Mental Health And University: Challenging Transitions


The prospect of attending university is daunting for many young people. From the very first time a teenager is asked, “So where do you think you’ll go for uni?” there are challenging and stressful decisions to be made: 

  • Which schools to apply to?
  • What programmes to choose?
  • Which places to consider moving to?
  • What will it mean to leave home?

And that’s before the start of the often time-consuming and complex application process itself. It is not surprising that many young people feel overwhelmed and frightened heading into their time at university.

For young people struggling with their mental health, those feelings are amplified by a host of other uncertainties. Considering how to continue treatment for an eating disorder, for example, or where to find support for a diagnosis of a mental health condition such as depression, anxiety, or PTSD can add extreme stress to the process for adolescents who may already be finding daily life a challenge.

At The Wave, we often support our young people through the university application process and help them as they prepare to take on the challenge of post-secondary education. We know that this is a time fraught with anxieties and uncertainties, and we work to provide stability and reassurance so that each young person can safely navigate the transition to their school of choice.

Over the next few weeks, our blog will explore some of the challenges of navigating university alongside considerations of mental health, as well as how any young person can ensure their mental health is supported in a post-secondary environment. 

This week, we’re taking a look at the difficulties of the university transition period for young people who are struggling with a mental health condition or complex personality disorder and how individuals and families can work towards maintaining stability during this stressful period of life.

Scaffolding Difficult Decisions

The first challenge facing any young person headed for university is choosing programmes and schools. For many, these decisions are made easier by looking at existing academic strengths and weaknesses – if you’re a maths whizz but have always hated history class, it makes sense to apply for mathematics programmes and not pursue history – but there is nevertheless a great deal of stress involved due to the perceived pressure to choose right.

For individuals who may already be under stress due to a mental health condition or have high levels of anxiety, these decisions can feel crippling. At best, choosing a course and a university may seem like a pointless stab in the dark, and at worst, it could feel like a threatening gauntlet that will place a young person on a path from which they will never be able to diverge. 

At this stage, it is important for all young people to remember that the choice they make when picking a university will not automatically determine the rest of their lives. Choosing a university programme is not a life sentence, and switching courses or schools is not only very possible but extremely normal. It is entirely acceptable to change courses if you don’t enjoy the one you have picked.

According to data from the United States Department of Education, about one-third of students enrolled in bachelor’s degree programmes in America changed their area of study, and one in ten students changed courses more than once.[1] Nor is it uncommon to switch universities altogether. Approximately 3% of students transfer universities in their first year in the UK without detriment to their overall degree success. [2] 

This is especially helpful to remember for young people who find decisions challenging because of the stress they present and the pressure they put on mental health. Working towards understanding that university is part of your life and that you control where and when you go is key to managing anxiety around picking a programme.

Prioritising Support Systems

Many young people feel pressured to pick a course or a university that will offer them academic success and opportunities, believing that this is the only way to succeed in the future. And while there is undoubtedly merit to choosing a programme and a place that will benefit career goals, for those who are struggling with mental health conditions, it is equally important to consider where you are in relation to your support systems.

For young people who have existing issues with anxiety or who know they may be vulnerable if moved far away from their family, friend or community support systems, choosing a nearby university could be far better in the long term than any particular programme, regardless of its opportunities. After all, if you aren’t mentally or physically able to do the work, there is no point in being in the course, regardless of its prestige. With the cost of living crisis escalating as it is, another reason to choose a university close to home may mean that students are able to stay living with parents while completing their degrees. According to a recent poll by Nationwide, a UK based bank – “one in seven university students fear they may become homeless within the next six months as escalating bills, rent and prices pile pressure on their limited finances”.

Understanding The Value of Distance

On the other hand, for individuals who find their existing community or social situations stressful or who have a challenging or traumatic relationship with their family, seeking a bit of distance could be a very good thing. Some young people who have been in treatment for mental health conditions such as depression, anxiety, or eating disorders may actually benefit from the opportunity to build new patterns of behaviour and action if going home could present a risk. 

In this case, choosing a university based on its location can be helpful rather than its accreditation or speciality programme. Cities or countries with strong social welfare systems may be a good place for young people who want to continue treatment in university and build their own support systems based on what they have learned on their recovery journey. 

Or, for young people who have learned to use specific tools to manage their mental health – like visual art, sport or music – picking a place with a vibrant culture in that area could be extremely beneficial to long-term success, both personally and academically.

When transitioning from school to university, it is normal for all young people to feel a certain amount of stress regarding the decision-making processes involved, but those who are struggling with mental health conditions may be even more adversely affected. 

Knowing that the decisions you make in the lead-up to university are not final is a key first step to managing this stressful time. In addition, taking steps to understand the factors at play besides academic standings – for example, family support systems or geographic resources  – can make all the difference in negotiating some of the frightening choices that need to be made in the transition to university.

Next week, we will look at a few universities which are particularly good at providing for students seeking mental health support.


[1] U.S. Department of Education. (2017) Data Point: Beginning College Students Who Change Their Majors Within 3 Years of Enrollment.

[2] Office for Students. (2022) Continuation and transfer rates.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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