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Effect of Suicide Prevention Education on Suicide Warning-Sign Recognition among University Students in Nigeria

Abstract

Suicide is an important public health concern that can have profound consequences for individuals, families, educational institutions, and communities. University students may experience academic pressure, financial difficulties, relationship challenges, social isolation, adjustment difficulties, and other stressors that can affect psychological well-being. Early recognition of warning signs associated with suicide risk can create opportunities for timely support, professional intervention, referral, and prevention. Suicide prevention education provides students with information about suicide, common warning signs, risk and protective factors, appropriate responses to individuals showing signs of distress, available mental health support services, and the importance of seeking immediate professional assistance when a person may be at risk. Suicide warning-sign recognition refers to a student's ability to correctly identify behavioural, emotional, verbal, and situational indicators that may suggest an individual is experiencing serious psychological distress or may be at risk of suicide. In Nigeria, limited mental health literacy, stigma, misconceptions about suicide, uncertainty about how to respond to distressed individuals, and inadequate awareness of available mental health services may reduce students' ability to recognize important warning signs and facilitate appropriate help-seeking. Effective suicide prevention education may improve students' knowledge, recognition skills, confidence, and awareness of appropriate referral pathways. Against this background, this study investigates the effect of suicide prevention education on suicide warning-sign recognition among university students in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding students' recognition of suicide warning signs and their readiness to respond appropriately. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping students' ability to identify and respond to mental health concerns. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from suicide prevention education may influence warning-sign recognition. Collectively, these theoretical perspectives provide a suitable framework for explaining how suicide prevention education may influence suicide warning-sign recognition among university students in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from undergraduate students in selected universities in Nigeria using a structured anonymous self-administered questionnaire and a standardized suicide warning-sign recognition assessment. A multistage sampling technique will be employed to select states, universities, faculties or departments, academic levels, and eligible students. Where feasible, selected student groups will be assigned to intervention and comparison groups. Students in the intervention group will receive structured suicide prevention education covering suicide prevention, common warning signs, risk and protective factors, appropriate ways to respond to a distressed person, the importance of taking warning signs seriously, professional help-seeking, available university counselling and mental health services, emergency referral pathways, and strategies for supporting peers while maintaining appropriate boundaries. Suicide warning-sign recognition will be assessed using standardized scenarios and items requiring students to identify recognized warning signs and distinguish them from non-specific or unrelated behaviours. Descriptive statistics will be used to summarize students' sociodemographic characteristics, baseline knowledge, exposure to education, and warning-sign recognition scores. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of suicide prevention education on suicide warning-sign recognition. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that suicide prevention education has a significant positive effect on suicide warning-sign recognition among university students in Nigeria. Students exposed to structured suicide prevention education are expected to demonstrate improved ability to identify important warning signs associated with suicide risk and psychological distress. Education may reduce misconceptions, improve mental health literacy, increase students' confidence in recognizing concerning changes in peers, and strengthen awareness of appropriate professional support and referral pathways. Improved recognition may create opportunities for earlier intervention and connection to appropriate mental health services. However, education alone may not guarantee effective responses because students may continue to face barriers such as stigma, fear of discussing suicide, uncertainty about confidentiality, limited access to qualified mental health professionals, and concerns about how to approach a distressed peer. Consequently, suicide prevention education is expected to be most effective when supported by accessible and confidential university mental health services, trained counsellors, clear referral procedures, peer-support structures, and institutional suicide-prevention policies. The study is expected to contribute to the literature on suicide prevention, mental health education, mental health literacy, warning-sign recognition, university student health, psychological well-being, health promotion, and public health in Nigeria by providing empirical evidence on the effect of suicide prevention education on suicide warning-sign recognition among university students. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Universities Commission, university administrations, university counselling units, student health services, mental health professionals, public health practitioners, development partners, and policymakers regarding strategies for strengthening suicide prevention among young adults. The study will also provide evidence-based recommendations for integrating suicide prevention education into university health programmes, strengthening mental health literacy, improving early recognition of warning signs, reducing stigma, expanding confidential counselling and referral services, and developing supportive university environments that facilitate timely access to professional help across Nigeria.

Keywords: Suicide prevention education, suicide warning-sign recognition, university students, suicide prevention, mental health education, mental health literacy, suicide awareness, help-seeking, university health, psychological well-being, public health, Nigeria.