Mental Health in Students

🧭 When to suspect

Students – at school, college and especially university – are at a developmentally high-risk life stage. The peak age of onset for many serious mental illnesses overlaps the student years; first-episode psychosis most commonly emerges between 16 and 30.

The transition to university is itself a recognised trigger – these all land at once:

• Leaving home

• New academic and financial pressures

• The loss of established support networks

Suspect a mental health problem in any student presenting with:

• A change in academic performance

• Social withdrawal

• A change in mood or behaviour

• Disturbed sleep

• Feeling overwhelmed and unable to cope

Presentations are often:

• Somatic: fatigue, headaches, abdominal pain

• Indirect: repeated attendances, or requests for sick notes and extensions

Actively screen for the common and serious conditions in this group:

• Depression

• Anxiety

• Eating disorders

• Substance (alcohol and drug) misuse

• Self-harm and suicidal thoughts

• Psychosis

Ask directly about self-harm and suicide in every at-risk presentation – asking about suicide does not plant the idea or increase risk.

Source: NICE NG222 · NICE NG225