Winzer, R., L. Lindberg, K. Gulbrandsson, and A. Sidorchuk, “Effects of Mental Health Interventions for Students in Higher Education Are Sustainable over Time: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” PeerJ 6, (2018): 1–27.
CENTRAL TAKEAWAY
There is a high probability that students who present with a mental health concern will require more than a single round of treatment. Face-to-face cognitive behavioral therapies appear to have longer-lasting effects on commonly experienced concerns like depression, and treatments usually remain effective for three to six months.
SUMMARY
Postsecondary students experience considerably more mental health challenges than non-student peers or the general population. These challenges often arise shortly after matriculation and generally persist with only minor fluctuations throughout their college years. While a wide variety of interventions have demonstrated short-term efficacy in reducing mental health symptoms in students, the prolonged nature of the challenges require treatment modalities that are effective over equally lengthy periods of time.
To assess which treatments have sustainable effects and for which outcomes, the authors systematically identified, appraised, and summarized “the existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions are sustained for at least three months of post-interventional follow-up” (p.3). Their literature search resulted in the inclusion of 26 randomized controlled trials.
DISCUSSION OF THE FINDINGS
Regarding the prevention of mental ill health, psychological interventions generally were more effective than untreated control groups during the three-to-six- and seven-to-twelve-month post-treatment period. However, beyond 12 months statistical differences were not detectable.
The type of intervention seems to matter. Cognitive behavioral therapy preventive interventions appeared to have consistent moderate positive effects, while psychoeducation and mind-body-related interventions were highly inconsistent or ineffective.
Furthermore, the mode of administering the intervention had a significant impact on its efficacy, with internet-based individual interventions being no better than going untreated, and face-to-face interventions carried out in pairs or in groups both being moderately effective.
Concerning the promotion of mental health and academic performance, interventions appeared to be effective for the first three to six months, but the effect was small and dwindled to insignificance after that time period. Interventions seemed to ameliorate depression symptoms for a longer period of time (13–18 months) than other mental health conditions.
IMPLICATIONS FOR ACTION BY CAMPUS LEADERS
While the COVID-19 pandemic significantly worsened student mental health, maintaining student wellbeing remains a challenge for institutional leaders. Maintaining positive mental health is often an ongoing struggle for students, and institutions should have well-developed systems in place to reincorporate previously treated students into their mental healthcare system if and when these students experience relapses.
However, this study provides evidence that some interventions may have more durable effects than others by improving mental health on campus over the long term. Most especially, campus leaders should consider implementing cognitive behavioral therapy in face-to-face conditions where possible. Furthermore, psychoeducation, internet interventions, and mind-body-related interventions, while useful for some situations, may not be as effective when prioritizing the sustainability of student health and care. As many CIC member institutions must be strategic in allocating resources, these insights may provide clarity regarding efficient ways to offer the necessary care for students.
ABOUT THE AUTHORS
Regina Winzer is a researcher at the Public Health Agency of Sweden.
Lene Lindberg is an adjunct senior lecturer at the Karolinska Instituet.
Karin Guldbrandsson is a researcher at the Public Health Agency of Sweden.
Anna Sidorchuk is a researcher at the Public Health Agency of Sweden.
RECOMMENDED FOLLOW-UP LITERATURE
Mak, W. W., A. T. Chan, E. Y. Cheung, C. L. Lin, and K. C. Ngai. “Enhancing Web-Based Mindfulness Training for Mental Health Promotion with the Health Action Process Approach: Randomized Controlled Trial.” Journal of Medical Internet Research 17, no. 1 (2015). https://doi.org/10.2196/jmir.3746.
Ibrahim, A.K., S. J. Kelly, C. E. Adams, and C. Glazebrook. “A Systematic Review of Studies of Depression Prevalence in University Students.” Journal of Psychiatric Research 47, no. 3 (2013):391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015.