Mental health and well-being during the COVID-19 pandemic in higher education: Evidence from G20 countries


Background: The spread of coronavirus (COVID-19) has resulted in a drastic alteration to billions of individuals’ emotional, physical, mental, social, and financial status. As of July 21st, 2020, there had been 14.35 million confirmed cases of COVID-19, including 0.60 million deaths in 216 countries.

Design and Methods:
 The study explores health and well-being in universities within the G20 countries (19 member countries and the European Union) during the COVID-19 pandemic. The sample selection of these countries was considered since it serves around 80% of the world’s economic output, two-thirds of the global population (including more than half of the world's poor), and 75% of international trade. Specifically, due to this public health concern, schools' nationwide closures are impacting over 60% of the world’s student population to promote their quality of life and well-being.

 This study investigates the G20 policies and procedures within higher education regarding health and well-being measures during the COVID-19 epidemic. The findings reveal that the lockdown, social distancing, and self-isolation requirements are stressful and detrimental for many individuals and have caused students' health and well-being concerns.

 Several countries within the G20 have taken significant steps to support health and well-being issues for university students; however, numerous countries are far behind in addressing this issue. Hence, government leaders of G20 countries, policymakers, and health providers should promptly take the necessary measures to regulate the outbreak, improve safety measures to decrease disease transmission, and administer those who demand medical attention.


Mohammad Nurunnabi, Department of Accounting, Prince Sultan University, Riyadh

St Antony's College, University of Oxford, UK


Lofgren ET, Rogers J, Senese M, Fefferman NH. Pandemic preparedness strategies for school systems: is closure really the only way? Anna Zool Fenn 2008;45:449–58. DOI:

Universities UK (2015). Student mental well-being in higher education | Good practice guide. London, February 13, 2015. Accessed June 15, 2020. Available from:

WHO. Mental health and psychological resilience during the COVID-19 pandemic. 2020, March 27. Accessed June 18, 2020. Available from:

Lima CKT, Carvalho PM., Lima IAAS, et al. The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatry Res 2020;287:112915. DOI:

Fues T, Messner D. G20: Concert of great powers or guardian of global well-being? (No. 9/2016). Briefing Paper. Deutsches Institut für Entwicklungspolitik (DIE), Bonn; 2016. Available from:

Kickbusch I, Leung GM, Bhutta ZA, et al. Covid-19: how a virus is turning the world upside down. BMJ 2020;369:m1336. DOI:

G20 Saudi Arabia. Extraordinary G20 Leaders' Summit. Statement on COVID-19; 2020. Accessed June 22, 2020.

Villa S, Lombardi A, Mangioni D, et al. The COVID-19 pandemic preparedness or lack thereof: from China to Italy. Global Health Med 2020;2:73–7. DOI:

Zhai Y, Du X. Addressing collegiate mental health amid COVID-19 pandemic. Psychiat Res 2020;288:113003. DOI:

Montemurro, N. (2020). The emotional impact of COVID-19: From medical staff to common people. Brain Behav Immun 2020;87:23–4.

Dorsey ER, Toprol EJ. Telemedicine 2020 and the next decade. Lancet. 2020;395:859. DOI:

Meo S, Abukhalaf D, Alomar A, et al. COVID-19 Pandemic: Impact of Quarantine on Medical Students’ Mental Wellbeing and Learning Behaviors. Pakistan J Med Sci 2020;36:S43–8. DOI:

Wang J, Tan S, Raubenheimer K. Rethinking the role of senior medical students in the COVID‐19 response. Med J Austral 2020;212:490–e1. DOI:

Smith J, Judd J. COVID-19: Vulnerability and the power of privilege in a pandemic. Health Promot J Austr 2020;31:158–60. DOI:

Song X, Fu W, Liu X, et al. Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China. Brain Behav Immun 2020;88:60-5. DOI:

Gallè F, Sabella E, Da Molin G, et al. Understanding knowledge and behaviors related to COVID-19 epidemic in Italian undergraduate students: The EPICO Study. Int J Environ Res Public Health 2020;17:3481. DOI:

Longhurst G, Stone D, Dulohery K, et al. Strength, Weakness, Opportunity, Threat (SWOT) analysis of the adaptations to anatomical education in the United Kingdom and Republic of Ireland in response to the Covid‐19 pandemic. Anatomical Sci Educ 2020;13:301–11. DOI:

Tashiro A Shaw R. COVID-19 pandemic response in Japan: What is behind the initial flattening of the curve? Sustainability (Basel) 2020;12:5250. DOI:

