Factors associated with depressive and anxiety symptoms, barriers, and facilitators for seeking support among European university students: a cross-sectional multicenter study

Abstract

Aim: The rationale for this current study was to assess the factors associated with anxiety and depressive symptoms in a cohort of students from seven universities across the European education system. Furthermore, the research sought to assess the barriers and facilitators for seeking support when students perceive any mental health issues.

Methods: A cross-sectional multicenter study was conducted, which included 4830 higher education students from seven European countries. A sociodemographic questionnaire, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) were used to assess depressive and anxiety symptoms, respectively. The Mental Health Inventory (MHI-5) assessed general psychological well-being. A questionnaire was used to assess preferences regarding support-seeking behavior and perceived barriers in the event of mental distress. Linear mixed models (LMMs) were used in the statistical analysis.

Results: Swedish students reported lower levels of moderate to severe depressive symptoms (34.1%) and moderate to severe anxiety (27.9%) when compared, for example, with Irish students (63.1% and 52.9%, respectively). Younger students, females, students with a history of mental disorder and lower levels of academic performance, or from a poorer socioeconomic background reported increased rates of depressive and anxiety symptoms. The most valued support-seeking strategies were speaking to friends or engaging in psychotherapy; in contrast, the most cited barrier to seeking support was the expense related to professional therapy and long waiting times for an appointment with professional therapists.

Conclusion: There is a need to develop and/or review mental health promotion strategies for higher education students across Europe. These strategies need to consider the individual and culturally specific needs of higher education students so that they are effective in removing perceived barriers when seeking support in the event of mental distress.