Collegezaal universiteit vol met studenten tijdens college

More than half of students (51%) suffer from mental health issues such as loneliness, pressure to achieve, stress and sleeping problems. Students who use cannabis on a weekly basis or sometimes use non-prescription concentration-enhancing medication are more likely to suffer from such issues. These are the findings of the first national survey into mental health and substance use among students of higher education.

Over 28,000 students from 15 Dutch research universities and universities of applied sciences participated in this survey, which was conducted during the third wave of COVID-19 (March–May 2021). For quite some time, there have been concerns about students' mental health and substance use. The results of the study have confirmed these worries and underline the need for a strong, comprehensive strategy.

Influence of COVID-19

The coronavirus crisis has resulted in a larger number of students suffering from mental health issues such as feelings of anxiety and depression. Compared to other studies conducted prior to the coronavirus crisis, the percentage of students with mental health issues is substantially higher. Figures from the 6-weekly COVID-19 behavioural study¹ show that the timing of this study was significant. During this period (spring 2021), the mental health of young adults reached its lowest point since the start of the pandemic. However, there have been concerns about mental health among students since long before the pandemic. COVID-19 is clearly not the only factor affecting mental health, although it may well be making things worse. For substance use, the picture is less clear.

Substance use among students remains high despite COVID-19

The consumption of alcohol and ecstasy has been strongly affected by the COVID-19 measures for the hospitality industry and events. Nearly half of students who drink alcohol and a third of ecstasy users say that they are consuming less as a result of COVID-19. However, 13% of students used ecstasy in the past year, and 1 in 6 students reported being a heavy drinker. This means they drink at least 4 (for women) or 6 (for men) glasses of alcohol in a single day at least once a week. One-third of students are cannabis users, with 28% of these students saying they have used it more as a result of the coronavirus crisis. Among students who play video games, 40% have stated that they play games more often as a result of the coronavirus crisis and associated measures. We also found that students who are frequent substance users are more likely to have high levels of student debt.

Loneliness, pressure to achieve, stress and sleeping problems

During their studies, young adults are particularly vulnerable to mental health issues. In 75% of cases, mental health issues manifest before the age of 24. This new study shows that students score below average for life satisfaction and resilience and that this correlates with the risk of developing mental health issues. A large group of students reported feelings of loneliness (80%) or pressure to achieve (76%). Many students also reported that, in the four weeks prior to the study, they had experienced high or extremely high levels of stress (62%) and had had sleeping problems (41%). The severity of these problems strongly correlates with lower levels of mental health and a higher risk of mental health issues. Students who perceive higher levels of social support experience fewer mental health issues.

Comprehensive strategy required

To a certain extent, many of the issues reported by students (such as periods of unhappiness or drinking/playing video games more often than usual) are normal. For most students, though not all, they will not result in serious problems. Future mental health issues and problematic substance use can be prevented and/or tackled by boosting students' mental health, focusing on preventive measures, ensuring timely identification of mental health needs and offering the right support. This requires a comprehensive approach based on everyday practice, policy, science and society, implemented together with students. 

The study was conducted by the Trimbos Institute, the Dutch National Institute for Public Health and the Environment (RIVM), the Netherlands Municipal Public Health Services and Medical Assistance in Accidents and Disasters (GGD GHOR Nederland). It was commissioned by the Ministry of Education, Culture and Science and the Ministry of Health, Welfare and Sport. The study will be repeated in the years to come (once every 2 years) in order to monitor developments in mental health and substance use among students.


¹ Conducted by the National Institute for Public Health and the Environment (RIVM), the Netherlands Municipal Public Health Services and Medical Assistance in Accidents and Disasters (GGD GHOR Nederland).