Protocol for a Mental Health and Substance Use Trend Study: the World Mental Health-International College Student (WMH-ICS) Survey in Canada (Preprint)

Abstract

The World Health Organization (WHO) World Mental Health-International College Student (WMH-ICS) initiative aims to screen for mental health and substance use problems among post-secondary students on a global scale as well as to develop and evaluate evidence-based preventive and ameliorative interventions for this population. The epidemiologic surveys—a core component of the WMH-ICS initiative—are self-administered online questionnaires that generate diagnostic estimates for a wide range of common mental disorders and have been administered to over 95,000 students across 16 countries around the world. This protocol paper presents the Canadian version of the WMH-ICS survey, detailing the adapted survey instrument, the unique weekly cross-sectional administration, the multi-tiered recruitment strategy, and the associated risk mitigation protocols.

This paper aims to provide a methodological resource for researchers conducting cross-national comparisons of WMH-ICS data, as well as to serve as a useful guide for those interested in replicating the outlined cross-sectional methodology to better understand how mental health and substance use vary over time among university students.

The online survey is based on the WMH-ICS survey instrument and has been modified to the Canadian context by the addition of questions pertaining to Canadian-based guidelines and the translation of the survey to Canadian French. The survey was administered through the Qualtrics survey platform and was sent to an independent stratified random sample of 350 students per site weekly, followed by two reminder emails. Upon survey closure every week, a random subsample of 70 non-responders were followed up with via phone or through a personal email in an effort to decrease non-responder bias. The survey is accompanied by an extensive risk mitigation protocol that stratifies respondents by level of need and provides tailored service recommendations, including a facilitated expedited appointment to student counselling services for those at increased risk of suicide.

In February 2020, the Canadian survey was deployed at the University of British Columbia. This was followed by deployment at Simon Fraser University (November 2020) and McMaster University (January 2021). Additional Canadian sites are currently in various stages of assessment and implementation. As of November 18th 2021, 21,143 responses have been collected.

The Canadian version of the WMH-ICS survey is based on a novel methodological approach centered on the weekly administration of a comprehensive cross-sectional survey to independent stratified random samples of university students. After 22 months of consecutive survey administration, we have developed and refined a survey protocol that has proven effective in engaging students at three Canadian institutions, allowing us to track how mental health and substance use vary over time using an internationally developed university student survey based on DSM-5 criteria.