Examining the long-term effects of the Covid-19 pandemic on the mental health of Students

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Introduction

The COVID-19 pandemic brought about exceptional challenges to persons and communities around the globe. As the virus spread so rapidly, governments across the globe were compelled to implement strict measures including, social distancing, and lockdowns to contain the pestilence from the spread (Hards et al., 2022). While most government services had to migrate online, the same was true with institutions of higher learning. Nonetheless, these measures had a negative bearing on students as their everyday life was disrupted and those with no access to online classes had prolonged school closures.

Consequently, the significant disruption caused by this pandemic resulted in increased cases of mental health problems such as anxiety, stress, and depression among others.  World Health Organisation (WHO) undertook a survey in 2020, which shows that while anxiety levels were high in 67% of students, 49% had depression and this was blamed on Covid-19 (WHO, 2022). These findings are supported by different studies indicating a decline in students’ mental health since the outbreak of Covid-19 (Cao et al., 2020; Wang et al., 2020).

The daily routine of students was disrupted and this impacted their mental health. The closure of schools and the adoption of online learning meant that students had lost the structure and social interaction that emanates from the conventional classroom setting. This resulted in loneliness, isolation, and dwindling enthusiasm to engage in school activities (Loades et al., 2020). While the drastic change in learning settings has been the cause of additional stress and anxiety, the closure of learning institutions has resulted in the loss of social life that leaves learners detached and desolate. The paper sets out to evaluate the long-term effect of the long terms effects of the Covid-19 pandemic on the mental health of students between the ages of 18-25 years.

 

Effects of the Covid-19 pandemic on the mental health

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Aim

To explore the enduring effects of COVID-19 on student’s mental health aged 18–25 years.

 

Objectives

To conduct in-depth qualitative research with students aged 18–25 to understand their

experiences and perceptions towards the impact of the pandemic on their mental

health.

To analyse the qualitative data obtained during the study and identify contributory

factors to mental health outcomes among young people.

To develop evidence-based mitigation and intervention measures and support systems

tailor-made for identified mental health needs of each individual within the age

bracket.

2.0 CHAPTER 2: LITERATURE REVIEW                 

2.1 Introduction:

In this section, a number of studies and research works are reviewed to assess effects of the Covid-19 pandemic on the mental health of students between the ages of 18-25 years. The reviewed studies indicate that the pandemic caused immense disruptions in diverse aspects of young people’s lives, especially education and social interaction. As physical school attendance was closed and learning transitioned to remote network-supported learning, students faced significant modifications in their academic, social, and personal lives.  Reviewed studies showed that these changes are the background with which COVID-19 pandemic effects on psychological health are constructed. This literature review therefore explores and evaluates the long-term effects of the pandemic on students’ mental health.

2.2 Impact of School Shutdown on Mental Health

Weber et al. (2022) found that the sudden cessation of physical school attendance due to the pandemic considerably disrupted learners’ routines and social interactions, which led to the development of anxiety and feelings of loneliness. Weber et al. (Ibid) further found that as the closures protracted and students felt longer periods of social isolation, the feeling of anxiety and loneliness worsened, thereby leading to considerable deterioration in their mental health status.  Similarly, Appleby et al. (2022) allege that the pandemic led to social isolation, which had significant negative impacts on the mental health of students. Even though the study by Appleby et al. (2022) specifically focused on female students, the findings were similar to those reported by Weber et al. (2022), who focused on male and female students. Appleby et al. (2022) reported that while students were keen to follow the government’s directives and engaged in self-isolation to prevent the spread of coronavirus, they were gripped with constant anxiety about the fate of their studies. For instance, about 79% of the students were worried about the implications of the pandemic on their academic and job prospects. A considerable proportion of the participants, about 29%, reported that they had doubts about continuing with studies at their present learning institutions as the pandemic had negatively impacted their perception of the university (Appleby et al., 2022). Moreover, the pandemic also disrupted the various activities that were vital to the students’ mental well-being.

