INTRODUCTION:

This study investigates the relationship between Screen Time, Green Time, and mental health among university students at Universiti Kuala Lumpur Royal College of Medicine Perak (UniKL RCMP), encompassing multiple health-science bachelor programs. Using a structured questionnaire with both positively and negatively framed items, the study evaluates perceived benefits of green time—such as relaxation, improved mood, and enhanced focus—as well as potential adverse effects of excessive screen time, including stress, anxiety, and reduced social interaction. By examining these associations, the research aims to clarify how digital engagement and exposure to natural environments interact to influence student well-being. The findings are intended to inform institutional strategies and personal lifestyle choices that support healthier mental health outcomes.

Over recent years, rapid technological advancement has substantially reshaped daily life, particularly among university students who rely on digital devices for academic tasks and social interaction. Increased access to smartphones, laptops, and social media platforms—defined as internet-based applications that enable users to communicate and share content¹—has contributed to a shift toward greater Screen Time, or time spent using electronic devices², and reduced Green Time, defined as time spent in natural environment³. In Malaysia, digital engagement is widespread, with high proportions of internet and social media users among young adults^4,5, reflecting a highly digitalized lifestyle that may influence behavioural patterns and well-being. While moderate Screen Time can support learning, communication, and social connection⁶, excessive exposure has been associated with stress, anxiety, sleep disruption, and poorer psychological outcomes^7,8,9. Conversely, Green Time has been consistently linked to improved mood, reduced stress, and better quality of life, even with brief exposure to natural environments^{10, 11,12}. However, university students often face barriers such as academic workload and limited awareness of green spaces, which may restrict their engagement with nature. Understanding the balance between Screen Time and Green Time is therefore essential, as both can produce beneficial or adverse effects depending on usage patterns, highlighting their combined influence on students’ mental health.

MATERIALS AND METHODS:

Study Design and Setting:

A cross-sectional survey was conducted among undergraduate students at Universiti Kuala Lumpur Royal College of Medicine Perak (UniKL RCMP) over one week (25 January–1 February 2025) to examine the relationship between Screen Time (time spent using digital devices), Green Time (time spent in natural environments), and mental health.

Study Population and Sampling:

The target population comprised students enrolled in bachelor programs (MBBS, Nursing, Pharmacy, Pharmaceutical Technology, and Physiotherapy). Sample size was calculated using a single-proportion formula (p = 0.65, Z = 1.96, d = 0.09), yielding 255; with a 10% allowance for non-response, the minimum required sample was 280. Participants were recruited through voluntary response sampling.

Eligibility Criteria:

Inclusion criteria were currently enrolled UniKL RCMP bachelor students who consented to participate. Individuals not enrolled or unwilling to participate were excluded.

Data Collection:

Data were collected using a structured, self-administered online questionnaire developed from previous literature ^10,12,13,14 and pilot tested before distribution. The questionnaire consisted of two sections: (1) sociodemographic information and (2) items assessing Screen Time, Green Time, and perceived mental health effects. Responses were measured using a 5-point Likert scale. The survey link was disseminated via WhatsApp and Telegram.

Data Analysis:

Data were cleaned in Microsoft Excel and analysed using SPSS. Descriptive statistics summarized participant characteristics, and associations between Screen Time, Green Time, and mental health variables were examined using the Chi-square test. Results were presented in tables and graphs.

RESULTS:

A total of 280 undergraduate students participated in this study, with the majority being female (60%), enrolled in the MBBS program (46.8%), and predominantly aged between 21 and 23 years. The majority of respondents (54.6%) (n=153) reported preferring to use screens during late-night hours, with nearly one-third of them (n=96) rarely taking breaks while using screens. Most students primarily utilized screens for academic purposes, and 32.1% (n=90) reported using screens for more than six hours per day. Additionally, 37.5% of the students (n=105) indicated using screens for recreational activities for about 2 to 4 hours daily.

Findings showed that smartphones and the tablets were most used gadgets while the PC and TV were less used items. The respondents reported experiencing several negative consequences associated with screen use, including self-comparison with others (58.6%), difficulty in disconnecting from screens (51.1%), overexposure to negative content (42.9%), and feeling pressured to remain constantly connected (29.3%) (Figure 1).

