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You are reading: Investigating the relevance of mental health for the current equity groups framework: An analysis of multi-agency linked-administrative data

Tomasz Zając1, Francisco Perales1, Ning Xiang1, Wojtek Tomaszewski1, Stephen R. Zubrick2

Executive summary

There are currently six recognised equity groups in the Australian higher education system: people from socioeconomically disadvantaged backgrounds, people from Non-English Speaking Background, Aboriginal and Torres Strait Islander People, people from regional and remote areas, people with disability and women in non-traditional areas of study. Critics of the Australian higher education equity framework have underscored the existence of other potential sources of educational disadvantage that currently lack official recognition.

Given the increasing prevalence of mental health issues among young people, some scholars and equity stakeholders have recommended refining or complementing the existing disability equity group by explicitly incorporating measures of poor mental health. A recent change to the definitions of higher education data elements might be seen as a step towards recognising poor mental health as a condition that can lead to educational disadvantage. Specifically, the new Tertiary Collection of Student Information (TCSI) system, which replaced HEIMS in 2021, includes mental health and neurological conditions among disabilities, impairments and long-term medical conditions that can impact studies. The present study provides empirical evidence that can help assess the validity of claims to formally incorporate student mental health within the current Australian framework for equity in higher education. Our analyses leverage a unique, customised Multi-Agency Data Integration Project (MADIP) dataset obtained through a partnership with the Australian Government Department of Education, Skills and Employment (DESE) to investigate how pre-existing poor mental health overlaps with the equity groups and their independent and compounding effects on disadvantage at the higher education participation stage. The studied equity groups include students with disability. However, as our study uses data from the 2012-16 period, all of the data pertain to the time before the recent change to the disability indicator in the HEIMS/TCSI data collections, which occurred in 2021. Therefore, the disability indicator in the data used here does not explicitly capture students with poor mental health.

The study

The analyses presented in this report fill two significant knowledge gaps. First, the study investigates the overlap between pre-existing poor mental health and membership in the officially identified equity groups (all of which are also defined on the basis of information preceding the commencement of university studies). Second, the study examines the impact of pre-existing poor mental health on early student outcomes, namely first-year attrition.

To measure student attrition, we relied on students’ enrolment status in the academic year following the year in which they commenced their undergraduate degrees. We considered three different measures of attrition: from a field of education, from a given higher education institution, and from the higher education system altogether. To capture poor mental health, we utilised official records from the Pharmaceutical Benefit Schedule and the Medicare Benefit Schedule on the use of mental health-related medication and services, which identify individuals who sought medical help.


Our analyses revealed that members of only two equity groups—Indigenous students and people with disability—were more likely to exhibit poor mental health prior to commencing their university studies than their non-equity counterparts. The disparity was much more substantial for students with and without disability. Overall, 42.1% of students with disability used mental-health services or medication, compared to 11.3% for students without disability. This indicated that students with poor mental health constituted a separate group that did not overlap with the officially identified equity groups, except for students with disability.

Critically, our analyses demonstrated that pre-existing poor mental health adversely affected all types of student attrition. The effects of poor mental health were most pronounced for student attrition at the higher education system level and weakest for attrition at the field-of-education level. Further, the effect of poor mental health on student attrition was largely independent of equity-group membership. Adjusting the models for equity-group membership did not meaningfully reduce the effects of poor mental health. In fact, the negative effect of poor mental health on student attrition was larger in magnitude than the effect of membership in each of the equity groups. Poor mental health was associated with a rise in the attrition rate ranging between 4.4 and 5.2 percentage points. Only the effect of being Indigenous was of a comparable magnitude (4.7 to 4.9 percentage points).

The impact of poor mental health on student attrition was similar among equity and non-equity students, except for students from Non-English Speaking Background. Poor mental health affected the attrition rates of students from Non-English Speaking Background to a greater extent than for their English-speaking background counterparts.

Altogether, our results unequivocally stress the critical importance of pre-existing poor mental health as a predictor of student attrition during the first year of university. Despite some overlap between students with poor mental health and students who belong to the officially identified equity groups—chiefly students with disability—our results indicate that the disadvantage stemming from pre-existing poor mental health is distinct from that stemming from being a member of any of the designated equity groups.


Based on our findings we formulate the following three recommendations:

Recommendation 1. Stakeholders at all levels should consider poor mental health as an important factor contributing to first-year student attrition and design more mental health-focused interventions.

Equity practitioners should be particularly mindful of poor mental health’s negative effects among students from Non-English Speaking Backgrounds, as this is the equity group whose members are most negatively affected by poor mental health. This pattern of results also deserves further consideration by future research studies.

Recommendation 2. The Australian Government should consider allocating more funding to support students with disabilities.

Our results show that despite the significant overlap between poor mental health and disability, as defined before 2021, the previous disability category did not capture a vast portion of students with poor mental health. The inclusion of students with poor mental health in the disability category results in a significant expansion of the category.

Recommendation 3. The Australian Government should consider funding (a) the collection or linkage of data that enable a more robust examination of the extent and repercussions of poor mental health amongst university students, and (b) research that expands the analytic scope of this report to other phases of the student life cycle.

These new data sources and research studies would significantly expand current understandings of how mental health impacts all aspects of students’ access, participation and success in higher education.

Read the full report: Investigating the relevance of mental health for the current equity groups framework: An analysis of multi-agency linked-administrative data

This research was conducted under the NCSEHE Research Grants Program, funded by the Australian Government Department of Education, Skills and Employment.

1The University of Queensland
2The University of Western Australia

Expert Review

Dr Nadine Zacharias
Student Engagement
Swinburne University

This important study by Tomasz Zajac and his colleagues at the Universities of Queensland and Western Australia provides unique empirical insights into a very timely issue: the impact of pre-existing mental health conditions on student attrition in their first year at university.
The research delivers empirical validation of the recent inclusion of mental health conditions into the disability definition used by the new Tertiary Collection of Student Information (TCSI) system which replaced HEIMS in 2021. Matt Brett and others had previously argued for a definitional change to bring higher education in line with the Disability Discrimination Act 1992 and the National Disability Insurance Scheme.
The study offers robust and sophisticated findings which the sector has not previously had access to. It draws on sector-level analysis (rather than a single institution), uses an administrative measure of mental ill-health (rather than students’ self-reports) and employs a longitudinal approach to capture actual attrition (rather than students’ intention to leave).

Zajac and colleagues show that pre-existing mental health conditions impact the successful transition to higher education of a large group of students and are a significant driver of attrition, especially for students from non-English speaking backgrounds. The magnitude of the impact is equivalent to that experienced by Indigenous students compared to their non-Indigenous peers. It suggests that a significant injection of funding by the Commonwealth is required to enable universities to effectively support their students with pre-existing mental health conditions and ensure their equitable participation in higher education.

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