Effects of the Covid-19 pandemic on the mental health

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The study by Zimmermann et al. (2021) specifically reported that the pandemic caused academic-related stress and uncertainty. The study discovered that the uncertainty that accompanied the COVID-19 pandemic, which included students’ concerns about their health, overall safety, and the future of their studies compounded stress levels among students. Moreover, Zimmermann et al. (2021) add that although online classes were crucial for the continuation of learning and allaying fears about the future of studies, the abrupt transition to that mode of learning heightened the academic pressure that students experienced. It is also to be considered that these unexpected changes were accompanied by the cancellation of extracurricular activities alongside changes in academic requirements. Already, prior research had demonstrated the close relationship between academic stress and mental health issues such as anxiety and students dealt with such stressors through engagement in physical activities (Xu et al., 2021). Accordingly, students had to spend extended periods online because of virtual classes and this caused digital fatigue and burnout. Zimmermann et al. (2021) reported that the accompanying feelings of being psychologically overwhelmed created a sense of heightened psychological distress among students. Additionally, the sudden transition to remote learning led to blurred boundaries between school and home settings and this compounded the feeling of emotional distress (Cao et al., 2020).

2.3 Depression, Stress, and Anxiety

Xu et al. (2021) established that the pandemic had a significant negative impact on the mental health of students. Their study demonstrates that the coronavirus caused a considerable sense of fear about the pandemic itself and also affected their psychological engagement. Xu et al. (2021) used the standardised Patient Health Engagement Scale (PHE-S) to measure the emotions, perceptions, and feelings of the respondent and found that fear was paramount among students, especially fear about deaths, upsurge in COVID-19 cases, distress about the risk of infection, limited knowledge and understanding about preventive measures. The findings are similar to Kleiman et al. (2020), who argue that anxiety attacks were prevalent among students during the initial phases of the pandemic and it was mainly caused by students’ fears and concerns about their lack of knowledge about and capacity to handle coronavirus in case of contagion.

Depression and anxiety have been widely reported in the literature hence all the reviewed studies touched on at least one or both as prevalent among students due to the pandemic (Radwan et al., 2020). In Xu et al. (2021), it was established that about 35% of students had high levels of anxiety due to the pandemic while 71.5% was caused by COVID-19. On depression, Xu et al. (2021) reported that 73% of the participants were depressed, and 87% reported some level of depressive signs. This study indicates that depression was a considerably prevalent issue among university students.

Weber et al. (2022) elevated levels of depression, stress, and anxiety, besides loneliness that are already reported in earlier in other studies. However, Weber et al. (2022) add that studies comparing the mental health status of students before and during or after the pandemic through a longitudinal approach found higher levels of psychological health issues, especially depression, stress, and anxiety in the pandemic era as compared to pre-pandemic period.

Depression was also characterised in terms of loss and grief reported in some studies such as Cao (2020), where some students lost loved ones due to the pandemic. The feeling of loss and bereavement had a significant impact on the mental health of the students (Xu et al., 2021). According to Xu et al. (2021), recovery from the mental effects brought by grief and sense of loss was difficult to achieve because there was inadequacy of social support and traditional griefing procedures were not available due to pandemic-related restrictions. This led to prolonged emotional suffering

2.4 Resilience and Coping Strategies

Reviewed literature and studies revealed that there were diverse strategies used by students to cope with the mental health effects of the pandemic. Weber et al. (2022) found that a significant proportion of students used active coping strategies that enabled them students to develop resilience. On the contrary, Chen and Lucock (2022) discovered that while many students were negatively affected by the pandemic, their desires to engage in coping activities were hampered by the accompanying social restrictions and isolation. That is, there were restrictions on people’s mobility and others were locked up in quarantine thereby creating more pressure on their mental health without having meaningful ways to engage. Weber et al. (2022) established that some students demonstrated resilience and coping through actively attending courses on mental health to better deal with the mental health effects and be prepared for future pandemics. The findings are similar to what Villani et al. (2021) term adaptive coping strategies where some students pursued short courses and attended seminars through social media and online to equip them with knowledge about managing psychological well-being. These adaptive strategies also included learning to do or engaging in repetitive thinking patterns as a form of blocking thoughts around the COVID-19 pandemic.