Satici B, Saricali M, Satici S, Griffiths MD. Intolerance of uncertainty and mental well-being: serial mediation by rumination and fear of COVID-19. Int J Mental Health Addict 2020:1-12. DOI:

Sundarasen S, Chinna K, Kamaludin K, et al. Psychological impact of covid-19 and lockdown among university students in malaysia: Implications and policy recommendations. Int J Environ Res Public Health 2020;17:6206. DOI:

Kamaludin K, Chinna K, Sundarasen S, et al. Coping with COVID-19 and movement control order (MCO): experiences of university students in Malaysia. Heliyon 2020;e05339. DOI:

Liu S, Yang L, Zhang C, et al. Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry 2020;7:e17-8. DOI:

Djalante R, Lassa J, Setiamarga D, et al. Review and analysis of current responses to COVID-19 in Indonesia: Period of January to March 2020. Progress Disaster Sci 2020;100091. DOI:

Reimers FM, Schleicher A. A framework to guide an education response to the COVID-19 Pandemic of 2020. OECD; 2020. Accessed April, 14, 2020. Available from:

Hossain SFA, Nurunnabi M, Hussain K, et al. Effects of variety-seeking intention by mobile phone usage on university students’ academic performance. Cogent Educ 2019;6:1574692. DOI:

Creswell JW, Clark VLP. Designing and conducting mixed methods research. Thousand Oaks: SAGE Publications; 2017.

Moorley C, Cathala X. How to appraise mixed methods research. Evidence-Based Nurs 2019;22:38–41. DOI:

Frey B. The SAGE encyclopedia of educational research, measurement, and evaluation (Vols. 1-4). Thousand Oaks: SAGE Publications: 2018. DOI:

Bowen GA. Document analysis as a qualitative research method. Qualit Res J 2009;9:27–40. DOI:

Shorten A, Smith J. Mixed methods research: expanding the evidence base. Evidence-Based Nurs 2017;20:74–5. DOI:

Organization for Economic Co-operation and Development (OECD). Regional well-being index. 2020. Accessed: June 11, 2020. Available from:

Bracht C. The 2015 G20 Antalya Summit Commitments. Toronto: University of Toronto: 2015. Accessed May 23, 2020. Available from:

Warren B. The 2016 G20 Hangzhou Summit Commitments. Toronto: University of Toronto; 2016. Accessed: May 23, 2020. Available from:

Warren, B. The 2017 G20 Hamburg Summit Commitments. Toronto: University of Toronto; 2017. Accessed May 23, 2020. Available from:

Warren, B. The 2019 G20 Buenos Aires Summit Commitments. Toronto: University of Toronto; 2018. Accessed May 23, 2020. Available from:

Warren, B. The 2019 G20 Osaka Summit Commitments. Toronto: University of Toronto. Accessed: May 23, 2020. Available from:

Lucas B. G7 and G20 commitments on health. K4D Helpdesk Report 673. September 27, 2019. Brighton, UK: Institute of Development Studies; 2019. Available from:

Nurunnabi M, Hossain SFAH, Chinna K, et al. Coping strategies of students for anxiety during the COVID-19 pandemic in China: a cross-sectional study. F1000Res 2020;9:1115. DOI:

Cicci A, Han JY, Popova I, et al. 2018 G20 Buenos Aires Summit Final Compliance Report. Toronto: University of Toronto; 2019. Accessed May 23, 2020. Available from:

McBride B, Hawkes S, Buse K. Soft power and global health: the sustainable development goals (SDGs) era health agendas of the G7, G20 and BRICS. BMC Public Health 2019;19:815. DOI:

Barnett S, Emorine H, G20 Research Group, et al. 2017 G20 Hamburg Summit Final Compliance Report. University of Toronto: 2018. Available from:

International Association of Universities. COVID-19: Higher Education challenges and responses. Available from:

SDG-Education 2030 Steering Committee. Recommendations for COVID‐19 Education Response. Available from:

Lipson SK, Lattie, EG, Eisenberg D. Increased rates of mental health service utilization by US college students: 10-year population-level trends (2007-2017). Psychiatr Serv 2019;70:60-3. DOI:

American Council on Education. Mental health, higher education and Covid-19: Strategies for leaders to support campus well-being. Available from:

Institute of International Education. COVID-19 Effects on US higher education campuses from emergency response to planning for future student mobility. 2020. Available from:

Department of Health, UK Government. Wellbeing. Why it matters to health policy. Available from:

GuildHE, Universities UK. Student Mental Well-being in higher education: Good Practice Guide. Available from:

Universities UK. Stepchange. Mentally Healthy Universities. Available from:

Australian Government, National Mental Health Commission. Our role. Available from: