Although substance use among students has remained largely unchanged, the past year has seen a slight decline in the use of some substances – for instance, in weekly cannabis use and the use of non-prescription sleeping medications and sedatives. As in previous years, alcohol and cannabis were the most frequently used substances. The slight improvement in mental health and the minor decrease in substance use happened in particular between 2021 and 2023, after the COVID-19 pandemic. 

More students received help 

In 2025, more students received counselling or help within or outside educational institutions. The number of students receiving counselling or help for mental health issues only increased between 2021 and 2023. For substance abuse issues, the number also increased between 2023 and 2025. The percentage of students that received counselling or help for substance abuse issues (22%) was considerably lower than the percentage that received counselling or help for mental health issues (66% of students who experienced mental health issues).  

Students’ learning and living environments play crucial role  

The MMMS-2025 shows that students’ mental health and substance use are influenced not only by their personal characteristics or background, but also by their social environment, educational contact and societal circumstances.  

For example, feeling at home and being able to be yourself during your studies is associated with better mental health. Conversely, students who experience considerable stress due to societal circumstances (such as financial worries or global political tensions) feel less well and use more substances. As another example, the use of alcohol and other substances is higher among students who live in student housing than among those who live at home.  

Importance of an integrative approach  

The MMMS-2025 outcomes make it clear that an integrative approach that aims to address multiple factors simultaneously is key to improving student well-being further. Many educational institutions already work with an integrative approach. It is important that they continue with this. An integrative approach focuses on boosting students’ health literacy, taking into account their personal circumstances, as well as on improving the social, educational and societal context in which students live and study. The monitor makes specific recommendations in this regard, such as promoting a culture of responsible substance use.  

Among other things, this will require better cooperation and a greater sharing of responsibilities between the various parties involved, including policymakers and professionals in education, prevention and care, but also the students themselves, their parents and others in their informal networks.  

RIVM and the Trimbos Institute’s Monitor on Mental Health will be published on 9 December 2025. This monitor, which will provide a nationwide overview of developments in the mental health of various age groups, will include the MMMS-2025 outcomes.  

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About the monitor 

The Monitor on Mental Health and Substance Use among Higher Education Students consists of a biannual survey into the mental health and substance use of students in higher education, conducted by the Trimbos Institute, RIVM and the Netherlands Municipal Public Health Services and Medical Assistance in Accidents and Disasters. This survey also identifies the factors associated with improved or worsened mental health and reduced or increased substance use. In addition, it shows the extent to which students have received counselling or help. The first survey was conducted in 2021, the second in 2023. The third survey was conducted in 2025 among more than 27,000 students. The outcomes of the fourth survey will be published in 2027. Find out more about this monitor.