Why Universities Should Stop Treating Student Mental Health as a Medical-Student Problem

Universities should stop treating student mental health primarily as a medical-student problem because psychological distress is not confined to medicine, and focusing too narrowly on one discipline can leave equally vulnerable students elsewhere on campus overlooked. Recent evidence from Pakistani university students illustrates the problem clearly: non-medical students in one cross-disciplinary study reported higher depressive and anxiety symptoms than medical students, while academic discipline itself explained only a small proportion of the overall variation in mental-health scores.

That finding does not mean medical students are psychologically protected. Decades of research show substantial depression, anxiety, burnout and help-seeking barriers within medical education. The more useful conclusion is different: universities should resist assuming they already know which faculty contains the students most in need. Mental-health systems should be designed around the whole student population, while still providing targeted support where particular risks are identified.

By Taimoor Asghar

The medical-student mental-health narrative is understandable, but incomplete

Medical education has received considerable attention in mental-health research for good reasons. Students may encounter high academic workloads, repeated examinations, competitive environments, long training pathways and, during clinical education, illness, suffering and death. These pressures have generated an extensive literature examining depression, anxiety, burnout and suicidal thinking among medical trainees.

That evidence matters. The mistake occurs when a well-documented problem becomes an implicit comparison: because medical students experience substantial distress, universities may begin to assume that they necessarily experience more distress than students studying engineering, business, humanities, social sciences or other disciplines.

Those are two different questions.

A high prevalence of depressive symptoms among medical students does not establish that their prevalence is higher than that of students in every other academic field. To answer the comparative question, researchers need samples containing students from different disciplines, ideally assessed using the same instruments, recruitment procedures and analytic framework.

This distinction is particularly relevant in countries where most university mental-health research has historically concentrated on medical colleges. If one group is studied repeatedly while another is rarely measured, the literature can create an illusion that the most frequently studied population is automatically the most affected population.

What our Pakistani student study found

A 2026 cross-sectional study published in BMC Psychology examined 602 undergraduate students from universities in Lahore, Pakistan. The sample included 424 medical students and 178 non-medical students. Participants completed two widely used symptom measures: the Patient Health Questionnaire-9 (PHQ-9) and the Depression Anxiety Stress Scales-21 (DASS-21).

The study did more than compare average scores. It also evaluated the psychometric behavior of the instruments using confirmatory factor analysis, item response theory, measurement invariance and symptom network analysis. Readers who want the complete methods and results can access the BMC Psychology study of PHQ-9 and DASS-21 symptoms among medical and non-medical Pakistani university students.

The simple comparison challenged the expected hierarchy. Median PHQ-9 scores were 10 among non-medical students and 9 among medical students. After adjustment for other measured characteristics, non-medical students also had higher PHQ-9 depression scores and higher DASS-21 depression and anxiety scores. The difference in DASS-21 stress scores was not statistically significant.

These results should not be converted into another oversimplification such as “non-medical students have worse mental health than medical students.” This was a cross-sectional sample from universities in Lahore, not a national census, and the results cannot establish a universal disciplinary ranking.

The more consequential result was that the regression models explained relatively little of the total variation in psychological symptoms. Reported R-squared values were only about 0.029 to 0.041 across the models. Academic discipline mattered statistically in several analyses, but knowing whether someone was a medical or non-medical student told us very little about the full complexity of that individual’s mental health.

Academic major is a weak shortcut for psychological risk

University administrators understandably look for practical ways to allocate limited resources. Faculty membership is visible, easy to categorize and administratively convenient. Mental-health vulnerability is much less visible.

But convenience should not be mistaken for predictive accuracy.

Two students enrolled in different degrees may share more meaningful risk factors than two classmates in the same course. Financial insecurity, inadequate sleep, social isolation, family conflict, discrimination, chronic illness, relationship problems, academic failure, previous mental-health difficulties and uncertainty about employment can cut across departmental boundaries.

The World Health Organization emphasizes that mental health is shaped by interacting individual, social and structural determinants rather than a single exposure. That framework fits university life well. A student’s faculty may influence their environment, but it is only one part of a much larger system.

This is also consistent with the Lahore study. Female students reported higher symptom scores across the measured domains. More sleep was associated with lower PHQ-9 scores, and a history of previous depression treatment was strongly associated with current symptoms. These associations cannot establish causality because the study was cross-sectional, but they illustrate why a single label such as “medical student” or “non-medical student” cannot adequately characterize psychological vulnerability.