Chen and Lucock (2022) established that social networks played a major role in helping students cope with the effects of the pandemic on their emotional health. The same finding is reiterated by McArthur et al. (2021), who noted that social network groups were very vital in dealing with the effects of the pandemic because they were functional in the face of social distance restrictions and thus students could get social support without worrying about physical contacts with wider population. Another adaptive coping tactic identified by Weber et al. (2022) is active involvement in self-care practices to buffer the adverse psychological health effects of adversity brought by the pandemic.

Villani et al. (2021) mentioned that engaging in other positive activities that promoted the health and well-being of the students helped them effectively buffer the effects of anxiety and stress caused by the pandemic. Villain et al. (2021) further observe that schools offer an avenue for students to get mental health support and a sense of community. This worked alongside other amenities availed by the learning institutions to promote coping and resilience-building initiatives among learners within institutions of higher learning. Weber et al. (2022) observed that while the pandemic caused a sense of loneliness among university students, especially when institutions were shut down during the social isolation and quarantine period, the introduction of online courses and remote learning significantly helped students cope. It helped to restore the sense of community and belonging and further helped drive away the prevailing atmosphere of loneliness and worry.

However, some studies found that some students engaged in risky taking behaviours such as drug abuse. For example, Zimmermann et al. (2021) reported that 76.6% of students indicated they did not use alcohol or drugs, and 23.4% used drugs to cope with the mental effects of the pandemic. Moreover, out of all the students who experienced distress, 25.4% turned down the idea of seeking help from professional or social sources. Another negative coping strategy reported by Xu et al. (2021) is cognitive and behavioral avoidance and problematic internet use these approaches were associated with an increased risk of greater mental health problems.

In short, the literature review has revealed that university students are considerably vulnerable to mental health risks such as depression, anxiety, psychological distress, and fear due to the pandemic. Moreover, some students choose unhealthy coping methods to deal with the pandemic. Wrong choice of coping strategies increases the risk of mental ill health of students and therefore important to have systems in place to ensure the availability of proper redress in case of events such as the coronavirus outbreak in the future (Xu et al., 2021). Long-term psychological services should be established in the universities to cater for the students’ psychological health needs (Zimmermann et al., 2021).

3.0 Methodology and Methods

This section presents the methodology and research methods used in the study. The first section and subsections provide a description of methodologies while the second section highlights the research methods and design utilised in the study.

3.1 Methodology

According to Sebastian (2019), a researcher needs to choose the right techniques, tools, philosophies, and approaches as well as methodologies as these are crucial to the success of the research. However, optimal results depend on the following specific steps in selecting appropriate tools, which are discussed in the preceding sections, and justifications for each choice made. The choices made were guided by the scope of the study, the nature of the question, and the desired type of information among other features.

3.1.1 Epistemology for the Study

Kelly (2021) argues that epistemology reflects knowledge and theory acquired from certain information sources. As such, in the research process recognising the views that influence the world is necessary when in comes to interpretation. The researcher utilised constructivism epistemology to acknowledge the students’ subjective experiences with the pandemic. According to Burns et al. (2022), constructivists believe that knowledge is acquired through personal experiences, which shape reality. However, such reality is constant; hence experiences are distinct because of contextual factors. In this regard, constructivism epidemiology was employed to unfold students’ perceptions of the effects of COVID-19 on their mental health. Essentially, this epistemology is useful since it considers the subjective experiences of people (Alexander, 2020). Moreover, it is integral in terms of refining meaningful views.

