The impact of social support on university students living with mental illness: a systematic review and narrative synthesis

Limited reviews address the role of social support for university students with mental health issues, despite its proven significance for other vulnerable groups. The current review aims to examine the current evidence on the nature and impact of social support for students with self-reported and diagnosed mental health problems, along with the availability and effectiveness of social support interventions. Electronic databases (CENTRAL, CINAHL, Embase, HMIC, MEDLINE, PsycINFO, SCOPUS, Web of Science) and grey literature databases (EThOS, SSRN) were systematically searched from inception to March 2024 Articles were eligible for inclusion if they reported on the nature and role of social support for university students with mental health problems. Data from included articles were extracted and narratively synthesised. Quality of included studies was assessed using the Mixed Methods Appraisal Tool. Ten studies, involving 3669 participants, were included. Findings indicated high social support significantly mitigated against suicide, depression, anxiety, and psychological distress. Barriers to support access and both positive and negative impacts on mental health were identified. Results underscore the need to consider the distinct support requirements of students with mental health problems, who often face insufficient access to high social support. This emphasises the potential for effective interventions in this population. The protocol for this review was registered with PROSPERO in December 2021 (CRD42022286385). The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were adhered to during the development and reporting of the systematic review (Page et al., 2021).尽管社会支持对其他弱势群体的有益作用已得到证实，但针对心理健康问题大学生的社会支持角色相关综述却十分有限。本综述旨在梳理现有证据，探讨社会支持对自我报告并经确诊的心理健康问题大学生的本质与影响，同时分析社会支持干预措施的可及性与有效性。本研究系统检索了自建库至2024年3月的电子数据库（CENTRAL、CINAHL、Embase、HMIC、MEDLINE、PsycINFO、SCOPUS、Web of Science）及灰色文献数据库（EThOS、SSRN）。纳入标准为：文献需围绕心理健康问题大学生的社会支持本质与作用展开研究报道。研究人员对纳入文献的数据进行提取，并采用叙述性合成法进行分析；同时使用混合方法评价工具（Mixed Methods Appraisal Tool）评估纳入研究的质量。最终共纳入10项研究，涉及3669名研究对象。研究结果显示，充足的社会支持可显著降低自杀风险，缓解抑郁、焦虑及心理痛苦症状。本研究同时识别出了社会支持获取的障碍，以及社会支持对心理健康产生的正负双向影响。研究结果强调，需关注心理健康问题大学生的差异化支持需求——这类群体往往难以获得充足的高质量社会支持，这也凸显了针对该人群开展有效社会支持干预的潜力。本综述的研究方案已于2021年12月在PROSPERO平台注册（注册号：CRD42022286385）。本系统综述的撰写与报告严格遵循《系统综述与荟萃分析首选报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-analyses, PRISMA）指南（Page等，2021）。