The COVID-19 pandemic has created the most severe disruption to global education systems in history. More than 1.6 billion students were affected by more than 190 country-wide closures of schools or universities at the peak of the crisis, (UNESCO. 2020). The University of Greenwich, similar to most of the universities in the UK, started their 2020-21 academic session with a Blended Learning approach (mixtures of online and controlled face-to-face teaching) as the first national lockdown (imposed from 26th March 2020) eased off but moved to online only from the end of November 2020 when the second national lockdown (imposed from 5th November 2020) came into force.
The prevalence of the adverse impact on mental health due to the pandemic and its containment measures is documented by the experts (Holmes, et al. 2020, Liu, et al. 2020) in recent years. For students, who are a population with an increased level of psychological distress (American College Health Association, 2019), containment measures of the pandemic and changes to their learning environment may have triggered anxiety and depression. In general, first-year university students are exposed to psychological distress as they experience a double transition: a developmental transition from adolescence to adulthood, and a life transition from one institution to another which is often very different (Cheun et al., 2020). Hence, during the COVID-19 pandemic, the first-year students are even more exposed to psychological distress.
However, the mental health of university students, particularly first year undergraduate, during the pandemic in the UK is relatively less known compared to the widespread and psychological effects due to the containment measures of the pandemic. Given the fact that the mental health and wellbeing of young adults, particularly female young adults, are disproportionally affected by the pandemic (Public Health England (2021), further research on mental health is a priority to take informed decisions to support this psychologically vulnerable group of population.
We investigated the level of anxiety (by using Spielberger’s self-reported state-and trait-anxiety inventory scale) and depression (by using self-reported PHQ-9 scale) of a sample of students during COVID-19. We also analysed the determinants of anxiety and depression during the COVID-19 crisis. State anxiety in our study measures situational anxiety which can be influenced by the stressful situations at the moment (Spielberger, 1989), e.g., COVID-19 and its containment measures, changes in circumstances etc. Whereas, the trait anxiety measures stress, worry, discomfort, exigency, etc. that a respondent experiences on a daily basis (Spielberger, 1989). On the other hand, depression measure of our study measures the self-reported depression during last two weeks of the survey. We surveyed first year undergraduate students of the Accounting and Finance department of the University of Greenwich from 19th of September 2020 to 24th of November 2020. The survey was approved by University Research Ethics Committee (UREC) of the University of Greenwich. The response rate was 50.22% (113 out of 225 students); out of them 56 were male and 57 were female students. The sample was comprised predominantly (88.5%) of students aged 24 years or less (more specifically 18 years or less [44.25%], 19 to 24 years [44.25%] and more than 24 years [11.5%]). The majority of the respondents described their ethnicity as Asian/Asian British (42.5%), with the remainder identifying as White (31.9%%), Black/African/Caribbean/Black British (15.9%), Mixed Ethnicity (6.2%), or Other (3.5%).
We found that 68.14% of the respondents have a self-reported high level of state anxiety that could be instigated by the pandemic and the changed arrangements of the learning environment that were taken to contain the virus. Almost a similar percentage of students found to have a high level of self-reported trait-anxiety or personal anxiety that may be associated with constant stress, exigency, anxiety adamantness and/or strong reaction to stimuli related to self-esteem and respect. On the other hand, more than 50% of the respondents are found to have mild to moderate levels of self-reported depression. Note that, the measure of anxiety in our study is not directly comparable with the study of ONS (2020) where they study personal well-being with only four questions (ONS, 2018) but can be compared with the study of UCL (2020) in broad context where self-reported anxiety and depression are studied with GAD-7 and PHQ-9 questionnaire respectively in general population. However, both the study of ONS and UCL reported a higher level of anxiety and depression particularly among younger adults (ONS, 2021).
When we looked at the determinants of anxiety and depression, we found that gender, age, accommodation, domicile (home or international), study hours and social media have a significant impact on students’ anxiety and/or depression. Our study found that female students are 2.8 times more likely to have self-reported state anxiety that may arise due to the current pandemic situation. Female students also have a higher level of personal (trait) anxiety (1.1 times higher than male students) that is irrespective of the current pandemic and its containment measures. These findings may reflect the argument that females, in general, express emotions to a greater extent and have lower uncertainty tolerance thresholds compared to males (Sundarasen, 2020). Interestingly, students in the higher age group are found to report a very high level of self-reported state anxiety. More specifically, students aged 24 years or older have 11.2 times higher state anxiety compared to students of 18 years or younger. Intuitively, since the greatest psychological morbidity could be observed in individuals at greatest risk of COVID-19 (Jia et al., 2020), the older age group could be exposed to a higher level of state anxiety. Consistent with this argument we also found that students of 24 years of age or older have a higher chance of having trait anxiety, however statistically insignificant. No quantifiable or significant association between age group and depression is found in our sample.