Student mental health is a university-wide issue

Broader research reinforces this point. A 2022 meta-analysis involving more than 100,000 college students across 64 studies estimated pooled prevalences of depressive symptoms of 33.6% and anxiety symptoms of 39.0%. The estimates varied substantially between regions, populations and measurement approaches, which is precisely why they should not be interpreted as fixed prevalence rates for every campus.

Still, the scale of the evidence demonstrates that psychological symptoms are not restricted to medical schools. Universities contain large populations of young adults during a period in which many mental-health problems first become apparent. WHO describes depression and anxiety among the leading causes of illness and disability in adolescents and young people, while emphasizing the importance of supportive educational and community environments.

The practical implication is that mental-health strategy belongs at the institutional level, not exclusively inside selected professional faculties.

What gets missed when universities focus mainly on medical students?

1. Distressed students in other faculties may become invisible

When a university’s mental-health messaging repeatedly highlights medical training, students elsewhere may conclude that their own distress is less expected or less legitimate. A business student struggling with severe depression, an engineering student experiencing panic symptoms or a humanities student dealing with persistent hopelessness does not become a lower priority simply because their curriculum lacks clinical rotations.

Institutional systems should detect need rather than assume where need will occur.

2. Resources may follow reputation instead of measured burden

Universities often operate under financial constraints. Counseling capacity, peer-support programs and preventive initiatives cannot always be expanded immediately. This makes evidence-based allocation even more important.

If one faculty receives disproportionate resources because it has a longstanding reputation for being stressful, administrators may inadvertently underinvest in faculties where students have comparable or greater measured needs.

Regular campus-wide assessment provides a better foundation for planning than disciplinary stereotypes.

3. Universities may overlook structural causes of distress

A narrow medical model can also frame mental health primarily as an individual clinical problem: identify the symptomatic student and refer that person for treatment.

Clinical care is essential for students who need it, but universities also influence many environmental conditions that affect well-being. Assessment scheduling, excessive workload clustering, housing insecurity, harassment, financial pressures, social belonging, disability accommodations, academic advising and access to recreational spaces can all influence student experience.

WHO’s mental-health framework explicitly recognizes that prevention requires action on social and structural determinants, often outside traditional health services. Universities therefore have responsibilities that extend beyond providing a counseling office.

4. Prevention may begin too late

If mental-health services are designed mainly for students who have already reached a clinical threshold, universities lose opportunities for earlier intervention.

Population-level approaches can include orientation programs explaining where support is available, mental-health literacy campaigns, faculty training to recognize concerning changes, peer-support systems, sleep and workload initiatives, digital support options and clear pathways from low-intensity assistance to professional assessment.

None of these should replace psychiatric or psychological treatment when treatment is indicated. Their role is to make support easier to reach before academic, social or health consequences become more severe.

A better model: universal support plus targeted intervention

The alternative to focusing disproportionately on medical students is not to treat every student identically. Some populations genuinely face distinctive risks. International students may encounter isolation, language barriers or immigration uncertainty. Students with disabilities may experience accessibility challenges. Clinical trainees may encounter emotionally difficult patient care. Students experiencing financial hardship may face another set of pressures.

The strongest model therefore combines universal and targeted approaches.

Universal layer

Every student should have access to a basic mental-health infrastructure regardless of faculty. This could include:

• clear information about counseling and crisis pathways;
• confidential and accessible routes to professional assessment;
• mental-health literacy during orientation;
• reasonable academic policies around illness and temporary impairment;
• training for selected staff who routinely interact with students;
• support for sleep, physical activity, social connection and healthy study practices;
• anti-stigma communication that applies across the institution.

Targeted layer

Universities can then add interventions for populations in which local data reveal elevated need. Importantly, those decisions should be based on measured patterns rather than inherited assumptions.

If engineering students at one university report unusually high anxiety, that faculty may require additional support. If medical trainees demonstrate burnout related to clinical placements, the intervention should address those placements. If first-year students across all departments report loneliness, then the response should be institution-wide but concentrated around transition periods.

This model allows universities to remain sensitive to subgroup differences without defining student mental health by academic major.

Screening should inform care, not label students

The Lahore study used the PHQ-9 and DASS-21 as symptom measures. Both demonstrated generally adequate reliability in the sample, and measurement invariance across discipline supported meaningful comparison between medical and non-medical groups.

However, screening questionnaires are not psychiatric diagnoses. A PHQ-9 score can help quantify depressive symptoms and identify people who may benefit from further assessment, but it cannot by itself determine the cause of those symptoms or establish an individualized treatment plan.

