Mental Health Services for Medical Students in Poland: 2025 Update of a National Evaluation

Abstract

Background: The mental health of medical students is a global concern, with high rates of depression, anxiety, burnout, and suicidal ideation. Despite growing awareness, mental health services in higher education remain inconsistent and underfunded in many countries. Poland represents a particularly vulnerable case, with a rapidly expanding medical education sector, limited public investment in student mental health. This study presents the third edition of a nationwide assessment evaluating psychological support services for medical students across all accredited Polish medical universities in 2025. Methods: An 11-item questionnaire was administered to all 33 Polish universities offering medical degree programmes. The questionnaire assessed service availability, delivery modalities, language accessibility, funding, communication strategies, crisis response, and targeted support for vulnerable student groups. Data collection took place between January and March 2025, with a response rate of 79% (N = 26). Results: Out of 26 institutions, 25 reported offering some form of psychological support for medical students. Services were free of charge at most universities and typically managed by internal university units. Hybrid delivery models were predominant (84%), while only 48% imposed no limit on the number of consultations. Multilingual support was available at 84% of institutions, and 80% provided supplementary mental health initiatives, such as workshops and mindfulness sessions. However, only 36% offered targeted services for at-risk groups, and just one institution published data on service utilization. Significant disparities were observed in funding, scope, accessibility, and evaluation practices. While some institutions demonstrated innovative and inclusive approaches, many lacked integration, transparency, and sustainability. Conclusions: Despite measurable progress since 2019, psychological support for Polish medical students remains fragmented and reactive. While many academic institutions have taken meaningful steps to support student mental health, lasting and equitable change might require systemic coordination and long-term investment. Without it, even the most dedicated local efforts risk being insufficient- ultimately undermining not only students’ well-being, but also the quality, safety, and sustainability of the future healthcare workforce.

1. Introduction

In 2024, the Organisation for Economic Co-operation and Development (OECD) estimated that mental ill-health absorbs approximately 4% of gross domestic product (GDP) across member countries, primarily due to lost productivity and early withdrawal from education and employment (OECD, 2021). In response, the World Health Organization (WHO) has emphasized the need to position universities as critical environments for population-level mental health promotion, given their dual role in training future healthcare providers and modelling institutional well-being. WHO urges member states to implement “learn-well” strategies that embed psychological safety into curricula and campus life (Comprehensive mental health action plan 2013–2030, 2021; World mental health report: Transforming mental health for all, 2022). Over the past decade, the psychological cost of medical training has become increasingly visible, transforming into a global issue for health education (Cotobal Rodeles et al., 2025; Di Vincenzo et al., 2024; Rotenstein et al., 2016). Prevalence of anxiety, depression, burnout, and suicidal ideation among medical students significantly exceeds that of their non-medical peers (Dyrbye et al., 2014; Quek et al., 2019; Rotenstein et al., 2016). A recent meta-analysis pooling data from over thirteen hundred thousand students across forty-five countries reported combined prevalence rates of 45% for anxiety and 48% for depression (Lin et al., 2024). Despite growing recognition of these patterns, help-seeking behaviours of students remain consistently low. Barriers include stigma, confidentiality concerns, perceived lack of time, and doubts about the effectiveness of available support (Berliant et al., 2022; Papa et al., 2025; Zaman et al., 2022). Encouragingly, recent findings suggest that medical students show openness to e-mental health interventions, especially when tailored to their academic context, reflecting broader trends toward digital acceptance in higher education mental health services (Grüneberg et al., 2025; Ta et al., 2025). These results align with international efforts to scale hybrid models, which blend flexibility with clinical oversight and reduce access barriers (Chen et al., 2024; Smith et al., 2023).