Our statistical analysis provides a mixed conclusion, albeit insignificant, when we looked at ethnicity as a determinant of anxiety and depression. Black/African/Caribbean/Black British and Asian/Asian British students are found to have 2 times and 1.8 times higher chance of having state anxiety respectively compared to White students. On the other hand, mixed ethnic groups are found to be 2.8 times more likely to be depressed compared to White students. The findings are consistent with the fact that BAME students are more likely to be in risk categories for adverse experiences during the pandemic (UCL, 2020) such as lower socio-economic status, pooper baseline mental health.
As homesickness, language barrier, new living, academic environments etc. can increase anxiety and depression of international students (Cheung et al., 2020), international students are found to be more anxious and depressed, in general, in our study compared to home students. Our study affirms that being an international student increases the probability of being depressed by 5.1 times compared to home students. International students also have higher chances of having trait anxiety, however statistically insignificant. The probability of having state anxiety is found to be almost similar (odds ratio is 0.91) across home and international students, even though insignificant.
Interestingly, higher social media usage is found to increase the probability of having anxiety and depression. Students using 2-4 hours of social media have around 5 times more chances of having state anxiety, 2.4 times more chance of having trait anxiety and 2.3 times more chance of having depressive symptoms compared to those who use social media for 1-2 hours or less. The highly significant influence of social media usage towards higher state anxiety is not surprising, albeit worrying, given the informational role of social medial during the COVID-19 pandemic. The argument is that individuals use social media with emotional and behavioural attachment hence the informational role of social media will affect the mental health of the users. Although social media plays a variety of positive roles in information exchange during the COVID-19 crisis, such as: disseminating health-related recommendations, showing public attitudes, experience, and perception of the disease (Merchant and Lurie, 2020; Zhu et al., 2020), it also fuelled the rapid spread of misinformation and rumours, which can create a sense of panic and confusion among the public (Garfin, Silver, and Holman, 2020). The relationship between media exposure and mental health has also been documented during collective trauma events such as the Sichuan earthquake, and several terrorist attacks. Recent studies (Zhao and Zhou, 2020; Gao et al., 2020) also find that social media usage is positively associated with higher depression and anxiety. They recommended to combat social media “infodemic” by communicating accurate information across the media.
Our study contributes to the current effect to study the effect of COVID-19 on risk of anxiety and depression of the first-year undergraduate students who are relatively less studies in the UK. We also analysed several risk factors, that are crucial in understanding who may be at greatest risk of mental health difficulties and in need of intervention, and their association with the anxiety and depression among the university students. Our study reveals high prevalence of anxiety and depression among the first year undergraduate students during the recent pandemic The findings of our study are not surprising, albeit worrying. Although we found a higher level of students’ self-reported anxiety and depression during the COVID-19 pandemic, students’ mental health, particularly mental health of first year undergraduate students, is relatively less explored in the UK. Based on the current literature, experts’ opinion and a discussion with a group of first year students we recommend further research in this context for effective intervention. Given the fact that first year undergraduate students possess higher anxiety and depression, research should be channelled towards teaching, learning and assessment strategies during pandemics to maximise learning experience as well as to improve the mental health of the students.
Although self-reported mental health should not automatically be interpreted as an increase in mental illness or need for mental health services (ONS, 2021), to support students during this difficult time we recommend that Universities should allocate more resources in mental health services and increase communication to reduce barriers. Expansion of counselling services (including tele-counselling programs) during the pandemic is highly recommended. The engagement of academic staff, particularly personal tutors, is also important to disseminate information, providing pastoral care and academic support. We also recommend having support classes in every module to mitigate students’ anxiety and depression (a comprehensive review of student’s mental health and recommendations can be found in the study of Storrie, Ahern and Tuckett, 2010).
Blog Authors
Dr Sohan Sarwar
Senior Lecturer
Department of Accounting and Finance
Greenwich Business School
g.sarwar@gre.ac.uk
Prof Luthful Alahi Kawsar
Department of Statistics
Shahjalal University of Science and Technology, Bangladesh
lakawsar-sta@sust.edu
Atiqul Islam
Department of Statistics
Jagannath University, Bangladesh
atique@stat.jnu.ac.bd
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