The same principle applies when universities collect population-level mental-health data. Screening results should guide prevention, service planning and appropriate referral pathways rather than create labels attached to particular faculties.

There are also practical questions that institutions must answer before launching screening programs: Who reviews concerning responses? How quickly can a high-risk student receive assessment? What happens when counseling services are already full? How is confidentiality protected? What emergency pathway exists for students reporting immediate safety concerns?

Collecting symptom scores without building a responsible response system can create the appearance of action without providing meaningful support.

Symptoms themselves may matter more than disciplinary labels

Another useful finding from the 2026 study came from item response theory and symptom network analysis. Certain symptoms, particularly those involving self-worth, concentration and feeling down or downhearted, emerged as comparatively informative or central within the statistical analyses.

These methods should be interpreted cautiously. A highly central network node is not automatically the cause of other symptoms, and item discrimination is a psychometric property rather than proof that one symptom is clinically more important than every other symptom.

Still, these findings reinforce an important conceptual shift. Instead of asking only, “Which faculty is this student in?” universities may gain more useful information by asking what the student is actually experiencing.

A student who cannot concentrate, feels persistently worthless, has stopped enjoying usual activities and is sleeping poorly deserves attention regardless of whether their ID card says medicine, computer science or economics.

Mental-health services must also address barriers to help-seeking

Providing services does not guarantee that students will use them. Systematic research on university help-seeking has identified recurring barriers including stigma, preference for self-reliance, uncertainty about whether symptoms warrant professional care, confidentiality concerns and difficulties accessing services.

A campus-wide strategy should therefore make support psychologically as well as physically accessible. Students need to know that seeking help is appropriate before a crisis develops and that using mental-health services will not automatically produce academic or professional penalties.

Communication also matters. If university campaigns repeatedly portray counseling as a service for students in extreme distress, those experiencing moderate but worsening symptoms may wait. If services are described only through diagnostic language, students who do not identify themselves as having a mental disorder may never approach them.

A stepped system can offer multiple entry points: reliable self-help information, peer support, brief counseling, primary-care assessment, psychological therapy and specialist psychiatric services when necessary.

What university leaders can do differently

A practical institutional strategy does not require universities to abandon specialty programs. It requires changing the order of reasoning.

Instead of deciding that a particular faculty is the mental-health priority and then searching for evidence to support that assumption, administrators can begin by measuring needs across the institution.

1. Collect representative campus-wide data. Include students from multiple faculties, years of study and demographic groups rather than relying on whichever department is easiest to survey.
2. Track more than average symptom scores. Examine service use, waiting times, academic disruption, sleep, loneliness, financial strain and other locally relevant indicators.
3. Identify vulnerable subgroups empirically. Faculty may be one relevant variable, but it should compete with other explanatory factors rather than automatically dominate the analysis.
4. Provide a universal minimum level of support. Every student should know how to access confidential assistance.
5. Add targeted programs where evidence supports them. Medical students can and should receive tailored programs when their training environment creates specific risks, just as other groups should when their circumstances warrant additional intervention.
6. Evaluate whether programs work. Participation counts alone are insufficient. Universities should assess accessibility, student experience, symptom change where appropriate and whether disparities in access are narrowing.

The goal is not to decide which students have it worst

Comparisons between academic disciplines can easily become an unhelpful competition over which group suffers more. That is not the purpose of this research.

Medical students face genuine pressures, and extensive research documenting those pressures should continue. The Lahore findings do not invalidate that evidence. They demonstrate why universities should be cautious about extrapolating from it.

In this sample, non-medical students reported higher depressive and anxiety symptoms on several measures. More importantly, discipline accounted for only a small amount of the overall variation. The psychological lives of students were considerably more complicated than their academic category.

That is the policy lesson universities should take seriously.

Student mental health should be treated as a campus-wide responsibility supported by universal prevention, accessible professional care, continuous measurement and targeted interventions based on demonstrated need. Medical schools remain part of that system, but they should not define its boundaries.

When universities stop asking which degree is supposed to produce the most distressed students and start asking which students actually need support, mental-health policy becomes both more equitable and more evidence-informed.

Medical disclaimer: This article provides general educational information about student mental health and research findings. Screening questionnaires and population-level findings do not diagnose an individual mental-health condition. Anyone experiencing persistent psychological symptoms, significant impairment or concerns about personal safety should seek assessment from an appropriately qualified healthcare or mental-health professional. Urgent or emergency concerns require prompt local professional assistance.