The Polish Context: Medical Education Sector in Rapid Transition

Mental healthcare in Poland remains chronically underfunded, with just 3.7% of the national health budget allocated to this domain. Well below the 5–10% range recommended by the WHO for high-income countries (Comprehensive mental health action plan 2013–2030, 2021; World mental health report: Transforming mental health for all, 2022). Moreover, the psychiatrist-to-population ratio stands at only 9 per 100,000 inhabitants, placing Poland among the lowest in the European Union (WHO Regional Office for Europe, 2023). Institutional data from Polish universities confirm this macro-level shortfall. In our first national study conducted in 2019, 79% of the 19 medical faculties surveyed provided some form of psychological support, yet these services were often fragmented, temporary, and poorly communicated (Walkiewicz & Guziak, 2021). Second edition study revealed modest improvements, including the emergence of hybrid delivery models and multilingual services; however, core challenges persisted, including limited funding, limited consultation quotas, and inconsistent evaluation mechanisms (Guziak & Walkiewicz, 2024). These pre-existing vulnerabilities were further exacerbated by two overlapping crises: the COVID-19 pandemic and the war in Ukraine. Cross-sectional studies conducted during this period found that 44% of Polish medical students considered leaving their studies due to mental health challenges, 33.6% reported suicidal thoughts or self-harm ideation, and 28.6% increased their use of alcohol, nicotine, or stimulants (Guziak & Walkiewicz, 2025).

Polish medical education has expanded rapidly over the past two decades. The number of accredited faculties has tripled, and student admissions have increased nearly fourfold (Guziak et al., 2025; Kupis et al., 2025). This growth occurred without proportional investment in student mental health infrastructure, leading to concerns about service quality, standardization, and accessibility (Guziak & Walkiewicz, 2024, 2025; Walkiewicz & Guziak, 2021). In the context of recent geopolitical disruptions, these deficiencies have gained urgency. The following study draws on longitudinal institutional data, international policy frameworks, and student-level evidence to evaluate not only the availability but also the equity and strategic alignment of psychological support services in Polish medical schools. This third edition builds on five years of continuous empirical monitoring. Its objectives are fourfold:

• To map the current scope of psychological support, including availability, delivery modality, language accessibility, and financing structures of psychological support across all Polish medical universities in 2025.
• To assess changes since 2019, highlighting policy-responsive and lagging areas.
• To benchmark Polish services against international good-practice indicators, including those from the WHO, as well as emerging standards in digital mental health.
• To generate actionable recommendations for medical faculties, accreditation bodies, and health policymakers committed to building a psychologically resilient healthcare workforce.

2. Materials and Methods

2.1. Survey Design

A questionnaire consisting of 11 open-ended questions was developed to assess the availability, scope, and organization of psychological support services for medical students at Polish universities. It is based on the original 9-item tool used in the first edition of the study (Walkiewicz & Guziak, 2021). In the second edition, it was expanded to 10 items by adding a new question on the impact of COVID-19 (Guziak & Walkiewicz, 2024). In the current 2025 edition, the questionnaire consists of 11 items, including additional questions addressing minority-specific support and contemporary contextual factors (e.g., the war in Ukraine). Across all editions, the core thematic domains were preserved to maintain cross-sectional comparability, while wording refinements and extensions of scope improved the instrument’s contemporary relevance. The survey was designed to capture institutional practices across three key domains:

(A)

The basic accessibility and structure of services;

(B)

Inclusivity and targeted support programmes;

(C)

Mechanisms for monitoring and responding to crisis-related mental health needs.

Survey questions addressed administrative responsibility, funding sources, formats of service delivery, access restrictions, multilingual support, inclusiveness, supplementary well-being initiatives, public communication strategies, internal monitoring mechanisms, and the impact of the war in Ukraine on student mental health. The survey items were as follows:

• Does the university offer psychological support services specifically for medical students?
• Which unit is responsible for organizing these services (e.g., internal university department or external provider)?
• What is the source of funding for these services, and what annual amount is allocated by the university for this purpose?
• What format of support is available (e.g., in-person, remote, or hybrid)?
• Are there any limits on the number of consultations provided to students? If so, what are the restrictions?
• Does the university provide psychological support in foreign languages (e.g., English, Ukrainian)?
• Is additional mental health–related activities offered to students (e.g., stress management workshops, mindfulness sessions, yoga)?
• Where can students access information regarding the availability of support (e.g., official university website, internal portal, social media, external project website)?
• Does the university collect and evaluate data regarding support services (e.g., reasons and volume of requests, demographic data of users, average waiting time, duration of care)? If so, are these data accessible?
• In your opinion, has the war in Ukraine affected the demand for psychological support among students, and if so, in what way?
• Does the university offer targeted psychological support services for specific student populations (e.g., ethnic minorities, LGBTQ+ students, international students)?

