Factors associated with mental health depending on the type of stress related to admission among correspondence course high school students in Japan

Objective This study aimed to determine the factors associated with mental health based on the type of stress related to high school admissions for correspondence courses.Methods The targeted participants were 3,888 students belonging to 11 campuses of a high school providing correspondence courses. During the homeroom, the teachers in charge distributed and collected questionnaires directly. The questionnaire was designed to collect data concerning demographic characteristics, stresses, mental health, and life skills. Concerning stress, the questions inquired about stress before admission and after admission. Further, they asked about stress related to entry regarding the study, friendship, relationship with teachers, club activities, school events, home environment, health, and work. Kessler 6 was used as an index of mental health.Results Questionnaires were returned by 2,424 students (response rate of 62.3%). Regarding the change in stress before and after admission, students showed decreases in anxiety after admission in other areas, excluding work. Because of the k-means clustering analysis, based on the scores of the eight areas of stress related to admission, six groups were extracted. Factors related to mental health were extracted from each group. Health stress was strongly associated with the K6 score in all groups. For the study stress group, friendship stress group, family environment, and health stress group, stress related to admission were associated with the K6 score. Furthermore, for the complex school-related stress group, friendship and family environment stress were associated with the K6 score. In the high-stress group, the K6 score was significantly associated with study stress. As for life skills, stress management and decision-making skills were associated with higher mental health.Conclusions These findings indicate that it is important to understand students' needs and support them in coping with stress and improving their life skills according to their stress type. Support should be developed for high school students enrolled in correspondence courses.