Mental health and academic failure among first-year university students in South Africa

Universities in South Africa face ongoing challenges with low rates of academic attainment and high rates of attrition. Our aims were to (1) investigate the extent to which common mental disorders evaluated early in the first year predict academic failure at the end of the year, controlling for sociodemographic factors and (2) establish the potential reduction in prevalence of failure that could be achieved by effectively treating associated mental disorders. Self-report data were collected from first-year students ( n = 1402) via an online survey at the end of the first semester. Participants were assessed for six common mental disorders. Academic performance data were subsequently obtained from institutional records at the end of the year. Bivariate and multivariate logistic regression models were used to identify the best sociodemographic and mental health predictors of academic failure. Population attributable risk analysis was used to assess the potential impact of treating associated mental disorders. In multivariate logistic regression models controlling for significant sociodemographic factors, the odds of failure were elevated among students with major depressive disorder (aOR = 3.69) and attention deficit hyperactivity disorder (aOR = 2.05). Population attributable risk analysis suggests that providing effective treatment to students with major depressive disorder and/or attention deficit hyperactivity disorder could yield a 6.5% absolute reduction in prevalence of academic failure (equivalent to a 23.0% proportional reduction in prevalence of academic failure). Providing effective and accessible campus-based mental healthcare services is integral to supporting students’ academic attainment and promoting transformation at South African universities.