Final-year university students’ mental health and access to support as they prepared to graduate

Figures & data

Table 1. Sociodemographic characteristics of graduating university students that participated in year 1 (2021) or year 2 (2022) of the SHIFT study

		Total	Y1	Y2
		N (%)/M (SD)	N (%)/M (SD)	N (%)/M (SD)
Age	20–23	429 (75.0%)	221 (79.5%)	208 (70.7%)
	24–27	90 (15.7%)	31 (11.2%)	59 (20.1%)
	28–50	53 (9.3%)	26 (9.4%)	27 (9.2%)
Gender & Sexual Orientation	Heterosexual cisgender women	345 (59.3%)	177 (63.0%)	168 (55.8%)
	Heterosexual cisgender men	132 (22.7%)	60 (21.4%)	72 (23.9%)
	Sexual/gender diverse^a	105 (18.0%)	15.7%)	61 (20.3%)
Living Situation	On-campus	12 (2.0%)	3 (1.1%)	9 (3.0%)
	Off-campus with family	331 (56.4%)	185 (65.6%)	146 (47.9%)
	Off-campus alone	40 (6.8%)	15 (5.3%)	25 (8.2%)
	Off-campus with friends/roommates	192 (32.7%)	76 (27.0%)	116 (38.0%)
	Other (no stable housing, prefer not to answer, missing	12 (2.0%)	3 (1.1%)	9 (3.0%)
Race/Ethnicity	White	341 (65.5%)	160 (64.5%)	181 (66.3%)
	BIPOC^b	180 (34.5%)	88 (35.5%)	92 (33.7%)
Born in Canada	Yes	458 (79.4%)	219 (78.2%)	239 (80.5%)
	No	119 (20.6%)	61 (21.8%)	58 (19.5%)
Parents Born in Canada	Yes	298 (52.0%)	153 (55.4%)	145 (48.8%)
	No	275 (48.0%)	123 (44.6%)	152 (51.2%)
Parental Education	High school or less	91 (16.0%)	51 (18.5%)	40 (13.5%)
	College/university degree	366 (63.8%)	180 (65.2%)	186 (62.6%)
	Graduate/professional degree	85 (14.8%)	43 (15.6%)	42 (14.1%)
	Some post-secondary education	6 (1.0%)	2 (0.7%)	4 (1.3%)
	Other (don’t know, prefer not to say)	25 (4.4%)	0 (0.0%)	25 (8.4%)
Current Financial Situation	Stressful	420 (73.9%)	196 (71.8%)	224 (75.9%)
	Not Stressful	148 (25.1%)	77 (28.2%)	71 (24.1%)
Financial Situation Growing up	Stressful	283 (50.0%)	126 (46.5%)	157 (53.0%)
	Not Stressful	284 (50.0%)	145 (53.5%)	139 (47.0%)
Mental Health Score	Anxiety	9.3 (6.8)	9.7 (6.5)	10.1 (6.0)
	Depression	9.9 (6.2)	9.2 (6.7)	9.5 (6.6)
	Wellbeing	28.6 (9.0)	28.0 (10.1)	29.2 (7.9)
	Perceived Stress	10.9 (3.3)	11 (4.1)	11.3 (3.6)

^aSexual/gender diverse includes: Non-Binary, Two-Spirit, Prefer not to Answer, Lesbian/Gay, Bisexual/Pansexual, Asexual, Queer, Questioning/Unsure, Other and Prefer not to Answer.

^bBIPOC includes: Indigenous peoples of Canada, Indigenous peoples outside of Canada, Arab, Black, Chinese, Filipino, Japanese, Korean, Latin, Central or South America, South Asian, Southeast Asian and West Asian.

Figure 1. Histograms displaying the distribution of anxiety, depression, perceived stress and psychosocial wellbeing scores in final-year undergraduate students that participated in the SHIFT study.

Note: The lines in the Anxiety and Depression graphs display the threshold for clinically relevant symptoms (GAD-7 ≥ 10, PHQ-9 ≥ 10).

