Knowledge, attitudes, and utilization of mental health services among undergraduates at the University of Lagos, Nigeria: a cross-sectional study

Knowledge, attitudes, and utilization of mental health services among undergraduates at the University of Lagos, Nigeria: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge, attitudes, and utilization of mental health services among undergraduates at the University of Lagos, Nigeria: a cross-sectional study Olumide A. Noah, Oluwatosin J. Akinsola, Ifeoluwa Sandra Bakare, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6335742/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : There is an increasing burden of mental health issues,and these issues often emerge in early adulthood, affecting many university students; however, mental health services remain underutilized due to stigma and limited awareness. the best of our knowledge, studies on the knowledgeattitudes and utilization of mental health services in this area are scarce. Therefore, this study aimed to assess the level of knowledge, attitudesand utilization of mental health services among undergraduates at the University of Lagos, Nigeria. Methods : A cross-sectional study was conducted withundergraduate students at the University of Lagos from August to November 2024. A multistage random sampling technique was used to select 450 students. Tests of association were assessed using chi-square tests (p < 0.05). Results :Most of the respondents (72%) had good knowledge of mental health services, and medical students demonstrated significantly better knowledge (94.4%, score ≥50% on knowledge metrics) nonmedical students did (69.2%). Most of the respondents (66.6%) exhibited a positive attitude toward mental health services. Despite this, mental health service utilization was generally low, with only 23% of respondents reporting good utilization of these services. The study also identified gender, religion, ethnicity, highest level of education, and academic department as significant factors influencing mental health service utilization among university students. Conclusion : The study revealed that while university students generally had good knowledge and a positive attitude toward mental health services, utilization of these services remained low. Few students engaged with these services regularly, revealing a gap between awareness and actual usage. The findings highlight the need for targeted interventions to improve service accessibility, promote help-seeking behavior, and address stigma and other barriers to the utilization of mental health services. mental health services undergraduates university students Nigeria knowledge attitudes utilization mental health BACKGROUND According to the World Health Organization (WHO), mental health is more common than mental disorders. It is a state of psychological wellness that empowers individuals to manage life pressures, recognize their capabilities, learn well and work well, and positively engage with their community ( 1 ). Mental health services are interventions, which include assessment, diagnosis, treatment, or counseling, are provided across private, public, inpatient, or outpatient settings, and are aimed at maintaining or improving mental health or addressing mental and behavioral disorders within both individual and group contexts ( 2 ). These services cultivate an environment of openness and support, contributing to the reduction of stigma surrounding mental health issues and the promotion of help-seeking behaviors among students, thus nurturing a more resilient and supportive campus community ( 3 ). University students constitute a distinct demographic undergoing a pivotal transition from adolescence to adulthood, a phase often marked by significant stress and personal challenges ( 4 ). Compared with any other age group, adolescents and young adults (aged 15–29) present the highest prevalence of mental health disorders, with estimates suggesting that up to 20% of adolescents are likely to develop mental health disorders ( 5 ). Mental health issues are widespread among college students, with substance use, anxiety, and mood disorders emerging as the most frequently encountered challenges ( 6 ). The combination of academic pressure and the stressors associated with beginning and attending college can trigger the initial occurrence of mental health issues and substance use problems or worsen existing symptoms ( 6 , 7 ). Despite the severity of these consequences, it is estimated that approximately half of individuals with depression and only one-third to half of those experiencing anxiety disorders actively seek professional help ( 8 ). Like adolescents and adults in the broader population, the majority of college students exhibiting probable mental disorders do not undergo treatment ( 9 ). Studies have shown that students who do not utilize mental health services may struggle to manage stress, anxiety, depression, and other mental health issues, leading to decreased academic performance, lower grades, and increased dropout rates ( 10 ).The utilization of mental health services can help students manage stress, anxiety, and depression, leading to improved focus, productivity, and overall academic success ( 11 ). A Nigerian study