Psychosocial predictors of mental well-being in higher education students: a comprehensive approach

BACKGROUND: Time spent in tertiary education can be crucial in establishing practices and attitudes that last a lifetime. Although higher education institutions can be one of the main promoters of health, students seem to be a particularly vulnerable group, exposed to constant pressure for academic results and to various stimuli with consequences for their health. It is common to find psychological distress situations, with high levels of depression, anxiety, stress, and even suicidal ideation. Strategies for preventing and promoting health in higher education need to be based on research on predictors of student well-being. Due to the large number of factors that can have a significant impact on student well-being, it is essential to analyze all of these influences together and identify potential priorities for intervention. In this study, this is done by taking a holistic approach to the various factors at multiple levels of analysis. The aim was to test the differential role of multiple predictors of mental well-being on a representative sample of Portuguese university students, using seven factors: (i) sociodemographic; (ii) health status; (iii) lifestyle choices; (iv) life satisfaction and self-esteem; (v) academic-related aspects; (vi) relationships; and (vii) leisure and cultural activities. METHODS: The research is based on a probabilistic stratified cluster sample representative of the student population of 30 Portuguese public higher education institutions for the 2021/2022 academic year (n = 9,611). Mental well-being was measured using the WHO-5 Well-being Index. A hierarchical multiple regression analysis with seven blocks of predictors was performed to test the differential role of sociodemographic, health status, lifestyle, life satisfaction and self-esteem, academic-related, relationship, and leisure and cultural activity factors. Multiple imputation (15 datasets) was used to handle missing data. RESULTS: Findings indicate that health, lifestyle, self-esteem, and life satisfaction are most predictive of mental well-being among students, followed by sociodemographic, leisure and cultural activities, academics, and relations. Conversely, lower levels of mental well-being were associated with being female, being younger, and experiencing persistent pain. By taking these multiple factors into account, we can better promote mental health interventions for students in higher education settings. CONCLUSIONS: These findings highlight the need for comprehensive mental health promotion strategies in higher education settings. Interventions should prioritize improving self-esteem, sleep quality, and leisure time, while also addressing the specific needs of more vulnerable groups, such as female and younger students. By adopting a psychosocial approach that considers multiple levels of influence, higher education institutions can play a pivotal role in promoting student mental well-being.