Effects of the Covid-19 pandemic on the mental health

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3.1.2 Methodological Approach

The research took a qualitative approach allowing the researcher to deeply explore the research questions. Vindrola-Padros and Johnson (2020) observed that the qualitative approach is appropriate for its capacity to focus more on specific issues, and allow for convergent reasoning on a subject. Moreover, Vindrola-Padros and Johnson (2020) add that the qualitative research approach enables participants to fully express their thoughts on the issue being investigated. As a result, the qualitative approach was appropriate as it helped in the attainment of an in-depth understanding of the experience of young persons and how the COVID-19 pandemic impacted their mental health. Additionally, the qualitative design was particularly useful because the topic, just like most topics dealing with the health of people, was found to be very sensitive. Therefore, using a qualitative approach provided an avenue that allowed young people to express their opinions and experiences on the issue. Cleland (2017) affirms that qualitative research is a systematic exploration of a research issue in a natural setting. Nonetheless, this approach overlooks contextual sensitivities with a profound emphasis of experiences and meanings (Rahman, 2017). Furthermore, it focuses on respondents’ opinions instead of other useful issues in the natural setting that shape the experiences. It is also laborious collecting and analysing qualitative information.  Rahman (2017) also indicates that this approach is at a high risk of subjective views and a small sample size that prevents generalisability of the results. Despite the limitations associated with this approach, it is useful in responding to the why and how research questions while facilitating a detailed understanding of the respondents’ experiences (Cleland, 2017). Therefore, this approach allowed the researcher to understand students’ perspectives regarding the effects of the pandemic on their mental well-being.

3.1.3 Study Philosophy

Research philosophy is an intricate component of every research undertaking. It aids in delivering the principles used by the study to achieve consistency study objectives. Some of the common research philosophies in qualitative research include interpretivist, pragmatism, realism, and positivism. It is evident that based on the nature of the present study, realism, and positivism were not suitable as they are deductive approaches, which would in turn demand conducting quantitative study. Interpretivism was more fitting than positivism because the principal intent leading the study was to discover the consequences of COVID-19 on the mental health of young people.

Alborough and Hansen (2023) posit that interpretivist philosophy assumes that reality is not only socially constructed but also subjective. In other words, researchers can recognise the realities of respondents through experience. However, this qualitative philosophy is subjective, and gathered data cannot be extended to the larger population (Matta, 2022). Moreover, it is prone to data overload making it complex to align data between groups. As such, this study involved 10 students, making interpretivist philosophy appropriate. Alborough and Hansen (2023) also argue that this approach is commonly used in qualitative research with a small sample to get a detailed understanding of their views on the topic being examined. Although interpretivist is prone to researcher bias and subjective (Matta, 2022), it was chosen since it helped in the participants’-researcher’s reflexivity, which was essential in understanding the impacts of COVID-19 on the psychological well-being of people aged 18 to 25 years.

3.2 Methods and Research Design

The present research was designed to explore how the COVID-19 pandemic impacted the psychological health of young people. In this case, a qualitative research design was adopted to collect views from 10 Birmingham Newman University using open-ended questions. In this design, the researcher focuses on uncovering and understanding human occurrences (Cleland, 2017). Usually, they focus on recognising people’s experiences. Due to its flexible nature, it enabled the researcher to comprehensively address the research objectives. Therefore, open-ended interview was used to gather respondents’ perspectives regarding the consequences of the pandemic on their emotional health. Open-ended questions are used to adequately explore a given topic (Weller et al. 2018). Therefore, this method is utilised in qualitative research design to interview respondents based on a set of questions. However, it can be challenging to compare respondents’ views that minimise validity. In addition, open-ended interviews can result in researchers’ bias particularly when they ask leading questions. Hence, the research used a n interview schedule (Appendix 1). Besides, participants can give views to please the researcher leading to social desirability bias. Even though it is challenging to conduct open-ended interviews, they were imperative in this study since they promoted the collection of detailed insights to help understand the impacts of COVID-19 on students’ mental well-being.

