize the potential for upward bias in our pooled prevalence estimates, we excluded studies that recruited students from campus counseling centers or other clinic-based settings. Studies that measured affective states, or state anxiety, before or after specific events (e.g., terrorist attacks, qualifying examinations) were also excluded.

If articles described the study sample in general terms (i.e., without clarifying the degree level of the participants), we contacted the authors by email for clarification. Similarly, if articles pooled results across graduate students in doctoral and non-doctoral degree programs (e.g., reporting a single estimate for a mixed sample of graduate students), we contacted the authors by email to request disaggregated data on the subsample of Ph.D. students. If authors did not reply after two contact attempts spaced over 2 months, or were unable to provide these data, we excluded these studies from further consideration.

Search strategy and data extraction

PubMed, Embase, PsycINFO, ERIC, and Business Source Complete were searched from inception of each database to November 5, 2019. The search strategy included terms related to mental health symptoms (e.g., depression, anxiety, suicide), the study population (e.g., graduate, doctoral), and measurement category (e.g., depression, Columbia-Suicide Severity Rating Scale) (Supplementary Table S4 ). In addition, we searched the reference lists and the grey literature.

After duplicates were removed, we screened the remaining titles and abstracts, followed by a full-text review. We excluded articles following the eligibility criteria listed above (i.e., those that were not focused on Ph.D. students; those that did not assess depression and/or anxiety using a validated screening tool; those that did not report relevant statistics of depression and/or anxiety; and those that recruited students from clinic-based settings). Reasons for exclusion were tracked at each stage. Following selection of included articles, two members of the research team extracted data and conducted risk of bias assessments. Discrepancies were discussed with a third member of the research team. Key extraction variables included: study design, geographic region, sample size, response rate, demographic characteristics of the sample, screening instrument(s) used for assessment, mean depression or anxiety symptom severity score (and its standard deviation), and the number (or proportion) of students experiencing clinically significant symptoms of depression or anxiety.

Risk of bias assessment

Following prior work 30 , 65 , the Newcastle–Ottawa Scale 111 was adapted and used to assess risk of bias in the included studies. Each study was assessed across 5 categories: sample representativeness, sample size, non-respondents, ascertainment of outcomes, and quality of descriptive statistics reporting (Supplementary Information S5 ). Studies were judged as having either low risk of bias (≥ 3 points) or high risk of bias (< 3 points).

Analysis and synthesis

Before pooling the estimated prevalence rates across studies, we first transformed the proportions using a variance-stabilizing double arcsine transformation 112 . We then computed pooled estimates of prevalence using a random effects model 113 . Study specific confidence intervals were estimated using the score method 114 , 115 . We estimated between-study heterogeneity using the I 2 statistic 116 . In an attempt to reduce the extent of heterogeneity, we re-estimated pooled prevalence restricting the analysis to studies conducted in the United States and to studies in which depression assessment was based on the 9-item Patient Health Questionnaire (PHQ-9) 117 . All analyses were conducted using Stata (version 16; StataCorp LP, College Station, Tex.). Where heterogeneity limited our ability to summarize the findings using meta-analysis, we synthesized the data using narrative review.

Woolston, C. Why mental health matters. Nature 557 , 129–131 (2018).

Article   ADS   CAS   Google Scholar  

Woolston, C. A love-hurt relationship. Nature 550 , 549–552 (2017).

Article   Google Scholar  

Woolston, C. PhD poll reveals fear and joy, contentment and anguish. Nature 575 , 403–406 (2019).

Article   ADS   CAS   PubMed   Google Scholar  

Byrom, N. COVID-19 and the research community: The challenges of lockdown for early-career researchers. Elife 9 , e59634 (2020).

Article   PubMed   PubMed Central   Google Scholar  

Alberts, B., Kirschner, M. W., Tilghman, S. & Varmus, H. Rescuing US biomedical research from its systemic flaws. Proc. Natl. Acad. Sci. USA 111 , 5773–5777 (2014).

Article   ADS   CAS   PubMed   PubMed Central   Google Scholar  

McDowell, G. S. et al. Shaping the future of research: A perspective from junior scientists. F1000Res 3 , 291 (2014).

Article   PubMed   Google Scholar  

Petersen, A. M., Riccaboni, M., Stanley, H. E. & Pammoli, F. Persistence and uncertainty in the academic career. Proc. Natl. Acad. Sci. USA 109 , 5213–5218 (2012).

Leshner, A. I. Rethinking graduate education. Science 349 , 349 (2015).

National Academies of Sciences Engineering and Medicine. Graduate STEM Education for the 21st Century (National Academies Press, 2018).

Google Scholar  

Charles, S. T., Karnaze, M. M. & Leslie, F. M. Positive factors related to graduate student mental health. J. Am. Coll. Health https://doi.org/10.1080/07448481.2020.1841207 (2021).

Riddle, E. S., Niles, M. T. & Nickerson, A. Prevalence and factors associated with food insecurity across an entire campus population. PLoS ONE 15 , e0237637 (2020).

Article   CAS   PubMed   PubMed Central   Google Scholar  

Soldavini, J., Berner, M. & Da Silva, J. Rates of and characteristics associated with food insecurity differ among undergraduate and graduate students at a large public university in the Southeast United States. Prev. Med. Rep. 14 , 100836 (2019).

Clark, U. S. & Hurd, Y. L. Addressing racism and disparities in the biomedical sciences. Nat. Hum. Behav. 4 , 774–777 (2020).

Gardner, S. K. The challenges of first-generation doctoral students. New Dir. High. Educ. 2013 , 43–54 (2013).

Seay, S. E., Lifton, D. E., Wuensch, K. L., Bradshaw, L. K. & McDowelle, J. O. First-generation graduate students and attrition risks. J. Contin. High. Educ. 56 , 11–25 (2008).

Rummell, C. M. An exploratory study of psychology graduate student workload, health, and program satisfaction. Prof. Psychol. Res. Pract. 46 , 391–399 (2015).

Salzer, M. S. A comparative study of campus experiences of college students with mental illnesses versus a general college sample. J. Am. Coll. Health 60 , 1–7 (2012).

Hysenbegasi, A., Hass, S. & Rowland, C. The impact of depression on the academic productivity of university students. J. Ment. Health Policy Econ. 8 , 145–151 (2005).

PubMed   Google Scholar  

Harvey, S. et al. Depression and work performance: An ecological study using web-based screening. Occup. Med. (Lond.) 61 , 209–211 (2011).

Article   CAS   Google Scholar  

Eisenberg, D., Golberstein, E. & Hunt, J. B. Mental health and academic success in college. BE J. Econ. Anal. Policy 9 , 40 (2009).

Lovitts, B. E. Who is responsible for graduate student attrition--the individual or the institution? Toward an explanation of the high and persistent rate of attrition. In:  Annual Meeting of the American Education Research Association (New York, 1996). Available at: https://eric.ed.gov/?id=ED399878.

Gardner, S. K. Student and faculty attributions of attrition in high and low-completing doctoral programs in the United States. High. Educ. 58 , 97–112 (2009).

Lovitts, B. E. Leaving the Ivory Tower: The Causes and Consequences of Departure from Doctoral Study (Rowman & Littlefield Publishers, 2001).

Rigler Jr, K. L., Bowlin, L. K., Sweat, K., Watts, S. & Throne, R. Agency, socialization, and support: a critical review of doctoral student attrition. In:  Proceedings of the Third International Conference on Doctoral Education: Organizational Leadership and Impact , University of Central Florida, Orlando, (2017).

Golde, C. M. The role of the department and discipline in doctoral student attrition: Lessons from four departments. J. High. Educ. 76 , 669–700 (2005).

Council of Graduate Schools. PhD Completion and Attrition: Analysis of Baseline Program Data from the PhD Completion Project (Council of Graduate Schools, 2008).

National Research Council. A Data-Based Assessment of Research-Doctorate Programs in the United States (The National Academies Press, 2011).

Akhtar, P. et al. Prevalence of depression among university students in low and middle income countries (LMICs): A systematic review and meta-analysis. J. Affect. Disord. 274 , 911–919 (2020).

Mortier, P. et al. The prevalence of suicidal thoughts and behaviours among college students: A meta-analysis. Psychol. Med. 48 , 554–565 (2018).

Article   CAS   PubMed   Google Scholar  

Rotenstein, L. S. et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: A systematic review and meta-analysis. JAMA 316 , 2214–2236 (2016).

Tsai, J. W. & Muindi, F. Towards sustaining a culture of mental health and wellness for trainees in the biosciences. Nat. Biotechnol. 34 , 353–355 (2016).

Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J. & Gisle, L. Work organization and mental health problems in PhD students. Res. Policy 46 , 868–879 (2017).

Nagy, G. A. et al. Burnout and mental health problems in biomedical doctoral students. CBE Life Sci. Educ. 18 , 1–14 (2019).

Garcia-Williams, A., Moffitt, L. & Kaslow, N. J. Mental health and suicidal behavior among graduate students. Acad. Psychiatry 28 , 554–560 (2014).

Sheldon, K. M. Emotionality differences between artists and scientists. J. Res. Pers. 28 , 481–491 (1994).

Lightstone, S. N., Swencionis, C. & Cohen, H. W. The effect of bioterrorism messages on anxiety levels. Int. Q. Community Health Educ. 24 , 111–122 (2006).

Clark, C. R., Mercer, S. H., Zeigler-Hill, V. & Dufrene, B. A. Barriers to the success of ethnic minority students in school psychology graduate programs. School Psych. Rev. 41 , 176–192 (2012).

Eisenberg, D., Gollust, S. E., Golberstein, E. & Hefner, J. L. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am. J. Orthopsychiatry 77 , 534–542 (2007).

Farrer, L. M., Gulliver, A., Bennett, K., Fassnacht, D. B. & Griffiths, K. M. Demographic and psychosocial predictors of major depression and generalised anxiety disorder in Australian university students. BMC Psychiatry 16 , 241 (2016).

Lipson, S. K., Zhou, S., Wagner, B. III., Beck, K. & Eisenberg, D. Major differences: Variations in undergraduate and graduate student mental health and treatment utilization across academic disciplines. J. Coll. Stud. Psychother. 30 , 23–41 (2016).

Lilly, F. R. W. et al. The influence of racial microaggressions and social rank on risk for depression among minority graduate and professional students. Coll. Stud. J. 52 , 86–104 (2018).

Lipson, S. K., Raifman, J., Abelson, S. & Reisner, S. L. Gender minority mental health in the U.S.: Results of a national survey on college campuses. Am. J. Prev. Med. 57 , 293–301 (2019).

Lipson, S. K., Kern, A., Eisenberg, D. & Breland-Noble, A. M. Mental health disparities among college students of color. J. Adolesc. Health 63 , 348–356 (2018).

Baker, A. J. L. & Chambers, J. Adult recall of childhood exposure to parental conflict: Unpacking the black box of parental alienation. J. Divorce Remarriage 52 , 55–76 (2011).

Golberstein, E., Eisenberg, D. & Gollust, S. E. Perceived stigma and mental health care seeking. Psychiatr. Serv. 59 , 392–399 (2008).

Hindman, R. K., Glass, C. R., Arnkoff, D. B. & Maron, D. D. A comparison of formal and informal mindfulness programs for stress reduction in university students. Mindfulness 6 , 873–884 (2015).

Hirai, R., Frazier, P. & Syed, M. Psychological and sociocultural adjustment of first-year international students: Trajectories and predictors. J. Couns. Psychol. 62 , 438–452 (2015).

Lee, J. S. & Jeong, B. Having mentors and campus social networks moderates the impact of worries and video gaming on depressive symptoms: A moderated mediation analysis. BMC Public Health 14 , 1–12 (2014).

Corral-Frias, N. S., Velardez Soto, S. N., Frias-Armenta, M., Corona-Espinosa, A. & Watson, D. Concurrent validity and reliability of two short forms of the mood and anxiety symptom questionnaire in a student sample from Northwest Mexico. J. Psychopathol. Behav. Assess. 41 , 304–316 (2019).

Meghani, D. T. & Harvey, E. A. Asian Indian international students’ trajectories of depression, acculturation, and enculturation. Asian Am. J. Psychol. 7 , 1–14 (2016).

Barry, K. M., Woods, M., Martin, A., Stirling, C. & Warnecke, E. A randomized controlled trial of the effects of mindfulness practice on doctoral candidate psychological status. J. Am. Coll. Health 67 , 299–307 (2019).

Bolotnyy, V., Basilico, M. & Barreira, P. Graduate student mental health: lessons from American economics departments. J. Econ. Lit. (in press).

Barry, K. M., Woods, M., Warnecke, E., Stirling, C. & Martin, A. Psychological health of doctoral candidates, study-related challenges and perceived performance. High. Educ. Res. Dev. 37 , 468–483 (2018).

Boyle, K. M. & McKinzie, A. E. The prevalence and psychological cost of interpersonal violence in graduate and law school. J. Interpers. Violence   36 , 6319-6350 (2021).

Heinrich, D. L. The causal influence of anxiety on academic achievement for students of differing intellectual ability. Appl. Psychol. Meas. 3 , 351–359 (1979).

