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

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dc.contributor.authorBantjes, Jasonen_ZA
dc.contributor.authorSaal, Wyleneen_ZA
dc.contributor.authorLochner, Christineen_ZA
dc.contributor.authorRoos, Janineen_ZA
dc.contributor.authorAuerbach, Randy P.en_ZA
dc.contributor.authorMortier, Philippeen_ZA
dc.contributor.authorBruffaerts, Ronnyen_ZA
dc.contributor.authorKessler, Ronald C.en_ZA
dc.contributor.authorStein, Dan J.en_ZA
dc.date.accessioned2020-01-28T07:17:41Z
dc.date.available2020-01-28T07:17:41Z
dc.date.issued2020-01-25
dc.date.updated2020-01-26T04:15:32Z
dc.descriptionCITATION: Bantjes, J. 2020. Inequality and mental healthcare utilisation among first-year university students in South Africa. International Journal of Mental Health Systems, 14:5, doi:10.1186/s13033-020-0339-y.
dc.descriptionThe original publication is available at https://ijmhs.biomedcentral.com
dc.description.abstractBackground: 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.description.urihttps://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-0339-y
dc.description.versionPublisher's version
dc.format.extent11 pagesen_ZA
dc.identifier.citationBantjes, J. 2020. Inequality and mental healthcare utilisation among first-year university students in South Africa. International Journal of Mental Health Systems, 14:5, doi:10.1186/s13033-020-0339-y
dc.identifier.issn1752-4458 (online)
dc.identifier.otherdoi:10.1186/s13033-020-0339-y
dc.identifier.urihttp://hdl.handle.net/10019.1/107383
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)en_ZA
dc.rights.holderAuthors retain copyright
dc.subjectMental healthcare utilisationen_ZA
dc.subjectEducational equalizationen_ZA
dc.subjectAdult college students — Mental healthen_ZA
dc.subjectFirst-year college students — South Africaen_ZA
dc.subjectMental disordersen_ZA
dc.titleInequality and mental healthcare utilisation among first-year university students in South Africaen_ZA
dc.typeArticle
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