Table 2. Multivariable linear regression using LS mean estimate models of depression and anxiety symptoms by sociodemographic characteristics among graduating university students in the SHIFT study (2021, 2022)

		Depression		Anxiety
		Β	95% CI	Β	95% CI
Age	20–23 vs. 24–27	−0.0	[−1.7, 1.6]	1.5	[−0.5, 3.4]
	20–23 vs. 28–50	1.7	[−0.4, 3.8]	1.4	[−0.8, 3.6]
	24–27 vs. 28–50	1.8	[−0.6, 4.2]	0.0	[−1.4, 1.5]
Gender & Sexual Orientation	Heterosexual cisgender men vs. Sexual/Gender diverse	−4.2***	[−6.1, −2.3]	−2.6**	[−4.3, −0.8]
	Heterosexual cisgender men vs. Heterosexual cisgender women	−0.8	[−2.2, 0.7]	−1.8**	[−3.1, −0.4]
	Sexual/Gender diverse vs. Heterosexual cisgender women	3.4***	[1.8, 5.1]	0.9	[−0.6, 2.4]
Race/Ethnicity	BIPOC vs. White	0.4	[−1.2, 2.1]	0.9	[−0.6, 2.4]
Student/ parent born in Canada	First generation Canadian vs. Not born in Canada	0.2	[−1.4, 1.8]	−0.3	[−1.8, 1.1]
	Second+ generation Canadian vs. Not born in Canada	1.2	[−0.8, 3.2]	1.3	[−0.6, 3.1]
	Second+ generation Canadian vs. First generation Canadian	−1.0	[−2.8, 0.7]	−1.6	[−3.2, 0.0]
Parental Education	At least some postsecondary vs. High school or less	−0.3	[−2.0, 1.4]	0.3	[−1.2, 1.9]
	Other vs. High school or less	0.4	[−2.7, 3.5]	0.4	[−2.4, 3.3]
	Other vs. At least some postsecondary	−0.7	[−3.5, 2.1]	−0.1	[−2.7, 2.5]
Current Financial Situation	Not stressful vs. Stressful	−2.4***	[−3.8, −1.0]	−2.0**	[−3.2, −0.7]
Financial Situation Growing up	Not stressful vs. Stressful	−1.5**	[−2.8, −0.2]	−1.5**	[−2.7, −0.3]
Living Situation	On-campus vs. off-campus alone or with roommates	0.8	[−3.2, 4.9]	0.7	[−3.0, 4.4]
	Off-campus with family vs. On-campus	0.5	[−0.7, 1.7]	0.8	[−0.3, 1.9]
	Off-campus with family vs. Off-campus alone or with roommates	0.3	[−3.7, 4.4]	−0.2	[−3.8, 3.5]

Notes: ** = p < .01, *** = p < .001. Reported p-values adjusted for multiple comparisons. Depression symptoms measured using the PHQ-9. Anxiety symptoms measured using the GAD-7.

Table 3. Multivariable linear regression using LS mean estimate models predicting psychosocial wellbeing and perceived stress by sociodemographic characteristics among graduating university students in the SHIFT study (2021, 2022)

