Are institutional factors associated with student mental health in Germany? A multilevel analysis

Background

While individual factors associated with students’ wellbeing are well studied, less is understood about the role of institutional context. This study examines how institutional characteristics relate to students’ mental health while accounting for personal factors.

Methods

The analysis used cross-sectional data from 12 German institutions (n = 13,715) collected in the StudiBiFra survey. Individual variables included gender, age, study field, and self-reported mental health indicators (wellbeing, depressiveness, cognitive stress, exhaustion). Institutional variables included type of institution, excellence status, multi-campus structure, size, and satisfaction with health promotion services. Multilevel regression models were applied.

Results

Adjusted for individual variables, students at universities of applied sciences were less likely to report depressiveness and exhaustion than their peers at universities. Students at medium-sized institutions reported more depressiveness and cognitive stress than those at small institutions. Those at institutions without excellence status had lower likelihood of depressiveness, stress, and exhaustion. Higher institution-level satisfaction with health promotion services was linked to lower depressiveness. Male gender, young age and studying a health-related subject were associated with better mental health for most outcomes.

Conclusions

Institutional context is associated with student mental health beyond individual factors, consistent with a holistic, setting-based approach. Effective student health promotion should be integrated into continuous organizational processes and address both institutional conditions (e.g., study structures, university culture) and marginalised student groups through low-threshold, discrimination-sensitive services.

Key messages

• Findings reinforce that gender, age and study subject play an important role, but also identified that institutional characteristics are associated with mental health and wellbeing of students.

• Higher satisfaction with health promotion programmes is associated with lower levels of depressiveness highlighting the need to improve the quality and accessibility of these services.