Hish, A. J. et al. Applying the stress process model to stress-burnout and stress-depression relationships in biomedical doctoral students: A cross-sectional pilot study. CBE Life Sci. Educ. 18 , 1–11 (2019).

Jamshidi, F. et al. A cross-sectional study of psychiatric disorders in medical sciences students. Mater. Sociomed. 29 , 188–191 (2017).

Liu, C. et al. Prevalence and associated factors of depression and anxiety among doctoral students: The mediating effect of mentoring relationships on the association between research self-efficacy and depression/anxiety. Psychol. Res. Behav. Manag. 12 , 195–208 (2019).

Sverdlik, A. & Hall, N. C. Not just a phase: Exploring the role of program stage on well-being and motivation in doctoral students. J. Adult Contin. Educ. 26 , 1–28 (2019).

University of California Office of the President. The University of California Graduate student Well-Being Survey Report (University of California, 2017).

The Graduate Assembly. Graduate Student Happiness & Well-Being Report (University of California at Berkeley, 2014).

Richardson, C. M., Trusty, W. T. & George, K. A. Trainee wellness: Self-critical perfectionism, self-compassion, depression, and burnout among doctoral trainees in psychology. Couns. Psychol. Q. 33 , 187-198 (2020).

Radloff, L. S. The CES-D Scale: A self-report depression scale for research in the general population. Appl. Psychol. Meas. 1 , 385–401 (1977).

Spitzer, R. L., Kroenke, K., Williams, J. B. W. & Lowe, B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch. Intern. Med. 166 , 1092–1097 (2006).

Mata, D. A. et al. Prevalence of depression and depressive symptoms among residents physicians: A systematic review and meta-analysis. JAMA 314 , 2373–2383 (2015).

Gloria, C. T. & Steinhardt, M. A. Flourishing, languishing, and depressed postdoctoral fellows: Differences in stress, anxiety, and depressive symptoms. J. Postdoct. Aff. 3 , 1–9 (2013).

Levis, B. et al. Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: Individual participant data meta-analysis. J. Clin. Epidemiol. 122 , 115-128.e111 (2020).

Tsai, A. C. Reliability and validity of depression assessment among persons with HIV in sub-Saharan Africa: Systematic review and meta-analysis. J. Acquir. Immune Defic. Syndr. 66 , 503–511 (2014).

Baxter, A. J., Scott, K. M., Vos, T. & Whiteford, H. A. Global prevalence of anxiety disorders: A systematic review and meta-regression. Psychol. Med. 43 , 897–910 (2013).

Ferrari, A. et al. Global variation in the prevalence and incidence of major depressive disorder: A systematic review of the epidemiological literature. Psychol. Med. 43 , 471–481 (2013).

Hasin, D. S. et al. Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry   75 , 336–346 (2018).

US Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 2020).

Kessler, R. C. et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 62 , 593–602 (2005).

Working Group report to the Advisory Committee to the NIH Director. Changing the Culture to End Sexual Harassment (U. S. National Institutes of Health, 2019).

National Academies of Sciences Engineering and Medicine. Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine (The National Academies Press, 2018).

Wadman, M. A hidden history. Science 360 , 480–485 (2018).

Hockfield, S., Magley, V. & Yoshino, K. Report of the External Review Committee to Review Sexual Harassment at Harvard University (External Review Committee to Review Sexual Harassment at Harvard University, 2021).

Bartlett, T. & Gluckman, N. She left Harvard. He got to stay. Chronicle High. Educ. 64 , A14 (2021). Available at: https://www.chronicle.com/article/she-left-harvard-he-got-to-stay/.

Tseng, M. et al. Strategies and support for Black, Indigenous, and people of colour in ecology and evolutionary biology. Nat. Ecol. Evol. 4 , 1288–1290 (2020).

Williams, D. R. et al. Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: Results from the National Survey of American Life. Arch. Gen. Psychiatry   64 , 305–315 (2007).

Wu, A. H. Gender bias in rumors among professionals: An identity-based interpretation. Rev. Econ. Stat. 102 , 867–880 (2020).

Kessler, R. C. Epidemiology of women and depression. J. Affect. Disord. 74 , 5–13 (2003).

Mattheis, A., Cruz-Ramirez De Arellano, D. & Yoder, J. B. A model of queer STEM identity in the workplace. J. Homosex 67 , 1839–1863 (2020).

Semlyen, J., King, M., Varney, J. & Hagger-Johnson, G. Sexual orientation and symptoms of common mental disorder or low wellbeing: Combined meta-analysis of 12 UK population health surveys. BMC Psychiatry 16 , 1–19 (2016).

Lark, J. S. & Croteau, J. M. Lesbian, gay, and bisexual doctoral students’ mentoring relationships with faculty in counseling psychology: A qualitative study. Couns. Psychol. 26 , 754–776 (1998).

Jaremka, L. M. et al. Common academic experiences no one talks about: Repeated rejection, imposter syndrome, and burnout. Perspect Psychol Sci 15 , 519–543 (2020).

Allen, H. K. et al. Substance use and mental health problems among graduate students: Individual and program-level correlates. J. Am. Coll. Health https://doi.org/10.1080/07448481.2020.1725020 (2020).

Turner, A. & Berry, T. Counseling center contributions to student retention and graduation: A longitudinal assessment. J. Coll. Stud. Dev. 41 , 627–636 (2000).

Dyrbye, L. N., Thomas, M. R. & Shanafelt, T. D. Medical student distress: Causes, consequences, and proposed solutions. Mayo Clin. Proc. 80 , 1613–1622 (2005).

Tija, J., Givens, J. L. & Shea, J. A. Factors associated with undertreatment of medical student depression. J. Am. Coll. Health 53 , 219–224 (2005).

Dearing, R., Maddux, J. & Tangney, J. Predictors of psychological help seeking in clinical and counseling psychology graduate students. Prof. Psychol. Res. Pract. 36 , 323–329 (2005).

Langin, K. Amid concerns about grad student mental health, one university takes a novel approach. Science https://doi.org/10.1126/science.caredit.aay7113 (2019).

Guillory, D. Combating anti-blackness in the AI community. arXiv , arXiv:2006.16879 (2020).

Galán, C. A. et al. A call to action for an antiracist clinical science. J. Clin. Child Adolesc. Psychol   50 , 12-57 (2021).

Wyman, P. A. et al. Effect of the Wingman-Connect upstream suicide prevention program for air force personnel in training: A cluster randomized clinical trial. JAMA Netw Open 3 , e2022532 (2020).

Knox, K. L. et al. The US Air Force Suicide Prevention Program: Implications for public health policy. Am. J. Public Health 100 , 2457–2463 (2010).

Inclusive Climate Subcommittee of the Government Department Climate Change Committee. Government Department Climate Change: Final Report and Recommendations (Government Department, Harvard University, 2019).

Inclusive Climate Subcommittee of the Government Department Climate Change Committee. Government Department Climate Survey Report (Government Department, Harvard University, 2019).

Magoqwana, B., Maqabuka, Q. & Tshoaedi, M. “Forced to care” at the neoliberal university: Invisible labour as academic labour performed by Black women academics in the South African university. S. Afr. Rev. Sociol. 50 , 6–21 (2019).

Jones, H. A., Perrin, P. B., Heller, M. B., Hailu, S. & Barnett, C. Black psychology graduate students’ lives matter: Using informal mentoring to create an inclusive climate amidst national race-related events. Prof. Psychol. Res. Pract. 49 , 75–82 (2018).

Mathur, A., Meyers, F. J., Chalkley, R., O’Brien, T. C. & Fuhrmann, C. N. Transforming training to reflect the workforce. Sci. Transl. Med. 7 , 285 (2015).

Scharff, V. Advice: Prepare your Ph.D.s for diverse career paths. Chronicle High. Educ. 65 , 30 (2018).

Beattie, T. S., Smilenova, B., Krishnaratne, S. & Mazzuca, A. Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis. PLoS Med. 17 , e1003297 (2020).

Ismail, Z. et al. Prevalence of depression in patients with mild cognitive impairment: A systematic review and meta-analysis. JAMA Psychiatry   74 , 58–67 (2017).

Lim, G. Y. et al. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci. Rep. 8 , 1–10 (2018).

Article   ADS   Google Scholar  

Jones-White, D. R., Soria, K. M., Tower, E. K. B. & Horner, O. G. Factors associated with anxiety and depression among U.S. doctoral students: Evidence from the gradSERU survey. J. Am. Coll. Health https://doi.org/10.1080/07448481.2020.1865975 (2021).

Moher, D., Liberati, A., Tetzlaff, J. & Altman, D. G. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann. Intern. Med. 151 , 264–269 (2009).

Helmers, K. F., Danoff, D., Steinert, Y., Leyton, M. & Young, S. N. Stress and depressed mood in medical students, law students, and graduate students at McGill University. Acad. Med. 72 , 708–714 (1997).

Rabkow, N. et al. Facing the truth: A report on the mental health situation of German law students. Int. J. Law Psychiatry 71 , 101599 (2020).

Bergin, A. & Pakenham, K. Law student stress: Relationships between academic demands, social isolation, career pressure, study/life imbalance and adjustment outcomes in law students. Psychiatr. Psychol. Law 22 , 388–406 (2015).

Stang, A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur. J. Epidemiol. 25 , 603–605 (2010).

Freeman, M. F. & Tukey, J. W. Transformations related to the angular and the square root. Ann. Math. Stat. 21 , 607–611 (1950).

Article   MathSciNet   MATH   Google Scholar  

DerSimonian, R. & Laird, N. Meta-analysis in clinical trials. Control Clin. Trials 7 , 177–188 (1986).

Wilson, E. B. Probable inference, the law of succession, and statistical inference. J. Am. Stat. Assoc. 22 , 209–212 (1927).

Newcombe, R. G. Two-sided confidence intervals for the single proportion: Comparison of seven methods. Stat. Med. 17 , 857–872 (1998).

Higgins, J. P. T. & Thompson, S. G. Quantifying heterogeneity in a meta-analysis. Stat. Med. 21 , 1539–1558 (2002).

Kroenke, K., Spitzer, R. L. & Williams, J. B. W. The PHQ-9: Validity of a brief depression severity measure. J. Gen. Intern. Med. 16 , 606–613 (2001).

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Acknowledgements

We thank the following investigators for generously sharing their time and/or data: Gordon J. G. Asmundson, Ph.D., Amy J. L. Baker, Ph.D., Hillel W. Cohen, Dr.P.H., Alcir L. Dafre, Ph.D., Deborah Danoff, M.D., Daniel Eisenberg, Ph.D., Lou Farrer, Ph.D., Christy B. Fraenza, Ph.D., Patricia A. Frazier, Ph.D., Nadia Corral-Frías, Ph.D., Hanga Galfalvy, Ph.D., Edward E. Goldenberg, Ph.D., Robert K. Hindman, Ph.D., Jürgen Hoyer, Ph.D., Ayako Isato, Ph.D., Azharul Islam, Ph.D., Shanna E. Smith Jaggars, Ph.D., Bumseok Jeong, M.D., Ph.D., Ju R. Joeng, Nadine J. Kaslow, Ph.D., Rukhsana Kausar, Ph.D., Flavius R. W. Lilly, Ph.D., Sarah K. Lipson, Ph.D., Frances Meeten, D.Phil., D.Clin.Psy., Dhara T. Meghani, Ph.D., Sterett H. Mercer, Ph.D., Masaki Mori, Ph.D., Arif Musa, M.D., Shizar Nahidi, M.D., Ph.D., Arthur M. Nezu, Ph.D., D.H.L., Angelo Picardi, M.D., Nicole E. Rossi, Ph.D., Denise M. Saint Arnault, Ph.D., Sagar Sharma, Ph.D., Bryony Sheaves, D.Clin.Psy., Kennon M. Sheldon, Ph.D., Daniel Shepherd, Ph.D., Keisuke Takano, Ph.D., Sara Tement, Ph.D., Sherri Turner, Ph.D., Shawn O. Utsey, Ph.D., Ron Valle, Ph.D., Caleb Wang, B.S., Pengju Wang, Katsuyuki Yamasaki, Ph.D.

A.C.T. acknowledges funding from the Sullivan Family Foundation. This paper does not reflect an official statement or opinion from the County of San Mateo.  

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A.C.T. conceptualized the study and provided supervision. T.K. conducted the search. E.N.S. contacted authors for additional information not reported in published articles. E.N.S. and T.K. extracted data and performed the quality assessment appraisal. E.N.S. and A.C.T. conducted the statistical analysis and drafted the manuscript. T.K., M.V.K., R.A., S.C., H.L., X.L., C.H.L., I.R., S.S., M.T. and M.Y. contributed to the interpretation of the results. All authors provided critical feedback on drafts and approved the final manuscript.

