Mental distress, perceived need, and barriers to receive professional mental health care among university students in Ethiopia

Abstract

Background: There is limited evidence on the extent of the perceived need and barriers to professional mental health service delivery to university students with mental distress in low-and middle-income countries (LMICs). This study was designed to assess the prevalence of mental distress, perceived need for professional mental health care and barriers to the delivery of services to affected undergraduate university students in Ethiopia. Methods: A multi-stage sampling technique was used to recruit 1135 undergraduate university students. Symptoms of mental distress were evaluated using the Self-Reported Questionnaire (SRQ-20) and a score of above seven was used to identify positive cases. The perceived need for professional mental health care was assessed using a single 'yes or no' response item and barriers to mental health care were assessed using Barriers to Access to Care Evaluation (BACE-30) tool. Percentage, frequency, mean, and standard deviation were employed to summarize demographic characteristics of the participants and to identify common barriers to mental health care service. Moreover, the association of demographic variables with total mean scores of BACE-III sub-scales was modeled using multiple linear regression. Results: The prevalence of mental distress symptoms was 34.6% and the perceived need for professional mental health care was 70.5% of those with mental distress. The top five barriers to receiving professional mental health service were (a) thinking the problem would get better with no intervention, (b) being unsure where to go to get professional help, (c) wanting to solve the problem without intervention, (d) denying a mental health problem existed, and (e) preferring to get alternative forms of mental care. Coming from a rural background, being a second and fourthyear student, and a family history of mental illness were significantly associated with barriers to receive professional mental health service. Conclusion: The high prevalence of mental distress, the paucity of mental health care, and the report of barriers to access what professional mental health care there is among Ethiopian undergraduate students is a call to address the disparity.

Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients

“…Another challenge is that there are several mentally ill patients who seek mental health support interventions from traditional healers and faith healers instead of accessing mental health interventions from trained mental health providers in medical or psychiatric settings (Saraceno et al, 2007 ; Barrow, 2016 ). A research carried out in Ethiopia revealed that the main impediments to non-adherence to mental health services are that the mentally ill people denied taking mental health services because of thinking that they would get better later and that they also want to solve their mental problems without seeking health care from mental health providers; lack of medical infrastructures; negative attitudes of healthcare providers toward mentally ill patients; and preference to get alternative forms of mental health services (Wakida et al, 2018 ; Negash et al, 2020 ). So, mental disorders affect hundreds of millions of people and if left untreated create enormous suffering, disability, and economic loss (Moses et al, 2011 ; Ambikile and Iseselo, 2017 ).…”

“…The 1994 genocide against the Tutsi in Rwanda killed more than a million people in only a short time (Barrow, 2016 ) and has affected nearly all Rwandans, and its effects still occur as one of the factors of a higher rate of mental disorders (Saraceno et al, 2007 ). However, although the government of Rwanda has made efforts to combat with mental disorders associated with this hazardous event through availing financial and human resources for proving mental healthcare services appropriately, the provision of efficient and effective mental health services remains a challenge (Berckmoes et al, 2017 ; Negash et al, 2020 ). Later, preceding studies found a remarkable improvement in providing mental health services due to an increase in financial and human resources and increase in the quality of the services provided (Mutuyimana et al, 2019 ).…”

Explanatory Models for Mental Distress Among University Students in Ethiopia: A Qualitative Study

“…Although the University has healthcare facilities, the majority (70.5%) of students with mental health problems did not receive professional mental healthcare. 21 This is due to barriers associated with: (i) thinking the problem would get better with no intervention; (ii) preferring selfmedication; (iii) denying a mental health problem existed; (iv) preferring to get alternative forms of mental care (religious leaders, friends, families, traditional healers, relatives, etc. ); and (v) lack of information about the counseling offices in the university.…”

“…); and (v) lack of information about the counseling offices in the university. 21 Near the university, there are churches and mosques, where both Christian and Muslim students pray to their God or Allah, respectively; such practice might foster their religious coping mechanism from mental distress. On the contrary, there are shops and hotels that sell Khat, cigarettes, and alcohol without any restriction.…”

“…20 However, a number of them do not receive mental health care despite its availability. 21 A significant number of these students receive help from informal sources, such as family, friends, relatives, herbalists, and religious leaders. 22 As well, the coping styles of students can be more or less helpful in managing their distress.…”