Mental health of students in higher education

More documents

Recommendations

Info

Mental disorder in studentsThere has been a very substantial increase in the numbers of young peopleleaving school and going on to higher education. As opportunities for studyhave arisen for greater numbers of young people who were previously deniedit, students from more socially and culturally diverse backgrounds may beentering higher education. The demographics of the student populationhave also changed, with many more mature and part-time students, andmany students from backgrounds with historically low rates of participationin higher education. The prevalence of important causal factors for mentaldisorder in young people in general has also shown substantial changes inthe past two decades. These include increased rates of family breakdown,consumption of alcohol and illegal drugs, and unemployment. Oneconsequence of all of this is that epidemiological studies conducted in thepast cannot be generalised to the present population of students and hencemay form a poor basis for planning the provision of services.Another significant change is the growing number of internationalstudents studying at UK universities. In consequence, studies of theprevalence of mental disorder in students in other countries are increasinglyof direct relevance to psychiatric practice in the UK. The epidemiology ofmental disorder in students was considered at length in the previous reporton the mental health of students (Royal College of Psychiatrists, 2003).The next section will be confined to a review of some recent studies anddiscussion of general issues around epidemiological research in students.Prevalence of mental disorders in studentsBewick et al (2008) carried out an internet-based survey of mental distressin students in four UK higher education institutions. Students were assessedusing the Clinical Outcomes in Routine Evaluation 10-item measure(CORE-10). This was done as part of a study of alcohol use in students.The researchers found that 29% of students described clinical levels ofpsychological distress. In 8%, this was moderate to severe or severe.The move from home to university is associated with an increasein reporting of psychiatric symptoms. Cooke et al (2006) conducted astudy of students in their first year at a British university using a standardassessment of psychiatric morbidity. Scores increased after students begantheir studies, with anxiety symptoms being particularly prominent. Symptomscores fluctuated in the course of the first year but did not return to preuniversitylevels.Andrews & Wilding (2004) assessed a group of UK undergraduates1 month before starting university and again in the middle of the secondyear, using the Hospital Anxiety and Depression Scale. Students werealso assessed in the second year with respect to stressful or threateningexperiences. By the second assessment, 9% of previously symptom-freestudents had developed depression and 20% were troubled with anxiety ata clinically significant level. Of those previously anxious or depressed, 36%had recovered.In the USA, the National College Health Assessment reported thatone in three undergraduates had at least one episode in the previous yearof ‘feeling so depressed it was difficult to function’ and one in ten described‘seriously considering attempting suicide’ (American College HealthAssociation, 2008). Rates of participation in treatment were low. Of thosediagnosed with depression, only 24% were receiving professional help. Inanother survey of a large cohort in the USA, 6% of undergraduates and 4%Royal College of Psychiatrists23
College Report CR166of postgraduates reported significant thoughts of suicide in the previous year(Drum et al, 2009).Blanco et al (2008) used data obtained in the USA from the NationalEpidemiologic Survey on Alcohol and Related Conditions (NESARC) tocompare the prevalence of psychiatric disorders, substance misuse andtreatment-seeking in young people aged 19–25 who attended college andtheir peers who did not attend college. Around half of young people in theUSA are enrolled in college on a full- or part-time basis. The overall rates ofpsychiatric disorders were no different when students were compared withnon-students. Psychiatric diagnoses were made using DSM-IV criteria. Themost prevalent disorders in students were alcohol use disorders (20.37%)followed by personality disorders (17.68%). In non-students, personalitydisorders were most prevalent (21.55%) followed by nicotine dependence(20.66%). Alcohol problems were significantly more prevalent