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National research findings on student mental health (2003)

Please note that this was compiled in 2003 and therefore does not take into account research undertaken after this date. For details of more recent research articles and publications relating to student mental health, please click see here.

As the majority of the students are under 30, they are likely to make less demands upon the local health services in relation to their physical health, than a typical cross section of the total local population. However, a number of recent studies suggest that the mental health of students is significantly worse than that of the general population. Anxiety and depression

A particularly comprehensive piece of research, published by Webb [1] and colleagues in the Lancet in 1996, is based on a sample of 3075 second year students, across 10 UK universities. The researchers achieved a response rate of "nearly 100%". This survey used a questionnaire on drug and alcohol use, combined with the Hospital Anxiety and Depression Questionnaire (HAD) which measures subjective well-being. The research highlighted significantly high rates of anxiety in the student population and these have been compared with general population norms [2] below.

Rates of Anxiety

  Male students Female students General UK population norms
Mild anxiety 23% 28% 21%
Moderate anxiety 27% 25% 10%
Severe anxiety 6% 10% 3%
Moderate and severe anxiety 33% 35% 13%

This study found that 12.1% of male students and 14.8% of female students had measurable levels of depression, ranging from mild to severe, a figure slightly higher than the 11.4% found in the general population. These figures do not seem to be a simple reflection of an age group, in fact they go against the trend for neurotic disorders to increase with age as seen in recently published [3] figures for the general population. In the general population the incidence of neurotic disorders rises from around 130 cases per thousand for people aged 16-19, to 160 per thousand for the 20-24 age group, but the figures are higher than this for all ages in the range 25 to 59 (peaking at around 200 cases per thousand for the ages 45 to 54).

A study [4] using the Social Functioning Scale SF36 found that emotional health problems had a negative impact on the work of 49% of a sample of 1208 university students (including 200 from Oxford Brookes University) compared to 21% in the general population of the same age range.

Similarly a survey of 482 students in London [5] found that their General Health Questionnaire GHQ-12 score was twice as severe as for the general population. Levels of student health were significantly below population norms matched for age and sex. 29.3% of the respondents' GHQ scores were in excess of 1 standard deviation above the population mean for their age and sex. 43.5% of the respondents produced Social Functioning (SF36) scores more than one standard deviation below the population mean, this compares with 16% in the general population.

In a large-scale study in the North-west of England students were found to be 1.64 times more likely to be prone to anxiety and/or depression (GHQ-12) than the general population [19].

A survey [6] of 1620 second year students at Leicester University identified 23% who reported anxiety, phobias and panic attacks, and 40% who experienced sadness, depression or mood changes. In the same study 14% of students had scores for depression on the Brief Symptom Inventory subscales and 13% had scores for the obsessive-compulsive subscale.

Whilst these figures indicate a high level of measurable emotional and psychological distress in the student population, there is little evidence as to how many students will become clinical 'cases'. However, the effects of stress on both physical and mental health is well documented [7] particularly in the case of individuals who are vulnerable to mental ill-health owing to either genetic factors, family circumstances or other causes [8]. Psychotic disorders

There has been very little published on the incidence of psychoses, e.g. manic depression (or bi-polar affective disorder) and schizophrenia in the student population. However, the onset of such illnesses is known to be greater in the late teen/early adult age. An interesting finding comes from the Office for National Statistics 1995 Report [9] on psychiatric morbidity amongst adults in Great Britain which showed that adults with GCE A-levels or higher qualifications had a much higher level of incidence of 'functional psychoses' at 10 per thousand for men and 8 per thousand for women, compared to the rate in the adult population of 4 cases per thousand.

Eating disorders

A Cambridge study [10] found that 6% of women students reported problems with diet and eating. Similarly a study [11] of over 1400 students (including Oxford Brookes University) found that 6% of all respondents and 9% of the female students had a probable lifetime eating disorder. In a survey within an Oxford University College [12] 36% of the female respondents reported having experienced eating disorders at some point in their lives, 10% reported an existing eating disorder. This compares with estimates of 1% of women aged 15-30 generally having Anorexia, a similar percentage of all women suffering from Bulimia and 3% from Binge Eating Disorder [13].

Alcohol use

Findings from the large-scale survey of students conducted by Webb and colleagues [1] give the following results:

  • Only 11% of respondents were non-drinkers.
  • Among drinkers 61% of the men and 48% of the women exceeded 'sensible' limits of 21 units per week for men and 14 for women.
  • Hazardous drinking (over 51 units for men and over 36 units per week for women) was reported by 15% of the drinkers.
  • Binge drinking was declared by 28% of drinkers.

The study in an Oxford college [12] found that 24% of women and 40% of men were consuming alcohol beyond the limits of safe drinking. At Leicester [6] 25% of male students and 14% of female students were drinking at dangerous levels, and a further 17% of males and 31% of females were drinking at levels that could be harmful. 58% of students claimed to drink heavily at least once a month.

A survey of students at Oxford Brookes University [14] reported that more than half of the male students and one third of female students were regularly exceeding safe limits. Whilst these figures are higher than for the general population, for male students they are within the range encountered amongst young males generally, but female students appear to drink more heavily than their age group in the general population.

