Determinants of mental distress among university students: a narrative review of global, regional, and local perspectives

Abstract

Background: An upsurge in mental distress among university students has been recorded worldwide. The emergence of COVID-19 has further complicated the mental health and well-being of university students due to frequent lockdowns and disruption of university learning schedules. However, extant literature shows that mental health issues of university students in sub-Saharan African countries including Kenya don’t receive equal attention compared to medical health problems. Locally, there is a paucity of studies on mental health among university students. Thus, more studies are needed to address this gap. Methods: This was a narrative review of peer-reviewed literature published in the last ten years. Literature was mainly searched from the PubMed database, grey literature and the list of references. A total of 18 studies were included in the review after screening for eligibility. Findings: The globally prevalence of mental health distress is relatively above 75%, with some studies reporting prevalence as high as 95% in the recent past. In sub-Saharan Africa, all studies reviewed have reported a prevalence of mental distress relatively below 50%. In Kenya, studies reviewed have shown that the prevalence of mental distress among university students is below 40%. Female gender, substance use, lack of social support, early years of university education, and poor grades in exams have been overwhelmingly cited as the key determinants of mental distress among university students. Conclusion: Currently, the actual situation of mental distress among university students in Kenya is unknown. This study recommends effective intervention treatment trials to establish which interventions can work best in reducing students’ mental health problems in Kenya. There is a need for student-centred drop-in-centres to provide social support, and counselling, and create extensive mental health awareness among university students. Universities should conduct frequent surveys on mental health problems affecting students and institute remedies as needed.