Quick summary: A survey of health sciences students at a rural South African university found that 34.0% screened at least moderate for anxiety and 55.9% screened at least moderate for depressive symptoms, while most came from low income households and only 15.7% had ever received professional psychological support. Faculties should move towards routine screening linked to counselling and financial help, because waiting for students to seek care on their own will miss many who are already distressed. Their well-being is also a healthcare and public policy concern, since these students are the future workforce of a strained health system and the quality of patient care depends on them.

Training to become a doctor, nurse, pharmacist, or other health professional is tough anywhere. At a rural South African university, a large survey suggests that anxiety and depressive symptoms among those students are common enough to treat as a faculty-wide concern.

A study, published in The Open Psychology Journal, surveyed undergraduate students across six health sciences programmes in 2024. Of 1,679 eligible students, 848 took part, a response rate of 50.5%. Questionnaires were anonymous and completed during teaching sessions in the second semester.

The lead author is Rajesh Vagiri, PhD, deputy dean and associate professor at Rhodes University in South Africa. The work was carried out with colleagues at a rural public university. Vagiri explained why the team measured the problem directly.

“Students training as doctors, nurses, pharmacists, and other health professionals are the future workforce of an already-strained health system. At a rural university, many of them also carry heavy financial and personal burdens. In our sample, 80% came from rural backgrounds, most came from low-income households, and nearly one in three reported past traumatic events. Yet very few had ever received psychological support. We wanted to measure how common anxiety and depressive symptoms really were, so that support could be based on evidence rather than assumptions.”

Using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, the researchers found that 34.0% of participants scored at least moderate for anxiety, and 55.9% scored at least moderate for depressive symptoms. The two scores were strongly linked, with a correlation of 0.65, suggesting that many students were carrying both kinds of distress at once.

Most participants were women (62.5%) and aged 18–21 (70.4%). Nearly two-thirds came from households earning below 20,000 South African rand a month (about £910), and 80.1% received a bursary or other funding. Only 15.7% said they had ever received professional psychological support.

In adjusted models, students from lower-income households had higher odds of screening positive for anxiety. Female students, and those on programmes other than medicine, had higher odds of screening positive for depressive symptoms. Students in earlier years of study had lower odds of depressive symptoms than those in their final year.

Vagiri said the results should change how universities respond. “The biggest takeaway is that distress among these students is common, not rare. More than half screened positive for at least moderate depressive symptoms, and about a third for anxiety. We cannot expect struggling students to seek help on their own. Universities, families and peers should check in actively, and seeking help should be seen as normal. Looking after future health workers also protects the patients they will one day care for.”

The authors stress that these patterns are cross-sectional correlates, not proof of cause and effect. Data were collected over four weeks in October 2024, close to exams, which may have raised reported symptoms. With just over half of eligible students taking part, the picture may also reflect who was present and willing to answer.

On the work still to come, Vagiri said the team would look beyond a single survey. “We plan to follow students over time at different universities in South Africa to see how their mental health changes during training. We also want to test practical, context-appropriate interventions for rural settings, including routine screening linked to counselling, trauma-informed support and stronger first-year support.”