reported a depression prevalence of 36.5% among university students, with 18.2% experiencing severe depression ( 12 ). Another Nigerian study reported that 66.7% of university students reported that they had never used mental health services and that fewer than 8% stated that they were always restricted from using mental health services because of the lack of qualified mental health personnel ( 13 ). A recent study in Zimbabwe reported that the majority of participants failed to acknowledge the importance and benefits of mental health services. Additionally, the study highlighted trust issues, as many participants lacked confidence in mental health providers, contributing to a negative attitude toward these services ( 14 ). The mental health issues experienced during college have long-term consequences that extend beyond the academic setting, some of which include suicide and suicidal behavior and can have harmful effects on relationships and work productivity ( 15 ). While the attitudes toward and utilization of mental health services among students have been widely studied in Western countries, research on this topic among university students in Nigeria is scarce ( 6 , 9 , 16 ). Therefore, this study aimed to evaluate the knowledge, attitudes and utilization of mental health services among undergraduate students at the University of Lagos and identify steps and interventions necessary to increase the uptake of mental health services in this population. METHODS Study area, design and period A cross-sectional study was conducted at the University of Lagos, Nigeria, between August and November 2024. The University of Lagos is a public research institution offering higher education, with three campuses located on the mainland of Lagos. Its main campus, spanning 802 acres, is bordered primarily by Lagos Lagoon. As of 2024, the university admits approximately 8,500 undergraduate students each year and enrolls over 57,000 students (17). Study population The study was conducted among undergraduate students from randomly selected departments the University of Lagos (UNILAG). Inclusion and exclusion criteria The inclusion criterion was as follows : All full-time undergraduate students who had completed at least one semester at the University of Lagos were included in the study. Exclusion criteria: Participants who did not provide electronic informed consent, were ill, or unable to communicate during data collection were excluded. Participants who were currently enrolled in postgraduate studies were excluded. Participants who did not confirm their studentship via their student ID were excluded. Sample size determination and sampling technique Sample size determination To calculate the minimum estimated sample size, Cochran’s formula was used at 95% CI and 5% marginal error, and the value of the proportion (p) was 35.6% from a previous study among Nigerian university students (13). The sample size was subsequently calculated as follows. where n = sample size, p = proportion from a previous study (35.6%), d = degree of precision (assumed to be 5%), and z = confidence interval set at 1.96 with a confidence rate of 95%. We employed a final sample size of 450 on the basis of the expected variability in knowledge, attitudes, and utilization scores and the need for sufficient statistical power for detecting meaningful associations. Sampling technique multistage probability sampling technique was employed. There are twelve faculty members at the University of Lagos. Simple random sampling by balloting was employed to select five of the twelve faculties. From the five faculties that were selected, a list of departments in each faculty was drawn out, and simple random sampling by balloting was performed to pick one department from each of these faculties. The selected departments were Cell Biology and Genetics, Sciences Education, English, Medicine and Surgery and Medical Laboratory Sciences. Simple random sampling was used to select 30 respondents from each level. If a selected participant declined to participate in the study, another number was randomly generated for that level. Data collection method and technique The study was carried out via a structured questionnaire that was self-administered. The questionnaire, used in the study was adapted from previously validated tools in prior studies (13,18,19), was divided into four sections. A pilot test (n = 30) confirmed its reliability (Cronbach’s α: knowledge = 0.78, attitude = 0.82, utilization = 0.75). The first section contained questions on the sociodemographic data of the respondents, such as age, gender, department, level of study, religion, ethnicity, marital status, level of education and educational funding. The second section contained questions to assess knowledge of mental health services. The third section contained questions on attitudes toward mental health services. The fourth section contained questions on the utilization of mental health services. Knowledge was assessed via a 4-point Likert scale (1 = no knowledge, 2 = Limited knowledge, 3 = Moderate knowledge, 4 = extensive knowledge). The respondents' knowledge was divided into two categories: good (≥50% of the total knowledge score) and poor (<50% of the total knowledge score). The