Music students in tertiary education struggle with a range of health-related problems. We investigated students’ self-referrals for counselling at a UK conservatoire in order to explore trends in students’ attendance at counselling sessions over time, and identify their reasons for seeking and continuing to attend counselling. We conducted a secondary analysis of data collected from 645 students by two in-house counsellors at the conservatoire between 2000 and 2016. We obtained analogous data on all students registered during the same period for comparison, running chi-square and non-parametric tests of association between groups. A total of 645 students attended a mean of eight (Mdn=4) counselling sessions over the 16-year period: 63% were female, 79% were from the UK, and 72.5% were undergraduate students. The percentages of students attending counselling increased from two (1%) in 2000-2001 to 71 (13%) in 2015-2016. The presenting concerns of almost one in ten students who sought counselling were related to self-esteem, self-confidence, ego strength and coping ability. Their main reasons for continuing to attend counselling were also to do with self and identity, relationships, academic concerns, loss, abuse, and anxiety. Female students, postgraduate students, and those studying singing were most likely to attend counselling sessions.