Mental Health and Academic Performance in University Students: A Literature Review

Abstract

Mental health has emerged as a central determinant of university students’ learning trajectories, shaping attendance, engagement, persistence, and academic achievement. At the same time, academic environments can amplify psychological distress through performance pressures, workload intensification, uncertainty about the future, and social transitions. This review synthesises contemporary evidence on the association between student mental health and academic performance, emphasising depression, anxiety, stress-related distress, and academic burnout. The literature selection approach targeted recent, peer-reviewed evidence on mental health and academic performance in university students. Searches were conducted across PubMed/MEDLINE, PsycINFO, Scopus, Web of Science, and ERIC, combining terms for population, exposures, and outcomes. The date range was January 2015 to December 2025, focusing on contemporary evidence. Across diverse contexts, poorer mental health is generally linked to lower grade point average, weaker academic engagement, and greater risk of academic difficulties, although effect sizes vary by symptom domain, measurement approach, and student subgroup. Depression shows the most consistent negative relationship with academic performance, while anxiety demonstrates more heterogeneous patterns, sometimes reflecting a performance-impairment association and sometimes a complex interplay with motivation and evaluative stress. Burnout and emotional exhaustion are increasingly recognised as academically consequential, with emerging longitudinal work highlighting potential bidirectional or context-dependent relations between grades and burnout. Mechanistically, mental health influences academic outcomes through cognitive functioning, motivation and self-regulation, health behaviours (including sleep), help-seeking, and social belonging. Evidence also supports multi-level intervention approaches, including campus services, prevention and promotion programs, mindfulness-based strategies, and scalable digital supports. The review concludes by outlining implications for institutional policy and student support systems, and it identifies priorities for future research designs that strengthen causal inference and address equity in academic and mental health outcomes.