		Psychosocial wellbeing ^a		Stress ^b
		Β	95% CI	Β	95% CI
Age	20–23 vs. 24–27	0.1	[−2.5, 2.8]	0.4	[−0.8, 1.5]
	20–23 vs. 28–50	−0.2	[−3.3, 2.8]	0.4	[−0.9, 1.7]
	24–27 vs. 28–50	0.3	[−1.7, 2.4]	−0.0	[−0.9, 0.9]
Gender & Sexual Orientation	Heterosexual cisgender men vs. Sexual/Gender diverse	4.5**	[2.1, 6.9]	−0.9	[−1.9, 0.1]
	Heterosexual cisgender men vs. Heterosexual cisgender women	−0.4	[−2.2, 1.5]	−0.3	[−1.1, 0.5]
	Sexual/Gender diverse vs. Heterosexual cisgender women	−4.8***	[−6.9, −2.8]	0.7	[−0.2, 1.6]
Race/ Ethnicity	BIPOC vs. White	3.2**	[1.1, 5.3]	0.2	[−0.7, 1.1]
Student/ parent born in Canada	First generation Canadian vs. Not born in Canada	0.1	[−1.9, 2.1]	0.2	[−0.6, 1.1]
	Second+ generation Canadian vs. Not born in Canada	1.0	[−1.5, 3.5]	0.3	[−0.8, 1.4]
	Second+ generation Canadian vs. First generation Canadian	−0.9	[−3.1, 1.3]	−0.1	[−1.0, 0.9]
Parental Education	At least some postsecondary vs. High school or less	0.6	[−1.5, 2.8]	−0.5	[−1.5, 0.4]
	Other vs. High school or less	−0.1	[−4.0, 3.8]	−0.3	[−2.0, 1.4]
	Other vs. At least some postsecondary	0.7	[−2.8, 4.2]	−0.3	[−1.8. 1.3]
Current Financial Situation	Not stressful vs. Stressful	1.0	[−0.7, 2.8]	−1.1**	[−1.9, −0.3]
Financial Situation Growing up	Not stressful vs. Stressful	−0.7	[−2.3, 0.9]	−0.8*	[−1.5, −0.1]
Living Situation	On-campus vs. off-campus alone or with roommates	−0.1	[−5.2, 5.0]	−0.6	[−2.8, 1.6]
	Off-campus with family vs. On-campus	0.1	[−1.4, 1.6]	0.4	[−0.2, 1.1]
	Off-campus with family vs. Off-campus alone or with roommates	−0.2	[−5.3, 4.8]	−1.0	[−3.2, 1.2]

Notes: * = p < .05, ** = p < .01, *** = p < .001. Reported p-values adjusted for multiple comparisons.

^aPsychosocial Wellbeing measured by the Flourishing Scale; higher scores represent greater psychosocial wellbeing; scores range from 8–56.

^bPerceived Stress Scale; higher scores correlate to more stress; scores range from 0–16.

Figure 2. Types of mental health support accessed by participating university students in the final year of their undergraduate program (2021, 2022; N = 587).

Table 4. Frequency and Chi-square results for knowing where to access support, and access of formal and informal support in the past year, by sociodemographic characteristics among graduating university students in the SHIFT study