Effects of the Covid-19 pandemic on the mental health

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3.2.1 Sampling and Participants

The study focused on young people aged between 18 and 25 years drawn from Birmingham Newman University. The study utilised convenience sampling, where participants are non-randomly selected from the general population (Stratton, 2021).

This is a type of non-probability sampling that recruits accessible as well as available study units. According to Jager et al. (2017), the convenience sampling method assumes individuals included in the study have the desired or similar characteristics. In this regard, the convenience sampling method was selected since the participants had undistinguishable features, for example, they were students drawn from Birmingham Newman University. Moreover, the rationale for using this technique was determined target population’s willingness to participate.  Nevertheless, this sampling does give the target population an equal chance of participating in the study (Jager et al., 2017). Hence, the research is likely to recruit respondents based on self-interests affecting the validity of the results. Stratton (2021) similarly argues that the success of the convenience sampling method relies on respondents’ motivation, which can lead to the introduction bias.

Despite the weaknesses, this sampling approach helped select available and accessible 10 students who were willing to share their opinions on how the pandemic affecting their psychological well-being. This method is cost-effective and not time-consuming, which makes it good for the current study.

3.2.2 Procedure

A total of 10 students met the inclusion criteria and were invited to give their views about the research aim. In this case, a copy of the interview schedule was emailed to the respondents notifying them about the proposed study. Furthermore, the open-ended questions were standardised allowing them to provide their views and help uncover the research aim and objectives. Connor Desai and Reimers (2019) discovered that the approach is cost-effective, and easy to administer whilst fostering confidentiality when exploring inquiry on sensitive topics.

3.3 Ethical Clearance and Considerations

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Various ethical considerations were adhered to and the researcher sought for the approval institution’s ethics committee. In respect to the ethical considerations, the researcher ensured that confidentiality was an utmost principle of study during and even after the data collection process. Before starting the data-gathering process, the researcher explained to the participants the various elements of the study. The participants were informed that their participation was 100% voluntary they were free to quit the process whenever they felt so and that they did not need to seek permission or give the reason for quitting.

Therefore, the study complied with ethical considerations to protect respondents’ privacy and confidentiality by obtaining approval form Birmingham Newman University (Appendix 2). In addition, participant information sheet (Appendix 3) outlining the aims, objectives, and potential risks of the study was distributed before participating in the research.

3.4 Data Synthesis and Analysis

Since the study followed the qualitative research approach, it opted for the thematic analysis. It is one of the most commonly used data extraction and analysis methods applied for extraction and conducting analysis of data in qualitative studies (Kiger and Varpio, 2020). Through thematic analysis, researchers identify recurring themes, patterns, or concepts across the included studies by systematically coding and organising relevant data extracts. This process involves iterative reading and re-reading of the data to ensure comprehensive coverage of key themes. Thematic analysis was selected due to its flexibility since it can be applied to diverse types of qualitative data (Ayre and McCaffery, 2022). This adaptability meant that it could be used to explore wide-ranging views acquired during data collection.

Pollock et al. (2023) argue that thematic analysis provides a greater depth of understanding by allowing researchers to explore the fundamental meanings and interpretations surrounding specific data. Identification of the patterns and themes provided an opportunity for a deeper understanding of the underlying effects of the COVID-19 pandemic on young adults. Moreover, the technique is easily accessible to researchers and it does not require possession of complex knowledge and skills. The method provided support for the underlying philosophical tenets of qualitative research including support for the inductive approach. It is also a participant-centred approach since it prioritised the voices and experiences of the young adults hence it allowed the researcher to authentically represent the perspectives of the young adults through themes that came out from the data extraction.

