Students without pre-existing mental health issues more severely affected by COVID-19 stressors

Surprisingly, university students without pre-existing mental health concerns seem to be suffering greater psychological distress during the pandemic than their peers with pre-existing mental health problems according to a study of close to 800 university students in Toronto carried out by researchers from McGill and University of Toronto.

"It is unexpected and counterintuitive," says Nancy Heath, a professor in the Department of Educational and Counselling Psychology at McGill and a co- author on the paper that was published today in Canadian Psychology. "We all expected that those 'at risk' due to prior mental health difficulties would be the most vulnerable to the COVID-19 stressors. However, those university students without mental health concerns are consistently and significantly more negatively impacted by COVID-19. Our explanation is that social isolation is hitting those without prior mental health difficulties much harder."

Weathering the loneliness of social isolation

The study compared the results of two surveys of close to 800 students, who answered questions online about their mental health and wellbeing, initially in May 2019, and then again in May 2020. 74% of the students were female, 25% were male and 1% were other.

Their average age was 18. The survey questions were designed to elicit information about a range of areas including recent stressful experiences, social support, depressive symptoms, difficulties in emotional regulation, non-suicidal self-injury, symptoms of anxiety along and alcohol dependence, among other subjects.

Analyses for mental health indicators after the survey in May 2020 showed that among students with pre-existing mental health concerns, there had been decreased levels of stress, sadness, depressive symptoms, anxiety and perceived burdensomeness over time. In contrast, students without pre-existing mental health concerns showed increasing stress, sadness, depressive symptoms, anxiety and burdensomeness over time.

Those with previous mental health difficulties showed either little change or even improvements. It seems that what is likely to be contributing to this, is that for those without mental health difficulties before the pandemic, COVID-19 resulted in them having greater social isolation AND social isolation was a significant contributor to their poor mental health outcomes after the beginning of the pandemic. But those with prior mental health difficulties were more likely to have the same or better social circumstances post-COVID-19 than they did before it. In effect, by being isolated pre-COVID, those with prior mental health difficulties were well positioned to weather COVID-19!"

Dr. Chloe Hamza, Ontario Institute for Studies in Education, University of Toronto and first author on the study

A need for support for students both with and without mental health challenges

"Our findings underscore the fact that universities will need to continue to support the ongoing needs of students with pre-existing mental health challenges," adds Heath. "However, our findings suggest that universities should also prioritize developing early intervention and prevention programming for students for whom the pandemic may be particularly challenging, such as students who are beginning to show declining mental health in response to increasing social isolation."