Factors Associated With College Students' Mental Health During the COVID-19 Pandemic

In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the virus that causes coronavirus disease (COVID-19), was first reported in China. By March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, forcing many higher education institutions to take measures to promote students' safety. The COVID-19 pandemic continues to upend the lives of students in higher education institutions. In particular, the pandemic has had deleterious effects on students' mental health, leading to increased prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD; Healthy Minds Network & American College Health Association [HMN], 2020). Students' mental health has become a paramount concern to institutional leaders: over 90% of college presidents expressed concern about students' mental health during the pandemic (Lederman, 2020).

As faculty, student affairs practitioners, administrators, and mental health providers brace for the impact of increasing numbers of students who experience mental health disorders in upcoming semesters, they may benefit from an enhanced understanding of the students who are likely to experience mental health disorders and of the roles that other stressors or supports can play in students' mental health. The unique context surrounding the pandemic may create conditions that alter previous research findings related to students' mental health; therefore, we designed this study to examine the associations between individual, interpersonal, institutional, health, and stress-related factors and undergraduates' risks for clinically significant MDD and GAD.

MENTAL HEALTH DISORDERS AMONG COLLEGE STUDENTS

Even before the pandemic, the frequency of college students' mental health disorders was increasing at an alarming rate. Recent estimates indicate that 31% of students experienced GAD and 41% experienced MDD during the pandemic (HMN, 2020). College students are a particularly vulnerable group when it comes to their risk for mental health disorders, many of which first present themselves in late adolescence and early adulthood (Liu et al., 2020). Some of the variables associated with college students' mental health can be grouped into five broad categories: (a) individual characteristics (e.g., gender and sexual orientation), (b) interpersonal factors (e.g., sense of belonging), (c) institutional factors (e.g., perceptions of a supportive environment), (d) health and safety factors (e.g., nutrition and sleep), and, (e) stressors (e.g., financial and academic; Fink, 2014; Oswalt & Wyatt, 2011).

The unique conditions surrounding the COVID-19 pandemic might exacerbate the effects of some of the aforementioned factors on students' MDD and GAD. While emerging studies on college students' mental health during the COVID-19 pandemic present useful information to practitioners, the majority of those studies are limited because of small sample sizes, single-institution samples, or a limited number of independent variables (Huckins et al., 2020; Liu et al., 2020). We examined a wide variety of factors associated with college students' rates of MDD and GAD with variables specific to students' experiences during the pandemic; our sample was drawn from 8 large, public research universities; and, our sample size allowed us to examine the effects among demographic groups typically excluded in studies because of their small numbers.

CONCEPTUAL FRAMEWORK

We drew from Fink's (2014) integrated model of college students' mental health, which combines Astin's (1993) input–environment–outcome model, the VicHealth framework (Keheler & Armstrong, 2005), and Keyes's (2002) mental health continuum. Fink examined the effects of students' individual characteristics, interpersonal factors, and institutional factors on students' mental health. We extended Fink's framework by adding stressors that we theorized would impact students' mental health, including health and safety factors and financial and academic stressors.

METHOD

Instrument and Sample

We used the Student Experience in the Research University (SERU) COVID-19 survey, developed by members of the SERU Consortium. Eight large, public research universities located in different regions of the US administered the census survey in June and July 2020. The response rates ranged from 13% to 30%, 90% of students answered all items in the survey; we excluded responses with missing data, and the final sample was N = 27,118. Detailed information about the sample is available in Table 1.

Measures

Our individual measures include...