Nonetheless, this data analysis procedure is susceptible to researchers’ bias that minimises validity (Finaly, 2021). It largely relies on codes, and in some cases, codes can fail to correctly capture the meaning. It is also time-consuming to compare the views of different participants. Regardless, the choice of thematic analysis offered a robust and flexible approach to exploring qualitative data from the included studies. This enabled the uncovering of meaningful insights and contributed to knowledge regarding the consequences of COVID-19 on young adults’ mental health.

Effects of the Covid-19 pandemic on the mental health

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Reference List

Alexander, K. (2020) ‘It’s just a prank, bro!: Examining college hazing with constructivist grounded theory and qualitative research methods’, The Qualitative Report, 25(10), pp. 3641-3656.

Appleby, J. A., King, N., Saunders, K. E., Bast, A., Rivera, D., Byun, J., … & Duffy, A. C. (2022). Impact of the COVID-19 pandemic on the experience and mental health of university students studying in Canada and the UK: A cross-sectional study. BMJ open, 12(1), e050187.

Ayre, J. and McCaffery, K.J., 2022. Research Note: Thematic analysis in qualitative research. J Physiotherapy.

Burns, M., Bally, J., Burles, M., Holtslander, L. and Peacock, S. (2022) ‘Constructivist grounded theory or interpretive phenomenology? Methodological choices within specific study contexts’, International Journal of Qualitative Methods, SAGE Publications, 21, p. 160940692210777.

Cao W, Fang Z, Hou G, et al. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi: 10.1016/j.psychres.2020.112934

Chen, T., & Lucock, M. (2022) ‘The mental health of university students during the COVID-19 pandemic: An online survey in the UK’. PloS one, 17(1), e0262562.

Chin, J., Di Maio, J., Weeraratne, T., Kennedy, K.M., Oliver, L.K., Bouchard, M., Malhotra, D., Habashy, J., Ding, J., Bhopa, S. and Strommer, S., (2023). ‘Resilience in adolescence during the COVID-19 crisis in Canada’, BMC Public Health, 23(1).

Connor Desai, S. and Reimers, S. (2019) ‘Comparing the use of open and closed questions for Web-based measures of the continued-influence effect’, Behavior Research Methods, 51, pp.1426-1440.

Hansen, E.C., 2020) Successful qualitative health research: a practical introduction. Routledge.

Jager, J., Putnick, D. L., & Bornstein, M. H. (2017) ‘More than Just Convenient: The scientific merits of homogeneous convenience samples’, Monographs of the Society for Research in Child Development, 82(2), 13.

Kelly, M. (2021) ‘Epistemology, epistemic belief, personal epistemology, and epistemics: A review of concepts as they impact information behavior research’, Journal of the Association for Information Science and Technology, 72(4), pp. 507-519.

Kiger, M.E. and Varpio, L. (2020) ‘Thematic analysis of qualitative data: AMEE Guide No. 131. Medical teacher, 42(8), pp.846-854.

Kleiman, E. M., Yeager, A. L., Grove, J. L., Kellerman, J. K., & Kim, J. S. (2020) ‘Real-time mental health impact of the COVID-19 pandemic on college students: ecological momentary assessment study.’ JMIR Mental Health, 7(12), e24815.

Liu, C. H., Pinder-Amaker, S., Hahm, H. C., & Chen, J. A. (2022) ‘Priorities for addressing the impact of the COVID-19 pandemic on college student mental health.’ Journal of American College Health, 70(5), 1356-1358.

McArthur, C., Saari, M., Heckman, G. A., Wellens, N., Weir, J., Hebert, P., … & Hirdes, J. P. (2021) ‘Evaluating the effect of COVID-19 pandemic lockdown on long-term care residents’ mental health: A data-driven approach in New Brunswick.’ Journal of the American Medical Directors Association, 22(1), 187-192.

Pollock, D., Peters, M.D., Khalil, H., McInerney, P., Alexander, L., Tricco, A.C., Evans, C., de Moraes, É.B., Godfrey, C.M., Pieper, D. and Saran, A. (2023) ‘Recommendations for the extraction, analysis, and presentation of results in scoping reviews.’ JBI Evidence Synthesis, 21(3), pp.520-532.

