When Elliot Bush first started thinking about university applications, the most pressing issues were module options and grade requirements. As a teenager, Elliot had experienced mental health issues, such as feelings of anxiety and hearing voices. “But it hadn’t affected my school work, and I was still getting good grades, so I didn’t think about it being a big issue at uni,” explains Elliot, who is now 21. But when Elliot left home in Colchester, Essex, to study German and Russian at a Russell Group university, things went downhill. “I was unprepared for uni. Living away from home, everything being new, I didn’t have the proper support in place. I wasn’t sleeping, I found it hard to make friends, I stopped taking my medication because I felt like it wasn’t working well. Five weeks into my first term, I ended up having a breakdown.” Elliot, who identifies as non-binary, took a year out to get well, and then re-applied to university via Ucas, taking a different approach. “I wanted to start again, somewhere new. This time I made sure I was prepared. I went to wellbeing service stands at open days and online; I sought out reviews of how each university handled mental health. I asked how tutors responded, how organised the wellbeing service was, and about the quality of the local GP or campus medical service.” 

Elliot is now studying linguistics at the University of Kent, Canterbury, which has a drop-in counselling service, university wellbeing advisers and mentors who help to liaise with tutors about any practical help needed. “The support has been vital on days when I have felt emotionally overwhelmed.” Elliot’s experience might sound exceptional, but in fact mental health pressures are a growing issue on campus, and the services on offer are increasingly important to applicants. 

The number of students who disclosed a mental health condition almost doubled between 2012 and 2015 to nearly 45,000, according to the Higher Education Statistics Agency. 

In 2015 alone, a record 2,050 students with mental health problems dropped out of university. The number of suicides among full-time students in England and Wales has also jumped - from 75 in 2007 to 134 in 2015. 

Universities are aware of the challenge: their trade body, Universities UK, has recently published new guidance to improve the link between the NHS and care provision at university, admitting that students moving from home to campus “may slip through the gaps in the health system, when they are most vulnerable” 

Prof Steve West, vice-chancellor of the University of the West of England, who chairs UUK’s mental health advisory group, admits that “health services aren’t properly designed to help students as they move from home to university … we must not fail a generation by not doing what is required.” 

While many universities offer counselling, train staff to spot signs of mental illness and have complex care packages in place, not all provide the same level of support. It’s worth would-be students taking a detailed look at what’s on offer. As Elliot puts it: “Sometimes everyone needs a bit of extra support. 

University is exciting, but can also be daunting - for most students its the first time living away from home, making new friends, settling in, alongside academia. Familiarising yourself with the services also means you’ll be able to support a friend should they need help.” No university league table yet includes a measure of pastoral services on offer. 

So what should potential applicants look for? The support available can come under different names, says Sarah Littlejohn, head of counselling at Manchester University. “It might be within counselling or in disability or wellbeing services. On the open day, ask the student union what they think of the support for mental health at their uni. It’s also worth emailing the services themselves to get a feel of how they respond.” If you have to look hard to find out what help is on offer, that could be a warning sign. 

Universities that invest time and effort into services tend to shout about them. If you do have to investigate, look out for how help is available. Is it online? Via phonelines? Workshops? Are there peer-support groups such as those run by the student mental health charity Student Minds? Its website lists the universities nationwide that offer staff-run mental health workshops. 

Are there night-time listening services and access to professional counselling, if it’s needed? Alan Percy, chair of Heads of University Counselling Services and head of counselling at Oxford University, warns that some universities “are using the wellbeing agenda to downgrade or remove altogether professional counsellors and psychologists, replacing them with more generic, non-clinically trained ‘wellbeing support’.” 

 Another important factor for applicants to look at is the speed of services on offer. How quickly can you get help? Worcester University offers a daily mental health triage, meaning students can turn up at short notice to see an expert, and immediate support is available if needed. It also offers a range of regular workshops, from therapeutic support to “fancy a cuppa” drop-ins for students needing to talk or struggling to make friends. “Focus on the quality of the service too,” advises Louise Knowles, head of counselling at the University of Sheffield. “Ask questions such as, ‘does the service offer anything other than one-to-one counselling?’, ‘can it be accessed out of hours, as well as online?’ and, ‘what do students and past users say about the service?’” Also ask whether there is specific support to help students at stressful times such as exams. 

At the universities of Bradford, Nottingham, and Leicester, for example, mental health advisers act as advocates for students with mental health issues within their academic departments, arranging, say, exam breaks or deadline extensions. 

They also support staff to better recognise and help struggling students, and assist students to resolve “off campus” personal issues that are affecting their studies . 

To parents worried about their children, far away for the first time, another thing to look for is whether there is support in halls of residence. They should also ask whether tutors are trained to look out for students feeling depressed or anxious. Wolverhampton University, for example, has trained 450 staff - including security guards, caretakers and cleaners who have regular out-of-hours contact with students - in recognising early warning signs in at-risk students, and how to follow up in a compassionate way. In a recent speech, the minister for universities, Sam Gyimah, described the “disorientating and demanding” university experience and said that universities needed to act “in loco parentis”. 

It was a controversial phrase: nearly all students are legal adults, and universities would disagree that they need to act “in place of parents”. 

On top of that, higher education institutions have strict protocols around confidentiality and will not share students’ health records with parents, despite almost three-quarters of applicants saying they would be willing for their university to contact a parent or guardian about their mental health, according to the Higher Education Policy Institute’s Reality Check report. “The hard thing for parents is getting the balance between offering support but also encouraging their adult children to take responsibility and develop the life skills to cope with challenges and disappointments,” Percy says. “Parents should try to resist the pull to take all responsibility for sorting out their children’s support unless they have genuine concerns, in which case they could notify an appropriate support service, such as counselling.” 

Finally, for sixth-formers with existing mental health issues, it’s a good idea to get organised as soon as you accept an offer, says Rebekah Dussek, a student at Southampton University who has depression and an eating disorder. 

Registering with her university’s “enabling services” months before freshers’ week meant she was invited to a transition day in the summer holidays. “I had the chance to sit down, one on one, with an adviser to talk about my difficulties and needs,” the 20-year-old explains. “It meant that I didn’t have to stress about it - it was all sorted before I even moved in.”