The two-stage health examination of university students: associations with mental health diagnoses during six-year follow-up
Keywords:
health check, electronic health questionnaire, mental health, university studentsAbstract
Mental disorders are highly prevalent among university students. Preventing and detecting mental health problems is one of the main goals of Finnish student health care. In Finland, all first-year university students are offered a two-stage health examination by the Finnish Student Health Service. First, the students receive an electronic health questionnaire (eHQ) and second, based on the eHQ responses, the respondents receive one of the three feedbacks: referral to health check, referral to another appointment or, receive health-supporting electronic feedback, when the other interventions are not considered necessary. The study explored associations between factors related to the two-stage health examination and receiving a mental health diagnosis (MHD) during the six-year follow-up.
The study was a retrospective register-based cohort study with a follow-up period of academic years 2011–2017. The cohort included all first-year university students from the academic year 2011–2012 in Finland (n=15,722). The data was obtained from three national health and education registers. MHD was based on ICD-10 diagnosis made by medical doctors. The data was analyzed with a logistic regression analysis and factor analysis.
Of the final data (n=14,314), 13.9% (F: 16.7%; M: 10.3%) had MHD during the follow-up. Of the students who responded to the eHQ (n=7838), 42.6% were invited for a health check. In female, responding to the eHQ was associated with receiving MHD compared to non-responders (OR 1.21 CI 1.07–1.38). MHD was more common in students invited to health check compared to non-invited (F: OR 3.33 CI 2.80–3.97; M: 2.77 CI 2.09–3.67), as well as in students who attending the health check compared to non-attended (F: OR 1.24 CI 1.02–1.51; M: OR 1.15 CI 1.15–2.22). The strongest predictor for MHD in the eHQ was low score in the factor Psychosocial (State of mind, Loneliness, Relationship with parents, Experience of social situations) (F: OR 3.67, CI 2.51-5.36; M: OR 9.95, CI 4.97-19.90).
The results suggest that the two-stage health examination may provide a low-threshold lead to mental health services in student health care. With the eHQ, it is possible to identify mental health related risk factors for study ability.
