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Due to the widespread occurrence of mental disorders among adolescents, there is globally a recognised need to assess the mental well-being of higher education students. Those in extended programmes, dealing with self-esteem and capability challenges intensified by peer and institutional attitudes, might face heightened susceptibility to mental health issues. Moreover, research suggests that the 2020 COVID-19 pandemic likely worsened students' mental health difficulties. This study aimed to assess the prevalence of mental health issues among students in a South African university's extended curriculum programme in 2022 while exploring potential gender differences. Furthermore, by comparing these findings to a 2017 study, it sought to assess the COVID-19 pandemic's potential impact on the mental health of extended programme students. Paper-based questionnaires evaluated depression, anxiety, and stress symptoms among first-year extended programme students in 2017 (pre-COVID, n = 208) and in 2022 (within the pandemic, post-lockdown, n = 202). The results showed consistently high levels of mental health issues for both cohorts, with no statistically significant difference between the cohorts. However, female students in the 2022 cohort faced notably more mental health challenges than their male peers. Universities should enhance mental health education and awareness campaigns and explore new counselling methods to assist the growing number of students in need of support. Further research ought to investigate the factors behind the heightened mental health issues, especially among female students. [ABSTRACT FROM AUTHOR]