Figure 1: Negative effect of screen time perceived by the respondents

Table 1. Respondent’s opinions on screen time effect on mental well-being

Screen time effect on mental health	N	%
Emotional distress
Always	21	7.5
Often	31	11.1
Sometimes	123	43.9
Rarely	74	26.4
Never	31	11.1
Increased stress or anxiety
Always	17	6.1
Often	34	12.1
Sometimes	86	30.7
Rarely	103	36.8
Never	40	14.3
Difficult to concentrate
Always	31	11.1
Often	74	26.4
Sometimes	111	39.6
Rarely	50	17.9
Never	14	5

According to Table 1, the respondents 11.1% (n=31) reported experiencing concentration difficulties almost all the time whereas 39.6% (n=111) claimed difficulty in concentration sometimes. Additionally, above 40% of the respondents (n=123) indicated that they sometimes experienced emotional distress and 86 respondents (30.7%) elevated stress levels due to screen use.

Table 2. Association between gender and screen use

Variables	Responses	Female	Male	P-value
Variables	Responses	N(%)	N(%)	P-value
Taking regular break during screen use	No	57 (33.9)	51(45.5)	0.034*
Taking regular break during screen use	Yes	111(66.1)	61(54.5)
Smartphone	No	11(6.6)	9(8)	0.407
Smartphone	Yes	156(93.4)	103(92)
Laptop/PC	No	105(62.9)	61(54.5)	0.101
Laptop/PC	Yes	62(37.1)	51(45.5)
Tablet	No	37(22.2)	50(44.6)	0.000**
Tablet	Yes	130(77.8)	62(55.4)
Television	No	157(93.5)	104(92.9)	0.514
Television	Yes	11(6.5)	8(7.1)

*Significant association at 0.05, **Significant association at 0.01

The Fisher’s Exact Test was conducted to examine gender-based differences in screen use. In this study, male students were less likely to take regular breaks during screen time compared to female students (P-value 0.034) and the results showed that a higher proportion of female students (66.1%) took regular breaks during screen time compared to male students (54.5%). In terms of device usage, the prevalence of tablet use was significantly higher among female students (77.8%) compared to their male counterparts (55.4%) with P-value 0.000. (Table 2)

Regarding the green time, 40% of the students preferred spending their green time with friends, and almost half the respondents reported spending between 1 to 3 hours in green spaces. The main barriers to engaging in green time were academic workload (59.6%) and a preference for indoor activities (25.7%) while 11.8% highlighted for lack of access green time. The most common outdoor activities practiced by the students included walking or jogging (44.2%), relaxing or meditating (20.8%), and participating in sports (18.6%).

41.8% (n=117) of the respondents reported never feeling mentally drained after spending time in nature. On the contrary, most students experienced an improvement in their mood following exposure to green spaces. Most respondents (98.2%) (n-275) perceived a reduction in feelings of anxiety and depression, while 86.8% agreed that spending time in nature (green time) could positively contribute to their overall well-being. 42.5% (n=119) confirmed they often improve the good mood during spending time in green spaces.

Table 3. Gender and barriers to engage in green time

Variables	Response	Female N (%)	Male N (%)	P-value
Busy schedule	No	28 (16.7)	18 (16.1)	0.352
Busy schedule	Yes	140 (83.3)	94 (83.9)
Preference for indoor activities	No	112 (66.7)	87 (77.7)	0.031*
Preference for indoor activities	Yes	56 (33.3)	25 (22.3)
Weather conditions	No	81 (48.2)	65 (58.0)	0.068
Weather conditions	Yes	87 (51.8)	47 (42.0)
Laziness	No	166 (98.8)	110 (98.2)	0.525
Laziness	Yes	2 (1.2)	2 (1.8)

Female students demonstrated a significantly greater preference for indoor activities compared to male students, with 33.3% of females versus 22.3% of males indicating such preference (P = 0.031), based on the Fisher’s Exact Test. Both female and male students emphasized that busy schedule with academic study is one factor for spending less in green spaces. (Table 3)

Meanwhile, the relationship between the gender and their willingness to support green time revealed that the majority of respondents 88.2% expressed willingness to support initiatives promoting green time on campus. Most students (78.9%) were also open to participate in programs that integrate green time with academic or social activities and encouraged spending more time in green spaces (85.7%). However, there was no significant statistical association between gender and students’ willingness to support green time initiatives.

