Mental disorders among college students in the World Health Organization World Mental Health Surveys

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Original Articles

Introduction

Although prevalence (Costello et al. 2005; Merikangas et al. 2009) and treatment (Fazel et al. 2014a , b ) of mental disorders among elementary and secondary school students has been the subject of considerable attention, less is known about mental disorder prevalence or treatment among college students other than in the USA (Eisenberg et al. 2007; Blanco et al. 2008; Cho et al. 2015; Kendler et al. 2015; Mojtabai et al. 2015). We know somewhat more about the associations of early-onset mental disorders with significant reductions in subsequent educational attainment (Kessler et al. 1995; Fergusson & Horwood, 1998; Johnson et al. 1999; Miech et al. 1999; Woodward & Fergusson, 2001; Fergusson & Woodward, 2002; Fletcher, 2008; Lee et al. 2009; Mojtabai et al. 2015), but this work is limited by either being based on small restricted samples or by being subject to long-term recall bias. Given the importance of an educated workforce for the human capital potential of a country, it would be valuable to know more about five questions. First, what is the prevalence of mental disorders among college students? Second, what proportion of those disorders had onsets prior to college entry? Third, to what extent are disorders with pre-matriculation onsets associated with college entry? Fourth, what is the relative importance of disorders with pre-matriculation and post-matriculation onsets in predicting college attrition? Fifth, what proportion of college students with mental disorders receives treatment? We address these five questions using data from community epidemiological surveys carried out in 21 different countries in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative.

Method

Samples

The WMH surveys are a cross-national series of community epidemiological surveys using consistent sampling designs, field procedures and instruments to facilitate pooled cross-national comparative analyses (Kessler & Üstun, 2011). The focus is on prevalence and correlates of common mental disorders. The data reported here come from the 23 WMH surveys carried out in 21 countries that assessed college student status and had a sufficiently large sample to: (i) estimate prevalence among college students aged 18-22 years; and (ii) estimate and compare prevalence in disaggregated subsamples of non-students in the same age range as students, distinguishing college...