Mental health of students in higher education

College Report CR166Epidemiological studies conducted more than 10–15 years ago cannot begeneralised to the present population of students and hence may forma poor basis for planning the provision of services. The growing numberof international students at UK universities means that estimates of theprevalence of mental disorder in students carried out in other countries areincreasingly of direct relevance to psychiatric practice in the UK. We have notattempted an exhaustive epidemiological survey but have focused on studiesthat provide data on the prevalence of mental disorders in different studentpopulations and trends over time.There is a need for long-term prospective research covering a rangeof higher education institutions to obtain a full picture of mental disorderin students. One development that may assist this process is the use ofinternet-based survey methods. Nearly all students now have a universityor college email address and access to the internet. Campus-wide emailsystems have already been used to recruit cohorts of students. Studentsseem to be willing to participate in surveys using this method and responserates have been highly satisfactory.Disability discrimination legislationIn the past 15 years, disability discrimination legislation has become ofincreasing importance in the context of mental disorder in students. Thisreport provides a detailed account of the history and current status of thislegislation. In September 2002, the Special Educational Needs and DisabilityAct 2001 (SENDA) extended the Disability Discrimination Act 1995 (DDA)to include education. Education providers now have a legal responsibility tostudents with disabilities, including those with severe or enduring mentalillnesses. The requirement for institutions to meet their legal obligationshas provided a further stimulus to the development of specialist services forthese students. The DDA laid down that there is a duty of care incumbenton higher education, with the potential for legal redress if ‘reasonableadjustments’ are not made, for instance by making adjustments in thestudy environment to compensate for disabilities. In addition to reasonableadjustments, the DDA stipulates that there is a positive duty to promote theequality of students and staff with disabilities.Student counsellingNearly all higher education institutions offer counselling services to students.A recent survey indicated that across the UK approximately 4% of universitystudents are seen by counsellors each year for a wide range of emotionaland psychological difficulties. Counsellors working in higher educationoffer their professional skills and can also utilise their understanding of theconnections between psychological and academic difficulties, their knowledgeof the educational context and their integration with the wider institution.No counselling service would undertake the diagnosis or treatment of severemental illness but all would consider it important to be sufficiently wellinformed to recognise the various forms of mental illness and to know whenreferral to medical and psychiatric services is necessary. The establishmentof links to these services for consultation and referral has always been seen8 http://www.rcpsych.ac.uk