Illicit drug use

Webb et al [1] found that 60% of the male students and 55% of the female students reported having used cannabis once or twice and 20% of the sample reported regular cannabis use (weekly or more often). Experience with other illicit drugs was reported by 33% of the sample, most commonly LSD, amphetamines, ecstasy and amyl/butyl nitrate. 34% of these had used several drugs. Similar figures were found within an Oxford college [5] 57% having used cannabis at some point in their lives and 23% were current users. Other current drug use was low, the highest category being amphetamines at 3%. At Oxford Brookes [14] half of the student respondents had experience of illicit drugs and one quarter were current users. These are similar figures to the 28% of the 16-19 age group and 33% of the 20-24 age group in the general population who reported use of illicit drugs in the previous year [3].

Suicide and self-harm

The Samaritans [15] report that 80% of suicides are by young men. Suicide is the cause of 20% of all deaths in young people [13]. Sell and Robson's study [12] of an Oxford college found that 31% of male and 35% of female students had contemplated suicide at some point in their lives. There has been considerable concern over the last five to ten years over the rate of suicides in the student population. Oxford was singled out for particular media attention over a spate of suicides in the late 1990's. However, Hawton [16] has found that attempted suicide rates in the age group 15-24 years were considerably lower amongst Oxford University students than the equivalent local population. Looking at the rates per 100 000 of the population the figures show:

  • 68 male students compared to 91 male residents
  • 178 female students compared to 261 female residents
  • 106 for all students compared to 165 for all residents.

In 84% of the student cases serious harm was unlikely to have resulted from the attempt, in the remaining 16% death was a distinct possibility.

Of those Oxford students who did commit suicide [17] over a 14 year period, there was a higher rate of definite suicides than in the expected figure for the general population aged 18-25:

  • 16 males against an expected 9.77
  • 5 females against an expected 1.32
  • 21 male and female students against an expected 11.09

However, when the figures are compared taking into account undetermined deaths, the differences are not so marked:

  • 16 males against an expected 14.69
  • 6 females against an expected 2.35
  • 22 male and female students against an expected 17.03

In a two year study of over 800 Cambridge University students [10] 93 students reported having considered suicide, 14 of these reporting actual attempts. This corresponds to annual rates of around 6% and 0.9% respectively. Compared with the general population, students show symptoms of higher levels of anxiety and depression. Female students seem more prone to eating disorders and excessive drinking than other females in their age group. Students belong to a section of the population more prone to psychotic disorders than those with qualifications below A-Level. Whilst there is only limited quantitative research carried out within the universities and colleges in Oxford, the consistency of findings across many student populations suggests a worrying picture. The qualitative research carried out by OSMHN supports the view that levels of stress are very high in the local student population and that for some students this can precipitate a mental health crisis.

Despite the stresses on students, colleges and universities have a lot to offer those who wish to develop their skills and knowledge and to improve their employment prospects. Those who do manage to complete their studies and gain a qualification are likely to enjoy better physical and mental health in later life than those who do not have higher educational qualifications [18].


1. Webb, E et al 1996 Alcohol and drug use in UK university students The Lancet Vol 348, 922-925

2. Crawford J, Henry J, Crombie C & Taylor E 2001 Normative data for the HADS from a large non-clinical sample British Journal of Clinical Psychology 40, 4, 429-434.

3. Singleton et al 2001 Psychiatric Morbidity among Adults living in Private Households 2000. HMSO Office for National Statistics.

4. Stewart-Brown S et al, 2000, The health of students in institutes of higher education: an important and neglected public health problem? Journal of Public Health Medicine 22, 2

5. Roberts R in Stanley N & Manthorpe J 2002 Students' Mental Health Needs: Problems and Responses London: Jessica Kingsley

6. Grant A (2002) in Stanley N & Manthorpe J 2002 Students' Mental Health Needs: Problems and Responses London: Jessica Kingsley

7. Martin P 1998 The Sickening Mind London: Harper Collins

8. Goldberg D and Huxley P 1992 Common Mental Disorders: A Bio-social Model London: Routledge

9. Meltzer H et al 1995 Psychiatric Morbidity in Private Households London HMSO

10. Surtees P, Wainwright N & Pharoah P, 2000, Student mental health, use of services and academic attainment: a report to the Review Committee of the University of Cambridge Counselling Service

11. Doll H et al, 2000, Eating disorders and emotional and physical well-being: associations between student self-reports of eating disorders and quality of life as measured by the SF-36 Draft Report Health Services Research Unit Oxford: Institute of Health Sciences

12. Sell L & Robson P, 1998, Perceptions of college life, emotional well-being and patterns of drug and alcohol use among Oxford undergraduates Oxford Review of Education 24, 2, 235-243

13. Bird L 1999 The Fundamental Facts: all the latest facts and figures on mental illness. London: The Mental Health Foundation

14. Wyville-Staples P et al. (1998a) The Health of Student at the Oxford Brookes University Health Services Research Unit, Department of Public Health, University of Oxford

15. Samaritans 2002 Web-site samaritans.org.uk

16. Hawton K et al, 1995, Attempted suicide in Oxford University Students 1976-1990. Psychological Medicine 25, 179-188

17. Hawton K et al, 1995, Suicide in Oxford University Students, 1976-1990. British Journal of Psychiatry 166, 44-50

18. HEFCE 2001 The Wider Benefits of Higher Education Higher Education Funding Council for England

19. Harrison J et al 1999 Social determinants of GHQ score by postal survey Journal of Public Health Medicine 21, 3, 283-288

Last edited: 16 06 2009