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Satinsky, E.N., Kimura, T., Kiang, M.V. et al. Systematic review and meta-analysis of depression, anxiety, and suicidal ideation among Ph.D. students. Sci Rep 11 , 14370 (2021). https://doi.org/10.1038/s41598-021-93687-7

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Relationship between mental health and students’ academic performance through a literature review

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Mindfulness has become increasingly popular to improve physical and mental health. Its implementation transcends boundaries of disciplines that study its impact. The aim of this study is to identify and analyze the benefits of mindfulness on mental health, academic performance, well-being, mindfulness and prosocial behavior of university students, as well as to identify the most effective way to achieve habituation to the practice. An analysis and systematic review of papers published in the Scopus database was conducted. It was found that publications on the implementation of mindfulness in higher education began in 2004. Their study has been developed in 22 countries, 15 are European, 3 Asians, 2 North American, one Latin American and one from Oceania. Spain is the only Spanish-speaking country. Academically, mindfulness stimulates creativity, exploratory thinking, critical thinking, attention regulation, increases concentration and improves the learning experience. In addition, immersive virtual reality experiences were found to positively influence habituation towards mindfulness practice among university students.

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1 Introduction

In recent decades, mindfulness has gained popularity as a technique for reducing stress, anxiety, and depression. As well as increasing the well-being and quality of life of people who practice it [ 1 ]. Its origin is found in the Buddhist tradition, as a way to achieve clarity of thought [ 2 ]. Although this technique has been practiced in the East for more than 25 centuries, in the West its popularity is recent [ 3 ]. However, its application is expanding more and more in different disciplines [ 4 ].

Social-emotional learning has been introduced in education. It refers to the training of attention, through meditation techniques, such as mindfulness, the most recent update of the programs that seek emotional intelligence [ 5 ]. This type of education is also known as contemplative education, which seeks to enhance the learning experience through reflection and personal perception [ 6 ].

Dr. Jon Kabat-Zinn defines mindfulness as “awareness that develops by paying concrete, sustained, deliberate, and non-judgmental attention to the present moment” [ 7 , p. 13]. It facilitates maintaining mental calm and training attention [ 8 ]; in addition to increasing mental clarity and awareness [ 9 ].

In terms of operability, three qualities that people develop while practicing mindfulness and three qualities related to how the practice is carried out are recognized. The first are observation, description, and participation. While in the mode of practice, acceptance is required, in the present moment and in an effective manner [ 10 ].

Mindfulness can be practiced formally and informally. In formal practice, a specific time is set aside daily for guided meditations. Informal practice brings awareness to daily activities. That is, paying attention to sensations and perceptions while walking, driving, eating, cleaning, among other activities [ 7 ].

Mindfulness has been shown to improve physical and mental health. In terms of physical health, it favors the increase of Brain Derived Neurotrophic Factor (BNDF) [ 11 ]. While in mental health it reduces symptoms of anxiety [ 12 ], stress [ 13 , 14 , 15 , 16 ] and depression [ 12 ]. It also facilitates coping with change and uncertainty [ 14 ] and increases well-being [ 17 ].

1.1 How might the efficacy of mindfulness be evaluated?

Blood tests can be used to measure the effectiveness of mindfulness. A reduction in the levels of cortisol, the stress hormone [ 13 ]; and of increased BNDF can be observed after two weeks of practice [ 11 ]. Increased blood BNDF levels are a potential mediator between meditation practice and brain health [ 13 ]. BNDF measured in the blood by plasma or saliva is called peripheral BNDF [ 18 ].

BNDF is a modulator that regulates neuron growth. It allows the creation of new dendrites which improves communication between neurons; in other words, it promotes greater neuronal plasticity in the central and peripheral nervous system [ 11 , 13 , 18 , 19 , 20 ]. Its main function is at the level of the hippocampus and cerebral cortex, structures linked to learning and memory functions [ 13 ].

BNDF is produced in the central nervous system and peripheral tissues. Over time, its production tends to decrease. Its absence is related to psychiatric and neurological disorders such as emotional burnout, anxiety, depression and Alzheimer’s disease [ 13 ] However, some activities stimulate its production. Exercising, practicing yoga, undergoing controlled stress, traveling, acquiring new experiences, learning and mindfulness stimulate its production [ 13 , 20 ].

1.2 What are the reasons for integrating mindfulness into higher education?

The increase in mental health illnesses in college students has become a recognized concern [ 16 , 21 ]; which requires innovative interventions to address this reality [ 22 , 23 ]. In this sense, mindfulness emerges as a proposed solution [ 12 ], to prevent and reduce professional burnout [ 24 ]. Thus, there is growing interest in its applications in higher education [ 25 , 26 ].

In addition to the physical and mental health benefits, mindfulness practice promotes better academic performance [ 8 , 27 , 28 ]. Such as increased attention, learning and thinking [ 29 ]; and reduced pre-test anxiety [ 29 , 30 ].

Mindfulness practice also stimulates exploratory thinking [ 4 ], creative thinking [ 4 , 31 ], and critical thinking [ 2 ]. It increases spatial and sensory awareness [ 4 ], academic self-efficacy [ 32 , 33 ], productivity and task quality [ 8 ]; in addition to increasing the feeling of personal accomplishment [ 34 ].

On the other hand, it facilitates information retention [ 35 ], improves concentration [ 22 , 26 , 36 , 37 ], attention self-regulation skills [ 32 , 37 , 38 ] and allows for a perceived improvement in the overall learning experience [ 31 , 37 , 39 , 40 , 41 ]. This is because it is essentially training the brain that facilitates focusing attention. A faculty that, for William James, father of American psychology, constituted the root of judgment, character and will [ 42 ].

1.3 Technological immersion in mindfulness

Studies show that technology is increasingly present in the field of mindfulness practice. Evidence of that is the introduction of video games such as the one developed at the University of Wisconsin called tenacity. This is to improve mindfulness through breathing exercises [ 5 ]. Mobile applications such as Headspace and Calm have also been developed to promote meditation techniques [ 43 , 44 ].

In addition to the above, immersive environments incorporating Virtual Reality (VR) have been developed to stimulate mindfulness practice. Home meditation studio, tripp and maloka are some of the applications that virtual reality allows mindfulness practice in totally immersive environments.

1.4 Virtual reality and mindfulness in education

VR makes it possible to experience alternative realities perceived atmospherically [ 45 ]. It is applied in disciplines and sciences such as medicine, engineering, mathematics, dentistry and education [ 46 ]. In education it is used to improve academic performance [ 29 ], and increase attention, creativity, flow state, and habituation to practice [ 47 ].

Pascual et al. [ 48 ] state that, despite there being few studies related to the evaluation of mindfulness interventions using VR, it is considered a more effective platform than standalone mobile meditation apps for encouraging daily practice. Along those lines, results from Miller et al. [ 49 ] study indicates that VR-guided meditation practice is associated with increased positive affect compared to non-VR meditation.

In the case study by Malighetti et al. [ 50 ] it was found that techniques for the development of emotional intelligence such as increased awareness, identification of emotional states, increased resilience and self-control implemented through VR allowed greater mental regulation in terms of eating habits in patients with binge eating disorders. In that order, students with greater emotional regulation have greater self-efficacy [ 51 ].

VR mindfulness promotes mental health [ 52 ]. Studies show that it can reduce insomnia and stress [ 53 ] and improve learning [ 46 ]. Coupled with the above, Kwon et al. [ 30 ] found that incorporating virtual environments through VR is feasible for managing anxiety stemming from academic exams.

Kaplan-Rakowski et al. [ 29 ] study showed that students who meditated with VR performed better academically than those who meditated using videos. While Yang et al.’s [ 47 ] research, immersive virtual reality experiences were found to affect traits associated with students' creativity such as flow state and attention. When students were assigned creative challenges or challenges, those who participated in immersive VR produced better quality products. They also maintained a more stable attention level than the control group.

VR can impact long-term learning. According to Mohring and Brendel [ 45 ] it use in the educational context needs to be reflected upon, because it triggers human perception with far-reaching consequences and people using it hardly question the alternative reality experience it offers. Nevertheless, it can contribute significantly to students’ training through the development of enhanced digital skills and increased mindfulness.

According to Mohring and Brendel [ 45 ] VR can trace the path towards mindfulness in different educational contexts: in teaching and in transforming the relationship between society and the environment. A view that coincides with Whewell et al. [ 54 ] who argue that these immersive experiences contribute to the development of enhanced digital skills, increased student engagement, cultural competence and global mindfulness in university students. VR can foster the conditions for students to become global change agents “within the spheres of entrepreneurship and education” [ 54 , p.1].

However, mindfulness benefits require continuous practice. According to the study by Pascual et al. [ 48 ], meditation sessions are associated with a decrease in anxiety. Therefore, identifying how to introduce and implement an effective program is of the utmost relevance for updating the current educational system.

In that sense, this research aims to identify programs that have been implemented to incorporate mindfulness into higher education. From its beginnings to the present, it analyzes the scientific literature to understand the evolution of its implementation. It identifies the countries where these programs are carried out, the universities that participate, the years they have been carried out and the types of documents published.

Mindfulness's documented benefits for mental health, academic performance, well-being, and students' awareness and prosocial behavior are discussed. Finally, technology, specifically virtual reality, is addressed as a medium that facilitates mindfulness practice stimulation and habituation.

Therefore, the following research questions were defined: 1. How many publications are published per year? 2. In what language are they published? 3. What kind of documents are published? 4. Which universities are involved in the research? 5. In which countries are mindfulness and higher education being studied? 6. What is the impact of mindfulness on higher education students' mental health? 7. What is the impact of mindfulness on higher education students' academic performance? 8. What is the impact of mindfulness on higher education students’ well-being? 9. What is the impact of mindfulness on higher education students’ conscientiousness and prosocial behaviour? 10. Is virtual reality the most effective medium for fostering mindfulness among higher education students?

An analysis of scientific publications in the scopus database, which could be accessed through an institutional account of the University of Burgos in Spain as part of a research stay, was carried out. The information search was conducted using English keywords. The keywords used to elaborate the search string were mindfulness, meditation, university students and higher education students. This search string yielded 70 publications as of July 19, 2024.

All Scopus database publication types were considered inclusion criteria: articles, book chapters, papers, reviews, books and short surveys. In English and Spanish. All articles whose information was not available, were not aimed at higher education students, or did not address any meditation technique were excluded.

An Excel document with the articles' information was extracted for analysis. One article was not available so 69 documents were considered. It was found that 11 publications did not actually mention meditation techniques and were excluded. Also, 5 publications not directed at higher education students were not considered. This resulted in 53 selected research papers. Figure  1 illustrates the situation.

Flow diagram

To answer questions 6, 7 and 8, a subsequent analysis was carried out to identify the measurement variables used by the authors. Measurement variables were identified in the selected documents. The variables were divided into four categories. Mental health, academic achievement, well-being, and prosocial awareness and attitude.

The mental health category includes 9 variables: reduction of stress, anxiety, depression, emotional exhaustion, depersonalization burnout and negative mood. Also increased mental health, calmness and positive mood. Of the 53 items, 4 address some mental health elements and 23 also include elements from other categories.

Academic achievement is made up of 16 variables: academic performance, clinical performance, exploratory thinking, critical thinking, creative thinking, productivity, task quality, academic speed, persistence, observation skills, attention regulation skills, information retention, academic self-efficacy and concentration. Additionally, the learning experience and divergent and convergent creative writing will be improved. Of the 53 items, 5 address elements relating to academic achievement and 19 also include elements from other categories.

The well-being category consists of 13 variables: increased life satisfaction, well-being, sense of belonging, emotional self-regulation, quality of life, self-compassion, physical activity, resilience, non-judgmental acceptance, perceived social support, and sense of accomplishment. Also included are better dietary decision making and improved sleep quality. Of the 53 items, 1 addresses well-being items and 20 include items from other categories.

In the category awareness and prosocial behavior, 14 variables were integrated: increased mindfulness skills, spatial awareness, sensory awareness, self-awareness, dispositional mindfulness, empathy, benevolence, prosocial behavior, collectivism, a sense of transcendence, universalalism, mental clarity, responsibility and improved interpersonal relationships. Of the 53 items, one addresses element unique to prosocial awareness and behavior and 21 also include elements from other categories.

To answer question 8, an additional search integrating technology and virtual reality was included. Although the object of this study is directed primarily at higher education students, research that analyses mindfulness incorporation at other educational levels was considered in this question.

The results of the research are presented in this section. We start with the general findings and then answer the research questions.

3.1 General findings

Although all the investigations analysed are directed at higher education students, 27 do not specify the discipline or the educational program in which the students are enrolled. However, it was found that the educational programs where mindfulness effectiveness is most frequently studied is in medicine and nursing with six investigations, engineering with four, and then anaesthesiology, arts and design, sciences, modern dance, law midwifery, writing, pharmacy, literature, music, social work and design pedagogy with one respectively.

Regarding the duration of the programs, of the 53 studies analysed, 31 do not specify the duration of the practice in weeks, days or sessions. However, in six investigations the programs lasted 8 weeks and in five investigations, 6 weeks. The longest program consisted of 12 weeks and the shortest 1 day. About the analysis of keywords, Fig.  2 shows the identified word networks.

Visualization of keyword networks based on a VOSviewer version 1.6.20 elaboration

In this analysis, it was found that of the 418 keywords used, 30 have at least a frequency of occurrence of 5. It is highlighted that the words with a higher frequency of occurrence and greater connectivity are mindfulness and meditation. Next, the research questions are answered.

How many papers are published each year about mindfulness and higher education students?

