B4056 - How does university attendance impact on mental health trajectories of young people - 03/05/2022

B number: 
Principal applicant name: 
Peter Fonagy | UCL
Mr Tom Osborn, Doctor Rob Saunders, Professor Will Mandy
Title of project: 
How does university attendance impact on mental health trajectories of young people
Proposal summary: 

The mental health of university students is a growing public health concern (1). Findings from population-based studies in the USA, UK and Norway point to a significant increase in mental distress among students over the last decade (2-5). Around 5% of young people in the UK have a diagnosis of either anxiety or depression, and the rate of people attending university has doubled in the past twenty years (6). For many the transition to university coincides with a developmentally high-risk period for the emergence of mental health concerns (7-9). This risk may be made worse by the need to adjust to a new social and academic environment whilst at the same time becoming financially independent (8, 10). This period could be particularly risky for students who have faced adversity, are socially disadvantaged (11), or for people who find it harder adjust to new social groups (8, 9). Few long-term studies have looked at these issues (12). While some evidence has shown how many students are likely to experience a mental disorder and use a mental health service at university (13); we do not currently know how much mental health need occurs prior to university attendance. By understanding this and any risk factors for the emergence and development of mental health need at this transition we could inform support-based prevention for students. This study aims to use data collected in ALSPAC to understand the risk university attendance poses on mental health and service use for a mental health reason among young people.

1. Barkham M, Broglia E, Dufour G, Fudge M, Knowles L, Percy A, et al. Towards an evidence-base for student wellbeing and mental health: Definitions, developmental transitions and data sets. Counselling and Psychotherapy Research. 2019;19(4):351-7.
2. Knapstad M, Sivertsen B, Knudsen AK, Smith ORF, Aarø LE, Lønning KJ, et al. Trends in self-reported psychological distress among college and university students from 2010 to 2018. Psychological Medicine. 2021;51(3):470-8.
3. Lipson SK, Lattie EG, Eisenberg D. Increased Rates of Mental Health Service Utilization by U.S. College Students: 10-Year Population-Level Trends (2007-2017). Psychiatric services (Washington, DC). 2019;70(1):60-3.
4. McManus S, Gunnell D. Trends in mental health, non‐suicidal self‐harm and suicide attempts in 16–24-year old students and non-students in England, 2000–2014. Social Psychiatry and Psychiatric Epidemiology. 2020;55(1):125-8.
5. Tabor E, Patalay P, Bann D. Mental health in higher education students and non-students: evidence from a nationally representative panel study. Social Psychiatry and Psychiatric Epidemiology. 2021;56(5):879-82.
6. Boero G, Nathwani, T., Naylor, R., Smith, J. Graduate Earnings Premia in the UK: Decline or Fall. Higher Education Statistics Agency (HESA): HESA; 2021.
7. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359-64.
8. Lei J, Brosnan M, Ashwin C, Russell A. Evaluating the Role of Autistic Traits, Social Anxiety, and Social Network Changes During Transition to First Year of University in Typically Developing Students and Students on the Autism Spectrum. Journal of Autism and Developmental Disorders. 2020;50(8):2832-51.
9. Adams KL, Saunders KE, Keown-Stoneman CDG, Duffy AC. Mental health trajectories in undergraduate students over the first year of university: a longitudinal cohort study. BMJ Open. 2021;11(12):e047393.
10. McCloud T, Bann D. Financial stress and mental health among higher education students in the UK up to 2018: rapid review of evidence. Journal of Epidemiology and Community Health. 2019;73(10):977-84.
11. Cullinan J, Walsh S, Flannery D. Socioeconomic Disparities in Unmet Need for Student Mental Health Services in Higher Education. Applied Health Economics and Health Policy. 2020;18(2):223-35.
12. Lewis GM, T. Callender, C. Higher Education and Mental Health: Analyses of the LSYPE cohorts: research reports. In: Education. Do, editor. 2021.
13. Eisenberg D, Hunt J, Speer N. Help seeking for mental health on college campuses: review of evidence and next steps for research and practice. Harvard review of psychiatry. 2012;20(4):222-32.

Impact of research: 
The findings from research aim to be published in a peer reviewed open access journal where the implications and recommendations for health service practice and policy can be disseminated. Findings will be shared at relevant academic and health service conferences. The authors are part of current policy initiatives at UCL Partners, the National Institute of Health Research Applied Research Collaboration, and PsychUP for Wellbeing at UCL in London and the UK to strengthen and implement policy initiatives aiming to improve student mental health. The results will directly inform the implementation of these initiatives.
Date proposal received: 
Wednesday, 20 April, 2022
Date proposal approved: 
Monday, 25 April, 2022
Mental health - Psychology, Psychiatry, Cognition, Mental health, Statistical methods, Childhood - childcare, childhood adversity