2.2. Data Collection

The survey was distributed using a two-stage strategy. In the first stage, in January 2025, it was emailed directly to staff members responsible for psychological support services at each institution who were identified during the previous editions of the study. In the second stage, in February 2025, printed copies were sent to the rector’s administrative offices of universities that did not respond during the first stage. Data collection was conducted between January and March 2025. The sampling frame consisted of all Polish higher education institutions accredited to offer medical degree programmes with granted admission limits for the academic year 2024/2025 (N = 33). A total of 26 institutions responded, yielding a response rate of 79%. Contact details for all institutions were retrieved from official websites. The survey builds upon two previous editions conducted using the same core set of questions, allowing for longitudinal comparisons across institutions and over time (Guziak & Walkiewicz, 2024; Walkiewicz & Guziak, 2021). While nine of the eleven items remained consistent with the previous version, two new questions were introduced in 2025 to reflect the evolving geopolitical context and the need to assess targeted support for vulnerable student subgroups.

3. Results

3.1. Institutional Participation

Among the 26 institutions that responded to the survey, only one- Pomeranian Medical University (PUM), reported the absence of a university-level psychological support programme. The information provided by PUM referred solely to services offered under the National Health Fund, which are theoretically accessible to all students in Poland due to universal health insurance. However, these services are not tailored to the pace and context of medical student life. Consequently, PUM was excluded from further analysis, resulting in a total of 25 valid responses.

3.2. Cost and Accessibility of Services

The only institution where psychological support was not entirely free of charge was Łazarski University (UŁa). The university subsidizes the first three consultations, after which students incur a cost of 30 PLN per appointment (approximately €6.90 or $7.50 as of June 2025).

3.3. Service Organization and Governance

Surveyed universities reported four formal strategies for organizing psychological support. The most common model, used by 80% (n = 20) of institutions, involves management by internal university units. In 12% (n = 3) of cases, support programmes are governed by external entities. The Medical University of Warsaw (MUW) entrusts responsibility to its clinical unit, while the Poznań University of Medical Sciences (PUMS) combines a university unit with a clinical partner.

3.4. Financing Model

Psychological support is funded from university resources in 56% (n = 14) of institutions, from Ministry of Education and Science subsidies in 56% (n = 14), from project grants in 20% (n = 5), and on a voluntary basis in 12% (n = 3). One university, the John Paul II Catholic University of Lublin (KUL), reported receiving additional funds from external financing bodies. Seven institutions provided specific data on total annual funding for psychological support services, covering all university students regardless of study programme: 130,000 PLN at Nicolaus Copernicus University (NCU), 63,000 PLN for 2025 at the Medical University of Gdańsk (MUG), 85,000 PLN in 2023/2024 at the Medical University of Łódź (MUŁ)- including approximately 34,000 PLN for Polish medical students and 8000 PLN for international students, 149,990 PLN at MUW (from 2025: 129,990 PLN for salaries and 20,000 PLN for equipment), 35,000 PLN at Andrzej Frycz Modrzewski Kraków University (AFMKU), 67,164.49 PLN in 2024 at Bydgoszcz University of Science and Technology (PBS), and 3360 PLN in 2024 at Calisia University (UK).

3.5. Delivery Format and Consultation Limits

Hybrid service delivery was the dominant model, implemented in 84% (n = 21) of universities, while 16% (n = 4) provided psychological support exclusively in person. Nearly half of the institutions, 48% (n = 12), imposed no regulations regarding the number of consultations per student. However, six of these institutions: AMiSNS (Academy of Applied Medical and Social Sciences), MUB (Medical University of Białystok), MUG, PBS, SUM (Medical University of Silesia), and URad (Casimir Pulaski University of Radom)—reported total institutional limits. For example, AMiSNS allocates one hour per month for consultations; MUG has a 50-consultation cap per month; PBS offers 72 hours per month (with possibility of extension); and URad allocates 20 hours monthly for students with disabilities and 8 hours for other students. Additionally, 52% (n = 13) of universities imposed limits on the number of consultations per student per academic year. Several institutions: MUG, UWM (University of Warmia and Mazury), JKU (Jan Kochanowski University), JDU (Jan Długosz University), UK, and PWR (Wrocław University of Science and Technology), emphasized that their services are short-term in nature.

