The mental maze: a mixed-methods approach to understanding undergraduate student mental health at a South African university

Abstract

Introduction: Depression, anxiety, and stress have been identified as global public health concerns among young adults, such as undergraduate university students. Limited studies have explored mental health through a mixed-methodological approach. Therefore, this study aimed to determine and explore the prevalence of mental health challenges among undergraduate students at a South African university. Methods: Using the sequential explanatory design, quantitative data were conveniently collected through the Depression, Anxiety, and Stress Scale (DASS-21) (n = 534), and analysed using SPSS v.29. Semi-structured interviews commenced with a convenient sample of undergraduate students (n = 18) and thematically analysed using ATLAS.ti v.8. Results: Results revealed a high prevalence of extremely severe anxiety among undergraduate students; 41.5% of males and 39.9% of females were affected. On-campus students reported higher anxiety levels (42.6%). Third- and fourth-year students exhibited the highest rates of extremely severe anxiety at 60% and 65.5%, respectively. The prevalence of anxiety was the highest among the Dentistry (60.4%), Law (59.6%), and Education (46.4%) faculties. Qualitatively, six key themes emerged: perceptions of mental health, coping mechanisms, sources of support, barriers to seeking help, stigma and awareness, and strategies for mental health maintenance. Discussion: While females reported slightly higher levels of depression and stress, males exhibited a higher prevalence of extremely severe anxiety. Relationship status, living arrangements, academic year, and faculty affiliation significantly influenced mental health outcomes. Conclusion: University policies must integrate tailored strategies to foster inclusive, sustainable mental health support systems, promoting Sustainable Development Goal 3 (good health and well-being).