According to Table  1 , publications on mindfulness in higher education began in 2004. In 2014, these rates began to remain constant. In the United States, the first publication was produced by the doctor Daniel Holland, associated with universities in Pennsylvania, Arkansas, Illinois, and Washington. At the University of Pennsylvania, the first program for developing resilience in children was developed. Furthermore, in the late 1990s, doctors Martin Seligman and Mihaly Csikszentmihalyi, both affiliated with the same university, pioneered positive psychology [ 55 ].

As part of positive education, positive psychology was introduced to institutions. The concept of positive education succeeds the concept of emotional education. In addition to emotions, this approach incorporates other elements such as meditation in order to increase well-being [ 56 ].

What is the language in which mindfulness research is published? There are 53 documents in the collection, 50 of which are in English and three of which are in Spanish

Are there any published documents that discuss mindfulness and students in higher education? Publications were classified into five categories: articles, reviews, book chapters, presentations and books. As shown in Table  2 , each type of document has a different quantity.

There are several different types of documents published. Articles are the most frequently published. Review articles, presentations, book chapters, and books follow.

What are the publications of universities on mindfulness and higher education students?

A summary of the publications produced, the universities that participate in collaborations, and the most important findings are presented in this section according to the type of document, the language, and the year.

3.2 Spanish-language articles

There have been only three articles published in Spanish. These include one by the University of Almería in Spain in 2009, another by the University of Lisbon in Portugal in 2022 and another by the University of Granada in Spain in 2024. A study by Justo and Luque [ 57 ] demonstrated that mindfulness leads to a deepening of reflection and self-awareness, which in turn stimulates prosocial values like benevolence, collectivism, and the sense of universalism and transcendence. Sobral and Caetano [ 58 ] conducted a study in which individual and collective activities were incorporated into two courses, including mindfulness, using students' portfolios and teachers’ notes. On the other hand, in the study by García-Pérez et al. [ 23 ] mindfulness is considered as a starting point to guarantee mental health and improve the well-being of university students.

3.3 Articles in English

In 2014, two English-language publications were published. One by Nottingham Trent University in the United Kingdom and one by Duke University Medical Center in the United States. Greeson et al. [ 59 ] found that the Koru mindfulness training program improved sleep, improved mindfulness skills, increased self-compassion, and decreased stress among college students.

According to Van Gordon et al. [ 3 ], the Meditation, Awareness Training (MAT) program has been evaluated by college students. During the eighth weeks of training, the students demonstrated improved well-being and self-regulation skills in terms of thoughts, feelings, and behavior. A significant increase was also observed in dispositional mindfulness.

In 2015 only one paper was published by Newcastle University in Australia. In this study, after 7 weeks of practicing mindfulness, students showed an improvement in their well-being, sleep quality, increased concentration, mental clarity and a reduction in negative mood was observed [ 22 ].

In 2016, two articles were published, one by Chatham University in the United States, and another where two universities from two different countries participated, the National University of Ireland and Coleraine University in the United Kingdom. In the study by Noone et al. [ 2 ] it was found that dispositional mindfulness facilitates critical thinking. While in the research of Spadaro and Hunker [ 38 ] it was found that after 8 weeks of practicing mindfulness online, nursing students in the United States reduced anxiety and stress. They also increased mindfulness self-regulation skills.

There were three articles published in 2017. The first study was conducted by Ohio State University in the United States, the second by Ryerson University in Canada, and the third by the Department of Psychiatry at MoleMann Hospital for Mental Health in the Netherlands.

Using reflective writing and guided mindfulness meditations, Klatt [ 60 ] conducted research at Ohio University to increase awareness of students' life goals. According to Schwind et al. [ 37 ], mindfulness and loving-kindness meditation practice after eight weeks reduced anxiety, improved learning experience, increased sense of calm, concentration, and attention self-regulation skills among Canadian university students.

While in the research of Van D’Ijk et al. [ 61 ] it was found that after 8 weekly sessions of two hours daily using the mindfulness-based stress reduction (MBSR) program, students from the Netherlands reduced anxiety and negative emotional states. Improved mental health, life satisfaction and increased mindfulness skills were also observed. However, empathy was not increased.

In 2018, three articles were published. One by the University of Seville in Spain, one by the National University of Ireland and one where an international collaboration between 5 universities took place. The University of Southampton in the UK, the Helvetiapraxis Medical Centre in Switzerland, Kings College London in the UK, the Coburg University of Applied Sciences and Arts in Germany and the Poznan University of Medical Sciences in Poland.

Research conducted by Bernárdez et al. [ 9 ] revealed that software engineering students at the University of Seville in Spain improved their academic self-efficacy after 6 weeks of practicing mindfulness.

Lynch et al. [ 25 ] evaluated mindfulness-based coping with university life (MBCUL), an adaptation of the MBSR program. College students increased their mindfulness skills, decreased stress, anxiety, and depression after eight weeks. The study by Noone and Hogan [ 62 ] found that practicing mindfulness using the headspace mobile app for 6 weeks or 30 sessions increased dispositional mindfulness, but not critical thinking. Students at the National University of Ireland participated in this study.

There were three articles published in 2019. In the United Kingdom, Birmingham City University submitted the first study, in the United States, Lousville University submitted the second, and in Iceland, the University of Rhode Island submitted the third.

A study conducted by Dutt et al. [ 84 ] from the University of Birmingham has demonstrated that mindfulness reduces stress and helps to make better dietary decisions. The University of Rhode Island conducted a study in which Lemay et al. [ 63 ] found that after 6 weeks of practicing viyansa yoga, pharmacy students were able to increase their mindfulness skills and reduce their levels of stress and anxiety. Weingartner et al. [ 39 ] found that mindfulness and compassion training increased mindfulness skills, dispositional mindfulness, and empathy in medical students at Lousville University. As a result, interpersonal relationships, resilience, nonjudgmental acceptance, observational skills, and learning experiences were also improved.

In 2020, four papers were published. In the United States, there are four, one from the University of North Carolina, one from the University of Florida, one from Juiz de Fora in Brazil, and one from the Department of Psychological and Behavioral Sciences at the London School of Economics and Political Science.

At the University of North Carolina, a slow sensory experience linked to meditation techniques is introduced in the modern dance program to improve concentration [ 64 ]. According to the study by Bóo et al. [ 27 ], mindfulness increases academic performance, emotional self-regulation, and self-awareness in the UK. However, Damião et al. [ 65 ] found no significant increase in mindfulness skills of medical students at the Federal University of Juiz de Fora, Brazil, following a 6-week mindfulness training program. Stress, anxiety, or depression did not decrease. Quality of life and mental health also showed no change.

A study by Williams et al. [ 40 ] concluded that medical students at the University of Florida improved their mindfulness skills, perceived social support, empathy, and prosocial behavior after 11 weeks participating in the Promoting Resilience in Medicine (PRIMe) program, although they did not reduce stress. Behaviors characterized by empathy and prosociality. As a result, the general well-being and learning experience have also improved.

There were three articles published in 2021. First, the University of Manitoba in Canada, second, Bilkent University in Turkey, and third, Johns Hopkins University in the United States. Altay and Porter [ 4 ] found that mindfulness practice among design psychology students in Turkey increased non-judgmental acceptance, exploratory thinking, creative thinking, spatial awareness, sensory awareness, and empathy.

An evaluation of the effectiveness of the Headspace mobile application was conducted by Carullo et al. [ 33 ]. Over the course of four months, anesthesiology and medical students from the United States practiced mindfulness. Depression levels were reduced and personal accomplishments were increased. The level of emotional exhaustion nor the level of depersonalization burnout, however, did not improve. Based on research conducted by Litwiller et al. [ 21 ] among college students in Canada, mindfulness, meditation, Tai Chi, yoga, exercise, and animal therapy have been found to be effective in reducing stress, anxiety, depression, and negative mood.

The year 2022 saw the publication of nine papers. The first was completed by the Aix-Marseille University in France, the second by the Department of Anthropology at the University of Missouri in the United States, and the third by the University of Central Arkansas in the United States in collaboration with the University of Missouri. It was also submitted by the University of Illinois in the United States, Kirikkale University in Turkey, Arizona State University in the United States, the University of Seville in Spain, Brock University in Canada, and the University of Lisbon in Portugal.

Researchers in Turkey found that mindfulness practice increases life satisfaction among nursing students. According to Bernárdez et al. [ 8 ], mindfulness enhanced academic performance, productivity, task quality, and academic speed in Spanish students. Devillers-Réolon et al. [ 66 ] found that stress, anxiety, and depression were reduced in their research. The ability of French university students to regulate their attention did not improve, despite improvements in their well-being.

Researchers at Arizona State University found that mindfulness practice increased concentration, non-judgmental acceptance, and resilience among arts and design students. An opinion survey conducted by Klonoff-Cohen [ 67 ] revealed that college students in Illinois believe meditation and mindfulness exercises are effective coping mechanisms. The study by Sensiper [ 26 ] from the Anthropology Department concluded that after 10 weeks of structured in-class meditations, mindfulness exercises, contemporary text readings, and reflective writing, college students exhibited reduced anxiety, improved well-being, increased emotional self-regulation, concentration, and dispositional mindfulness.

As part of the research conducted by Sobral and Caetano [ 58 ], the University of Lisbon conducted a self-study on emotional education. Teachers evaluated the students’ portfolios in order to identify recurrent problems, and students evaluated mindfulness practices, collective and individual projects.

Strickland et al. [ 68 ] reported that mindfulness combined with a modified version of Dr. Robert Boice’s blocked writers program increased positive mood and resilience to stress and anxiety in students and teachers in higher education.

According to Woloshyn et al. [ 31 ], mindful writing stimulates creative thinking, increases empathy and prosocial behavior in higher education students and teachers in Canada. A positive emotional state can also be achieved through non-judgmental acceptance, increased self-awareness, self-compassion, and non-judgmental acceptance. In addition, it enhances well-being and the learning experience.

Six papers have been published in 2023. One by the University of Rome in Italy, one by Griffith University in Australia, another is the result of a collaboration between the University of South Carolina and Winthrop University both in the United States; and another due to collaboration between the Institute of Psychology of Lorand University in Hungary, the University of Vienna and the University of Artois in France.

One paper is the result of a collaboration between the University of the West of England in United Kingdom, and Dongguk University in South Korea. And another article was the result of a collaboration between University of Limoges, University of Montpellier and University of Paris Cité in France and University of Brussels in Belgium.

In the research by Fagioli et al. [ 32 ] University students in Italy practice mindfulness online for 28 days. An improved sense of belonging increased academic self-efficacy and self-regulation of attention skills were observed. In the study by García et al. [ 69 ], mindfulness was practiced for 1 week, 5 min daily. This exercise reduced anxiety, increased physical activity and improved sleep in United States students. Nagy et al. [ 70 ] found that mindfulness practice can increase persistence in those with a strong disposition toward a growth mindset or mindfulness.

In the research of Hagège et al. [ 71 ] it was found that the Meditation-Based Ethics of Responsibility (MBER) program had a positive impact on sense of responsibility and convergent and divergent creative writing tasks in undergraduate science students. In undergraduate music therapy students, it was found that eight weeks of practicing mindfulness can reduce stress and improve mindfulness and well-being [ 72 ]. While Pearson’s [ 73 ] looks for strategies on how mindfulness can be introduced into law education programs in Australia.

So far in 2024, three papers have been published. One by the Virginia Tech College of engineering. Another by the collaboration of Idaho State University and the University of Wisconsin Oshkosh, in the United States. Another by Kaohsiung Medical University and Meiho University, both from Taiwan.

In the research of Giesler et al. [ 74 ] the Caring Action Leadership Mindfulness model is proposed to increase mental health and sense of belonging in undergraduate social work students. In the study by Liu et al. [ 75 ] it was found that practicing mindfulness for 50 min a week for 8 weeks reduced stress and increased mindfulness skills in nursing students. On the other hand, Martini et al. [ 76 ] found that although most engineering students after practicing mindfulness experienced a reduction in perceived stress, a sense of calm, increased energy, and greater concentration, other students who expressed feeling more tired and distressed after meditation practice.

3.4 Book chapters

Book chapters are rare. One by Queen Margaret University in 2015 and one by the University of Surrey in 2020, both UK universities. In the Oberski et al. [ 35 ] study, it was documented that mindfulness in college students allows for increased information retention and a positive emotional state. In Kilner-Johnson and Udofia’s [ 77 ] research, techniques for incorporating mindfulness in the humanities in higher education are proposed.

On the other hand, only one book was published by the University of Groningen in the Netherlands in 2021. This work addresses the benefits of incorporating mindfulness into higher education courses. It documents the results of the Munich model named mindfulness and meditation in the university context. It also includes practical exercises with instructions for implementation in educational institutions.

3.6 Conferences

Three conferences have been published from the United States. One in 2006 by the University of Arkansas, another by the University of Denver Colorado in 2021, and another by Northeastern University in 2023. Holland [ 6 ] presents a course developed and implemented in some universities in the United States through his personal experience, while Wu [ 41 ] states that sonic meditation for higher education students improves the learning experience. In the study by Grahame et al. [ 78 ] it was found that daily mindfulness practice enables engineering undergraduates to reduce stress.