		Know where to access N (%)	Chi-square (df) p-value	Formal support N (%)	Chi-square (df) p-value	Informal support N (%)	Chi-square (df) p-value
Age	20–23 (N = 429)	138 (32.2)	14.5 Carver et al. (2015) 0.025	129 (30.1)	121.0 Carver et al. (2015) <.001	304 (70.9)	115.3 Carver et al. (2015) <.001
	24–27 (N = 90)	33 (36.7)		39 (43.3)		63 (70.0)
	28–50 (N = 53)	21 (40.0)		18 (34.0)		39 (73.6)
Gender & Sexual Orientation	Heterosexual cisgender women (N = 345)	110 (32.0)	41.0 Carver et al. (2015) <.001	107 (31.0)	365.6 Carver et al. (2015) <.001	250 (72.5)	352.3 Carver et al. (2015) <.001
	Heterosexual cisgender men (N = 132)	42 (31.8)		34 (26.0)		89 (67.4)
	Sexual/Gender diverse ^a (N = 105)	41 (39.0)		48 (45.7)		74 (70.5)
Living Situation	On-campus (N = 12)	4 (33.3)	9.96 Carver et al. (2015) 0.126	5 (41.7)	5.76 Arnett (2015) 0.123	12 (100.0)	3.45 Arnett (2015) 0.326
	Off-campus with family (N = 331)	102 (31.0)		118 (35.6)		244 (73.7)
	Off-campus alone or with friends (N = 232)	86 (37.1)		64 (27.6)		157 (67.7)
Race/Ethnicity	White (N = 341)	117 (34.3)	1.7 MacLeod and Brownlie (2014) 0.785	98 (28.7)	30.7 MacLeod and Brownlie (2014) <.001	240 (72.5)	24.7 MacLeod and Brownlie (2014) <.001
	BIPOC ^b (N = 180)	58 (32.2)		64 (35.6)		126 (70.0)
Student/parent born in Canada	No (N = 267)	91 (34.1)	67.6 Carver et al. (2015) <.001	85 (31.8)	1.66 Arnett (2015) 0.647	196 (73.4)	12.6 Arnett (2015) 0.006
	First generation Canadian (N = 188)	60 (31.9)		58 (30.9)		137 (72.9)
	Second+ generation Canadian (N = 118)	42 (35.6)		44 (37.3)		78 (66.1)
Parental Education	High school or less (N = 91)	41 (45.1)	16.4 Wiljer et al. (2016) 0.037	28 (30.8)	3.91 MacLeod and Brownlie (2014) 0.418	65 (71.4)	2.3 MacLeod and Brownlie (2014) 0.680
	At least some postsecondary (N = 457)	144 (31.5)		151 (33.0)		326 (71.3)
	Other (N = 25)	8 (32.0)		8 (32.0)		20 (80.0)
Current Financial Situation	Stressful (N = 420)	155 (37.0)	51.7 MacLeod and Brownlie (2014) <.001	145 (34.5)	93.2 MacLeod and Brownlie (2014) <.001	309 (73.6)	100.1 MacLeod and Brownlie (2014) <.001
	Not Stressful (N = 148)	37 (25.0)		42 (28.4)		99 (66.9)
Financial Situation Growing up	Stressful (N = 283)	103 (36.4)	44.3 MacLeod and Brownlie (2014) <.001	104 (36.7)	90.1 MacLeod and Brownlie (2014) <.001	206 (72.8)	92.2 MacLeod and Brownlie (2014) <.001
	Not Stressful (N = 284)	88 (31.0)		82 (28.9)		201 (70.8)
Depression	Yes (PHQ-9 ≥ 10) (N = 222)	81 (36.5)	70.5 MacLeod and Brownlie (2014) <.001	90 (41.0)	449.9 MacLeod and Brownlie (2014) <.001	177 (80.0)	453.4 MacLeod and Brownlie (2014) <.001
	No (PHQ-9 < 10) (N = 361)	107 (29.6)		100 (27.8)		237 (66.0)
Anxiety	Yes (GAD-7 ≥ 10) (N = 256)	91 (35.5)	59.5 MacLeod and Brownlie (2014) <.001	102 (40.0)	450.6 MacLeod and Brownlie (2014) <.001	203 (79.3)	455.4 MacLeod and Brownlie (2014) <.001
	No (GAD-7 < 10) (N = 327)	101 (31.0)		88 (27.0)		211 (64.5)

^aGender/Sexual minority includes: Non-Binary, Two-Spirit, Prefer not to Answer, Lesbian/Gay, Bisexual/Pansexual, Asexual, Queer, Questioning/Unsure, Other and Prefer not to Answer.

^bBIPOC category includes: Indigenous peoples of Canada, Indigenous peoples outside of Canada, Arab, Black, Chinese, Filipino, Japanese, Korean, Latin, Central or South America, South Asian, Southeast Asian and West Asian.

Table

	Anxiety		Depression		Perceived Stress		Psychosocial Wellbeing
	2022	2021	2022	2021	2022	2021	2022	2021
Mean	17.1	16.2	18.5	17.6	12.0	11.2	29.2	28.0
Standard Deviation	41.5	53.3	51.7	65.4	9.7	15.8	58.9	101.7
P(T≤t) two-tail	−1.4		1.5		2.9*		1.6
t Critical two-tail	2.0		2.0		2.0		2.0

*Significant at the p < 0.05 level (2-tailed).

Table

Variable	N (%)
Age	15 (2.6)
Gender & Sexual Orientation	1 (0.2)
Employed During School Year	2 (0.3)
Living Situation^a	12 (2.0)
Race/Ethnicity	66 (11.2)
Born in Canada	7 (1.2)
Parents Born in Canada	11 (1.9)
Parental Education	14 (2.4)
Current Financial Situation	19 (3.2)
Financial Situation Growing up	20 (3.4)
Anxiety^b	27 (4.6)
Depression^b	28 (4.8)
Perceived Stress^b	33 (5.6)
Psychosocial Wellbeing^b	34 (5.8)

^aIncludes: Other (no stable housing, prefer not to answer) or Missing.