in students,whereas drug misuse and nicotine dependence were less prevalent. Mentalhealth treatment rates were low for all disorders. Young people with mooddisorders were most likely to have received treatment. The lowest rates oftreatment were for alcohol and drug problems.Specific disordersSome research has focused on specific disorders and examples of this follow.SchizophreniaSchizophrenia is a major mental illness found across the world with anapproximate lifetime risk of between 0.7 and 1.3% of the population. Theannual incidence of schizophrenia is approximately 1 in 10000. The peakage at onset is between late adolescence and early adulthood and as suchstudents may represent a high-risk group. It must be noted that low socialclass and professional achievement may be associated with schizophreniaand thus it may occur less frequently in a student population. Indeed, manypeople who are diagnosed with schizophrenia may be unable to commence orcomplete a university course. In a survey of approximately 14600 studentsregistered with the Leeds Student Medical Practice, only two were recordedas having a diagnosis of schizophrenia (Mahmood, personal communication,2002, quoted in Royal College of Psychiatrists, 2003).DepressionThe estimated prevalence of any depressive or anxiety disorder was 15.6%for undergraduates and 13.0% for graduate students in an internet-basedsurvey in the USA (Eisenberg et al, 2007). A study in Lebanon found that theprevalence of depression in medical students was as high as 28% (Mehanna& Richa, 2006). A further study from Pakistan indicated that the prevalenceof depression in female medical students was 19.5%; 43.7% of this cohortalso reported anxiety (Rab et al, 2008).Bipolar disorderBipolar disorder usually begins in adolescence or early adulthood (commonlywith an episode of depression) but the correct diagnosis is often delayedfor up to 10 years. Recent epidemiological data suggest that exceptionalintellectual ability may be associated with bipolar disorder, placing the24 http://www.rcpsych.ac.uk
Page 1 and 2: Mental healthof studentsin higher e
Page 3 and 4: DisclaimerThis guidance (as updated
Page 5 and 6: Working groupPrincipal contributors
Page 7 and 8: AcronymsAMOSSHE, Association of Man
Page 9 and 10: College Report CR166Epidemiological
Page 11 and 12: College Report CR166Care pathwayThe
Page 13 and 14: College Report CR166Psychiatrists w
Page 15 and 16: College Report CR166Promotion of Me
Page 17 and 18: IntroductionThe purpose of this doc
Page 19 and 20: College Report CR166managing mental
Page 21 and 22: College Report CR166Students who ex
Page 23: College Report CR166Students must a
Page 27 and 28: College Report CR166alcohol use. Fo
Page 29 and 30: College Report CR166driving, unsafe
Page 31 and 32: College Report CR166the first, the
Page 33 and 34: College Report CR166ConclusionsWhen
Page 35 and 36: College Report CR166undergraduates
Page 37 and 38: College Report CR166and the Institu
Page 39 and 40: College Report CR166body. The EHRC
Page 41 and 42: College Report CR166and provision o
Page 43: College Report CR166consultation to
Page 46 and 47: Higher education contextConclusions
Page 48 and 49: Higher education contextMental heal
Page 50 and 51: Higher education contextHealthy Uni
Page 52 and 53: Higher education contextImproving h
Page 54 and 55: Pathways to psychiatric careIn coun
Page 56 and 57: Pathways to psychiatric careand is
Page 58 and 59: What to do if a psychiatric patient
Page 60 and 61: What to do if a psychiatric patient
Page 62 and 63: Mental health issues facedby intern
Page 64 and 65: Mental health issues faced by inter
Page 66 and 67: Medical and other healthcare studen
Page 68 and 69: ReferencesAdams, T. & Moore, M. (20
Page 70 and 71: ReferencesJumaian, A. (2001) Preval
Page 72 and 73: ReferencesSocial Exclusion Unit (20
Page 74 and 75:
Appendix 1understanding of, student
Page 76 and 77:
Appendix 2Internal liaison within h
Page 78 and 79:
Appendix 3Different models of psych
Page 80 and 81:
Appendix 3see this as a step forwar
Page 82 and 83:
Appendix 4I have also been involved
Page 84 and 85:
Appendix 5University general practi
Page 86 and 87:
Appendix 6Initiatives from counsell
Page 88 and 89:
Appendix 6The Westminster mentoring
Page 90 and 91:
Appendix 6to the volunteer and then
Page 92 and 93:
Northampton Assessment CentreUniver
Page 94 and 95:
Appendix 8AimsThe aims of the MWBHE
Page 96 and 97:
Appendix 8Current projectsThe group
show all

Mental health of students in higher education

Create successful ePaper yourself

Delete template?

Save as template?