3.6. Language Accessibility

Psychological help in languages other than Polish was available at 84% (n = 21) of surveyed universities, with English being the most common (80%, n = 20). Five institutions provided support in other languages, including Ukrainian, French, Italian, Russian, and Polish Sign Language.

3.7. Supplementary Mental Health Initiatives

A total of 80% (n = 20) of universities offered additional mental health activities. The most common were thematic workshops (76%, n = 19). A smaller number of institutions provided lectures or webinars (16%, n = 4) and yoga classes (12%, n = 3). Eight universities reported other forms of engagement, such as awareness campaigns, life coaching, career counselling, speed friending, peer support, elective courses, discussion panels, and multimedia broadcasts. Thematic content included interpersonal communication, mindfulness, coping with stress, meditation, assertiveness, resilience, emotional self-regulation, multicultural emotional literacy, loneliness, neurodiversity, and the management of altered states of consciousness (e.g., dreams).

3.8. Communication Strategies

The majority of universities (88%, n = 22) published information about psychological support on their official websites. Additional channels included social media (56%, n = 14), websites dedicated to support programmes (36%, n = 9), internal platforms (36%, n = 9), email announcements (28%, n = 7), and physical posters or leaflets (20%, n = 5). Some institutions also collaborated with student government (12%, n = 3), provided information at student events including orientation (12%, n = 3), or relied on onsite consultants (12%, n = 3). UWM included this information in its student guidebooks, while MUW used the student government calendar and freshman welcome materials.

3.9. Data Collection and Transparency

Seventy-six percent (n = 19) of universities reported collecting data on psychological support services. However, in almost all cases, these data were not publicly available. The Jagiellonian University (JU) was the only institution that shared selected statistics, which it published annually on social media. Collected data typically included the number and duration of consultations, waiting times, types of requests, demographic profiles of service users, and the number of referrals to external specialists.

3.10. Impact of the War in Ukraine

When asked about the consequences of the war in Ukraine, 20% (n = 5) of surveyed universities reported increased demand for psychological support. Another 24% (n = 6) acknowledged increased need but attributed it to broader geopolitical circumstances. Sixteen percent (n = 4) had no relevant data, and 36% (n = 9) observed no change in demand. The Medical University of Wrocław (UMW) stated that an increase in psychological support needs was observed after the war began in 2021, but this effect had since diminished. However, given the cross-sectional nature of this study, these findings should be interpreted as contextual observations rather than evidence of direct causal effects.

3.11. Targeted Support for Vulnerable Student Groups

Sixty-four percent (n = 16) of universities did not offer targeted psychological services for specific groups of students, such as national minorities, LGBTQ+ students, or international students. The remaining 36% (n = 9) reported such services. Six institutions specified their scope: URad provided dedicated support for students with disabilities; UWM operated a development group for LGBTQ+ students; JKU offered psychological services tailored to international students, such as those in Erasmus programmes; JDU hosted an Equality and Anti-Discrimination Team; JU collaborated with the LGBTQ+ student organization TęczUJ; and PWR had previously offered additional support for Ukrainian, Russian, and Belarusian students, though no interest in these services was recorded (Table 1).

Table 1. Comparative Overview of Mental Health Services for Medical Students in Poland.