DISCUSSION:

This study demonstrates that screen time usage among UniKL RCMP students is highly prevalent with most respondents reporting late-night usage and substantial daily exposure for both academic and recreational purposes. Although digital devices are essential for learning, prolonged screen exposure—particularly at night—may impair sleep quality and cognitive performance, potentially affecting academic outcomes¹⁵. A considerable proportion of students also reported experiencing emotional distress, reduced concentration, and difficulty disconnecting from screens, suggesting that excessive or unregulated screen use may negatively influence psychological well-being and attention capacity^16,17. Notably, recreational screen time showed a significant association with mental drainage and anxiety, whereas academic screen time did not. This indicates that unstructured or entertainment-based digital engagement may contribute more strongly to mental fatigue and stress than goal-oriented academic use, consistent with evidence that limiting recreational screen exposure can improve mood and mental well-being¹⁸.

In contrast, engagement with green environments was strongly associated with positive psychological outcomes. Most respondents reported improved mood, reduced anxiety or depressive feelings, and greater relaxation after spending time in nature. Statistical analysis confirmed a significant relationship between green time and relaxation levels, with longer exposure linked to better outcomes. These findings align with research demonstrating that natural environments reduce stress, enhance attention, and promote emotional restoration^19,20,21. Despite these benefits, academic workload emerged as the primary barrier limiting students’ participation in green activities, indicating that structural constraints rather than lack of awareness may restrict engagement.

Gender differences were minimal overall, although female students were more likely to take breaks during screen use and showed a higher prevalence of tablet use. Sociodemographic factors such as age and gender were not significantly associated with mental drainage, suggesting that mental fatigue may be a common experience across student groups due to shared academic pressures. A near-significant trend by program of study indicates that academic demands may still influence mental exhaustion levels.

Overall, the findings highlighted the importance of maintaining a balance between screen time and green time. While digital tools support academic productivity and social connectivity, excessive recreational screen exposure appears detrimental to mental health, whereas time spent in natural environments provides measurable psychological benefits. Universities should therefore consider implementing structured initiatives that promote green time opportunities, as accessible campus green spaces and nature-based activities may help students manage stress and enhance well-being²².

CONCLUSION:

This study underscores the significant influence of screen time and green time on university students’ mental well-being. While academic-related screen use was not significantly associated with mental exhaustion or anxiety, excessive recreational screen time demonstrated a clear relationship with mental fatigue and emotional distress. In contrast, greater exposure to natural environments was strongly linked to improved relaxation and reduced stress, with students who spent more time outdoors reporting the most favourable psychological outcomes.

However, despite recognizing these benefits, many students faced barriers—particularly academic workload—that limited their engagement in green time. Encouragingly, most respondents acknowledged that spending time in nature can help counterbalance the negative effects of prolonged screen exposure.

Overall, maintaining a healthy balance between recreational screen use and outdoor activity appears essential for supporting students’ mental health. Universities should therefore consider implementing structured initiatives and supportive environments that promote green time participation while fostering responsible and mindful screen habits.

CONFLICT OF INTEREST:

There is no conflict of interest between authors

ACKNOWLEDGEMENT:

Authors would like to appreciate Intan Fatihah Binti Mohd Ridza, Nayli Damia Binti Ahmad Zaki, Irfan Bin Che Azizi, Nur Aaqilah Binti Mohamad, Muhammad Luqman Hakim Bin Mohd Khairi and Sharifah Sofia Al-Yahya Binti Syed Hussain for their kind contribution in this project.

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Received on 04.01.2026 Revised on 30.03.2026

Accepted on 27.05.2026 Published on 05.06.2026

Available online from June 06, 2026

Research J. Pharmacy and Technology. 2026;19(6):2709-2713.

DOI: 10.52711/0974-360X.2026.00387

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.