Improving emotional, economic and behavioural resilience to COVID-19 in African University students

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The Covid-19 pandemic has had significant adverse effects on university students, whose education and training has been severely disrupted and their social contacts and job prospects lost. Even before the pandemic around of a third of students would had had symptoms of depression, with students who are economically disadvantaged at greatest risk. Depressed students do less well academically which has negative impacts on their employment prospects and they are also less likely to follow health advice. Thus depressed students are particularly vulnerable to the health and economic impacts of the COVID-19 pandemic. This is a particular concern for students in less developed countries such as Zambia where access to mental health services is limited by the lack of resources and by the stigma associated with psychiatric illness. This study aims to address this cycle of disadvantage by providing targeted access to an effective, online treatment programme for depression (moodgym) to a 1000 students who identify themselves as having symptoms of depression. These students will be recruited from universities in Zambia, Malawi and Botswana: all countries identified as eligible for overseas development assistance. Moodgym is based on principles of cognitive behavioural therapy and aims to reduce the risk of depression by helping users to recognize and change those negative thoughts and behaviour patterns which can drive and sustain low mood. The 5 modules are particularly aimed at young people aged 15 to 25 and include exercises, practical assignments and quizzes. This study will investigate whether combining moodgym with a university-wide online COVID-19 prevention programme will improve students' mental health and enhance their ability to withstand the health and economic challenges of COVID-19. The online COVID-19 prevention program, adapted for each local context, will portray health-promotion behaviours such as social distancing and face coverings as a normal part of student life. We will collect feedback data from the prevention programme and survey data before and after the moodgym/ COVID-19 prevention programme intervention to look for improvements in depression, academic performance and COVID prevention behaviours and to check whether benefits are felt equally by men and women. We will also interview participants to try to understand how moodgyam helped them and to explore their feelings about the impact of COVID-19 on their mood and their studies. We also want to find out which factors are associated with improved mental health and academic outcomes so that we can ensure the intervention's sustainability and successful implementation in other less developed countries.