^bIncludes: missing all items on the scale.

Table

Question	Response Option
“How old are you?”	Open-ended response
“What is your gender identity?”	“Woman”, “Non-binary”, “Two-Spirit”, “Man” and “I prefer not to answer”
“Are you someone with trans experience (meaning that your gender identity does not align with your sex assigned at birth)?”	“Yes”, “No” and “I prefer not to answer”
“What is your sexual orientation?”	“Heterosexual”, “Lesbian/Gay”, “Bisexual/Pansexual”, “Asexual”, “Queer”, “Questioning/Unsure”, “Other. Please specify”: and “I prefer not to answer”
“Where do you currently live?”	“University residence”, Other on-campus housing”, “Off-campus with family (e.g. parents, spouse/partner, children)”, “Off-campus alone”, “Off campus with friends or roommates”, “I do not have stable housing (e.g. couch-surfing, living in a vehicle, facing eviction)” and “I prefer not to answer”
“Please indicate how you self-identify. If you are of mixed-descent, please select all that apply”	“Indigenous peoples of Canada (First Nations, Métis, Inuit)”, “Indigenous (outside of Canada)”, “Arab”, “Black”, “Chinese (including Mainland China, Hong Kong, Macau and Taiwan)”, “Filipino”, “Japanese”, “Korean”, “Latin, Central, or South American (e.g. Brazilian, Chilean, Columbian, Mexican)”, “South Asian (e.g. Indian, Pakistani, Sri Lankan, etc.)”, “Southeast Asian (e.g. Cambodian, Indonesian, Laotian Vietnamese, etc.)”, “West Asian (e.g. Afghan, Iranian, Syrian, etc.), “White” and “If none of the above, please specify”
“Were you born in Canada?”	“Yes” and “No”
“What is the highest level of formal education obtained by your parent(s)/guardian(s)?”	“High school or less”, “Completed a college program (e.g. diploma, certificate, apprenticeship)”, “Completed a university degree (e.g. Bachelor)”, “Completed a graduate or professional degree (e.g. Master’s, PhD, Law, Medicine)”, “I don’t know” and “I prefer not to answer”
“How would you describe your current financial situation?”	“Always stressful”, “Sometimes stressful”, “Rarely stressful”, “Never stressful”
“How would you describe your financial situation while growing up?”	“Always stressful”, “Sometimes stressful”, “Rarely stressful”, “Never stressful”

Table

Variable		N (%)
Age	20–27	525 (91.8)
	28–35	25 (4.4)
	36–42	12 (2.1)
	43–50	10 (1.7)
Gender	Women	420 (72.0)
	Men	154 (26.4)
	Non-Binary	6 (1.0)
	Two-Spirit	1 (0.2)
	Prefer Not to Answer	2 (0.3)
Trans Experience	Yes	12 (2.1)
	No	566 (97.1)
	Prefer Not to Answer	5 (0.9)
Sexual Orientation	Heterosexual	483 (82.8)
	Lesbian/Gay	12 (2.1)
	Bisexual/Pansexual	51 (8.7)
	Asexual	6 (1.0)
	Queer	2 (0.3)
	Questioning/Unsure	18 (3.1)
	Other	4 (0.7)
	Prefer Not to Answer	7 (1.2)
Living Situation	University Residence	10 (1.7)
	Other on-campus housing	2 (0.3)
	Off-campus with family	331 (57.4)
	Off-campus alone	40 (6.9)
	Off-campus with friends or roommates	192 (33.3)
	I do not have stable housing	1 (0.2)
	Prefer not to answer	1 (0.2)
Race/Ethnicity	Indigenous peoples of Canada	14 (2.2)
	Indigenous (outside of Canada)	2 (0.3)
	Arab	12 (1.9)
	Black	35 (5.6)
	Chinese	33 (5.3)
	Filipino	10 (1.6)
	Japanese	3 (0.5)
	Korean	5 (0.8)
	Latin, Central, or South America	17 (2.7)
	South Asian	75 (11.9)
	Southeast Asian	15 (2.4)
	West Asian	8 (1.3)
	White	380 (60.6)
	Other	18 (2.9)
Born in Canada	Yes	458 (79.4)
	No	119 (20.6)
	Prefer not to Answer	0 (0.0)
Parents Born in Canada	Yes	298 (52.0)
	No	275 (48.1)
	Prefer not to Answer	0 (0.0)
Parental Education	High school or less	91 (15.9)
	Completed a college program	155 (27.1)
	Completed a university degree	211 (36.8)
	Completed a graduate or professional degree	85 (14.8)
	I don’t know	5 (0.9)
	Prefer not to Answer	1 (0.2)
	Some post-secondary education but no completed degree	25 (4.4)
Current Financial Situation	Always Stressful	63 (11.1)
	Often Stressful	110 (19.3)
	Sometimes Stressful	244 (42.8)
	Rarely Stressful	107 (18.8)
	Never Stressful	41 (7.2)
	Prefer not to Answer	5 (0.9)
Financial Situation Growing Up	Always Stressful	50 (8.7)
	Often Stressful	95 (16.6)
	Sometimes Stressful	138 (24.1)
	Rarely Stressful	172 (30.0)
	Never Stressful	112 (19.5)
	Prefer not to Answer	6 (0.9)

