Students׳ mental health and psychological counselling in Europe

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Abstract

Facts and figures on mental health of students and the provision of counselling services will be presented in this article, gathered by the former European Student Counsellors network Forum Européenne de l׳Orientation Académique/European Forum on Student Guidance (FEDORA). The Center for Academic Advising and Psychological Counselling of the Freie Universität in Berlin can serve as an example for a typical institution. After the Bologna reform in Europe, putting students under more stress than before, and ever more students coming to European universities with preexisting mental conditions and subsequent adjustment issues, integrated learning support and mental health strategies are called.

Introduction

Since long, an overview of the worldwide lay of the land in regard to students׳ mental health and Psychological Counselling in Higher Education, as provided now in this issue of Mental Health and Prevention (Holm-Hadulla & Koutsoukou-Argyraki, 2015), was missing. From a European perspective, an EU Consensus paper on Mental Health in Youth and Education stated in 2008, that

“there is to date no set of indicators that can be used comparably across EU-Member States. Such indicators set should include the prevalence of mental disorders in children and adolescents (currently being monitored not systematically at the country level using different tools and methodologies), indicators for positive mental health, and infrastructural/resource information such as children׳s per capita spending on mental health and service provision, quality of services and continuity.” (Jané-Llopis & Braddick, 2008, 21).

The same is true for data on the mental health of students in Europe.

Generally speaking, though, with regard to European student׳s mental health, there is good and bad news. The good news is: statistically, students are better off than the rest of the general population. In Germany, data from a recent health survey showed that 33,3 per cent of the population between the ages of 18 and 65 suffered from some kind of mental disorder (German Health Interview & Examination Survey, 2011). According to statistics from a survey on students, only 11% of the student population are diagnosed with mental disorders (Isserstedt, Middendorf, Fabian & Wolter, 2007, 395). Even when looking at higher figures of 20–25% of students with psychological disorders in past surveys and recent studies (e.g., Holm-Hadulla et al., 2009, National Union of Students, 2013), there remains a striking difference. This is true for most countries in the EU and the US as well, even when the years of assessment differ (Figure 1).

The bad news, on the other hand, is a growing prevalence of mental illness among young people observed since the last 15 years. A proportion of this might be due to more attention given to mental health in general, more thorough diagnoses and more treatment options. These explanations aside, however there seems to be a real increase in the numbers of young people afflicted.

Students suffering from mental disorders are mostly diagnosed with depression, anxiety and problems with self-worth regulation. Compared to young people of the same age not studying, there is a much higher prescription rate of anti depressive medication. No other disease impairs the ability to carry on with the studies like mental health problems: in a German survey, 91% of those afflicted report an inability to pursue their course work (Isserstedt et al., 2007, 40).

As early between 2000–2004, a considerable increase in students with mental health problems had been reported in a survey comprising 18 universities in the UK: Bristol +29%, Leeds +59%, Southampton +69%. More severe problems were observed: in 2004, Cambridge reported 43 suicidal students, 56 suffering from bulimia/anorexia, and 70 with self-harm problems. The TIMES concluded in an article in 2005: “It is estimated that one of four students will experience some form of mental distress during their time at university…mental health is no longer a minority (The Times Online, 2005) (Figure 2).

Mental health issues of students are quite often a topic in news coverage, more so in the north of Europe (UK, Sweden, Norway, Germany) than in the south.1 At the political level, the European Union for School and University Health and Medicine (2007) published a Declaration on Student Health Care in Europe.

Section snippets

A mental health risk factor: the burden of stress

Many students feel burdened by stress. Various newspaper articles and TV-sources reported that in Sweden, the quota of students who felt stressed increased from 52% in 2007 to 70% in 2010. In Germany, 59% of students complained about stress, in Austria 61%. In the US, 85% of the students reported to suffer from stress.

According to data provided by a recent survey in Germany, students perceived too high achievement demands, the examination phase at the end of the semester, “bulimic” learning

Mental disorders and stress interact with identity development

Being a student involves finding solutions to issues like separation from parents/family, questions of purpose in life and orientation towards goals, relationships, a balance between work, studying and private life, and finances. All this is part of identity development. A main task in adolescence is generating and maintaining a congruent feeling of personal identity. This process is going along with crises, anxiety and self-doubt. To develop the ability to positively cope with crises builds

Provision of Psychological Counselling services

In 1994, a first survey on “Psychological Counselling in Higher Education – A European Overview” was published (Bell, McDevitt, Rott & Valerio, 1994). Data were collected by PSYCHE, the Psychological Counselling in Higher Education working group, established by the Forum Européenne de l׳Orientation Académique/European Forum on Student Guidance (FEDORA). National reports came from Belgium, Germany, Denmark, France, Greece, the United Kingdom, Italy and the Netherlands. In 2008, an update of this

Structural quality

The above mentioned report by FEDORA (Katzensteiner, Ferrer-Sama & Rott, 2008) stated: “The main difference between Psychological guidance services and others is, that they are staffed by highly qualified personnel” (332). Most psychological counsellors have a strong academic background in the psychological science. In lots of countries, laws regulate qualifications for those offering psychological treatment, psychotherapy and in some cases Psychological Counselling as well. In Germany, most of

Problems dealt with

According to the FEDORA, 2006, problems reported as most prominently dealt with in the services varied somewhat between nations (Figure 4).

In countries like Greece and Turkey, psychological counsellors in universities often also were involved in smoking cessation campaigns. Psychological Counselling is offered in individual sessions and group sessions. Formats range from two-hour-workshops to term-long training courses. Individual treatment can last between one to ten sessions, with an average

Methods applied

In most European countries, Cognitive Behavior Therapy (CBT) is the dominating intervention method in Psychological Counselling. Traditionally, Psychological Counselling in the UK has a strong background in psychodynamic and psychoanalytic theory and practice. Psychological Counselling has always been a field open to eclectic combination of approaches in order to do justice to the developmental stage of the patients and the various, simultaneously important aspects of life phase they are in.

International students׳ mental health

Increasing worldwide mobility has brought more and more international students to European universities. International students face the same life events and stressors as other students, but also additional pressures without the support system from friends and family home. The transition from one academic system to another can be confusing. Adjusting to a foreign culture can bring about a sense of loss in regard to native language, security and the self. Culture shock, loneliness, problems of

Outlook: mental health and learning support policy

Universities need to develop a holistic view of students with emphasis on the fact that successful academic learning is interrelated with personal growth and development. The enormous competition among HE institutions worldwide in recruiting international students calls for a special sensitivity to their well being and success. Thus, institutions are well advised to implement a mental health and learning support policy, involving:

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    training and awareness raising strategies, including the

Conflict of interest

A conflicting interest exists when professional judgement concerning a primary interest (such as patient׳s welfare or the validity of research) may be influenced by a secondary interest (such as financial gain or personal rivalry). It may arise for the authors when they have financial interest that may influence their interpretation of their results or those of others. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert

Funding source

All sources of funding should also be acknowledged and you should declare any involvement of study sponsors in the study design; collection, analysis and interpretation of data; the writing of the manuscript; the decision to submit the manuscript for publication. If the study sponsors had no such involvement, this should be stated.

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