The target populations are health and social care providers and university students at 6 universities in Jinan, Shandong, China. The 6 universities were chosen based on (1) the diversity of the student population, that is, students from local and rural areas, (2) the diversity of disciplines and programs, and (3) their locations in each of the 3 regions within Shandong, China.

We will recruit 600 participants (100 per university site) to take part in a survey of general mental health-related symptoms, including depression, anxiety, and stress (DASS-21), stigma of mental illness (CAMI), mental health literacy (MHKQ), and mental health resources. Other measures evaluating clinical mental health symptomology were not included, as the purpose of the contextual analysis is to observe trends in mental health and resources supporting mental well-being. Inclusion criteria for participation include students, self-identified as 18 years of age or older, and attending 1 of the 6 partnering universities in Jinan (Table 1). They will also be asked complete the qualitative data collection tool to identify concerns and needs in mental health care. Survey participants interested in taking part in the follow-up focus group will be entered into a database. We will select 144 participants (24 per university site) to take part in focus groups to gain a deeper understanding of the complex contexts and factors of mental health issues among university students, including social structures and networks of access.

At each university, we will host 2 focus groups (12 people each) with a total of 144 service providers to take part in a needs assessment. Inclusion criteria are service providers who self-identified as 18 years of age or older and provide health care, social care, or supportive services to university students in Jinan. Participants will first complete basic demographics information and information to identify concerns and needs in mental health care. Service providers participating will include psychiatrists, primary care physicians, nurses, social workers, university counsellors, and youth league leaders. Similar to above, focus groups will explore the complex contexts and factors of mental health issues among university students as well as identify training needs.

Partner organizations will keep track of and establish a 6-month baseline on quantities and types of services used by students. These organizations will include university counselling centers, individual school/faculty/departments at the 6 partner universities, community hospitals and clinics, and other regional organizations with stakes in the promotion of mental health and well-being of university students. These data will be used to measure reach and effectiveness.

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