The impact of the COVID-19 pandemic on student mental health and wellbeing in UK university students: a multiyear cross-sectional analysis

Figures & data

Figure 1. Timeline of key survey dates, COVID-19 milestones and summer exams.

Table 1. Confounding variables controlled for within multivariable logistic regression models.

Variable	Variable coding
Gender	Female (reference group) Male Non-binary or another gender
Age	24 years or younger (reference group) 25 years or older
Fee status	Home/EU (reference group) International students studying in the UK
First generation	Previous generation universityeducated (reference group) First generation in family at university
Sexuality	Heterosexual (reference group) Lesbian, gay, bisexual or another sexuality
Ethnicity	White British (reference group) Black, Asian and minority ethnic
Course type	Undergraduate (reference group) Postgraduate taught Postgraduate research
Lifetime mental health	No diagnosis in lifetime (reference group) Previously diagnosed/prefer not to say

Table 2. Respondent socio-demographic characteristics for 2019, 2020 and 2021.

	2021 (N = 2772)	2020 (N = 3693)	2019 (N = 2637)
Gender, n (%)
Female	1753 (63.2%)	2411 (65.3%)	1829 (69.4%)
Male	893 (32.2%)	1209 (32.7%)	720 (27.3%)
Nonbinary or another gender	126 (4.6%)	52 (1.4%)	63 (2.4%)
Missinga	0 (0.0%)	21 (0.6%)	25 (1.0%)
Age
<25	2262 (81.6%)	2900 (78.5%)	2167 (82.2%)
≥25	510 (18.4%)	787 (21.3%)	445 (16.9%)
Missing^a	0 (0.0%)	6 (0.2%)	25 (1.0%)
Ethnicity, n (%)
Black, Asian or minority ethnicity	663 (23.9%)	1220 (33.0%)	528 (20.0%)
White British	2037 (73.5%)	2435 (65.9%)	2072 (78.6%)
Missing	72 (2.6%)	38 (1.0%)	37 (1.4%)
Sexual orientation, n (%)
Heterosexual	1817 (65.6%)	2733 (74.0%)	1968 (74.6%)
Lesbian, gay, bisexual or other sexuality	728 (26.3%)	620 (16.8%)	492 (18.7%)
Prefer not to say	227 (8.9%)	325 (8.8%)	155 (5.9%)
Missing^a	0 (0.0%)	15 (0.4%)	22 (0.8%)
Fee status, n (%)
Home/EU	2366 (85.4%)	2810 (76.1%)	2325 (88.2%)
International students	406 (14.6%)	871 (23.6%)	307 (11.6%)
Missing^a	0 (0.0%)	12 (0.3%)	5 (0.2%)
Course type, n (%)
Postgraduate research	277 (10.0%)	458 (12.4%)	279 (10.6%)
Postgraduate taught	368 (13.3%)	675 (18.3%)	314 (11.9%)
Undergraduate	2127 (76.7%)	2560 (69.3%)	2041 (77.4%)
Missing^a	0 (0.0%)	0 (0.0%)	3 (0.1%)
First generation, n (%)
First generation in family at university	847 (30.6%)	782 (21.2%)	566 (21.5%)
Previous generation university educated	1925 (69.4%)	2899 (78.5%)	2028 (76.9%)
Missing^a	0 (0.0%)	12 (0.3%)	43 (1.6%)
Lifetime mental health, n (%)
No diagnosis	1824 (65.8%)	2793 (75.6%)	1739 (66.0%)
Previously diagnosed/prefer not to say	948 (34.2%)	897 (24.3%)	884 (33.5%)
Missing^a	0 (0.0%)	3 (0.1%)	14 (0.5%)

a Respondents were unable to skip this question in 2021.

Table 3. Mental health and wellbeing outcomes in 2021, 2020 and 2019.

