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Effect of Water, Sanitation and Hygiene Practices on Diarrhoeal Disease Prevalence among Children Under Five in Nigeria

Abstract

Mental health awareness is an important component of mental health promotion because it can improve individuals' ability to recognize mental health problems, understand available sources of professional support, and make informed decisions about seeking care. Mental health service utilization refers to the extent to which individuals access and use available professional mental health services, including counselling, psychological support, psychiatric services, crisis intervention, and other forms of formal mental healthcare. University students represent an important population for mental health research because they may experience academic pressure, financial difficulties, relationship challenges, social adjustment, uncertainty about employment and future prospects, and other stressors that can affect psychological well-being. In Nigeria, mental health concerns among young adults have received increasing public health attention, while the utilization of formal mental health services remains relatively low. Barriers to utilization may include inadequate awareness of available services, stigma, misconceptions about mental illness, concerns about confidentiality, financial limitations, limited availability of mental health professionals, and preference for informal sources of support. Improved mental health awareness may enable students to recognize symptoms, understand the importance of professional intervention, identify available services, and seek appropriate assistance when necessary. However, increased awareness may not automatically result in service utilization when structural, financial, cultural, and attitudinal barriers persist. Against this background, this study investigates the impact of mental health awareness on mental health service utilization among university students in Nigeria. The study is anchored on the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Andersen's Behavioral Model of Health Services Use. The Health Belief Model explains health-seeking behaviour through perceptions of susceptibility, severity, benefits, and barriers, while mental health awareness may influence students' understanding of mental health risks and the benefits of seeking professional assistance. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioral control influence individuals' intentions and subsequent health-seeking behavior. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors and provides a framework for understanding how awareness, availability, affordability, and perceived need influence mental health service utilization. Collectively, these theoretical perspectives provide a comprehensive framework for examining the relationship between mental health awareness and mental health service utilization among university students in Nigeria. The study adopts a quantitative cross-sectional research design. Primary data will be collected from undergraduate and postgraduate students enrolled in selected universities in Nigeria using a structured self-administered questionnaire. A multistage sampling technique will be employed to select universities, faculties, departments, and eligible students. Mental health awareness will be measured using knowledge of common mental health conditions, recognition of mental health symptoms, understanding of risk factors, awareness of available mental health services, knowledge of where to obtain professional assistance, and understanding of the importance of early help-seeking. Mental health service utilization will be measured using previous or current use of counselling services, psychological services, psychiatric services, university mental health services, referrals to mental health professionals, frequency of service use, and willingness to seek professional assistance when experiencing mental health difficulties. Descriptive statistics will be used to summarize respondents' sociodemographic characteristics and levels of mental health awareness and service utilization. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be employed to determine the impact of mental health awareness on mental health service utilization. Appropriate diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the estimated relationships. The study anticipates that mental health awareness will have a significant positive impact on mental health service utilization among university students in Nigeria. Students with higher levels of mental health awareness are expected to be more capable of recognizing symptoms of psychological distress, understanding the importance of professional intervention, identifying available mental health services, and seeking appropriate assistance when necessary. Improved awareness may also reduce misconceptions surrounding mental health conditions and encourage students to discuss psychological concerns with qualified professionals. However, awareness alone may not guarantee service utilization because students may continue to experience barriers such as stigma, fear of discrimination, concerns about confidentiality, financial constraints, inadequate availability of mental health professionals, long waiting periods, and preference for family members, friends, religious leaders, or self-management strategies. Consequently, improving mental health service utilization among university students requires both effective mental health awareness programmes and accessible, affordable, confidential, and student-friendly mental health services. This study is expected to make significant contributions to the literature on mental health, health education, health-seeking behaviour, and public health in Nigeria by providing empirical evidence on the relationship between mental health awareness and mental health service utilization among university students. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, universities, university health centres, counselling units, mental health professionals, student affairs departments, public health practitioners, development partners, and policymakers regarding strategies for improving students' access to appropriate mental health support. The study will also provide evidence-based recommendations for strengthening mental health education in universities, increasing awareness of available services, reducing mental health stigma, improving confidentiality and accessibility of counselling services, increasing the availability of qualified mental health professionals, and integrating mental health promotion, screening, referral, and support services into university health programmes in Nigeria.

Keywords: Mental health awareness, mental health service utilization, university students, mental health literacy, health-seeking behaviour, counselling services, psychological support, mental health education, public health, Nigeria.