Social determinants of depression and anxiety symptoms in undergraduate university students in Australia; Findings from The UNIversity student’s LIFEstyle and Mental Health Study (UNILIFE-M)

Entering university marks a pivotal developmental transition, marked by increasing independence. However, it is also associated with heightened mental ill-health, with 85 % of first-year students in this study screening positive for symptoms of anxiety, depression, or both. Understanding social determinants of mental health is essential for guiding interventions and policy, although knowledge gaps remain for this population. This study examined associations between social determinants (sex, gender, sexual orientation, employment, living situation, ethnicity, and First Nations) and mental health outcomes (positive screen for symptoms of anxiety only, depression only, both or neither, and anxiety [Generalized Anxiety Disorder (GAD-7)] and depression [Patient Health Questionnaire (PHQ-9)] symptom severity). The UNIversity student’s LIFEstyle and Mental Health Study (UNILIFE-M) is an international cohort study conducted across 84 universities in 27 countries. This secondary cross-sectional analysis used baseline Australian data collected in 2023/2024 from 974 first-year students (aged 18–35 years) at six Australian universities. Sixty percent of participants screened positive for both depression and anxiety symptoms, 17 % for anxiety symptoms only and 9 % for depression symptoms only. Among GAD-7 responders, 28 % had moderate and 22 % had severe anxiety severity. Among PHQ-9 completers, 20 % had moderately severe and 13 % severe depression severity. Higher odds of greater anxiety and depression severity were observed among female, First Nations, and sexually and ethnically diverse students. Findings can be used to support universities, policy makers and the mental health sector in implementing both preventative and treatment interventions and policies to address the needs of at-risk students.