Demographic, history, university and lifestyle factors associated with university student mental health: cross-sectional analysis across five UK universities

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BACKGROUND: The whole-university approach to mental health emphasises that well-being should be a strategic priority across all aspects of higher education. However, there is limited evidence on which aspects of university life institutions should target to maximise well-being. AIM: To identify factors associated with student mental health and well-being and provide an evidence base for developing initiatives that protect and promote this. METHODS: The Nurture-U survey was conducted across five universities in the UK from 2022 to 2024. This cross-sectional sample of the survey data assessed student well-being and mental health at the start of the academic year. Hierarchical linear regression models examined the relative association between demographic, family history, university and lifestyle variables and self-reported depression, measured using the Patient Health Questionnaire-9 (PHQ-9), anxiety, measured using the Generalised Anxiety Disorder-7 (GAD-7) and well-being, measured using the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). RESULTS: A total of 14 172 students completed the survey. Over a quarter self-reported probable anxiety or depression based on established screening thresholds. Regression analysis indicated that younger age, identifying as female or lesbian, gay, bisexual, transgender, queer/questioning, intersex or asexual (LGBTQIA+) and reporting a disability were associated with poorer mental health. There was minimal evidence of mental health impact associated with university factors, such as course of study or university attended. There was a strong association with exercise and self-care. CONCLUSIONS: We have provided evidence that exercise and self-care may be areas that universities can target when considering a whole-university approach to student mental health and well-being. Increasing opportunities for students from all backgrounds, means and abilities to adopt healthy behaviours is vital to supporting university students.