	2021 (N = 2772)	2020 (N = 3693)	2019 (N = 2637)
Depression, n (%)
PHQ-9 < 10 (no/mild symptoms)	1438 (51.9%)	2297 (62.2%)	1383 (52.5%)
PHQ-9 ≥ 10 (moderate/severe symptoms)	1334 (48.1%)	1396 (37.8%)	1219 (46.2%)
Missing	0 (0.0%)	0 (0.0%)	35 (1.3%)
Anxiety, n (%)
GAD-7 < 10 (no/mild symptoms)	1589 (57.32%)	2630 (71.2%)	1663 (63.1%)
GAD-7 ≥ 10 (moderate/severe symptoms)	1183 (42.7%)	1063 (28.8%)	947 (35.9%)
Missing	0 (0.0%)	0 (0.0%)	27 (1.0%)
Subjective wellbeing (SWB), n (%)
SWEMWBS >19.5 (moderate/high SWB)	1212 (43.7%)	1882 (51.0%)	1320 (50.1%)
SWEMWBS ≤19.5 (low SWB)	1560 (56.3%)	1811 (49.0%)	1290 (48.9%)
Missing	0 (0.0%)	0 (0.0%)	27 (1.0%)

Table 4. Factors associated with depression (model 1), anxiety (model 2) and low SWB (model 3)^a.

	Depressionb	Anxietyc	Low SWBd
	OR (95% CI)	OR (95% CI)	OR (95% CI)
Survey year
2019 (reference)	1.00	1.00	1.00
2020	0.74 (0.66–0.82)	0.79 (0.70–0.89)	1.06 (0.95–1.18)
2021	0.96 (0.85–1.08)	1.25 (1.11–1.41)	1.27 (1.14–1.43)
p Value	<0.001	<0.001	<0.001
Gender
Female (reference)	1.00	1.00	1.00
Male	0.89 (0.81–0.98)	0.72 (0.65–0.80)	0.98 (0.89–1.07)
Nonbinary or another gender	1.75 (1.22–2.51)	0.94 (0.67–1.30)	1.59 (1.11–2.27)
p Value	<0.001	<0.001	0.034
Age
<24 (reference)	1.00	1.00	1.00
25+	0.89 (0.76–1.04)	0.89 (0.76–1.05)	0.91 (0.78–1.06)
p Value	0.143	0.166	0.211
Ethnicity
White British (reference)	1.00	1.00	1.00
Black, Asian or minority ethnicity	1.46 (1.28–1.67)	1.16 (1.02–1.33)	1.35 (1.19–1.53)
p Value	<0.001	0.027	<0.001
Sexuality
Heterosexual (reference)	1.00	1.00	1.00
Lesbian, gay, bisexual or other sexuality	1.89 (1.68–2.12)	1.45 (1.29–1.63)	1.41 (1.26–1.58)
Prefer not to say	1.57 (1.31–1.86)	1.22 (1.02–1.46)	1.73 (1.45–2.06)
p Value	<0.001	<0.001	<0.001
Fee status
Home/EU (reference)	1.00	1.00	1.00
International students	1.00 (0.85–1.16)	1.06 (0.90–1.25)	.90 (0.77–1.05)
p Value	0.962	0.464	0.173
Course type
Undergraduate (reference)	1.00	1.00	1.00
Postgraduate taught	0.97 (0.83–1.12)	1.05 (0.90–1.22)	1.03 (0.90–1.19)
Postgraduate research	0.66 (0.55–0.81)	0.81 (0.66–0.98)	1.00 (0.83–1.20)
p Value	<0.001	0.034	0.877
First generation
Previous generation uni-educated (reference)	1.00	1.00	1.00
First generation in family at university	1.22 (1.10–1.35)	1.30 (1.17–1.44)	1.07 (0.97–1.19)
p Value	<0.001	<0.001	0.181
Lifetime mental health
No diagnosis (reference)	1.00	1.00	1.00
Previously diagnosed/prefer not to say	3.02 (2.73–3.34)	3.06 (2.77–3.38)	2.50 (2.27–2.77)
p Value	<0.001	<0.001	<0.001

a All three models control for all factors listed in the table.

b 8772 respondents.

c 8781 respondents.

d 8778 respondents.