University student mental health before and after implementation of a mental health strategy: a repeated cross-sectional study from Australia.

Studies have consistently indicated that university students are at risk of experiencing poor mental health. This study analysed survey waves at an Australian university in 2019 and 2022 preceding and following implementation of a student mental health strategy to evaluate progress on supporting student mental health. Key indicators for mental health and wellbeing; diversity and inclusion; and risk and protective factors for psychological distress were assessed. Regression analyses examined change between survey waves and risk and protective factors within waves. For mental health measures, the findings demonstrate that in 2022 more students found university stressful while no improvement was seen for risk of mental illness, wellbeing, and coping. Students were also less able to identify a mental health problem, more likely to deal with a mental health problem alone, and less aware of the confidentiality of university-based health services. However, help seeking intention increased and diversity and inclusion indicators improved with more students feeling included and accepted. Risk and protective factors were generally consistent across waves with elevated risks associated with non-Australian country of birth, LGBTQI+ status, current health condition, and current financial stress. Protective factors were age, social inclusion, social acceptance, and satisfaction. Limited progress on key indicators may be due to the COVID-19 pandemic and deterioration in economic conditions. The findings suggest universities can support student mental health by making students feel included, accepted, and satisfied, but that universities should also consider how to address the broader social and economic pressures that students face.