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Depression A Pressing Concern for South African University Students

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Wits - University of the Witwatersrand - Depression

Depression, a mental health disorder characterised by persistent low mood and diminished interest in activities, is a prevalent yet often undiagnosed condition. With a lifetime risk estimated at 10% globally, depression ranks among the most common mental illnesses. In South Africa, projections indicate that one in three individuals will experience depression, anxiety, or a substance use disorder at some point in their lives as reported by News Drum. University students face a heightened risk, with approximately 24.2% suffering from mild depression and 12.4& experiencing moderate to severe depression, according to a local study. Globally, around 21% of university students are diagnosed with major depressive disorder.

These statistics are alarming as depression among students brings forth unique challenges such as poorer academic outcomes, reduced productivity, increased susceptibility to alcohol abuse in adulthood, and higher rates of suicide. Consequently, tailored interventions are needed to support this vulnerable population. Unfortunately, however, there is a lack of comprehensive data on the prevalence and drivers of depression among students in Johannesburg, South Africa’s primary commercial city and home to a significant student population. To address this knowledge gap, a recent online survey was conducted among undergraduate students at the University of the Witwatersrand.

The study revealed that nearly half of the participants screened positive for probable depression. Factors associated with probable depression included socio-demographic indicators such as economic status and modifiable behavioural factors like substance use, commonly identified as correlates of depression in this group. The prevalence of probable depression among undergraduate students in this study was notably higher than that of the general population, highlighting the urgent need for tailored mental health programs in universities.

The survey utilised the Patient Health Questionnaire (PHQ-2) to assess depression prevalence and identify associated factors such as age, marital status, and substance use (alcohol, cannabis, tobacco, and other substances). Although the response rate was 8.4%, which is typical for online surveys, the key findings align with similar studies conducted elsewhere. Among the participants, 48% screened positive for probable depression.


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Socio-demographic factors played a role in the likelihood of screening positive for depression, with white students being 36% less likely than black students to exhibit symptoms. Additionally, students who could afford essential items but few luxuries were 50% less likely to screen positive compared to those who could barely meet their basic needs. Interestingly, students who had enough money for luxury goods and extras were 56% per cent less likely to screen positive for depression than those who struggled to fulfil their basic necessities.

These findings echo those of a recent study among undergraduate physiotherapy clinical students. Furthermore, substance use was found to be associated with a higher likelihood of screening positive for depression, with cannabis users being 29% more likely to exhibit symptoms compared to non-users. It is important to note that the global research on the link between cannabis use and depression presents varying results, but considering the legal use of cannabis in South Africa, our finding holds significance.

Notably, alcohol use was prevalent among the surveyed students, although it did not show a significant association with probable depression, contrary to findings from other studies. In addition, the lack of significant associations between tobacco use and screening positive for depression in the study differs from the strong association reported in research involving adolescents and adults.

While the study focused on specific factors, it is crucial for mental health professionals working with undergraduate students at the University of the Witwatersrand to strengthen mental health screening, including depression, and identify risk factors such as substance use, referring students for treatment services as needed. Additionally, raising awareness and encouraging the utilisation of existing counselling services within the university campus and beyond, such as the South African Depression and Anxiety Group’s helpline, is essential. By recognising and addressing depression among university students, it can pave the way for better mental.

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