3.7 Reviews

Six reviews have been published. One was in 2004 by Southeastern Illinois University in the United States. In 2017 there were 2 publications. One by the University of Portland in the United States and one by LaTrobe University in Australia. In 2019 the Medical Department of the University of Amsterdam in the Netherlands also published a review. In 2021, a collaboration between three UK universities—Queens University, the University of Suffolk and the University of York was published. In 2024 another was published by Padjadjaran University in Indonesia.

Holland [ 79 ] outlines how mindfulness can be incorporated into higher education and the benefits this can bring for students with disabilities and promote health. McConville et al. [ 33 ] found that mindfulness reduces stress, anxiety, and depression. It also increases mindfulness skills, empathy, a positive emotional state, and academic self-efficacy. Stillwell et al. [ 80 ] found that both the MBSR program, yoga, breath work, meditation, and mindfulness in nursing students reduced stress.

Breedvelt et al. [ 81 ] evaluated the effectiveness of meditation, yoga, and mindfulness on symptoms of depression, anxiety, and stress in college students. They concluded that most publications regarding mindfulness have a high risk of bias, are of poor quality, and do not specify which technique provides the benefits. For it is unclear whether it is mindfulness, yoga or another meditation technique that is effective. McVeigh et al. [ 28 ] found that mindfulness practice in nursing students reduces stress, increases clinical academic performance and self-awareness. In the research of Yosep et al. [ 82 ] it was found that digital mindfulness through audios and videos is effective in improving the mental health of university students.

What are the countries where mindfulness and higher education students are most widely published?

Based on the description of the universities in question three, Fig.  3 illustrates the countries and locations where publications on mindfulness and higher education students have been published.

Geographical location of countries where mindfulness research has been conducted. Font: Own elaboration in the Mapchart application [ 83 ]

As can be seen, the United States leads in mindfulness research and higher education students. It is followed by the United Kingdom, Canada, Australia and Spain. Spain is the only Spanish-speaking country on the list.

On the other hand, although the research is carried out in 22 countries, the collaboration networks include 14 countries. Figure  4 shows the collaboration networks detected.

Cross-country collaboration networks based on a VOSviewer version 1.6.20 elaboration

Figure  4 shows a collaborative network of 14 countries composed of four nodes. One is formed by Austria, Belgium, Canada, France and Hungary in red. In green by the United Kingdom, Turkey, South Korea and Ireland. In blue, Germany, Switzerland and Poland and in yellow, Australia and the Netherlands.

What are the benefits of mindfulness practice for higher education students’ mental health?

Mindfulness practice reduces stress [ 21 , 25 , 28 , 33 , 38 , 59 , 63 , 66 , 80 , 84 ] anxiety [ 21 , 25 , 26 , 33 , 37 , 38 , 61 , 63 , 66 , 69 ] and depression [ 21 , 25 , 33 , 34 , 66 ].

Mindfulness reduces negative mood [ 21 , 22 , 61 ]. As well as increasing positive mood [ 31 , 33 , 35 , 68 ]. In research by Bernárdez et al. [ 9 ], mindfulness was found to reduce emotional exhaustion and depersonalization burnout. While Van D’Ijk et al. [ 61 ], that it improves mental health. Schwind et al. [ 37 ] found that it increases the feeling of calm.

3.8 Stress reduction

In the case of Devillers-Réolon et al. [ 66 ] and Spadaro & Hunker [ 38 ] the mindfulness practice was conducted online and lasted for 17 days and 8 weeks respectively. Greeson et al. [ 59 ] study was also practiced online using the Koru program. Although the duration of this is not specified.

In Lynch et al. [ 25 ] research, the MBSR program was used for 8 weeks. While Stiwell et al. [ 80 ] the same program was used, although the duration of time is not specified. Of the five studies in which mindfulness is practiced traditionally through guided meditations, only one, that of Lemay et al. [ 63 ] indicates that the program lasted 6 weeks in 60-min sessions. The other investigations do not indicate weeks or practice sessions.

According to Yogeswaran and Morr [ 16 ] online mindfulness practice can be effective in addressing stress. However, at least for medical students, the evidence was not sufficient to prove its efficacy in decreasing symptoms of depression and anxiety. In contrast, the study by Ahmad et al. [ 12 ] found that, among university students in Toronto, Canada, internet-based Cognitive Behavioral Mindfulness Therapy interventions could reduce symptoms of anxiety, depression and stress after 8 weeks.

What are the benefits of mindfulness practice on higher education students’ academic performance?

Mindfulness increases clinical performance [ 28 ] and academic performance [ 8 , 27 , 28 ]. Stimulates exploratory thinking [ 4 ], creative thinking [ 4 , 31 ] and critical thinking [ 2 ].

It increases productivity, task quality and academic speed [ 8 ]. As well, it also increases academic self-efficacy [ 9 , 32 , 33 ], improves the learning experience [ 31 , 37 , 39 , 40 , 41 ], and improves observation skills [ 39 ].

Coupled with the above, it improves information retention [ 35 ], increases concentration [ 22 , 26 , 36 , 37 ], and attention self-regulation skills [ 32 , 37 , 38 ]. Another finding in relation to academic performance is that mindfulness can increase persistence in people with a strong disposition toward mindfulness or a growth mindset [ 70 ].

3.9 What benefits does mindfulness practice have on higher education students?

Mindfulness practice increased perceived social support [ 31 , 40 ], improves well-being [ 3 , 22 , 26 , 31 , 40 , 66 ] and improve dietary decision-making [ 84 ]. It also increases sense of belonging [ 32 ], life satisfaction [ 61 , 85 ], physical activity [ 69 ]; and improves sleep quality [ 22 , 59 , 69 ]. Damião´s et al. [ 65 ] research showed no improvements in quality of life after the intervention.

Mindfulness allows increasing self-compassion [ 31 , 59 ], sense of personal achievement [ 34 ], self-regulation of thoughts, feelings and behaviors [ 3 , 26 , 27 ]. It stimulates the development of resilience for stress and anxiety management [ 36 , 39 , 68 ]; and it helps to manage the judgmental voice. That is, it facilitates non-judgmental acceptance [ 4 , 31 , 36 , 39 ].

What are the benefits of mindfulness practice on mindfulness and prosocial behavior in higher education students?

Mindfulness allows for increases in self-awareness [ 27 , 28 , 31 ], sensory and spatial awareness [ 4 ], mindfulness skills [ 25 , 33 , 39 , 40 , 59 , 61 , 63 ] and disposition toward mindfulness [ 3 , 26 , 39 , 68 ].

It also stimulates prosocial behavior [ 40 ], collectivism [ 31 , 57 ]. It increases empathy [ 4 , 31 , 33 , 39 , 40 ] and benevolence [ 57 ]. It improves interpersonal relationships [ 31 , 39 , 40 ], clarity of thought [ 22 ]; and increases the sense of universalism and transcendence [ 57 ].

Is virtual reality the most effective way to promote mindfulness among higher education students?

Virtual reality could facilitate mindfulness habituation. In the study by Navarrete et al. [ 86 ] conducted with university medical students in Valencia, Spain, it was found that those who participated in the virtual reality program meditated twice as long as those who only practiced through regular guided meditation. Along these lines, Pascual et al. [ 48 ] found that health professionals who practiced meditation completed more sessions than those who did not use VR.

Likewise, in the study by Modrego-Alarcón et al. [ 15 ] and Miller et al. [ 49 ] it was found that VR students acquired greater immersion and mindfulness practice. Therefore, immersive virtual reality environments favor habituation toward mindfulness practice.

4 Discussion

The benefits of mindfulness in higher education students at the psychoemotional level have been widely documented [ 12 , 13 , 14 , 15 , 16 , 17 , 87 ]. One of the most frequently highlighted benefits of mindfulness in higher education students is the positive effect on self-esteem, as evidenced by the findings of several studies [ 88 , 89 ]. Additionally, mindfulness has been shown to reduce stress levels [ 25 , 33 , 39 , 40 , 59 , 61 , 63 , 90 ]. These types of benefits have also been observed in other demographic groups. For example, a study conducted by Chandna et al. [ 91 ] with an adult population demonstrated that mindfulness practice was associated with significant improvements in self-esteem and self-efficacy.

As previously stated, mindfulness practice has been identified as a potential solution to the emotional difficulties experienced by higher education students in the current context [ 12 ]. The positive effects of mindfulness on students’ psychoemotional well-being have been demonstrated in numerous studies [ 66 , 67 , 85 ]. It can thus be inferred that these benefits will also affect other areas of students’ lives, reducing their difficulties both psychoemotionally and academically, for example.

In terms of academic performance, the findings of Bóo et al. [ 27 ], Bernárdez et al. [ 8 ] and McVeigh et al. [ 28 ] are worthy of note. This is not exclusive to students in higher education. A study by Artika et al. [ 92 ] with a sample of 469 secondary school students indicates that mindfulness is a significant predictor of student participation in the school context, with an associated increase in participation through improved self-esteem. In contrast, Cordeiro et al. [ 93 ] conducted an experimental study with a control group of third-grade students and found that mindfulness significantly enhanced cognitive flexibility and handwriting fluency.

Prosocial behaviour has been identified as another key area of interest by a number of studies [ 4 , 22 , 31 , 33 , 39 , 40 , 57 ]. A study by Akhavan et al. [ 90 ] demonstrates the efficacy of mindfulness practice in a sample of teachers, including enhanced relationships with students and reduced stress.

With regard to the manner in which these mindfulness programmes can be supported, the utilisation of VR has been found to confer considerable benefits [ 15 , 48 , 49 , 86 ]. This is primarily attributable to the degree of adherence to the programme. In their seminal work, Friedlander et al. [ 94 ] introduced the concept of the ‘therapeutic alliance’ to describe this phenomenon of patient adherence in a therapeutic context. They posited that it represents a crucial factor in the efficacy of any therapeutic intervention. In this case, although it is an educational context, the effects of such adherence are similar; therefore, it is worthwhile to explore the potential of the VR format as a key factor for the success of mindfulness.

5 Conclusions

In response to the research questions initially posed, it can be stated that they have been addressed, resulting in comprehensive data pertaining to the volume, language and year of publication of the various research projects. It is notable that there has been a significant increase in publications over the past four years, as well as the prevalence of the article format. As is to be expected, the majority of publications have been in English. It is also evident that universities in countries with an Anglo-Saxon tradition have published the most research on this topic, with the USA being the country with the highest volume of studies.

In answer to questions 6, 7, 8 and 9, it might be stated that mindfulness practice has been shown to promote mental health, academic performance, awareness, prosocial behaviour and well-being in student populations. Mindfulness practice might promote mental health, and well-being in the student population. The positive impact of this practice is not limited to how it is performed. That is, whether it is through traditional guided meditations, mobile applications, videos, online exercises or virtual reality.

However, according to the available literature, habituation is easier to acquire. Therefore, additional benefits can be obtained by increasing the number of sessions completed or minutes of practice. In answer to question 10, in studies where VR was effective for mindfulness practice, students practiced longer than those in the control group. Therefore, VR could be a more effective way to introduce contemplative science by introducing meditation techniques in higher education.

The objective has been fulfilled by analysing the benefits of mindfulness on mental health, academic performance, well-being, mindfulness and prosocial behaviour of university students, as well as identifying the most effective way to achieve habituation to the practice. It is also noteworthy that these benefits are highly relevant, and it would be beneficial to introduce mindfulness practice in the context of higher education.

6 Limitation and implication

One of the issues highlighted is the lack of comprehensive data that would allow for a more thorough comparison. For example, aspects such as the geographical location of the study subjects or the duration of the mindfulness programme applied mean that there are a large number of studies whose effectiveness is not entirely clear. At the same time, this is a topic that is becoming increasingly relevant, but there is still no consensus among researchers.

With regard to prospective implications, it is evident that the implementation of mindfulness in educational settings offers substantial advantages. Consequently, higher education institutions should facilitate the availability of structured mindfulness programmes for students. Undoubtedly, this would prove to be a valuable addition to their psycho-emotional and academic development.

Data availability

The author confirms that all data generated or analysed during this study are included in this published article.

Palomo P, Rodrigues de Oliveira D, Pereira B, García J, Cebolla A, Baños R, Da Silva E, Demarzo M. Study protocol for a randomized controlled trial of mindfulness training with immersive technology (virtual reality) to improve the quality of life of patients with multimorbidity in primary care: the mindful-VR study. Annu Rev Cyberther Telemed. 2018;2018(16):140–7.

Google Scholar  

Noone C, Bunting B, Hogan M. Does mindfulness enhance critical thinking? Evidence for the mediating effects of executive functioning in the relationship between mindfulness and critical thinking. Front Psychol. 2016. https://doi.org/10.3389/fpsyg.2015.02043 .

Article   PubMed   PubMed Central   Google Scholar  

Van Gordon W, Shonin E, Sumich A, Sundin E, Griffiths M. Meditation Awareness Training (MAT) for psychological well-being in a sub-clinical sample of university students: a controlled pilot study. Mindfulness. 2014;5:381–91. https://doi.org/10.1007/s12671-012-0191-5 .

Article   Google Scholar  

Altay B, Porter N. Educating the mindful design practitioner. Think Skills Creativity. 2021. https://doi.org/10.1016/j.tsc.2021.100842 .

