Mental Health of university students in Germany
“One in four students in Germany feels strongly stressed. Almost equally high is the proportion of those who report exhaustion.” This is the result of a 2018 online study on mental health of students in Germany including data from about 6200 students, which was performed by the German Center for University and Science Research (DZHW), the FU Berlin and the Techniker Krankenkasse (TK). According to this survey, psychological distress is particularly high among female students. With one fifth complaining about symptoms of the so-called “generalized anxiety disorder”, these women reported frequent nervousness, anxiety or tension as well as a lack of control over their own worries. Every sixth female student showed signs of a depressive syndrome, i.e. often felt downcast, melancholic or hopeless and lost interest and joy. Another very recent study revealed high lifetime (69.3%), past year (45.9%) and past month (28.3%) prevalence of illicit substance use in a sample of 9.351 Berlin college students, with the numbers being higher than in the general German population (Viohl et al., 2019).
These are alarming facts. Latest health reports in Germany consistently pointed to the increasing importance of mental disorders regarding vocational impairment. According to data from representative studies, about every third to fourth adult suffers at least one mental illness (Jacobi et al., 2014). The lifetime risk of being affected by a mental disorder at some point in your life is estimated at over 50%. This seems dramatically high, but is quite comparable to the numbers for physical illnesses (about 60% lifetime risk).
Students have long been portrayed as a very healthy cohort, young, dynamic and self-reflective, coping with the transition from education to entry into working life. In the early 1970s, attention was focused for the first time on mental disorders in students, and psychological and psychotherapeutic counseling and treatment facilities were set up. However, these facilities exclusively treated students with mental illness. Therefore, the emotional burden of students remained unclear for several decades.
Broader awareness was first raised by the health report of 2011 by the Techniker Krankenkasse (Gesundheitsreport 2011), which was based on data from approximately 140,000 students, and allowed a more differentiated view pointing to a different picture: Psychopharmaceutical consumption among students doubled from 2006 to 2010 and compared to same age women and men who were not studying but working the number of visits to psychotherapists was much higher than those of the peer group. Overall, these numbers indicated that about 21% of students suffer from a mental disorder (general population: 20%). More particularly, there was a significant increase after the age of 26 years, i.e. older students and doctoral students seem to be particularly affected. At the age of 31, male students are treated about twice as often as male workers with antidepressants, and female students are more than 60% more likely to be affected than female workers. Especially for mood disorders (mostly depression), anxiety disorders (especially examination and existence anxiety), but also somatoform and eating disorders, a special need has been identified.
These initial numbers have been repeatedly reported within the last years (see also Arztreport Barmer, 2018), indicating that students’ mental health is an important topic that should not be neglected in times of excellence (referring to the University of Tübingen being successful in the Excellence Strategy 2019).
These figures clearly show that studying does not “protect” one from mental disorders and clearly speak against the stereotypes portrayed above. The onset of the disease often falls into adolescence and early adulthood. However, the onset of a mental disorder during this period is often not properly recognized or treated with the consequence that the condition may worsen and become chronic. It is precisely this critical episode – the academic study period – that is often associated with maturing crises and social problems in which students have to master a variety of developmental tasks: learning an academic style of work, transforming relationships with parents and peers, establishing new relationships and developing new emotional and intellectual values. Also, the increased amount of side jobs, often necessary to finance the studies, causes students to experience a double burden, which may be linked to an increase in mental disorders. According to the report of the German Student Union 2011, the number of compulsory courses increased by the restructuring of the degree programs within the framework of the Bologna Reform, the prescribed performance per semester and the preparations for numerous credits also lead to higher strain. In addition, students are increasingly putting pressure on competition as a cause of mental discomfort, but also perceive some system acceleration (such as shortening study time), which can create stress and thereby facilitate the onset of a mental disorder.
At the moment, students often experience their studies as a mere succession of exams and feel the constant pressure to earn enough credits to quickly graduate. However, one cannot blame the universities (and the academic system) alone, many students bring extremely high and ultimately unfulfillable expectations of themselves into their studies, which cause strong internal pressure.
What can we do?
Different courses, for example, on techniques of work organization, self-organization or stress management can help to spread the knowledge on how the study phase can be well planned and managed. This requires significantly increased financial resources, but they are well invested. After all, those who have learned to deal with mental stress in a good and efficient way during their studies will benefit considerably in their later personal and professional lives. This can only be in the interest of us all.
Who can help?
In Tübingen several services are available for students and employees of the University:
- Zentrale Studienberatung, Email: firstname.lastname@example.org,
- Psychotherapeutische Beratungsstelle des Studierendenwerks Tübingen-Hohenheim, Email: email@example.com
For employees (including PhD students with a contract with the University):
- Psycho-soziale Beratungstelle. Here you can ask for counselling in German and English: Mrs Polen-Beer (firstname.lastname@example.org), Mrs Mauch (annette.mauch@
Jacobi F, Höfler M, Strehle J, …, Wittchen HU. 2014. Psychische Störungen in der Allgemeinbevölkerung: Studie zur Gesundheit Erwachsener in Deutschland und ihr Zusatzmodul Psychische Gesundheit (DEGS1-MH). Der Nervenarzt, 85:77–87. [Mental disorders in the general population: Study on the health of adults in Germany and the additional module mental health (DEGS1-MH)].
Viohl L, Ernst F, Gabrysch J, Petzold MB, Köhler S, Ströhle A, Betzler F. 2019. “Higher education” – substance use among Berlin college students. Eur J Neurosci, doi:10.1111/ejn.14340.
Birgit Derntl is a clinical psychologist and Professor in the field of Innovative Neuroimaging at the Department of Psychiatry and Psychotherapy.
Jennifer Svaldi is Professor and head of the department of Clinical Psychology and Psychotherapy at the Faculty of Science, Department of Psychology. She is also head of the affiliated Psychotherapy Outpatient Service.