Background: Mental-health difficulties are widely reported among university students, but prevalence estimates vary considerably according to the outcome measured, assessment instrument, student population and study context. UK-specific evidence remains fragmented, and combining conceptually distinct outcomes can obscure meaningful variation in the underlying burden.

Methods: A systematic review and meta-analysis were conducted using studies published between January 2012 and August 2022. PubMed, MEDLINE, CINAHL and PsycINFO were searched for peer-reviewed quantitative studies involving students enrolled in UK higher-education institutions. Eligible studies used validated measures of depression, anxiety, poor mental wellbeing or psychiatric caseness and provided sufficient data to derive prevalence estimates. Study quality was assessed using an adapted Newcastle-Ottawa Scale. Outcome-specific random-effects meta-analyses were conducted in R, with heterogeneity assessed using Cochran's Q and I² statistics.

Results: Eight eligible studies contributed 10 independent samples or survey waves representing 12,799 participant observations. The pooled prevalence of depressive symptoms was 37.3% (95% CI 28.1% to 46.4%), anxiety symptoms 43.6% (95% CI 35.5% to 

51.7%), and poor mental wellbeing 41.9% (95% CI 33.9% to 49.8%). Psychiatric caseness was reported in one eligible study at 17.3% and was not pooled. Considerable heterogeneity was observed across the outcome-specific analyses, with I² values exceeding 98%. Variation was evident across measurement instruments, student populations, academic contexts and survey periods.

Conclusion: Depression, anxiety and poor mental wellbeing are common among university students in the UK, although prevalence estimates vary substantially between studies. The findings support outcome-specific interpretation rather than use of a single composite estimate of student mental ill-health. Greater consistency in measurement, sampling and timing of assessment is required to improve comparability and strengthen mental-health surveillance across UK higher education.

Anxiety, depression, higher education, mental health

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