Goleman D, y Senge P. Triple focus. Ediciones B; 2016.

Holland D. Contemplative education in unexpected places: teaching mindfulness in Arkansas and Austria. Teach Coll Rec. 2006;108(9):1842–61. https://doi.org/10.1111/j.1467-9620.2006.00764.x .

Kabat-Zinn J. Mindfulness para principiantes. Penguin Random House; 2023.

Bernárdez B, Durán A, Parejo J, Juristo N, Ruiz-Cortés A. Effects of mindfulness on conceptual modeling performance: a series of experiments. IEEE Trans Software Eng. 2022;48(2):432–52. https://doi.org/10.1109/TSE.2020.2991699 .

Bernárdez B, Durán A, Parejo J, Ruiz-Cortés A. An experimental replication on the effect of the practice of mindfulness in conceptual modeling performance. J Syst Softw. 2018;136:153–72. https://doi.org/10.1016/j.jss.2016.06.104 .

Dimidjian S, Linehan M. Defining an agenda for future research on the clinical application of mindfulness practice. Clin Psychol Sci Pract. 2003;10(2):166–71.

Gomutbutra P, Srikhamjak T, Sapinun L, Kunapun S, Yingchankul N, Apaijai N, Shinlapawittayatorn K, Phuackchantuck R, Chattipakorn N, Chattipakorn S. Effect of intensive weekend mindfulness-based intervention on BDNF, mitochondria function, and anxiety. A randomized, crossover clinical trial. Comp Psychoneuroendocrinol. 2022. https://doi.org/10.1016/j.cpnec.2022.100137 .

Ahmad F, El Morr C, Ritvo P, Othman N, Moineddin R, Ashfaq I, Bohr Y, Ferrari M, Fung W, Hartley L, Maule C, Mawani A, McKenzie K, Williams S. An eight-week, web-based mindfulness virtual community intervention for students’ mental health: randomized controlled trial. JMIR Ment Health. 2020. https://doi.org/10.2196/15520 .

Cahn B, Goodman M, Peterson C, Maturi R, Mills P. Yoga, meditation and mind-body health: increased BDNF, Cortisol awakening response, and altered inflammatory marker expression after a 3-month yoga and meditation retreat. Front Hum Neurosci. 2017. https://doi.org/10.3389/fnhum.2017.00315 .

Hernández-Ruiz E, Sebren A, Alderete C, Bradshaw L, Fowler R. Effect of music on a mindfulness experience: an online study. Arts Psychother. 2021. https://doi.org/10.1016/j.aip.2021.101827 .

Modrego-Alarcón M, López-del-Hoyo Y, García-Campayo J, Pérez-Aranda A, Navarro-Gil M, Beltrán-Ruiz M, Morillo H, Delgado-Suarez I, Oliván-Arévalo R, Montero-Marin J. Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: a randomized controlled trial. Behav Res Ther. 2021. https://doi.org/10.1016/j.brat.2021.103866 .

Article   PubMed   Google Scholar  

Yogeswaran V, Morr C. Mental health for medical students, what do we know today? Procedia Computer Science. 2022. https://doi.org/10.1016/j.procs.2021.12.245 .

Osorio M, Zepeda C, Carballido J. Towards a virtual companion system to give support during confinement. In: 3rd international conference of inclusive technology and education (CONTIE); 2020. p. 46–50. https://doi.org/10.1109/CONTIE51334.2020.00017

Gomutbutra P, Yingchankul N, Chattipakorn N, Chattipakorn S, Srisurapanont M. The effect of mindfulness-based intervention on brain-derived neurotrophic factor (BDNF): a systematic review and meta-analysis of controlled trials. Front Psychol. 2020. https://doi.org/10.3389/fpsyg.2020.02209 .

Huang E, Reichardt L. Neurotrophins: roles in neuronal development and function. Annu Rev Neurosci. 2001. https://doi.org/10.1146/annurev.neuro.24.1.677 .

Binder D, Scharfman H. Brain-derived neurotrophic factor. Growth Factors. 2004;22:123–31. https://doi.org/10.1080/08977190410001723308 .

Litwiller F, White C, Hamilton-Hinch B, Gilbert R. The impacts of recreation programs on the mental health of postsecondary students in North America: an integrative review. Leis Sci. 2021;44(1):96–120. https://doi.org/10.1080/01490400.2018.1483851 .

Van der Riet P, Rossiter R, Kirby D, Dluzewska T, Harmon C. Piloting a stress management and mindfulness program for undergraduate nursing students: student feedback and lessons learned. Nurse Educ Today. 2015;35(1):44–9. https://doi.org/10.1016/j.nedt.2014.05.003 .

García-Pérez L, Collado Fernández D, Lamas-Cepero JL, Ubago-Jiménez JL. Healthy pills: physical activity program for the prevention of mental health and improvement of resilience in university students. Intervention protocol. Retos. 2024;55:726–35. https://doi.org/10.47197/retos.v55.104012 .

Ramos C, Castañón M, Almendra Y, Monge L. Puede el Mindfulness Reducir el Burnout en los Docentes. Ciencia Latina Revista Científica Multidisciplinar. 2024;8(1):42–55. https://doi.org/10.37811/cl_rcm.v8i1.9384 .

Lynch S, Gander M, Nahar A, Kohls N, Walach H. Mindfulness-based coping with university life: a randomized wait-list controlled study. SAGE Open. 2018. https://doi.org/10.1177/2158244018758379 .

Sensiper S. Teaching meditation to college students within an historical and cultural context: a qualitative analysis of undergraduate reflections on contemplative practice. Curr Psychol. 2022;42:15356–67. https://doi.org/10.1007/s12144-022-02811-x .

Bóo S, Childs-Fegredo J, Cooney S, Datta B, Dufour G, Jones P, Galante J. A follow-up study to a randomised control trial to investigate the perceived impact of mindfulness on academic performance in university students. Couns Psychother Res. 2020. https://doi.org/10.1002/capr.12282 .

McVeigh C, Ace L, Ski C, Carswell C, Burton S, Rej S, Noble H. Mindfulness-based interventions for undergraduate nursing students in a university setting: a narrative review. Healthcare. 2021. https://doi.org/10.3390/healthcare9111493 .

Kaplan-Rakowski R, Johnson K, Wojdynski T. The impact of virtual reality meditation on college students’ exam performance Smart Learn. Environ. 2021. https://doi.org/10.1186/s40561-021-00166-7 .

Kwon J, Hong N, Kim K, Heo J, Kim J, Kim E. Feasibility of a virtual reality program in managing test anxiety: a pilot study. Cyberpsychol Behav Soc Netw. 2020;23(10):715–20. https://doi.org/10.1089/cyber.2019.0651 .

Woloshyn V, Obradovć-Ratković S, Julien K, Rebek J, Sen P. Breathing our way into mindful academic writing: a collaborative autoethnography of an online writing community. J Furth High Educ. 2022;46(8):1135–48. https://doi.org/10.1080/0309877X.2022.2055450 .

Fagioli S, Pallini S, Mastandrea S, Barcaccia B. Effectiveness of a brief online mindfulness-based intervention for university students. Mindfulness. 2023. https://doi.org/10.1007/s12671-023-02128-1 .

McConville J, McAleer R, Hahne A. Mindfulness training for health profession students-the effect of mindfulness training on psychological well-being, learning and clinical performance of health professional students: a systematic review of randomized and non-randomized controlled trials. Explore (NY). 2017;13(1):26–45. https://doi.org/10.1016/j.explore.2016.10.002 .

Carullo P, Ungerman E, Metro D, Adams P. The impact of a smartphone meditation application on anesthesia trainee well-being. J Clin Anesth. 2021. https://doi.org/10.1016/j.jclinane.2021.110525 .

Oberski I, Murray S, Goldblatt J, DePlacido C. Contemplation & mindfulness in higher education. Glob Innov Teach Learn High Educ. 2014;11:317–40. https://doi.org/10.1007/978-3-319-10482-9_19 .

Henriksen D, Heywood W, Gruber N. Meditate to create: mindfulness and creativity in an arts and design learning context. Creativity Stud. 2022;15(1):147–68. https://doi.org/10.3846/cs.2022.13206 .

Schwind J, McCay E, Beanlands H, Schindel L, Martin J, Binder M. Mindfulness practice as a teaching-learning strategy in higher education: a qualitative exploratory pilot study. Nurse Educ Today. 2017. https://doi.org/10.1016/j.nedt.2016.12.017 .

Spadaro K, Hunker D. Exploring the effects of an online asynchronous mindfulness meditation intervention with nursing students on stress, mood, and cognition: a descriptive study. Nurse Educ Today. 2016;39:163–9. https://doi.org/10.1016/j.nedt.2016.02.006 .

Weingartner L, Sawning S, Shaw M, Klein J. Compassion cultivation training promotes medical student wellness and enhanced clinical care. BMC Med Educ. 2019. https://doi.org/10.1186/s12909-019-1546-6 .

Williams M, Estores I, Merlo L. Promoting resilience in medicine: the effects of a mind-body medicine elective to improve medical student well-being. Glob Adv Integr Med Health. 2020. https://doi.org/10.1177/2164956120927367 .

Wu J. An innovative and inclusive mindset: teaching embodied sonic meditation in higher education. In: Proceedings of the AES international conference; 2021. https://acortar.link/CzcWDc

Goleman D. Focus desarrollar la atención para alcanzar la excelencia. Kairós; 2013.

Gordon C, Posner J, Klein E, y Mumm C. (productores). La mente, en pocas palabras [documental]. Estados Unidos: Netflix; 2019.

Ramos C. Inteligencia de la pasión En búsqueda de una educación contemporánea integral e inteligentemente apasionada. RIDE Revista Iberoamericana para la Investigación y el Desarrollo Educativo. 2021. https://doi.org/10.23913/ride.v11i22.950 .

Mohring K, Brendel N. Producing virtual reality (VR) field trips – a concept for a sense-based and mindful geographic education. Geographica Helvetica. 2021;76:369–80. https://doi.org/10.5194/gh-76-369-2021 .

Frewen P, Oldrieve P, Law K. Teaching psychology in virtual reality. Scholarsh Teach Learn Psychol. 2022. https://doi.org/10.1037/stl0000341 .

Yang X, Lin L, Cheng P, Yang X, Ren Y, Huang Y. Examining creativity through a virtual reality support system. Educ Tech earch Dev. 2018;66:1231–54. https://doi.org/10.1007/s11423-018-9604-z .

Pascual K, Fredman A, Naum A, Patil C, Sikka N. Should mindfulness for health care workers go virtual? A mindfulness-based intervention using virtual reality and heart rate variability in the emergency department. Workplace Health Saf. 2023;71(4):188–94. https://doi.org/10.1177/21650799221123258 .

Miller M, Mistry D, Jetly R, Frewen P. Meditating in virtual reality 2: phenomenology of vividness, egocentricity and absorption-immersion. Mindfulness. 2021;12:1195–207. https://doi.org/10.1007/s12671-020-01589-y .

Malighetti C, Schnitzer C, Potter G, Nameth K, Brown T, Vogel E, Riva G, Runfola C, Safe D. Rescripting emotional eating with virtual reality: a case study. Annu Rev Cyberther Telemed. 2021;19:117–21.

Sun G, Lyu B. Relationship between emotional intelligence and self-efficacy among college students: the mediating role of coping styles. Discov Psychol. 2022;2:42. https://doi.org/10.1007/s44202-022-00055-1 .

Crosswell L, Yun G. Examining virtual meditation as a stress management strategy on college campuses through longitudinal, quasi-experimental research. Behaviour & Information Technology. 2020;41:864–78. https://doi.org/10.1080/0144929X.2020.1838609 .

De Zambotti M, Yuksel D, Kiss O, Barresi G, Arra N, Volpe L, King C, Baker F. A virtual reality-based mind-body approach to downregulate psychophysiological arousal in adolescent insomnia. Digital Health. 2022. https://doi.org/10.1177/20552076221107887 .

Whewell E, Caldwell H, Frydenberg M, Andone D. Changemakers as digital makers: connecting and co-creating. Educ Inf Technol. 2022;27:6691–713. https://doi.org/10.1007/s10639-022-10892-1 .

Seligman M. El circuito de la esperanza. Penguin Random House; 2018.

Ramos C. Inteligencia de la pasión: una perspectiva del comportamiento humano a través de la neurociencia. Fontamara. 2022. https://doi.org/10.29059/LUAT.307 .

Justo C, Luque M. Effects of a meditation program on values in a sample of university students. Electron J Res Educ Psychol. 2009;7(3):1157–74.

Sobral C, Caetano A. Addressing pedagogical tensions in emotional education at university: an integrative path HUMAN REVIEW. Int Hum Rev Revista Internacional De Humanidades. 2022;11(5):1–13. https://doi.org/10.37467/revhuman.v11.3873 .

Greeson J, Juberg M, Maytan M, James K, Rogers H. A randomized controlled trial of Koru: a mindfulness program for college students and other emerging adults. J Am Coll Health. 2014;62(4):222–33.

Klatt M. A contemplative tool: an exposé of the performance of self. J Transform Educ. 2017;15(2):122–36. https://doi.org/10.1177/1541344616683280 .