respondents’ attitudes were assessed via Likert-type questions measured on a 4-point rating scale (4 =strongly agree, 3 = agree, 2 = disagree, 1 = strongly disagree). The respondents' attitudes were divided into two categories: positive (≥50% of the total attitude score) and negative (<50% of the total attitude score). The utilization of mental health services consists of four Likert-type questions and is measured via a 4-point rating scale (1 = never, 2 = rarely, 3 = occasionally, 4 = always). Utilization was categorized into good (≥50% of the total utilization score) and poor (<50% of the total utilization score). Statistical analysis Data obtained from fully completed questionnaires were entered into Microsoft Excel 2021 and analyzed via IBM SPSS Version 29. Descriptive analysis (frequencies, percentages, means, and standard deviations) was conducted for sociodemographic variables. Bivariate analysis (chi-square tests) was used to assess associations between variables and independent variables (p < 0.05). Ethical approval This research received approval from the Health Research and Ethics Committee of Lagos University Teaching Hospital (LUTH). Electronic informed consent was obtained prior to survey participation. Only respondents who provided consent were included in the final analysis. RESULTS Sociodemographic characteristics A total of 450 respondents completed the questionnaire, of whom 165 (36.7%) were male and 285 (63.3%) were female, with a mean age of 22.0 ± 2.7 years. There was an equal distribution across the five departments—Cell Biology and Genetics, English, Medical Laboratory Sciences, Medicine and Surgery, and Science Education—with 90 respondents from each department. The demographic characteristics of the respondents are shown in Table 1. Table 1 Distribution of the study population according to.sociodemographic variables (n = 450). Variable Categories Frequency Percent (%) Age in years 16 - 21 201 44.7 22 - 27 230 51.1 28 - 33 19 4.2 Gender Female 285 63.3 Male 165 36.7 Year of study 100 L 60 13.3 200 L 120 26.7 300 L 150 33.3 400 L 90 20.0 500 L 30 6.7 Department Cell biology and genetics 90 20.0 English 90 20.0 Medical Laboratory Sciences 90 20.0 Medicine and Surgery 90 20.0 Science Education 90 20.0 Religion Christianity 333 74.0 Islam 111 24.7 Others a 6 1.3 Ethnicity Hausa 6 1.3 Igbo 56 12.4 Yoruba 350 77.8 Others b 38 8.4 Highest level of education Completed secondary school (High school) 120 51.1 Advanced Level 230 15.3 Tertiary Degree 123 33.6 Others a : Atheist and Free thinker, Others b : Delta, Edo, Efik, Esan, Igala, Itshekiri, Urhobo Source of information and awareness of mental health services Among the respondents, 356 (79%) were aware of mental health services available in Lagos State. The most commonly cited source of information was the internet (84.4%), followed by friends (51.3%). Additionally, the majority of respondents, 380 (84.2%), were aware of Federal Neuropsychiatric Hospital, Yaba, whereas 24 (5.3%) reported being unaware of any of the listed mental health care facilities. Table 2 Description of information sources and awareness of mental health services (n = 450). Variable Categories Frequency Percent (%) Awareness Yes 356 79 No 94 21 Source of information Television 194 43.1 Internet 380 84.4 Radio 84 18.7 Billboards 76 16.9 Friends 231 51.3 Lecturer 205 45.6 Awareness of mental health facilities Federal Neuropsychiatric Hospital, Yaba 379 84.2 Psychiatric clinic, LUTH 256 56.9 Psychiatric clinic, LASUTH 87 19.3 Prison asylum 30 6.7 None of the above 24 5.3 LUTH: Lagos University Teaching Hospital, LASUTH: Lagos State University Teaching Hospital Knowledge of mental health services The degree of knowledge of mental health services for each item is listed in Table 3. The majority of the respondents (71.8%) were knowledgeable about mental health conditions such as depression and anxiety. However, approximately half (49.6%) of the respondents knew nothing to very little about how to obtain professional mental health services when needed. Overall, the majority of the students (72%) demonstrated good knowledge of mental health services, with an average score of 12.1±3.7. Table 3 Knowledge of mental health services No. Knowledge of this statement Extensive knowledge n (%) Moderate knowledge n (%) Limited knowledge n (%) No Knowledge n (%) Total n (%) 1 Classified medical/behavioral mental health or psychological disorders e.g., depression, anxiety, schizophrenia, etc. 133 (29.6) 191 (42.4) 105 (23.3) 21 (4.7) 450 (100) 2 The type of treatment models/clinical interventions (e.g., psychotherapy) used in professional mental health clinics 59 (13.1) 154 (34.2) 158 (35.1) 79 (17.6) 450 (100) 3 How to get professional mental health or psychological counseling services when needed (e.g., procedures and requirements) 64 (14.2) 160 (35.6) 163 (35.6) 63 (14.0) 450 (100) 4 Common drug treatments prescribed to individuals with mental health or psychological problem 63 (14.0) 112 (24.9) 144 (32.0) 131 (29.1) 450 (100) 5 Your eligibility for mental health care under your current health insurance plan. 36 (8.0) 94 (20.9) 129 (28.7) 191 (42.4) 450 (100) Attitudes toward mental health services The attitudes toward mental health services for each item are listed in