Well-Being Mental Health

Fully online college courses linked with worse student mental health: study

“Colleges should be aware of the mental health burden associated with attending fully online classes and consider possible in-person components and supports for students.”
Online class.
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Story at a glance


  • College students who attended fully online classes reported more psychological distress than their peers who attend class in a hybrid format.

  • Prior to COVID-19, young Americans faced a growing mental health crisis that was exacerbated by the pandemic. 

  • Researchers suggest mental health professionals consider how course delivery models impact mental health outcomes.  

The COVID-19 pandemic saw many higher education institutions switch from in-person learning to fully online courses in an effort to curb disease transmission. 

But new research suggests fully remote classes can take a significant toll on students’ mental health, compared with a mix of online and in-person courses. 

Data from 59,250 full-time undergraduate students show those who attended fully online classes reported higher levels of psychological distress than their peers, regardless of current anxiety or depressive disorders, COVID-19 concerns and time spent socializing with friends. 

“​​Mental health professionals may wish to consider the association of course delivery models with mental health outcomes when working with college students,” authors explained, writing in JAMA Network Open


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“Colleges should be aware of the mental health burden associated with attending fully online classes and consider possible in-person components and supports for students,” they added.

Findings follow reports of a growing mental health crisis among young Americans. Throughout the 2020-2021 school year, more than 60 percent of college students met criteria for at least one mental health problem, according to the American Psychological Association.

“Compared with before the pandemic, the prevalence of depressive symptoms among US adults aged 18 to 39 years old during the pandemic more than quadrupled by April 2020,” JAMA authors wrote.

Stressors like the loss of a loved one, financial hardships, racial discrimination or moving back in with their parents could have influenced this steep rise in poor mental health. 

To better understand what effect course delivery models had on students, researchers assessed data from a national college health survey carried out between January and June 2021. 

All participants were attending four-year programs, the average student age was around 21 and the majority of students were female. 

Of those surveyed, 3.5 percent attended fully in-person classes, 61.2 percent attended fully online classes, and 35.3 percent attend a mix of in-person and online classes. 

Authors hypothesize course models with some in-person components could be better for students, as they preserve a degree of normalcy.

In fully remote learning environments, many faced challenges with limited internet or technology access, as well as loss of extracurricular activities, internships or study abroad opportunities. 

Socializing with friends was also likely more difficult, and students may have been given the option to opt into fully online or partially online classes.

“Such increased perceived control could also help mitigate the negative effect of stressful situations,” authors wrote.

Some students reported feeling distracted or procrastinating in online learning environments and may have had decreased motivation to connect with professors in the absence of face-to-face interactions.