Mental health of students in higher education

College Report CR166alcohol use. For this reason, frank dependence is rare in young people. Themain problem in students is harmful or hazardous drinking. In a Newcastlestudy, only 11% of the students did not drink alcohol (Webb et al, 1996).Among those who did, 61% of the men and 48% of the women exceeded‘sensible’ limits (21 units per week for men and 14 for women). Hazardousdrinking (≥51 units per week for men, ≥36 for women) was reported by15% of those who drank alcohol, whereas binge drinking was declared by28%. This pattern was confirmed in a study of undergraduates in Aberdeen(MacCall et al, 2001), where 50% of men and 34% of women exceededsensible drinking limits, 11.5% of men and 5.2% of women were drinking athazardous levels and 9.4% of students reported no alcohol use.The Harvard School of Public Health College Alcohol Study surveyedstudents at a representative sample of colleges on four occasions between1993 and 2001; more than 50 000 students in 120 colleges took part. Amongthose who drank alcohol, 48% reported that getting drunk was an importantreason for consuming alcohol, 23% were drinking 10 or more times in thecourse of a month and 29% reported being intoxicated 3 or more times in amonth (Wechsler & Nelson, 2008). Caldeira et al (2009) identified high levelsof problematic use of alcohol and marijuana in a cohort of undergraduates inthe USA. A further concern was that only a small minority of these studentsrecognised that there was a problem or sought professional help.These high levels of alcohol use are a concern in themselves. Theyrender students vulnerable to ill health and academic underperformanceand place them at risk of accidental harm and assault. There is also the riskthat heavy drinking is the precursor of a longer-term pattern of hazardousdrinking, with the consequent risk of dependence.Krebs et al (2009a) found that 20% of US women undergraduates hadexperienced some form of sexual assault in the time that they had been atcollege or university. In most cases, the victim had voluntarily consumedalcohol before the assault. Women who consume more alcohol and who getdrunk more often are more likely to be victims of sexual assault. Mohler-Kuo et al (2004), using data from the Harvard School of Public HealthCollege Alcohol Study, found that 4.7% women reported being raped. Nearlythree-quarters (72%) of these victims experienced rape while intoxicatedwith alcohol. The risk of rape while intoxicated was higher in women whowere aged under 21, were White, resided in sorority houses, used illicitdrugs, drank heavily in high school and attended colleges with high rates ofheavy episodic drinking. Reed et al (2009), in an online survey of students,found that all forms of substance misuse were associated with physicalvictimisation in men and with sexual victimisation in women. Substance usewas common in the perpetrators of both types of violence.Drug misuseMacCall et al (2001) surveyed recreational drug use in undergraduates inAberdeen. The most commonly used drug was cannabis – 22% had used itonce or twice, 23% had used it more than once or twice and 17% were usingit regularly. Regular use of other drugs was rare: 3.7% of undergraduatessaid that they used amphetamines regularly and 3% stated that theyregularly used ecstasy. Only 5% had ever used opiates and less than 1%used opiates regularly.The problem of misuse of prescription drugs is one that has achievedgrowing prominence in recent years. The UK, the USA and Canada havesome of the highest prescribing rates in the world for medications for26 http://www.rcpsych.ac.uk