Table 4. Approximately two-thirds (67.1%) of the respondents preferred to handle emotional disturbances on their own, and nearly half (47.1%) of the respondents agreed that cultural beliefs about mental illness affect their use of mental health services. Overall, 66.6% of the students had positive attitudes toward mental health services. Table 4 Attitudes toward mental health services No. Statements Strongly agree n (%) Agree n (%) Disagree n (%) Strongly disagree n (%) Total n (%) 1. I feel I can get professional help if I was having a mental breakdown 148 (31.8) 203 (45.1) 76 (16.8) 28 (6.2) 450 (100) 2. When I am emotionally disturbed, I prefer solving it on my own 80 (17.8) 222 (49.3) 126 (28.0) 22 (4.9) 450 (100) 3. I feel comfortable talking about my personal problems 67 (14.9) 205 (45.6) 118 (26.2) 60 (13.3) 450 (100) 4. If I am mentally disturbed, I do not see it as my personal matter but also a threat to my friends and family 89 (19.8) 89 (19.8) 253 (56.2) 19 (4.2) 450 (100) 5. I do not use mental health services because of the belief that culture has on the mentally ill individuals 47 (10.4) 212 (47.1) 123 (27.3) 68 (15.1) 450 (100) 6. I feel the treatment young people receive at mental health clinics make them talk gibberish 73 (16.2) 75 (16.7) 261 (58.0) 41 (9.1) 450 (100) 7. I think individuals diagnosed as mentally ill in mental clinics suffer from its symptoms throughout their life 62 (13.8) 164 (36.4) 214 (47.6) 62 (13.8) 450 (100) Utilization of mental health services The use of mental health services for each item is listed in Table 5. The majority of the respondents (73.8%) indicated that they never utilized mental health services, whereas 20.4% of the respondents reported rare usage. More than half (55.3%) believed that health professionals were not receptive to their needs. Overall, the majority of the students (77%) reported poor utilization of mental health services, whereas 23% reported good utilization of mental health services. Table 5 Utilization of mental health services No. Statement Always n (%) Occasionally n (%) Rarely n (%) Never n (%) Total n (%) 1. How often do you use mental health services? 3 (0.7) 23 (5.1) 92 (20.4) 334 (73.8) 450 (100) 2. I am restricted to the use of mental health services due to the lack of qualified mental health personnel 25 (5.6) 39 (8.7) 100 (22.2) 286 (63.6) 450 (100) 3. I discuss my personal issues with the mental health specialist 13 (2.9) 25 (5.6) 92 (20.4) 320 (71.1) 450 (100) 4. The health professionals are receptive to my needs 36 (8.0) 58 (12.9) 107 (23.8) 249 (55.3) 450 (100) Associations of selected knowledge, attitudes and utilization items with some sociodemographic variables Undergraduate students in the medical field were significantly more likely to have good knowledge of mental health services (χ² = 24.3, p < 0.001). Additionally, sociodemographic variables such as female sex (χ² = 6.4, p < 0.012), Christianity (χ² = 10.9, p < 0.004), Yoruba ethnicity (χ² = 9.2, p < 0.026), and having a university diploma with the highest level of education (χ² = 12.2, p < 0.007) were significantly associated with good utilization of mental health services. DISCUSSION This study was conducted among undergraduates at the University of Lagos, Nigeria, to evaluate the knowledge, attitudes and utilization of mental health services. A total of 450 interviewer-administered questionnaires were correctly administered and analyzed. The majority of participants (63.3%) were female, which is consistent with findings from the United States (20), where over 55% of the student population was female, and a Nigerian university, where females accounted for 52.4% of the student population (13). This trend may be attributed to females' greater inclination to participate in studies related to mental health than males do (21). Most respondents (72%) had good knowledge of mental health services. This is similar to a study conducted at a university in the United States (22), where 68% of participants demonstrated limited knowledge in this area.This differs from a study conducted among Arab Muslims (19), where only 35% of respondents had adequate knowledge of mental health services. This could be attributed to differences in the economic, cultural and educational levels of respondents in different regions. The majority of respondents (79%) were aware of the mental health services available in Lagos State. This percentage is lower than that reported in a study conducted in Lagos, which reported an awareness level of 94% (23). However, it is higher than that reported in studies conducted in India (24) and Enugu State (18), where the awareness levels were 28% and 54.4%, respectively. This variation may be due to differences in local awareness campaigns and study populations. The internet was the most commonly cited source of information about mental health services (84.4%), followed by friends (51.3%) and lecturers (45.6%). This is similar to a study conducted among university students in the United States, where friends and the internet were the primary sources of information (22). However, it differs from a study in which the majority of participants cited friends (35.5%), followed by radio (17.4%) and television (16.1%) as their main sources of information (18). The difference in findings could be attributed to varying access to technology and media platforms in different regions. Our results showed that the majority of respondents (66.6%) had a positive attitude toward utilizing mental health services. This finding is consistent with a study conducted at a Nigerian university, which reported that 85% of participants exhibited a positive attitude toward mental health services (13). This may be due to a growing awareness of mental health issues, improved education, and a reduction in stigma surrounding mental health. Despite the growing awareness of mental health challenges among undergraduate students, the majority of the respondents (77%) in our study reported poor utilization of mental health services. This finding aligns with a study among Nigerian university students, where 64.4% of participants reported poor use of mental health services (13). Similarly, a study among college students in the United States reported that 64% had limited engagement with mental health services (9). The gap between knowledge/attitude and utilization aligns with Andersen’s behavioral model, which posits that healthcare access is influenced by predisposing (e.g., stigma), enabling (e.g., cost), and need-based (e.g., symptom severity) factors. In this study, stigma and lack of trust in providers (Table 4) likely acted as predisposing barriers, whereas the limited availability of qualified personnel (Table 5) represents an enabling barrier. In our study, females (52.9%) demonstrated better utilization of mental health services than males did (47.1%). This aligns with findings from a Nigerian university where females were more likely to exhibit good utilization of mental health services (13). This difference may be attributed to factors such as greater health-seeking behavior, better emotional awareness, and reduced stigma associated with seeking mental health support among females. Recent studies suggest that men seek mental health support less often than women do, potentially because of societal gender roles. Traits such as seeking help, prioritizing health, and expressing emotions are often associated with traditional ideals of femininity (25). Limitations Owing to the cross-sectional study design, this study may not establish a temporal relationship between the dependent and independent variables. Like in previous studies (13,18), we did not apply a standardized, interviewer-rated, or formally validated questionnaire because no existing tool adequately captured the specific variables of interest in our study population. Despite these limitations, this study provides new data on university students' knowledge, attitudes, and utilization of mental health services and identifies critical areas for future research and interventions. CONCLUSION The study revealed that while university students generally had good knowledge and a positive attitude toward mental health services, utilization of these services remained low. Few students engaged with these services regularly, revealing a gap between awareness and actual usage. This study underscores the critical need for multilevel interventions—addressing stigma through education, expanding telehealth access, and training campus-based counselors—to bridge the gap between mental health awareness and service utilization among Nigerian undergraduates. Declarations Ethics approval and consent to participate This study was approved by the Health Research and Ethics Committee of Lagos University Teaching Hospital with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Health Research and Ethics Committee of Lagos University Teaching Hospital (ADM/DCST/HREC/APP/796). The survey was anonymous, and data confidentiality was maintained. Electronic informed consent was obtained before survey participation, and participants could withdraw from the study at any time. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available as a supplement file “QUESTIONNAIRE” Competing interests The authors declare that they have no conflicts of interest. Funding This work has received no funding. Clinical trial number: Not applicable. Acknowledgment We would like to thank Roheemah Odunfa and Ajayi-Segun Boluwatito for their contributions to this project's data collection and all of the participants who contributed to our work. Authors' information Authors and Affiliations College of Medicine, University of Lagos, Lagos, Nigeria Olumide A. Noah [email protected] Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria Oluwatosin J. Akinsola [email protected] Ternopil State Medical University, Ternopil, Ukraine Ifeoluwa Sandra Bakare [email protected] College of Medicine, University of Lagos, Lagos, Nigeria Daniella M. 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Awareness, accessibility and utilization of mental health care services among youths in Lagos State, Nigeria. Shodh Sari-An International Multidisciplinary Journal [Internet]. 2023;02(02):99–118. Available from: https://doi.org/10.59231/SARI7577 Nirmala, Snehalatha Reddy and Ramya B. Exploring the Awareness Gap: A Study on Mental Health Service Awareness Among Primary Caregivers of Mentally Ill Patients in Bapuji Hospital, Davangere. International Journal of Advanced Research [Internet]. 