The growing prevalence of mental health challenges among students in higher education has become one of the most urgent social and institutional issues of our time. Across South Africa, university students are navigating complex academic, emotional, and financial pressures that can severely impact their well-being, and universities have a duty to be responsive to and address this matter with the urgency it deserves, an education expert warns.

Research by Higher Health South Africa (Higher Health SA), the implementing agency of the Department of Higher Education and Training (DHET) responsible for health and wellness across the post-school education and training system, reveals the depth of the problem, says Dr Linda Meyer, MD at IIE Rosebank College and Waterfall School of Business, and President of Rosebank International University College Ghana.

Between January 2021 and June 2023, Higher Health delivered mental health prevention interventions to over 321,000 students and provided psychosocial support and counselling to more than 23,450 students. These statistics not only reflect the enormous demand for support but also the growing awareness of mental health as an essential pillar of student success.

 “University life coincides with a developmental period when most mental health conditions first emerge. Disorders such as anxiety, depression, and bipolar disorder commonly surface between the ages of 17 and 25, precisely when young people are pursuing tertiary education,” says Dr Meyer.

“This transition, often marked by leaving home and facing new social and academic expectations, can be exhilarating yet overwhelming. Added to this are the burdens of financial stress, housing insecurity, social isolation, and the pressure to meet family or community expectations. The result is a population of young adults at high risk of psychological distress but often reluctant or unable to seek help,” she says.

 A national study conducted across 17 South African universities found that 37.1% of students met the criteria for anxiety disorders, 16.3% for mood disorders, and 24.4% reported suicidal ideation within the preceding month. Despite this, only about one in five received treatment.

“Barriers include cost, lack of time, fear of stigma, and the misconception that mental illness is a sign of weakness. These challenges contribute to declining academic performance, absenteeism, dropouts, and, in extreme cases, suicide. Universities are left to contend not only with the personal tragedies that accompany these outcomes but also with the institutional and societal costs of unaddressed mental health crises,” Dr Meyer says.

She says universities must go beyond crisis management and build a culture of prevention and care. This begins with leadership commitment.

“University executives must integrate mental health into institutional strategy, allocate resources for counselling and support, and train academic and administrative staff to identify at-risk students.

“Regular well-being check-ins, anonymous mental health surveys, and workshops on stress management, emotional regulation, and resilience can create a proactive well-being ecosystem. Teaching and learning practices should also reflect awareness of mental health realities: more flexible deadlines, compassionate academic engagement, and inclusive pedagogies can significantly reduce psychological distress.”

For students navigating the pressures of university life, recognising early warning signs can make the difference between temporary distress and a severe mental health crisis. Practical steps to identify when you may be struggling include:

• Persistent sadness or hopelessness: Feeling down for more than two weeks, crying often, or losing interest in activities you previously enjoyed.
• Changes in sleep or appetite: Sleeping far more or less than usual, frequent insomnia, or loss of appetite can be indicators of depression or anxiety.
• Difficulty concentrating or making decisions: Struggling to focus on studies or feeling mentally “foggy” may signal cognitive overload or burnout.
• Social withdrawal: Avoiding friends, classes, or social activities may reflect emotional fatigue or anxiety.
• Irritability, anger, or emotional numbness: Extreme mood swings or emotional detachment are often overlooked signs of distress.
• Decline in academic performance: Missing deadlines, skipping lectures, or failing assessments can be linked to deteriorating mental health.
• Physical symptoms: Frequent headaches, stomach problems, or unexplained aches may have psychological roots.
• Thoughts of self-harm or suicide: Any thoughts of ending one’s life, even fleeting, should be taken seriously and lead to immediate professional support.

If a student recognises these warning signs, the next step is to reach out early. This might mean speaking with a campus counsellor, health practitioner, lecturer, or residence advisor. Many institutions have peer support programmes or student wellness ambassadors trained to listen and refer students to appropriate services. Digital tools and helplines such as Higher Health’s 24-hour crisis support line (0800 36 36 36) or WhatsApp helpline (083 937 7200) offer confidential assistance.

“Early intervention is not a sign of weakness, but rather a sign of self-awareness and strength. Seeking help prevents escalation, protects academic progress, and promotes long-term well-being,” Dr Meyer says.

Partnerships are critical, she adds. Collaborations between universities, Higher Health SA*, the Department of Health, and community mental health organisations can expand capacity and ensure access to professional care. Investment in mental health research, remarkably contextually grounded studies within South African higher education, is crucial for developing effective interventions. Data-driven approaches enable universities to monitor trends, assess their impact, and continually adapt their strategies.

 “Ultimately, addressing the mental health crisis in higher education is both a moral and strategic imperative. A university cannot achieve academic excellence without nurturing the psychological well-being of its students,” says Dr Meyer.

“South Africa’s future leaders must be equipped not only with knowledge but also with resilience, empathy, and emotional intelligence. By embedding mental health into the core mission of higher education, and by empowering students to recognise when they need help, universities can transform from institutions of learning into communities of care.”

HIGHER HEALTH SA

*The work of Higher Health SA offers a model for addressing the mental health crisis in Higher Education challenge systematically. Operating across all 26 public universities, 50 TVET colleges, and nine community colleges, Higher Health provides comprehensive programmes that include awareness campaigns, peer education, mental health screenings, counselling, and linkages to external clinical support. Their initiatives are grounded in prevention and early intervention, focusing on destigmatising mental illness and empowering students to recognise signs of distress in themselves and others. This approach underscores a critical truth: while universities must provide professional services, students themselves also need tools to identify when they need help.