Van D’Ijk I, Lucassen P, Akkermans R, Van Engelen B, Van Weel C, Speckens A. Effects of mindfulness-based stress reduction on the mental health of clinical clerkship students: a cluster-randomized controlled trial. Acad Med. 2017;92(7):1012–21. https://doi.org/10.1097/ACM.0000000000001546 .

Noone C, Hogan M. A randomised active-controlled trial to examine the effects of an online mindfulness intervention on executive control, critical thinking and key thinking dispositions in a university student sample. BMC Psychol. 2018. https://doi.org/10.1186/s40359-018-0226-3 .

Lemay V, Hoolahan J, Buchanan A. Impact of a yoga and meditation intervention on students’ stress and anxiety levels. Am J Pharm Educ. 2019;83(5):7001. https://doi.org/10.5688/ajpe7001 .

Baran A. Sneaking meditation. J Dance Educ. 2022;22(1):23–31. https://doi.org/10.1080/15290824.2020.1765248 .

Damião A, Lucchetti A, da Silva O, Lucchetti G. Effects of a required large-group mindfulness meditation course on first-year medical students’ mental health and quality of life: a randomized controlled trial. J Gen Intern Med. 2020;35(3):672–8. https://doi.org/10.1007/s11606-019-05284-0 .

Devillers-Réolon L, Mascret N, Sleimen-Malkoun R. Online mindfulness intervention, mental health and attentional abilities: a randomized controlled trial in university students during COVID-19 lockdown. Front Psychol. 2022. https://doi.org/10.3389/fpsyg.2022.889807 .

Klonoff-Cohen H. College students’ opinions about coping strategies for mental health problems, suicide ideation, and self-harm during COVID-19. Front Psychol. 2022. https://doi.org/10.3389/fpsyg.2022.918891 .

Strickland D, Price-Blackshear M, Bettencourt B. Mindful writing for faculty and graduate students: a pilot mixed-methods study of effects of a six-week workshop. Innov Educ Teach Int. 2022. https://doi.org/10.1080/14703297.2022.2080099 .

García L, Ferguson S, Facio L, Schary D, Guenther C. Assessment of well-being using Fitbit technology in college students, faculty and staff completing breathing meditation during COVID-19: a pilot study. Ment Health Prev. 2023;30: 200280.

Nagy T, Sik K, Török L, Bőthe B, Takacs Z, Orosz G. Brief growth mindset and mindfulness inductions to facilitate task persistence after negative feedback. Collabra Psychol. 2023. https://doi.org/10.1525/collabra.74253 .

Hagège H, Ourmi M, Shankland R, Arboix-Calas F, Leys C, Lubart T. Ethics and meditation: a new educational combination to boost verbal creativity and sense of responsibility. J Intelligence. 2023. https://doi.org/10.3390/jintelligence11080155 .

Hwang M, Bunt L, Warner C. An eight-week zen meditation and music programme for mindfulness and happiness: qualitative content analysis. Int J Environ Res Public Health. 2023. https://doi.org/10.3390/ijerph20237140 .

Pearson M. Student perceptions of mindful reflection as a media law teaching tool. Aust J Rev. 2023;45(2):201–15. https://doi.org/10.1386/ajr_00132_1 .

Giesler F, Weeden M, Yee S, Ostler M, Brown R. CALM: caring action leadership mindfulness: a college counseling practice-based education model. Soc Work Educ. 2024. https://doi.org/10.1080/02615479.2024.2312940 .

Liu Y, Lee C, Wu L. A mindfulness-based intervention improves perceived stress and mindfulness in university nursing students: a quasi-experimental study. Sci Rep. 2024. https://doi.org/10.1038/s41598-024-64183-5 .

Martini L, Huerta M, Jurkiewicz J, Chan B, Bairaktarova D. Exploring students’ experiences with mindfulness meditations in a first-year general engineering course. Educ Sci. 2024. https://doi.org/10.3390/educsci14060584 .

Kilner-Johnson A, Udofia E. Using mindfulness meditation techniques to support peer-to-peer dialogue in seminars. In: Gravett K, Yakovchuk N, Kinchin I, editors. Enhancing student-centred teaching in higher education. Cham: Palgrave Macmillan; 2020. https://doi.org/10.1007/978-3-030-35396-4_19 .

Chapter   Google Scholar  

Grahame K, Jay A, Gillen A, Freeman S. Meaningful moments: first-year student perceptions of mindfulness and meditation in the classroom. In: ASEE annual conference and exposition, conference proceedings, Baltimore, USA; 2023.

Holland D. Integrating mindfulness meditation and somatic awareness into a public educational setting. J Humanist Psychol. 2004;44(4):468–84. https://doi.org/10.1177/0022167804266100 .

Stillwell S, Vermeesch A, Scott J. Interventions to reduce perceived stress among graduate students: a systematic review with implications for evidence-based practice. Worldviews Evid Based Nurs. 2017;14(6):507–13. https://doi.org/10.1111/wvn.12250 .

Breedvelt J, Amanvermez Y, Harrer M, Karyotaki E, Gilbody S, Bockting C, Cuijpers P, Ebert D. The effects of meditation, yoga, and mindfulness on depression, anxiety, and stress in tertiary education students: a meta-analysis. Front Psychiatry. 2019. https://doi.org/10.3389/fpsyt.2019.00193 .

Yosep I, Suryani S, Mediani H, Mardhiyah A, Ibrahim K. Types of digital mindfulness: improving mental health among college students—a scoping review. J Multidiscip Healthc. 2024;17:43–53. https://doi.org/10.2147/JMDH.S443781 .

Mapchart. Create your own custom map; 2024. https://www.mapchart.net/world.html

Dutt S, Keyte R, Egan H, Hussain M, Mantzios M. Healthy and unhealthy eating amongst stressed students: considering the influence of mindfulness on eating choices and consumption. Health Psychol Rep. 2019;7(2):113–20. https://doi.org/10.5114/hpr.2019.77913 .

Aşık E, Albayrak S. The effect of mindfulness levels on the life satisfaction of nursing students. Perspect Psychiatr Care. 2022;58(3):1055–61. https://doi.org/10.1111/ppc.12898 .

Navarrete J, Martínez-Sanchis M, Bellosta-Batalla M, Baños R, Cebolla A, y Herrero, R. Compassionate embodied virtual experience increases the adherence to meditation practice. Appl Sci (Switzerland). 2021;11(3):1–16. https://doi.org/10.3390/app11031276 .

Huang T, Larsen K, Ried-Larsen M, Møller N, Andersen L. The effects of physical activity and exercise on brain-derived neurotrophic factor in healthy humans: a review. Scand J Med Sci Sports. 2014;24:1–10. https://doi.org/10.1111/sms.12069 .

Cheng MWT, Leung ML, Lau JCH. A review of growth mindset intervention in higher education: The case for infographics in cultivating mindset behaviors. Soc Psychol Educ Int J. 2021;24(5):1335–62. https://doi.org/10.1007/s11218-021-09660-9 .

Saraff S, Tiwari A, Rishipal. Effect of mindfulness on self-concept, self-esteem and growth mindset: evidence from undergraduate students. J Psychosoc Res. 2020;15(1):329–40. https://doi.org/10.32381/JPR.2020.15.01.28 .

Akhavan N, Walsh N, Goree J. Benefits of mindfulness professional development for elementary teachers: considerations for district and school-level leaders. J School Admin Res Dev. 2021;6:24–42. https://doi.org/10.32674/jsard.v6i1.2462 .

Chandna S, Sharma P, Moosath H. The mindful self: exploring mindfulness in relation with self-esteem and self-efficacy in Indian population. Psychol Stud. 2022;67:261–72. https://doi.org/10.1007/s12646-021-00636-5 .

Artika MY, Sunawan S, Awalya A. Mindfulness and student engagement: the mediation effect of self esteem. Jurnal Bimbingan Konseling. 2021;10(2):89–98. https://doi.org/10.15294/jubk.v10i2.47991 .

Cordeiro C, Magalhães S, Rocha R, Mesquita A, Olive T, Castro SL, Limpo T. Promoting third graders’ executive functions and literacy: a pilot study examining the benefits of mindfulness vs. relaxation training. Front Psychol. 2021;12: 643794. https://doi.org/10.3389/fpsyg.2021.643794 .

Friedlander ML, Escudero V, Heatherington L. La alianza terapéutica. En la terapia familiar y de pareja. Paidós; 2009.

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C.L.R.M., S.M.C. and E. L. M have designed the study. C.L.R.M. and S.M.C. carried out the methodology and results sections. V. D. B. and C.L.R.M have written the Introduction C.L.R.M. and E.L.M. have written the Discussion, Conclusions and Limitations. All authors wrote and reviewed the manuscript.

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Ramos-Monsivais, C.L., Rodríguez-Cano, S., Lema-Moreira, E. et al. Relationship between mental health and students’ academic performance through a literature review. Discov Psychol 4 , 119 (2024). https://doi.org/10.1007/s44202-024-00240-4

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Higher education faculty and staff can feel a lack of support from their institutions when it comes to addressing student wellness. A new white paper offers ideas for how to better engage with learners and support front-line staff.

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Over the past decade, college students have reported higher rates of anxiety, depression and trauma , which means mental health has increasingly become a retention concern for higher education leaders and those working with students.

A 2023 Student Voice survey by Inside Higher Ed and College Pulse found 45 percent of students believe professors have a responsibility to help students who are struggling with their mental health. An additional 38 percent of students pointed to advisers, and 32 percent said administrators also have a role in supporting student mental health concerns.

Providing trauma-informed care is something faculty and staff say they want to do , but employing these skills can be a challenge as practitioners juggle their own mental health issues .

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A recent white paper from the student success coaching group InsideTrack and the Corporation for a Skilled Workforce (CSW) identifies strategies to alleviate staff trauma and toxic stress at higher education institutions. Adapting these strategies can have long-term consequences, including improved student retention, employee morale and overall success for underrepresented groups, according to the report.

What’s the need: Students aren’t the only group experiencing greater mental health concerns; nationally , 19 percent of adults have reported anxiety disorders, and 8 percent say they’ve experienced major depression. Individuals from historically marginalized groups, such as people of color, those with disabilities or those from low-income backgrounds, are more likely to face mental health concerns without receiving care, as well.

Some institutions lack the resources to adequately support staff who are struggling or experiencing heightened levels of stress at work. A recent Tyton Partners report found 37 percent of academic and faculty advisers believe adviser burnout and turnover are top concerns in support staffers’ work lives.

“Staff members are burned out and facing their own trauma, along with compassion fatigue that can lead to workplace tension and turnover. These dedicated hard-working providers are literally working on the front lines of a mental health crisis,” according to the report.

To address trauma and toxic stress in the workplace, college leaders should provide appropriate tools, bandwidth and resources for staff to assist students better by integrating trauma-informed approaches into the workplace.

The how-to: Campus leaders should, according to the InsideTrack/CSW white paper, first identify ways to make the institutional system a supportive workplace that values:

• Safety, respect and structured interaction. The institution should take steps to ensure staff feel physically, psychologically and emotionally safe at their jobs, as well as valued in their contributions.
• Trust and transparency. Ensure staff are informed about the organization and decisions that may affect them.
• Peer support and belonging. Provide opportunities for genuine connection and relationship building among staff members, including fun activities and regular check-ins. 
• Collaboration and mutuality. Staff members should know their role is working with students, not to or for them.
• Empowerment, voice, choice and flexibility. Staff can share ideas and influence decisions, as well as have options in their work, such as taking a mental health break or day.
• Cultural humility and critically engaging difference. As a collective, the workplace should show respect for and value diverse backgrounds.  

“While these principles may seem straightforward, the true challenge lies in consistently applying them throughout the organization,” according to the white paper. “This requires dedicated time, intentionality and a commitment to integrating these principles into every aspect of daily operations, services, programs, supervision and policies.”

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This helps build capacity for campus stakeholders to engage with students who may be experiencing mental health challenges or other struggles in a trauma-informed way.

InsideTrack uses a framework to guide conversations. CLEAR, short for confirm, legitimize, evaluate and respond, promotes understanding before practitioners can delve into solutions, which is particularly beneficial for working with individuals experiencing heightened emotions, facing life choices or dealing with difficult situations.

CLEAR asks practitioners to think from the student’s point of view, be aware of their own feelings and show constant support from the college, which can remove risks for heightening students stress or retriggering traumas.

The white paper also recommends staff consider the U.S. surgeon general’s Framework for Workplace Mental Health and Well-Being as an additional resource.

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Essay on Depression Among College Students

How it works

In college, where academic stress meets the ups and downs of finding oneself, depression is becoming a big issue. This essay looks into what causes depression in students and suggests ways to help them cope and feel better.

• 1 The Hidden Struggle: What is Depression?
• 2 Why is This Happening?
• 3 Finding a Way to Help: Solutions and Support
• 4 Conclusion

The Hidden Struggle: What is Depression?

Depression, often called the “invisible illness,” shows up in many ways. It can be constant sadness, feeling hopeless, or even physical stuff like being tired all the time or not being able to sleep. For college students, depression can hit hard because of the unique problems they face.

There’s the stress of classes, social pressures, money worries, and growing up. Trying to keep up with schoolwork, while feeling like you have to be the best, can make students feel like they’re not good enough. Social life in college isn’t easy either. Making new friends and fitting in can leave students feeling lonely.

