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Cited by 171Mental Health Treatment and AccessStudent Stress and CopingHealthcare professionals’ stress and burnout

University students’ use of mental health services: a systematic review and meta-analysis

Open access
Osborn, T. G., Li, S., Saunders, R., Fonagy, P.·2022·International Journal of Mental Health Systems
DOI 10.1186/s13033-022-00569-0PMC PMC9758037
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Abstract

Background: International estimates suggest around a third of students arrives at university with symptoms indicative of a common mental disorder, many in late adolescence at a developmentally high-risk period for the emergence of mental disorder. Universities, as settings, represent an opportunity to contribute to the improvement of population mental health. We sought to understand what is known about the management of student mental health, and asked: (1) What proportion of students use mental health services when experiencing psychological distress? (2) Does use by students differ across health service types? Methods: A systematic review was conducted following PRISMA guidelines using a Context, Condition, Population framework (CoCoPop) with a protocol preregistered on Prospero (CRD42021238273). Electronic database searches in Medline, Embase, PsycINFO, ERIC and CINAHL Plus, key authors were contacted, citation searches were conducted, and the reference list of the WHO World Mental Health International College Student Initiative (WMH-ICS) was searched. Data extraction was performed using a pre-defined framework, and quality appraisal using the Joanna Briggs Institute tool. Data were synthesised narratively and meta-analyses at both the study and estimate level. Results: 7789 records were identified through the search strategies, with a total of 44 studies meeting inclusion criteria. The majority of included studies from the USA (n = 36), with remaining studies from Bangladesh, Brazil, Canada, China, Ethiopia and Italy. Overall, studies contained 123 estimates of mental health service use associated with a heterogeneous range of services, taking highly variable numbers of students across a variety of settings. Discussion: This is the first systematic quantitative survey of student mental health service use. The empirical literature to date is very limited in terms of a small number of international studies outside of the USA; studies of how services link together, and of student access. The significant variation we found in the proportions of students using services within and between studies across different settings and populations suggests the current services described in the literature are not meeting the needs of all students.

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Crossref · 10.1186/s13033-022-00569-0

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  • High levels of psychological distress in university students are linked to lower academic performance, poorer self-care, relationship breakdowns, and increased dropout tendency.

    “In university students, high levels of psychological distress have been linked to lower academic performance, poorer self-care, breakdowns in relationships, and increased tendency to drop out”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Osborn et al., 2022

    The Background (page not available) says mental health difficulties among university students can have significant consequences, including poorer academic performance and relationship breakdown. It does not mention poorer self-care or an increased tendency to drop out; the consequence it names instead is exclusion from the labour market. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Cost is a primary barrier preventing students from seeking mental health help.

    “A primary barrier was cost, where private services off-campus, or even on-campus paid services were sometimes too costly for students, and therefore not a service made use of by students (Osborn et al., 2022).”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Osborn et al., 2022

    The Discussion (page not provided) says cost was the most common barrier to seeking help among community college students, and the Background lists cost among barriers reported by students. It does not establish cost as a primary barrier for students generally or say that private off-campus and paid on-campus services went unused because they were too costly. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Relationships are often at risk when students face high levels of stress.

    “relationships are often at risk when students face high levels of stress (Osborn et al., 2022).”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Osborn et al., 2022

    The Background (page not provided) says that mental health difficulties among students can have consequences including relationship breakdown. It also says academic and financial pressures may contribute to poorer mental health, but it does not specifically establish that high levels of stress often put relationships at risk. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Factors such as sex, gender, ethnicity, and age often influence help-seeking behaviour more than need.

    “Factors such as 'sex and gender, ethnicity, and age' often influence help-seeking behaviour, more so than need (Osborn et al., 2022).”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Osborn et al., 2022

  • Students who choose not to seek treatment despite psychological distress may fear stigma or have confidentiality or privacy concerns.

    “Students who choose not to seek treatment despite experiencing psychological distress may also fear facing stigma or have concerns of confidentiality or privacy (Osborn et al., 2022).”

    From A Scoping Review of Acceptance and Commitment Therapy in Higher Education (2024) · cites this paper as Osborn et al., 2022

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Authors
Osborn, T. G., Li, S., Saunders, R., & Fonagy, P.
Affiliations
University College London (GB)
Corresponding author
Osborn, T. G.
ORCID
Venue
International Journal of Mental Health Systems
Publisher
Springer Science and Business Media LLC
Published
2022-12-17
Volume
16
Issue
1
Pages
57-57
ISSN
1752-4458 (ISSN-L)
DOI
10.1186/s13033-022-00569-0
PMC
PMC9758037
OpenAlex
W4312067515
Cited by
167
References
81
Citations by year
2026: 66 · 2025: 36 · 2024: 38 · 2023: 27
FWCI
3.78
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Mental Health Systems (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
Funders
NIHR Applied Research Collaboration North Thames
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
student mental health, mental health service utilization, university students, psychological distress, help-seeking, common mental disorders, access to mental health care, adolescent mental health

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