2023 [cited 2025 Mar 3]; Available from: journalijar.com/article/46979/ Prevention and promotion in mental health [Internet]. [cited 2025 Mar 3]. Available from: https://www.who.int/publications/i/item/9241562161 Additional Declarations No competing interests reported. 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Akinsola","email":"","orcid":"","institution":"Department of Community Health \u0026 Primary Care, university of lagos","correspondingAuthor":false,"prefix":"","firstName":"Oluwatosin","middleName":"J.","lastName":"Akinsola","suffix":""},{"id":452685481,"identity":"b0eb6c3c-0429-45ec-8a44-8ab037aefa9b","order_by":2,"name":"Ifeoluwa Sandra Bakare","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAElEQVRIiWNgGAWjYBACewY2GDOBgeFDBZBmZm7Aq8WwAUkL44wzIC2M+LUYHEDSwszbBmIQ0GLYfizxc0VFnbw5e+7Dz7zzaqP524FaflRsw6nFniftsOSZM4cNd/Y8N5acu+147ozDjA2MPWdu4/FLeoNkY9sBxg030hgk3m47ltsA1MLM2IZbi8H5580/G//V2QO1MP/gnXMsdz5BLTfSjkk2NjAnArWwSfI21ORuIKTFcMazNMuGY4eTN5x5xmY549iB3I1ALQfx+cWeP834ZkNNne2G42nMNz7U1OXOO3/44IMfFbi1oIPDYPIA0eqBoI4UxaNgFIyCUTBCAACXPWPwLQQvfAAAAABJRU5ErkJggg==","orcid":"","institution":"Ternopil State Medical University","correspondingAuthor":true,"prefix":"","firstName":"Ifeoluwa","middleName":"Sandra","lastName":"Bakare","suffix":""},{"id":452685482,"identity":"037aab5b-9532-43c5-a790-574cd3cb8c18","order_by":3,"name":"Daniella M. Olu-Festus","email":"","orcid":"","institution":"University of Lagos","correspondingAuthor":false,"prefix":"","firstName":"Daniella","middleName":"M.","lastName":"Olu-Festus","suffix":""},{"id":452685483,"identity":"d541c913-c1c6-4b47-85ce-2b008abf255d","order_by":4,"name":"Foluke Adenike Olatona","email":"","orcid":"","institution":"Department of Community Health \u0026 Primary Care, university of lagos","correspondingAuthor":false,"prefix":"","firstName":"Foluke","middleName":"Adenike","lastName":"Olatona","suffix":""}],"badges":[],"createdAt":"2025-03-29 19:53:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6335742/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6335742/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101398238,"identity":"3dcd1c50-af23-4898-8341-d583d420d4de","added_by":"auto","created_at":"2026-01-29 09:40:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1045479,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6335742/v1/f38c7c93-f60b-49cc-b82e-23817af29931.pdf"},{"id":82328108,"identity":"b9a6fbfc-b1f6-4c6c-aa44-0a00e0cc2de4","added_by":"auto","created_at":"2025-05-09 06:40:40","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":21795,"visible":true,"origin":"","legend":"","description":"","filename":"QUESTIONNAIRE.pdf.docx","url":"https://assets-eu.researchsquare.com/files/rs-6335742/v1/fc9ed7eb9e54b470b4f65a34.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eKnowledge, attitudes, and utilization of mental health services among undergraduates at the University of Lagos, Nigeria: a cross-sectional study\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eAccording to the World Health Organization (WHO), mental health is more common than mental disorders. It is a state of psychological wellness that empowers individuals to manage life pressures, recognize their capabilities, learn well and work well, and positively engage with their community (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Mental health services are interventions, which include assessment, diagnosis, treatment, or counseling, are provided across private, public, inpatient, or outpatient settings, and are aimed at maintaining or improving mental health or addressing mental and behavioral disorders within both individual and group contexts (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). These services cultivate an environment of openness and support, contributing to the reduction of stigma surrounding mental health issues and the promotion of help-seeking behaviors among students, thus nurturing a more resilient and supportive campus community (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUniversity students constitute a distinct demographic undergoing a pivotal transition from adolescence to adulthood, a phase often marked by significant stress and personal challenges (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Compared with any other age group, adolescents and young adults (aged 15\u0026ndash;29) present the highest prevalence of mental health disorders, with estimates suggesting that up to 20% of adolescents are likely to develop mental health disorders (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Mental health issues are widespread among college students, with substance use, anxiety, and mood disorders emerging as the most frequently encountered challenges (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The combination of academic pressure and the stressors associated with beginning and attending college can trigger the initial occurrence of mental health issues and substance use problems or worsen existing symptoms (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Despite the severity of these consequences, it is estimated that approximately half of individuals with depression and only one-third to half of those experiencing anxiety disorders actively