One of the toughest things about depression in college is the stigma. Even though people are talking more about mental health now, lots of students still don’t ask for help because they’re scared of being judged or seen as weak. This makes things worse because not getting help can make depression symptoms stronger, making it harder to handle school and personal life.

Why is This Happening?

To really tackle depression in college, we need to know what’s causing it. Academic pressure is a big one. The load of homework, exams, and keeping grades up can lead to constant stress and feeling burned out. At top schools, this pressure can be even worse, making students feel like they always have to outdo their classmates.

Money problems are another big cause. College is expensive, and student loans can make students feel very insecure about their finances. Many students work part-time jobs while studying, which throws off their balance and adds more stress.

The social side of college also affects students’ mental health. Trying to fit in, make friends, and feel like you belong can be a lot. Social media doesn’t help either, with its perfect pictures making students feel even more inadequate and lonely. Moving from high school to college often means leaving behind family and old friends, causing homesickness and a sense of losing touch, which can add to depression.

Finding a Way to Help: Solutions and Support

Helping depressed college students needs a bunch of different efforts, like raising awareness, having good support systems, and making changes at the school level. First, creating a culture where mental health is openly talked about and understood is really important. Schools should focus on mental health education, using workshops, seminars, and support groups to spread awareness and reduce stigma. By making it normal to talk about mental health, students might feel more at ease asking for help without fearing judgment.

Good mental health services are crucial. Colleges need to make sure counseling is easy to get, well-staffed, and able to handle all kinds of student needs. Adding mental health resources to academic advising can help too, offering a complete approach to student well-being, covering both school and emotional problems.

Making a supportive campus environment is key to reducing factors that lead to depression. Schools can have policies that help balance work and life, like flexible deadlines, mental health days, and activities to relieve stress. Encouraging students to join extracurriculars and creating inclusive communities can help them make meaningful connections and feel less isolated.

On a bigger scale, tackling financial stress is necessary. Schools should look into financial aid, scholarships, and affordable housing to ease the load of student loans and reduce money stress. Offering resources for financial literacy and budgeting can also help students manage their money better.

Depression among college students is a complicated issue that needs a kind and thorough approach. By understanding the special challenges students face and addressing the root causes of depression, we can create a supportive environment that promotes mental well-being and academic success. It’s everyone’s job—schools, lawmakers, parents, and friends—to make sure students have the resources and support they need to handle the pressures of college and come out stronger and more resilient.

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Prevalence of Depression among University Students: A Systematic Review and Meta-Analysis Study

Diana sarokhani.

1 Student Research Committee, Ilam University of Medical Science, P.O. Box 69311-57793, Ilam, Iran

2 Department of Computer, Faculty of Engineering, Malayer University, P.O. Box 95863-65719, Hamadan, Iran

Ali Delpisheh

3 Department of Clinical Epidemiology, Ilam University of Medical Sciences, P.O. Box 69315-138, Ilam, Iran

4 Psychosocial Injuries Research Center, Ilam University of Medical Science, P.O. Box 69315-138, Ilam, Iran

Yousef Veisani

Mohamad taher sarokhani.

5 Science and Research Branch, Islamic Azad University, Kermanshah, Iran

Rohollah Esmaeli Manesh

6 Eslamabad Payame Noor University, Kermanshah, Iran

Kourosh Sayehmiri

7 Social Medicine Department, Medicine Faculty, Ilam University of Medical Sciences, P.O. Box 69315-138, Ilam, Iran

Introduction . Depression is one of the four major diseases in the world and is the most common cause of disability from diseases. The aim of this study is to estimate the prevalence of depression among Iranian university students using meta-analysis method. Materials and Methods . Keyword depression was searched in electronic databases such as PubMed, Scopus, MAGIran, Medlib, and SID. Data was analyzed using meta-analysis (random-effects model). Heterogeneity of studies was assessed using the I 2 index. Data was analyzed using STATA software Ver.10. Results . In 35 studies conducted in Iran from 1995 to 2012 with sample size of 9743, prevalence of depression in the university students was estimated to be 33% (95% CI: 32–34). The prevalence of depression among boys was estimated to be 28% (95% CI: 26–30), among girls 23% (95% CI: 22–24), single students 39% (95% CI: 37–41), and married students 20% (95% CI: 17–24). Metaregression model showed that the trend of depression among Iranian students was flat. Conclusions . On the whole, depression is common in university students with no preponderance between males and females and in single students is higher than married ones.

1. Introduction

Depression among university students is extremely prevalent and widespread problem across the country [ 1 – 3 ]. University students are a special group of people that are enduring a critical transitory period in which they are going from adolescence to adulthood and can be one of the most stressful times in a person's life. Trying to fit in, maintain good grades, plan for the future, and be away from home often causes anxiety for a lot of students [ 4 ]. As a reaction to this stress, some students get depressed. They find that they cannot get themselves together. They may cry all of the time, skip classes, or isolate themselves without realizing they are depressed. Previous studies reported that depression in university students is noted around the world [ 5 – 7 ] and the prevalence seems to be increasing [ 8 ].

The average age of onset is also on the decline, making depression a particularly salient problem area for university student populations [ 8 ]. Over two-thirds of young people do not talk about or seek help for mental health problems [ 9 ].

In Iran, preliminary studies on emotional distress have emerged in recent years including depression in Iranian university. Within the abovementioned background, the aim of this study is to estimate the prevalence of depression among university students using meta-analysis method.

2. Methods and Materials

2.1. literature search.

Our search strategy, selection of publications, and the reporting of results for the review will be conducted in accordance with the PRISMA guidelines [ 10 ]. Literatures on the depression among student were acquired through searching Scientific Information Databases (SID), Global Medical Article Limberly (Medlib), Iranian Biomedical Journal (Iran Medex), Iranian Journal Database (Magiran), and international databases including PubMed/Medline, Scopus and ISI Web of Knowledge. The search strategy was limited to the Persian and/or English language and articles published up until February 2012 were considered. All publications with medical subject headings (MeSh) and keywords in title, abstract, and text for words including student depression were investigated. Iranian scientific databases were searched only using the keyword “student depression,” as these databases do not distinguish synonyms from each other and do not allow sensitive search operation using linking terms such as “AND,” “OR” or “NOT.” Consequently, this single keyword search was the most practical option.

2.2. Selection and Quality Assessment of Articles

All identified papers were critically appraised independently by two reviewers. Disagreements between reviewers were resolved by consensus. Appraisal was guided by a checklist assessing clarity of aims and research questions. The inclusion criteria were as follows: (1) studies in the mentioned databases with full text, despite the language of original text; (2) having a standardized assessment of depression (either self-report or observer-rated). Exclusion criteria were (1) studies upon student overlapping time intervals of sample collection from the same origin; (2) low-quality design (STROBE checklist score's below 7.75 [ 11 ]); (3) inadequate reporting of results.

2.3. Data Extraction

Data were extracted using a standardized and prepiloted data extraction form. Data extraction will be undertaken by the first reviewer, and checked by a second reviewer although the process will be discussed and piloted by both reviewers. All identified papers will be critically appraised independently by both reviewers. Disagreements were resolved through discussion. Appraisal will be guided by a checklist assessing clarity of aims and research questions. Information was extracted from each included study (including author, title, year and setting of study, methods of sample selection, sample size, study type, age, STROBE score, and prevalence). These data abstraction forms were reviewed and eligible papers were entered into the meta-analysis.

2.4. Statistical Analysis

The random effects model was used for combining results of studies in meta-analysis. Variance for each study was calculated using the binomial distribution formula. The presence of heterogeneity was determined by the DerSimonian-Laird (DL) approach [ 12 ]. Significance level was <0.1 and I 2 statistic for estimates of inconsistency between studies. The I 2 statistic estimates the percent of observed between-study variability due to heterogeneity rather than to chance and ranges from 0 to 100 percent (values of 25%, 50% and 75% were considered representing low, medium and high heterogeneity, resp.). A value of 0% indicates no observed heterogeneity whilst 100% indicates significant heterogeneity. For this review, we determined that I 2 values above 75 percent were indicative of significant heterogeneity warranting analysis with a random effects model as opposed to the fixed effects model to adjust for the observed variability [ 13 ]. This heterogeneity was further explored through subgroup analyses and metaregression. Univariate and multivariate approach were employed to assess the causes of heterogeneity among the selected studies. Egger test was conducted to examine potential publication bias. Data manipulation and statistical analyses were done using STATA software, version 10. P values < 0.05 were considered as statistically significant.

According to the literature search strategies, 65 studies were identified, but 30 studies were excluded as they did not meet the inclusion criteria. Finally, 35 studies were published between 1995 and 2012 and included in meta-analysis ( Table 1 and Figure 1 ).

Results of the systematic literature search.

Feature and characteristic studies included in study.

The overall prevalence of depression among university students was 33% (CI 95%: 32–34) ( Figure 2 ). Prevalence of depression among subgroup including male and female students and single and married students was 28% (CI 95%: 26–30), 23% (CI 95%: 22–24), 39% (95%: 37–41), and 20% (CI 95%: 17–24) respectively ( Figure 3 ).

Forest plots of student depression for random effects meta-analyses. (Squares represent effect estimates of individual studies with their 95% confidence intervals of depression with size of squares proportional to the weight assigned to the study in the meta-analysis. The diamond represents the overall result and 95% confidence interval of the random-effects meta-analysis.)

Forest plots of student depression for subgroups analysis (forest plot (a) depression among male students, (b) among female students, (c) among single students, and (d) among married students).

The meta regression of the prevalence of student depression again sample size of studies showed no statistically significant relationship ( P = 0.66) ( Figure 4 ). Scatter plot year of study and the prevalence of student depression meta regression showed a negative and no statistically significant relationship ( P = 0.70). Since 1995, the student depression showed a stable trend ( Figure 5 ).

Meta-regression plots of change in depression according to changes in continuous study moderator's sample size.

Meta-regression plots of change in depression according to changes in continuous study moderator's year.

4. Discussion

In this systematic review, we have fully described our search strategy, study selection, data summary, and analysis to allow sensitivity analysis of any aspect of our approach. We have included every study that to our knowledge satisfies our inclusion criteria and employed techniques of estimation that allow integration of studies with high heterogeneity. In situations with high between-study heterogeneity (93.3%), the use of random-effects models is recommended as it produces study weights that primarily reflect the between-study variation and thus provides close-to-equal weighting [ 13 ].

In the current study, the Beck depression inventory (BDI) has been utilized to detect the prevalence of depression among university students. Although it is not designed for diagnostic purposes, its epidemiologic utility has been evaluated in several studies, which concluded that it is a reliable and valid instrument for detecting depressive disorders in nonclinical populations. Several studies support the BDI's usefulness in measuring and predicting depression in adolescent samples [ 46 , 47 ].

The study showed that the prevalence of depression among university student was 33% (CI 95%: 32–34). Steptoe et al. showed that Asian countries had the highest level depressive symptoms [ 48 ], which was consistent with our result. The incidence of depression in our study was higher than in other studies, and as Bayram and Bilgel reported that depression were found in 27.1% of Turkish university students [ 49 ], Bostanci reported that out of all university students in Denizli, 26.2% had a BDI score of 17 or higher [ 50 ]. This variation has been explained to be due to cultural differences, different measurement tools, different methods, and different appraisal standards. University is an important transient life stage, with special academic, financial, and interpersonal pressures. Undergoing these transitions may lead to an increased risk of depression. However, the prevalence of depressive symptoms in the present study is a high incidence rate, more than that seen in average people. Most students who join university in Iran are leaving their homes for the first time. This might subject them to loss of the traditional social support and supervision, in addition to residing with other students and peer relationships. Moreover, there is a change in the style of learning from what the students are used to in school. These changes may act as risk factors to depression in university students in Iran.

We found no differences in depression between genders in our study. Similar to our results, some previous studies [ 49 – 51 ] showed that no differences in depression were observed among male and female students. This might originate from the fact that Iranian female university students have equal experience of the same pressure. However, some studies findings are contrary to our results and found higher levels of depression among female students [ 50 – 52 ].

We found that single students were susceptible to depression compared with married students. This may be because the single students face more stressful events than the married students, such as employment, economic, graduation, and marriage pressures. Contrary to our study, some studies showed that married students reported higher levels of depression [ 49 ].

One of the limitations of this study is that the difference in assessment tools and researchers varies in their choice of cut point according to the study location. Secondly, the more studies were observational and patients were not randomly chosen in addition our ability to assess study quality was limited by the fact that many studies failed to offer detailed information on selected subjects or valid data on important factors. Therefore selection bias and confounding seem inevitable. Thirdly, many of our data were extracted from the internal databases in Iran.

5. Conclusion

In summary, we found that depression is common in university students with no preponderance between males and females and in single students is higher than married ones. Our findings point to importance of screening of this vulnerable population and taking appropriate interventional measures to prevent the complications of depression. Further research studying sociodemographic factors and the effect of depression on the academic performance is needed.

Conflict of Interests

The authors declare no conflict of interests.

Acknowledgment

This study was supported financially by Ilam University of Medical Sciences, Ilam, Iran.