Predictive value of a pre-registration card for future mental health events among first-year university students

Abstract

Objectives: To assess the predictive value, for subsequent mental health problems, and service use of a pre-registration card sent to all first-year students at the University of Bristol. Methods: A retrospective cohort study of all enrolling first-year students at the University of Bristol. Information was abstracted from the health records and pre-registration cards of a one-in-two systematic sample of all first-year students at the University Student Health Service (SHS) during the 1994/1995 academic year. The pre-registration card contained information about their past medical history and several questions concerning depression and anxiety. Data were entered into SPSS and regression analyses performed. Results: 1435 students had complete pre-registration and service utilisation data which were used in the analysis. Mental health problems accounted for 5.6% of all morbidity. Students with a self-reported history of depression (OR 6.87, CI 2.86-16.5), breakdown (OR 15.38 CI 0.98-241) or receipt of counselling (OR 3.93, CI 2.52-8.07) were at greatest risk of presenting with a mental health problem to the SHS. Although the sensitivity and specificity of these 'risk factors' were relatively low, they did have high negative predictive value. Conclusion: Attendance for mental health problems at a student health service can be predicted from self-completed answers to questions on a pre-registration card. The literature indicates that mental health problems contribute to withdrawal and failure at university. The pre-registration card could be used to identify an 'at risk' group and an intervention designed to prevent mental health morbidity.