University	Availability of Psychological Support	Unit Responsible for Organizing Support	The Source of Funding for These Services and the Annual Budget	Format of Support	Limits on the Number of Consultations During Year	Availability of Support in Foreign Languages	Additional Activities Offered to Students	Source of Information About Support	University Collection and Evaluation of Data Regarding Support	Demand for Services After the Outbreak of War in Ukraine	Availability of Targeted Support for Vulnerable Student Groups
Medical University of Białystok (MUB)	Yes	University unit	A subsidy from the Ministry of Education and Science, the university’s resources	Hybrid	No	Yes, in English	No	Social media, university website	Yes (number of consultations), data is not publicly available	No	No
Nicolaus Copernicus University in Toruń (NCU)	Yes	University unit	A subsidy from the Ministry of Education and Science. 130,000 PLN	Hybrid	Yes, 4 consultations per student	Yes, in English	Awareness campaign, lectures, thematic workshops	Internal network, project website	No	No	No
Medical University of Gdańsk (MUG)	Yes	University unit	EU project grant. For 2025—63,000 PLN from the project grant, and if needed the university’s resources are also available	Hybrid	No	Yes, in English	Thematic workshops	Internal network, leaflets, onsite consultants, university website	Yes (number of consultations), the data is not publicly available.	Increased demand but along with other geopolitical issues	No
Medical University of Silesia in Katowice (SUM)	Yes	University unit	The university’s resources	Hybrid	No	Yes, in English	Thematic workshops, webinars	Internal network, Student Government network, university website	Yes (number of consultations, number of referrals to other specialists), the data is not publicly available.	No data	No
Jagiellonian University in Kraków (JU)	Yes	University unit	No data	Hybrid	Yes, 12 consultations per student	Yes, in English	Lectures, thematic workshops	Leaflets, posters, project website, social media, student events	Yes (duration of care, nature of requests, number of consultations). Part of the data is published once a year on social media.	Increased demand	We cooperate with the student organization TęczUJ helping LGBTQ+ community
Medical University of Łódź (MUŁ)	Yes	University unit	The university’s resources. In 2023/2024 - 85,000 PLN (Approximately 34,000 PLN for Polish medical students and 8000 PLN for foreign medical students)	In-person	Yes, 5 consultations per student	Yes, in English	Career counselling, life couching, thematic workshops	Internal network, mailing, project website, university website	No	No	No
Poznań University of Medical Sciences (PUMS)	Yes	University unit, clinical unit	EU project grant (FERS), National Health Fund contract, the university’s resources	Hybrid	No	Yes, in English and Russian	Thematic workshops	Mailing, posters, university website	Yes (demographic data, waiting time), the data is not publicly available. Waiting time - up to 2 weeks.	Increased demand but along with other geopolitical issues	No
Medical University of Warsaw (MUW)	Yes	Clinical unit	The university’s resources. From 2025—129,990 PLN for specialists’ salaries + 20,000 PLN for equipping the clinic, and possible grants	Hybrid	Yes, 3 consultations per student (possible to extend if necessary)	Yes, in English	Thematic workshops, yoga (during PE)	Freshman welcome packages, internal network, mailing, posters, social media, Student Government calendar, university website	Yes, the data is not publicly available.	No	No
Medical University of Wrocław (UMW)	Yes	University unit	In 2024/2025—the university’s resources, previously—EU project grant	Hybrid	No	Yes, in English	Thematic workshops	Mailing, social media, university website	No	At first—increased demand, currently—no	No
University of Warmia and Mazury in Olsztyn (UWM)	Yes	University unit	A subsidy from the Ministry of Education and Science, the university’s resources	Hybrid	Yes, 5–6 consultations per student (possible to extend if necessary)	Yes, in English	Speed friending, thematic workshops	Project website, social media, university guidebooks, university website	Yes (duration of care, nature of requests, number of consultations), the data is not publicly available	Increased demand but along with other geopolitical issues	We run development education group for LGBTQ + community
Jan Kochanowski University of Kielce (JKU)	Yes	University unit	Local authorities’ grant, project grant, the university’s resources	Hybrid	No	Yes, in English and in Italian	Thematic workshops	Freshman events, mailing, university website	Yes (nature of requests, number of consultations), the data is not publicly available	Increased demand	We provide dedicated psychological support for international students (e.g. Erasmus students)