seek professional help (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Like adolescents and adults in the broader population, the majority of college students exhibiting probable mental disorders do not undergo treatment (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Studies have shown that students who do not utilize mental health services may struggle to manage stress, anxiety, depression, and other mental health issues, leading to decreased academic performance, lower grades, and increased dropout rates (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).The utilization of mental health services can help students manage stress, anxiety, and depression, leading to improved focus, productivity, and overall academic success (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA Nigerian study reported a depression prevalence of 36.5% among university students, with 18.2% experiencing severe depression (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Another Nigerian study reported that 66.7% of university students reported that they had never used mental health services and that fewer than 8% stated that they were always restricted from using mental health services because of the lack of qualified mental health personnel (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). A recent study in Zimbabwe reported that the majority of participants failed to acknowledge the importance and benefits of mental health services. Additionally, the study highlighted trust issues, as many participants lacked confidence in mental health providers, contributing to a negative attitude toward these services (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The mental health issues experienced during college have long-term consequences that extend beyond the academic setting, some of which include suicide and suicidal behavior and can have harmful effects on relationships and work productivity (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). While the attitudes toward and utilization of mental health services among students have been widely studied in Western countries, research on this topic among university students in Nigeria is scarce (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Therefore, this study aimed to evaluate the knowledge, attitudes and utilization of mental health services among undergraduate students at the University of Lagos and identify steps and interventions necessary to increase the uptake of mental health services in this population.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy area, design and period\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional study was conducted at the University of Lagos, Nigeria, between August and November 2024. The University of Lagos is a public research institution offering higher education, with three campuses located on the mainland of Lagos. Its main campus, spanning 802 acres, is bordered primarily by Lagos Lagoon. As of 2024, the university admits approximately 8,500 undergraduate students each year and enrolls over 57,000 students (17).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted among undergraduate students from randomly selected departments the University of Lagos (UNILAG).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eexclusion\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe inclusion criterion was as follows\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eAll full-time undergraduate students who had completed at least one semester at the University of Lagos were included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eParticipants who did not provide electronic informed consent, were ill, or unable to communicate during data collection were excluded.\u003c/li\u003e\n \u003cli\u003eParticipants who were currently enrolled in postgraduate studies were excluded.\u003c/li\u003e\n \u003cli\u003eParticipants who did not confirm their studentship via their student ID were excluded.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eSample size determination and sampling technique\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size determination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo calculate the minimum estimated sample size, Cochran\u0026rsquo;s formula was used at 95% CI and 5% marginal error, and the value of the proportion (p) was 35.6% from a previous study among Nigerian university students (13). The sample size was subsequently calculated as follows.\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"120\" height=\"40\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003ewhere n\u0026thinsp;=\u0026thinsp;sample size, p = proportion from a previous study (35.6%), d\u0026thinsp;=\u0026thinsp;degree of precision (assumed to be 5%), and z = confidence interval set at 1.96 with a confidence rate of 95%.