Table

Question	Response
“In the past 12 months, have you received support for your mental or emotional health from any of the following sources? (select all that apply)”	“Mental health related clinician (e.g. psychologist, counsellor, psychotherapist, or psychiatrist)”, “Other health care professional (e.g. nurse, physician)”, “Roommate, friend, or significant other”, “Family member”, “Instructor/Professor”, “Religious counsellor or other religious contact”, “Support group (e.g. student peer support, online support group)”, “Other nonclinical source (please specify)”, “Other clinical source (please specify)”, and “No, none of these”
“Have you accessed formal support for your emotional or mental health (e.g. individual or group counselling) on campus/online through Brock University? (Check all that apply)”	“Yes, within the current school year”, “Yes, prior to the current school year”, “No, I have never accessed campus-based resources/services for mental health”
“Have you accessed formal support for your emotional or mental health (e.g. individual or group counselling) off campus/online outside of Brock University? (Check all that apply)”	Yes, in the current school year”, “Yes, since starting at Brock University”, “Yes, prior to starting at Brock University”, “No, I have never accessed off-campus mental health services”
“How much do you agree with the following statements? If I currently needed to seek professional help for my mental or emotional health… “	“I would know where to access campus-based resources (online or in person)”, “I would know where to access off-campus resources (online or in person outside of Brock University”
“If you have tried (successful or not) to access formal support for emotional or mental health on campus, please describe any barriers you have encountered”.	Open-ended response
“If the following were available at Brock to prepare you for life after graduation, how likely would you be to access programs/information to help”,	“Find a family doctor in your community”, “Find other health professionals in your community (e.g. dentistry, occupational therapy, etc.)”, “Connect with mental health services in your community”, “Get supplemental health insurance (e.g. dental, prescriptions)”, “Apply for immigration/visa to remain in Canada or work/study abroad”, “Develop coping skills for managing stress”, “Develop healthy physical activity, eating, & other habits”, “Manage finances (e.g. student loans, debt, other budgeting)”, “Prepare to graduate with a peer support or mentorship program”
“Can you think of any other information, services, or programs that you would find helpful in preparing to graduate and/or the year after graduation?”	Open-ended response

Table

	Anxiety	Depression	Psychosocial Wellbeing	Perceived Stress
Anxiety	-	0.78**	0.08*	0.62**
Depression	0.78**	-	−0.02	0.62**
Psychosocial Wellbeing	0.08*	−0.02	-	0.32**
Perceived Stress	0.62**	0.62**	0.32**	-

*Correlation is significant at the p < 0.05 level.

**Correlation is significant at the p < .01 level.

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Data availability statement

The data that support the findings of this study are available from the corresponding author, [MM] upon reasonable request.