Apart from exam stress and the pressure to perform and fit in, SA students also face a barrage of socio-economic challenges such as potential rape, victimisation and destructive protests on campus that could make them more vulnerable to anxiety and depression.
The recent violent protests that again erupted at the University of Cape Town (UCT) and the Cape Peninsula University of Technology (CPUT) is a case in point. Several students were arrested for violent protests at UCT and angry students torched lecture rooms, which saw classes being suspended at CPUT.
Similar protests seem to have become the norm at tertiary institutions across the country with fears of riots intensifying again in the lead up to this year’s final exams.
A 2015 study that was conducted by Stellenbosch University among 1 337 students of varying backgrounds found that as many as 12% of university students experienced moderate to severe symptoms of depression and 15% reported moderate to severe symptoms of anxiety.
Shouqat Mugjenker, Mental Health Portfolio Manager at Pharma Dynamics points out that nearly a quarter (24.5%) of students that participated in the survey reported some form of suicidal ideation two weeks prior to being interviewed.
“This is higher than the 9.1% prevalence that is reported for the general South African population and higher than the 6.3% and 11.4% prevalence reported among college students in the US and Turkey respectively.”
“Suicidal ideation is when a person has thoughts about killing him or herself, but does not include the final act of following through on these thoughts. Being a student involves a lot of change and uncertainty as they transition from adolescence to adulthood. The added stress to perform in a highly demanding environment, whilst developing a capacity for intimate relationships and trying to establish their own identity, often makes them more prone to developing depressive tendencies.
“Some SA students also fear for their own personal safety on campus, which could further exacerbate matters and make them more anxious – often a pre-cursor for depression,” he remarks.
Mugjenker adds that students also have to deal with all of these challenges before their brain is fully mature since the prefrontal cortex – the part of the brain that helps you to reason and control impulses – is only fully developed by the age of 25.
“As a result, teenagers and young adults process information differently since they use the amygdala – the emotional part of the brain to analyse information. That’s why you will find that younger people are less risk averse and give in to peer-pressure more so than older adults. Their reward-seeking tendencies however could also lead them to experiment with pleasure-inducing substances like drugs and alcohol, which could lead to a dependence and depression over time.”
Mugjenker says even though it may be difficult to pinpoint depression in someone, there are some tell-tale signs to look out for in young adults. These include:
- A loss of interest in activities that they used to enjoy
- Being less sociable, withdrawing from their peers and spending more time alone
- Lack of energy, increased fatigue
- Poor concentration and inattentiveness while in class or social situations
- Erosion of self-esteem and increased feelings of hopelessness
- Finding it difficult to fall asleep or waking up often during the early hours of the morning
- Overindulging in alcohol as a possible escape or to numb the pain of loneliness
- Low sex drive
- Significant weight-loss or weight gain
- Suicidal thoughts or attempts
In South Africa, accessing mental healthcare remains problematic and even though most academic institutions provide professional student counselling services, these are often overprescribed. Consequently, students are unable to access even minimally adequate care to support their mental well-being.
Students who suffer from ill mental health and don’t receive the required treatment are also at greater risk of academic failure and are more likely to drop out of university.
Mugjenker cites a study that was done at the University of Michigan among 2 800 students, which showed that depressed students performing at the 50th percentile of the Grade Point Average (GPA) would typically experience a 13% drop in academic performance, while a student with depression and anxiety’s marks went down to about the 23rd percentile.
Interventions at universities and other tertiary institutions still predominantly rely on traditional approaches to psychotherapy, such as one-on-one counselling which most students can’t afford and may also not be suitable for all students.
In the absence of sufficient accessible and affordable public mental healthcare in SA and tertiary institutions, Pharma Dynamics has developed an e-intervention, called Let’s Talk, which aims to support students with mental health concerns.
The portal encourages individuals to open up and share their struggles and advice regarding mental illness in a safe space, where trained psychiatrists offer support and encourage sufferers to take an active step in their own recovery via psychotherapy in the form of videos and webinars; advice about medication and alternative therapy options; educational literature and nutrition.
Mugjenker says the Let’s Talk platform aims to address the barriers which prevent students from accessing needed psychological care and could help young adults to identify risk factors in themselves and fellow students before their illness reaches a debilitating stage.
“We believe that technological interventions are critical in making treatment more accessible to students and could over time change the trajectory of mental health disorders,” he concludes.