Inequality and mental healthcare utilisation among first-year university students in South Africa

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• dc.contributor.author Bantjes, Jason
• dc.contributor.author Saal, Wylene
• dc.contributor.author Lochner, Christine
• dc.contributor.author Roos, Janine
• dc.contributor.author Auerbach, Randy P.
• dc.contributor.author Mortier, Philippe
• dc.contributor.author Bruffaerts, Ronny
• dc.contributor.author Kessler, Ronald C.
• dc.contributor.author Stein, Dan J.
• dc.date.accessioned 2020-06-08T06:46:42Z
• dc.date.available 2020-06-08T06:46:42Z
• dc.date.issued 2020
• dc.description.abstract Background: Addressing inequalities in mental healthcare utilisation among university students is important for socio-political transformation, particularly in countries with a history of educational exclusion. Methods: As part of the WHO World Mental Health International College Student Initiative, we investigated inequalities in mental healthcare utilisation among first-year students at two historically "White" universities in South Africa. Data were collected via a web-based survey from first-year university students (n = 1402) to assess 12-month mental healthcare utilisation, common mental disorders, and suicidality. Multivariate logistic regression models were used to estimate associations between sociodemographic variables and mental healthcare utilisation, controlling for common mental disorders and suicidality. Results: A total of 18.1% of students utilised mental healthcare in the past 12 months, with only 28.9% of students with mental disorders receiving treatment (ranging from 28.1% for ADHD to 64.3% for bipolar spectrum disorder). Of those receiving treatment, 52.0% used psychotropic medication, 47.3% received psychotherapy, and 5.4% consulted a traditional healer. Treatment rates for suicidal ideation, plan and attempt were 25.4%, 41.6% and 52.9%, respectively. In multivariate regression models that control for the main effects of mental health variables and all possible joint effects of sociodemographic variables, the likelihood of treatment was lower among males (aOR = 0.57) and Black students (aOR = 0.52). An interaction was observed between sexual orientation and first generation status; among second-generation students, the odds of treatment were higher for students reporting an atypical sexual orientation (aOR = 1.55), while among students with atypical sexual orientations, the likelihood of mental healthcare utilisation was lower for first-generation students (aOR = 0.29). Odds of treatment were significantly elevated among students with major depressive disorder (aOR = 1.88), generalised anxiety disorder (aOR = 2.34), bipolar spectrum disorder (aOR = 4.07), drug use disorder (aOR = 3.45), suicidal ideation (without plan or attempt) (aOR = 2.00), suicide plan (without attempt) (aOR = 3.64) and suicide attempt (aOR = 4.57). Likelihood of treatment increased with level of suicidality, but not number of mental disorders. Conclusion: We found very low mental healthcare treatment utilisation among first-year university students in South Africa, with enduring disparities among historically marginalised groups. Campus-based interventions are needed to promote mental healthcare utilisation by first-year students in South Africa, especially among male and Black students and first-generation students with atypical sexual orientations.
• dc.format.mimetype application/pdf
• dc.identifier.citation Bantjes J, Saal W, Lochner C, Roos J, Auerbach RP, Mortier P, et al. Inequality and mental healthcare utilisation among first-year university students in South Africa. Int J Ment Health Syst. 2020 Jan 25; 14:5. DOI: 10.1186/s13033-020-0339-y
• dc.identifier.doi http://dx.doi.org/10.1186/s13033-020-0339-y
• dc.identifier.issn 1752-4458
• dc.identifier.uri http://hdl.handle.net/10230/44915
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.rights Copyright © The Author(s) 2020. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to th
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Common mental disorders
• dc.subject.keyword Mental healthcare utilisation
• dc.subject.keyword South Africa
• dc.subject.keyword Treatment
• dc.subject.keyword University students
• dc.title Inequality and mental healthcare utilisation among first-year university students in South Africa
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion