Depression is one of the leading causes of disability worldwide and also one of the most common mental disorders among university students (Paolucci et al., 2018). It is characterised by loss of mood, symptoms of sadness, lack of interest in routine, negative thoughts and high rates of comorbidity with other mental disorders and cardiovascular disease (Lattie et al., 2019). Depression affects individuals of all ages and it was reported that the typical age of onset for depression is early to mid-20s (Kessler & Bromet, 2013). According to World Health Organization (WHO), the prevalence rate for depression is at 10.4% and affects more than 300 million people globally; nearly half of these people live in the Southeast Asia region (SEA; WHO, 2018). Research evidence has shown that Southeast Asia has the highest rate of depression, with a lifetime risk of 12% for males and 25% for females (Maddock et al., 2021). Along with a high prevalence rate, depression is associated with high economic costs. The total cost for depression in 2010 was $210.5 billion USD and has risen to $326.2 billion USD in 2018 (Greenberg et al., 2021).
Depression Among University Students
Young adults in university have been found to be more prone to depression because of their stressful academic lifestyles, transition from adolescence to adulthood, and occasionally part-time employment to ease their financial burdens (Dessauvagie et al., 2022). The prevalence rate of depression for university students is alarming, estimated at 10.2% (Sokratous et al., 2014). Moreover, Dessauvagie et al. (2022), through systematic review has found that the prevalence rate of depression for SEA countries was 29.4% and 7.6% for severe depression. Singapore, a multi-ethnicity country with a total population of 4.03 million, comprises 74.4% Chinese, 13.4% Malays, 9.0% Indians and 3.2% other ethnicities (Singapore Department of Statistics, 2019). According to the Ministry of Education Singapore (2020), approximately 111,600 students were enrolled in a local university in 2019 (excluding private universities). Singapore Mental Health Study (SMHS; 2018) data in 2016 reported that the lifetime prevalence rate for depression in Singapore residents aged 18-34 was as high as 9.2%.
Singapore's neighbouring country, Malaysia, with a total population of 32.7 million, comprises 22.6% Chinese, 69.6% Malay, 6.8% Indian and 1.0% other ethnicities (Department of Statistics Malaysia, 2020). According to Malaysia Educational Statistics (2019), approximately 552,702 students were enrolled in a public university (excluding private universities) and the prevalence rate of depression for Malaysian students was 20% in 2016 (Fauzi et al., 2021). Unfortunately, 73% of Singaporeans and 76% of Malaysian university students did not seek treatments for their mental health issues (Ibrahim et al., 2019; Ong et al., 2021). Reluctant to seek help from mental health professionals is not uncommon in Singapore and Malaysia (Nahas et al., 2019; Tan et al., 2021). Picco et al. (2016) reported that individuals recommended non-professionals sources of help such as friends or family for people with mental health issues. However, family and friends are not mental health professionals who can recognize the signs and symptoms, which may lead to a delay in treatments (Tan et al., 2021).
Therefore, timely detection and management of depression and its correlate among young adults in university are essential to safeguard public health (Fauzi et al., 2021). This is vital for their educational achievement, intended growth and development in life, as today's youth are tomorrow's leaders (Shamsuddin et al.,2013).