The Mental Maze: A Mixed-Methods Approach to Understanding Undergraduate Student Mental Health at a South African University

Introduction Depression, anxiety, and stress have been identified as global public health concerns among young adults, such as undergraduate university students. Limited studies have explored mental health through a mixed-methodological approach. Therefore, this study aimed to determine and explore the prevalence of mental health challenges among undergraduate students at a South African university. Methods Using the sequential explanatory design, quantitative data were conveniently collected through the Depression, Anxiety, and Stress Scale (DASS-21) (n = 534), and analysed using SPSS v.29. Semi-structured interviews commenced with a convenient sample of undergraduate students (n = 18) and thematically analysed using ATLAS.ti v.8. Results Results revealed a high prevalence of extremely severe anxiety among undergraduate students; 41.5% of males and 39.9% of females were affected. On-campus students reported higher anxiety levels (42.6%). Third- and fourth-year students exhibited the highest rates of extremely severe anxiety at 60% and 65.5%, respectively. The prevalence of anxiety was the highest among the Dentistry (60.4%), Law (59.6%), and Education (46.4%) faculties. Qualitatively, six key themes emerged: perceptions of mental health, coping mechanisms, sources of support, barriers to seeking help, stigma and awareness, and strategies for mental health maintenance. Discussion While females reported slightly higher levels of depression and stress, males exhibited a higher prevalence of extremely severe anxiety. Relationship status, living arrangements, academic year, and faculty affiliation significantly influenced mental health outcomes. Conclusion University policies must integrate tailored strategies to foster inclusive, sustainable mental health support systems, promoting Sustainable Development Goal 3 (good health and well-being).