Radwan, E., Radwan, A., & Radwan, W. (2020). The mental health of school students and the COVID-19 pandemic. Aquademia, 4(2), ep20020.

Schmidt, L., Olorisade, B.K., McGuinness, L.A., Thomas, J. and Higgins, J.P., 2020. Data extraction methods for systematic review (semi) automation: A living review protocol. F1000Research, 9.

Sebastian, K., 2019. Distinguishing between the strains grounded theory: Classical, interpretive and constructivist. Journal for Social Thought, 3(1).

Singh, A. (2020) ‘Maintaining mental health during COVID-19 pandemic’, Epidemiology International Journal, 4(4).

Stratton, S.J. (2021) ‘Population research: Convenience sampling strategies’, Prehospital and disaster Medicine, 36(4), pp. 373-374.

Swedberg, R., 2020. Exploratory research. The production of knowledge: Enhancing progress in social science, 2(1), pp.17-41.

Villani, L., Pastorino, R., Molinari, E., Anelli, F., Ricciardi, W., Graffigna, G., & Boccia, S. (2021). Impact of the COVID-19 pandemic on psychological well-being of students in an Italian university: a web-based cross-sectional survey. Globalization and health, 17, 1-14.

Vindrola-Padros, C. and Johnson, G.A., 2020. Rapid techniques in qualitative research: a critical review of the literature. Qualitative health research, 30(10), pp.1596-1604.

Weber, M., Schulze, L., Bolzenkötter, T., Niemeyer, H., & Renneberg, B. (2022). Mental health and loneliness in university students during the COVID-19 pandemic in Germany: a longitudinal study. Frontiers in psychiatry, 13, 848645.

Xu, Y., Su, S., Jiang, Z., Guo, S., Lu, Q., Liu, L., … & Lu, L. (2021). Prevalence and risk factors of mental health symptoms and suicidal behavior among university students in Wuhan, China during the COVID-19 pandemic. Frontiers in psychiatry, 12, 695017.

Zimmermann, M., Bledsoe, C., & Papa, A. (2021). Initial impact of the COVID-19 pandemic on college student mental health: A longitudinal examination of risk and protective factors. Psychiatry research, 305, 114254.

World Health Organisation [WHO](2022) ‘The impact of COVID-19 on mental health       cannot be made light of.’ https://www.who.int/news-room/feature-          stories/detail/the-impact-of-covid-19-on-mental-health-cannot-be-made-light-        of: Accessed April 15, 2024

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R.S., Choo, F.N., Tran, B.,   Ho, R., Sharma, V.K. and Ho, C., 2020. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain,   behavior, and immunity, 87, pp.40-48.             https://doi.org/10.1016/j.bbi.2020.04.028

Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J. and Zheng, J., 2020. The     psychological impact of the COVID-19 epidemic on college students in             China. Psychiatry research, 287, p.112934.             https://doi.org/10.1016/j.psychres.2020.112934

Loades, M.E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R.,        Brigden, A., Linney, C., McManus, M.N., Borwick, C. and Crawley, E., 2020.    Rapid systematic review: the impact of    social isolation and loneliness on the     mental health of children and adolescents in the context of COVID-19. Journal    of the American Academy of Child & Adolescent Psychiatry, 59(11), pp.1218-        1239. https://doi.org/10.1016/j.jaac.2020.05.009

Hards, E., Loades, M.E., Higson‐Sweeney, N., Shafran, R., Serafimova, T., Brigden,       A., Reynolds, S., Crawley, E., Chatburn, E., Linney, C. and McManus, M.,        2022. Loneliness and mental health in children and adolescents with pre‐          existing          mental health problems: A rapid systematic review. British Journal of     Clinical Psychology, 61(2), pp.313-334. https://doi.org/10.1111/bjc.12331

By admin in Essays on January 16, 2025