Abstract Background In recent years, the incidence of depression among college students has shown a significant upward trend, becoming a serious public health issue. Although most universities have established counseling centers, their services primarily focus on post-event intervention, with notable deficiencies in universal prevention and education. Existing research indicates that integrating systematic mental health knowledge—particularly nursing education principles—into campus systems holds potential value for enhancing students' psychological resilience. However, the effectiveness and specific implementation pathways for systematically transforming mental health nursing education into scalable prevention strategies require further exploration. Therefore, this study aims to address the aforementioned gap and provide empirical evidence for developing a scientific and effective depression prevention model in higher education settings. By designing and implementing a structured mental health education program, the research evaluates its effectiveness in enhancing students' depression awareness, self-regulation abilities, and reducing depression risk within the university environment. Methods This study employed a cluster randomized controlled trial design. Four non-senior classes were randomly selected from a university and assigned to either an intervention group (2 classes, n = 98) or a control group (2 classes, n = 102). The intervention group received a 12-week structured mental health education program (2 academic hours per week), covering core knowledge about depression, stress management techniques, emotion regulation strategies, effective help-seeking pathways, and peer support skills. The control group received no structured intervention and maintained routine campus activities. All participants were assessed pre- and post-intervention using the Patient Health Questionnaire-9 (PHQ-9), Depression Cognitive Scale, and Self-Psychological Coping Ability Scale. Differences in post-intervention scores between groups were compared using covariance analysis and independent samples t-tests via SPSS 25.0 software. Results Data analysis demonstrated significant intervention effects post-program. PHQ-9 depression scores in the intervention group decreased significantly from pre-test (6.54 ± 3.21) to post-test (3.89 ± 2.45), while the control group's scores slightly increased from pre-test (6.48 ± 3.35) to post-test (6.91 ± 3.58). with a statistically significant difference between groups at post-test (t = -7.632, p.001). Additionally, the intervention group demonstrated higher scores on the Depression Cognitive Scale (post-test: intervention group (42.15 ± 5.62) vs. control group (33.78 ± 6.91), p.01) and the Self-Psychological Coping Ability Scale (post-test scores: intervention group (38.90 ± 4.13) vs. control group (31.45 ± 5.87), p.001). Findings indicate that this mental health education program effectively alleviates depressive symptoms among students while significantly enhancing their depression-related cognitive levels and self-psychological coping abilities. Discussion The findings confirm that integrating systematic mental health care education into the higher education system constitutes an effective primary prevention strategy. This approach not only significantly reduces students' depression risk but also empowers them by enhancing psychological self-help and mutual support capabilities, holding significant public health implications. This model provides an actionable pathway for shifting university depression prevention efforts from reactive counseling to proactive intervention. Future research should conduct long-term follow-ups across broader university samples to validate the sustainability of these effects. Additionally, exploring blended online-offline educational models and institutionalizing peer support volunteer training mechanisms could further expand the reach and impact of this prevention strategy.
Shu et al. (Sun,) studied this question.