University of Rzeszów (UR)	Yes	External entity	A subsidy from the Ministry of Education and Science	Hybrid	Yes, 12 consultations per student (possible to extend if necessary)	Yes, in English and in Ukrainian	Thematic workshops	Internal network, mailing, onsite consultants, project website, social media, university website	Yes (demographic data), the data is not publicly available	Increased demand but along with other geopolitical issues	If needed, it is possible to organize such support
Andrzej Frycz Modrzewski Kraków University (AFMKU	Yes	University unit	A subsidy from the Ministry of Education and Science, the university’s resources. Approximately 35,000 PLN	Hybrid	Yes, 6 consultations per student (possible to extend if necessary)	Yes, in English	Thematic workshops	Freshman events, university website	Yes (number of consultations), the data is not publicly available	No	No
Łazarski University (UŁa)	Yes	External entity	A subsidy from the Ministry of Education and Science	In-person	First 3 consultations are subsidized	Yes, in English	No	Mailing, university website	Yes, the data is not publicly available	Increased demand but along with other geopolitical issues	No
University of Opole (UO)	Yes	University unit	A subsidy from the Ministry of Education and Science	Hybrid	Yes, 5 consultations per student (possible to extend if necessary)	Yes, in English and in French	Thematic workshops	Social media, university website	Yes (demographic data, number of consultations), the data is not publicly available	Increased demand	If needed, it is possible to organize such support
Casimir Pulaski University of Radom (URad)	Yes	University unit	A subsidy from the Ministry of Education and Science, the university’s resources	In-person	No	No	No	Project website, social media, university website	Yes, the data is not publicly available	No	We provide dedicated psychological support for students with disabilities
Cardinal Stefan Wyszyński University in Warsaw (UKSW)	Yes	University unit	A subsidy from the Ministry of Education and Science, volunteering	Hybrid	Yes (number not specified)	Yes, in English	Thematic workshops, yoga	Project website	Yes, the data is not publicly available	Increased demand	Yes
Maria Skłodowska- Curie Medical University (UMMSC)	Yes	University unit	Volunteering	Hybrid	No	Yes	No	Social media, university website	No	No data	If needed, it is possible to organize such support
Jan Długosz University in Częstochowa (JDU)	Yes	University unit	A subsidy from the Ministry of Education and Science	Hybrid	No	Yes, in English	Electives, peer support, thematic workshops, yoga (during PE)	Internal network, posters, project website, social media, university website	Yes (number of consultations), the data is not publicly available	No	We have Equality and Anti- Discrimination Team within our structures
Academy of Applied Medical and Social Sciences (AMiSNS)	Yes	University unit	The university’s resources	In-person	No	No	No	Social media, university website	No	No	No
The John Paul II Catholic University of Lublin (KUL)	Yes	University unit	A subsidy from the Ministry of Education and Science, external funds from financing institutions	Hybrid	No	Yes, in English	Peer support, thematic workshops	Internal network, project website, social media, university website	Yes (duration of care, number of consultations, waiting time), the data is not publicly available. Waiting time—about 1 week	Increased demand	No
University of Applied Sciences in Tarnów (UAS)	Yes	University unit	The university’s resources, volunteering	Hybrid	Yes, 4 consultations per student (possible to extend if necessary)	Yes, in English	Yes, as electives	Social media, Student Government network, university website	Yes (number of consultations), the data is not publicly available	No data	No
Bydgoszcz University of Science and Technology (PBS)	Yes	University unit	A subsidy from the Ministry of Education and Science. In 2024- 67,164.49 PLN	Hybrid	No	No	Thematic workshops	Social media, university website	Yes, the data is not publicly available	No	No
Calisia University (UK)	Yes	External entity	A subsidy from the Ministry of Education and Science. In 2024 - 3360 PLN	Hybrid	Yes, 3–4 consultations per student	No	Discussion panels, lectures, thematic workshops	Onsite consultants, university website	No	No data	No
Wrocław University of Science and Technology (PWR)	Yes	University unit	A subsidy from the Ministry of Education and Science, the university’s resources	Hybrid	Yes (number not specified)	Yes, in English and in Polish sign language	Broadcasts, thematic workshops	Internal network, Student Government network, university website	Yes (number of consultations), the data is not publicly available	Increased demand but along with other geopolitical issues	After the outbreak of war in Ukraine, we offered additional support dedicated to Ukrainian, Russian, and Belarusian students but we did not register any interest
Pomeranian Medical University (PUM)	No	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A

