Julieta Galante1,2, Géraldine Dufour1,4, Maris Vainre2, Adam P Wagner2,3, Jan Stochl1,2, Alice Benton1, Emma Howarth2, Peter B Jones1,2; 1University of Cambridge, 2National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England, 3University of East Anglia, 4British Association for Counselling & Psychotherapy
Background: More young people are going to university, but there is concern about an increasing demand for student mental health services. We designed a pragmatic randomised controlled trial to test the hypothesis that providing mindfulness courses to university students would promote their resilience to stress. Methods: University of Cambridge students without severe mental illness or crisis were randomised to join an 8-week mindfulness course adapted for university students (MSS), or to mental health support as usual (SAU). The primary outcome was self-reported psychological distress during the examination period measured using the Clinical Outcomes in Routine Evaluation Outcome Measure. Intention-to-treat analysis was masked to allocation. Findings: In total, 616 students were randomised; 74% completed the primary outcome measure; 59% of the MSS arm participants completed at least half of the MSS course. MSS significantly reduced distress during the exam period compared with SAU (β=-0.44, 95%CI -0.60 to -0.29; p < 0.0001). 57% of SAU participants had distress scores above a validated clinical threshold level compared with 37% of MSS participants (number needed to treat=6). SAU distress worsened over the year whereas MSS scores improved after the course and were maintained during exams. Active monitoring revealed no adverse reactions related to self-harm, harm or suicidality. Other secondary outcomes were measured. Interpretation: Our results replicate evidence from several smaller trials conducted across a range of higher education institutions and countries. Mindfulness training appears an effective component of a wider student mental health strategy. Comparisons with alternative interventions would deepen the evidence.
