After Vaccines & Easing of Lockdowns, College Students' Mental Health Still Poor
College students are not bouncing back from the changes brought on by the COVID-19 pandemic, a troubling new study finds.
Researchers were surprised to find that one year after the start of the pandemic, college students were still less active and more at risk for depression even as social restrictions were lifted and many were vaccinated.
While the new study focused on the experiences of college students in spring 2021, preliminary results from continued research suggest those trends carried on into early fall.
"The surprising fact is that despite the lifting of many restrictions and in light of the vaccine, still the students reported very high rates of mental distress," said study author Osea Giuntella. He is an assistant professor in the department of economics in the Kenneth P. Dietrich School of Arts & Sciences at University of Pittsburgh.
Back in the spring of 2019, researchers from four universities -- University of Pittsburgh, Carnegie Mellon University in Pittsburgh, University of California, San Diego, and the University of Gothenburg in Sweden -- started tracking University of Pittsburgh college students' mental health and physical activity using biometric and survey data. They were initially studying physical activity and mental health to consider ways to nudge students into healthier behaviors, Giuntella said.
When the pandemic struck the world a year later, it provided an unusual opportunity to compare student experiences with a pre-pandemic world.
The researchers studied five cohorts of students in different semesters in 2019, 2020 and 2021. The students had a median age of 19, and 95% were under 23.
While the students got about 9,800 tracked steps per day before the pandemic, that dropped to 4,600 steps per days in March and April 2020. The study participants gradually increased their steps to 6,300 per day in May to July 2020 then 6,900 in September to November 2020 before dropping down to 6,400 in February to May 2021, a 35% decline from pre-pandemic numbers.
While screen time continued to be significantly higher during the pandemic, social interactions were restored.
Using the Center for Epidemiological Depression scale, the researchers found students' scores increased 50% as the pandemic began. By spring 2021, they were still 24% higher than pre-pandemic levels.
The team estimated that between 42% and 56% of spring 2021 study participants were at risk for clinical depression.
"They were vaccinated. They were going back to campus, yet their mental well-being was not going back to the pre-pandemic levels," Giuntella said.
The researchers think that one of the reasons students are not experiencing the same well-being as before the pandemic is because of a lack of novelty, Giuntella said. They've lost the ability to meet new people in classes or to explore campus life to the fullest potential. Some students may have adapted to life during COVID-19 and now feel stress about returning to normalcy, Giuntella said.
It will be important for colleges to develop interventions to improve student well-being and increase activity, according to the study authors.
"More research should be done to enlighten us on what could be the factors, and then what can we do to improve the physical activity and mental well-being of college students," Giuntella said.
The findings were published online Dec. 2 in Scientific Reports.
The information is consistent with many other data sets, which have found that young adults were disproportionately impacted by the sudden changes during the pandemic, said Dr. Rachel Conrad, director of Young Adult Mental Health in the department of psychiatry at Brigham and Women's Hospital in Boston. Conrad was not involved in the new study.
Among the changes that caused distress for college students was the forced relocation from on-campus housing, Conrad said.
"We really saw that there's a lot of different drivers that uniquely impacted the college students at the beginning of the pandemic, the forced relocation, separation from their friends, loneliness, worrying about COVID transmission," Conrad said.
At the same time, the young adults lost some of their primary coping mechanisms including exercise and socializing. It was a traumatic loss and the type of experience that people don't always recover from quickly even when their lives have normalized again, Conrad said. And, of course, some uncertainty continues.
"When people have a potentially traumatic experience and then the uncertainty persists, it actually really impedes their capacity to recover," Conrad said. "All of this is compounded by our fragmented and inadequate mental health system for college students."
College mental health systems were already underfunded, understaffed and poorly structured, she explained. They need to significantly expand services, Conrad suggested. Telehealth options can help for rural colleges. Increasing peer support and mentoring can also bridge the gap while there is a shortage of mental health professionals.
"There needs to be an expectation of parity between mental and physical health. There is an attitude at certain educational institutions that they are not necessarily responsible for the mental health of their student body while they feel like they don't have expertise in these areas and they don't have the funding to expand these services," Conrad said.
"But if we think about the physical health of a student body, for example if there was a COVID outbreak on a campus [or] if there was an E. coli outbreak in a cafeteria," she said, "it wouldn't be acceptable for an educational institution to say, 'COVID isn't our problem or E. coli isn't our problem.'"
The National Alliance on Mental Illness has more on mental health in college.
SOURCES: Osea Giuntella, PhD, assistant professor, department of economics, Kenneth P. Dietrich School of Arts & Sciences, University of Pittsburgh, Penn.; Rachel Conrad, MD, director, Young Adult Mental Health, department of psychiatry, Brigham and Women's Hospital, Boston; Scientific Reports, Dec. 2, 2021, online