4. Discussion

According to WHO standards, support service users “should be offered a variety of support and interventions, with their will and preferences respected. Even when a full range of options is not immediately available, maintaining choice remains crucial” (Guidance on mental health policy and strategic action plans: Module 2. Key reform areas, directives, strategies, and actions for mental health policy and strategic action plans, 2025). Among recommended, evidence-based activities supporting mental health, universities are encouraged to implement a broad spectrum of interventions, e.g., psychoeducation, stress management, and emotional support, including crisis intervention (World mental health report: Transforming mental health for all, 2022). Practices like yoga and meditation are also acknowledged as beneficial and our study shows that approximately half of Polish medical universities incorporate them, either within mental health support programmes or even within obligatory physical education curricula (Comprehensive mental health action plan 2013–2030, 2021; Hughes & Spanner, 2019).

Given the high stress burden of medical education, the emphasis on strengthening individual psychological resources, such as communication skills, empathy, self-care, resilience, decision-making, and problem-solving is particularly relevant (National student mental health and suicide prevention framework. Implementation guide, 2020; World mental health report: Transforming mental health for all, 2022). In this context, the finding that 80% of universities offer supplementary activities covering at least some of these domains is encouraging. However, particularly lacking are services supporting long-term development and career alignment. Although the WHO explicitly highlights the link between pursuing a meaningful career path and maintaining good mental health, only one institution-MUŁ, declared offering life coaching or career counselling within the scope of its psychological support (Guidance on mental health policy and strategic action plans: Module 2. Key reform areas, directives, strategies, and actions for mental health policy and strategic action plans, 2025).

Another critical gap relates to the absence of structured peer support networks. International recommendations emphasize the value of group peer support as a mechanism for companionship, shared understanding, emotional validation, and community-building (Comprehensive mental health action plan 2013–2030, 2021; Guidance on mental health policy and strategic action plans: Module 2. Key reform areas, directives, strategies, and actions for mental health policy and strategic action plans, 2025; National student mental health and suicide prevention framework. Implementation guide, 2020; Hughes & Spanner, 2019). As the WHO notes, such initiatives not only facilitate early identification of psychological distress but also reinforce social connectedness in times of isolation or academic overload. Despite these benefits, only three institutions (UWM, JDU, KUL) reported offering formalized peer support, suggesting a significant opportunity for low-cost, high-impact expansion in this area.

The current findings also highlight insufficient efforts in mental health promotion. Only four institutions (NCU, JDU, UK, PWR) reported running awareness campaigns, despite the repeated emphasis in WHO documentation on the importance of destigmatizing mental illness and enhancing health-literacy in the student population (Comprehensive mental health action plan 2013–2030, 2021; Guidance on mental health policy and strategic action plans: Module 2. Key reform areas, directives, strategies, and actions for mental health policy and strategic action plans, 2025; National student mental health and suicide prevention framework. Implementation guide, 2020; Hughes & Spanner, 2019). This shortfall becomes even more concerning when considering that only 56% of universities disseminate information via social media, despite well-documented increases in time spent on such platforms by young adults (Woodward et al., 2025). The Mental Health and Psychosocial Support Minimum Service Package (MHPSS MSP) specifically recommends the use of posters, leaflets, social media, chatbots, and other digital tools to increase access and visibility (The mental health and psychosocial support minimum service package, 2025). Underutilization of these platforms represents a missed opportunity to normalize help-seeking behaviours and promote early access to support.

Most concerning, however, is the limited practice of monitoring and evaluating psychological services for students. Although 76% of surveyed universities report collecting internal data on demand for mental health services, only one institution (JU) makes any portion of this information publicly available. This precludes national benchmarking and undermines institutional accountability. Moreover, the scope of collected data remains narrow, focused primarily on usage frequency, waiting times, and demographic indicators, and falling short of international recommendations to monitor user satisfaction, symptom reduction, quality of life, student risk and protective factors, referrals, and incidents related to violence, substance use, or harassment (Guidance on mental health policy and strategic action plans: Module 2. Key reform areas, directives, strategies, and actions for mental health policy and strategic action plans, 2025; National student mental health and suicide prevention framework. Implementation guide, 2020). Without such data, it is difficult to evaluate impact, identify systemic inefficiencies, or advocate effectively for sustainable funding and policy change (Guidance on mental health policy and strategic action plans: Module 2. Key reform areas, directives, strategies, and actions for mental health policy and strategic action plans, 2025; The mental health and psychosocial support minimum service package, 2025; WHO European framework for action on mental health 2021–2025, 2021; Hughes & Spanner, 2019).

A particularly illustrative example of formal versus functional availability is the case of the Pomeranian Medical University (PUM). Although the institution does not offer a university-level psychological support programme, it informs students via the university website about their right to access mental health services through the national public healthcare system. While this gesture may technically fulfil the principle of “availability,” it lacks specificity, responsiveness, and adaptability to the psychosocial realities of medical education. National health services, while theoretically universal, are not designed to accommodate the urgency, frequency, or contextual nuances of psychological challenges experienced by medical students. What is offered, therefore, is not a genuinely accessible or adapted resource, but rather a referral to a general system already known for its administrative overload and long waiting times. This distinction highlights a broader structural issue: the difference between fulfilling a formal obligation and meeting an actual students’ needs. A central point of debate concerns the mandate of academic institutions: are universities expected to provide a comprehensive psychological care, or should their responsibility be limited to facilitating access and ensuring basic safety nets (KRAUM, 2023)?

Taken together, the findings of this study demonstrate a widening gap between the formal presence of mental health services and their substantive, student-centred functionality. While Poland has expanded service access for medical students since 2019, its alignment with international best practices remains limited. Initiatives are often implemented without sufficient integration, evaluation, or sustainability planning. The decentralized, university-dependent nature of service provision maintains inequities across institutions and weakens the potential for coordinated national response. These also reflect a deeper question: should universities be responsible for broad psychological support, or merely ensure access to external services?

The findings of our analysis reflect global challenges related to the expansion and coordination of mental health services within medical education. Similar discussions have been observed in Italy and Spain, where student well-being initiatives are gradually evolving from fragmented local programmes into more coordinated national frameworks (Cotobal Rodeles et al., 2025; Di Vincenzo et al., 2024). Therefore, this analysis may serve as a model or benchmark for other countries planning similar national assessments, providing a structured framework for evaluating and improving mental health services for medical students.

5. Conclusions

Despite progress, psychological support for medical students in Poland remains reactive in design and fragmented in implementation. The absence of national guidelines has led to substantial variability in service quality, financing mechanisms, language accessibility, and evaluation practices. Although the majority of universities report offering psychological services, many limit the number of consultations, rely on temporary funding, or provide support that is short-term and not well integrated into the broader academic environment. Targeted assistance for high-risk groups, such as international students, LGBTQ+ individuals, and students with disabilities, remains limited. While most institutions collect internal data on service utilization, public reporting is almost entirely absent, restricting accountability and evidence-informed improvement. While some universities have developed commendable initiatives, relying solely on institutional discretion may lead to fragmented efforts. Broader dialogue is needed on how to support students’ psychological well-being in a consistent and sustainable way. It requires coordinated, long-term public policy, grounded in reliable data, transparent evaluation, and the recognition that mental health is a structural component of medical education- not a secondary concern. To address these challenges, we recommend the following policy actions:

• Establish national standards for psychological support in medical education that clearly define minimum service requirements.
• Ensure stable and adequate funding that reflects the real cost of providing professional psychological care.
• Introduce clear expectations for public reporting on service delivery, utilization, waiting times, and outcomes to enhance transparency and accountability.
• Expand targeted support for high-risk student groups through linguistically accessible, culturally competent, and socially inclusive services.
• Clarify stakeholder responsibility, ensuring that reforms involve not only university leadership but also national authorities such as the Ministry of Health, the Ministry of Education and Science, and accreditation bodies.
• Strengthen national coordination, as lasting and equitable improvements are unlikely without systemic alignment and long-term investment.

While many academic institutions have taken meaningful steps to support student mental health, lasting and equitable change might require systemic coordination and long-term investment. Without it, even the most dedicated local efforts risk being insufficient- ultimately undermining not only students’ well-being, but also the quality, safety, and sustainability of the future healthcare workforce.