\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"275\" height=\"40\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003eWe employed a final sample size of 450 on the basis of the expected variability in knowledge, attitudes, and utilization scores and the need for sufficient statistical power for detecting meaningful associations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling technique\u0026nbsp;\u003c/strong\u003emultistage probability sampling technique was employed. There are twelve faculty members at the University of Lagos. Simple random sampling by balloting was employed to select five of the twelve faculties. From the five faculties that were selected, a list of departments in each faculty was drawn out, and simple random sampling by balloting was performed to pick one department from each of these faculties. The selected departments were Cell Biology and Genetics, Sciences Education, English, Medicine and Surgery and Medical Laboratory Sciences. Simple random sampling was used to select 30 respondents from each level. If a selected participant declined to participate in the study, another number was randomly generated for that level.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection method and technique\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was carried out via a structured questionnaire that was self-administered. The questionnaire, used in the study was adapted from previously validated tools in prior studies (13,18,19), was divided into four sections. A pilot test (n = 30) confirmed its reliability (Cronbach\u0026rsquo;s \u0026alpha;: knowledge = 0.78, attitude = 0.82, utilization = 0.75). The first section contained questions on the sociodemographic data of the respondents, such as age, gender, department, level of study, religion, ethnicity, marital status, level of education and educational funding. The second section contained questions to assess knowledge of mental health services. The third section contained questions on attitudes toward mental health services. The fourth section contained questions on the utilization of mental health services. Knowledge was assessed via a 4-point Likert scale (1 = no knowledge, 2 = Limited knowledge, 3 = Moderate knowledge, 4 = extensive knowledge). \u0026nbsp;The respondents\u0026apos; knowledge was divided into two categories: good (\u0026ge;50% of the total knowledge score) and poor (\u0026lt;50% of the total knowledge score). The respondents\u0026rsquo; attitudes were assessed via Likert-type questions measured on a 4-point rating scale (4 =strongly agree, 3 = agree, 2 = disagree, 1 = strongly disagree). The respondents\u0026apos; attitudes were divided into two categories: positive (\u0026ge;50% of the total attitude score) and negative (\u0026lt;50% of the total attitude score). The utilization of mental health services consists of four Likert-type questions and is measured via a 4-point rating scale (1 = never, 2 = rarely, 3 = occasionally, 4 = always). Utilization was categorized into good (\u0026ge;50% of the total utilization score) and poor (\u0026lt;50% of the total utilization score).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData obtained from fully completed questionnaires were entered into Microsoft Excel 2021 and analyzed via IBM SPSS Version 29. Descriptive analysis (frequencies, percentages, means, and standard deviations) was conducted for sociodemographic variables. Bivariate analysis (chi-square tests) was used to assess associations between variables and \u0026nbsp;independent variables (p \u0026lt; 0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received approval from the Health Research and Ethics Committee of Lagos University Teaching Hospital (LUTH). Electronic informed consent was obtained prior to survey participation. Only respondents who provided consent were included in the final analysis.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 450 respondents completed the questionnaire, of whom 165 (36.7%) were male and 285 (63.3%) were female, with a mean age of 22.0 \u0026plusmn; 2.7 years. There was an equal distribution across the five departments\u0026mdash;Cell Biology and Genetics, English, Medical Laboratory Sciences, Medicine and Surgery, and Science Education\u0026mdash;with 90 respondents from each department. The demographic characteristics of the respondents are shown in Table 1.\u003c/p\u003e\n\u003cp\u003eTable 1 Distribution of the study population according to.sociodemographic variables (n = 450).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eAge in years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e16 - 21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e44.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e22 - 27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e28 - 33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e63.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e36.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eYear of study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e100 L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e200 L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e26.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e300 L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e400 L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e500 L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eDepartment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eCell biology and genetics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eEnglish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eMedical Laboratory Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eMedicine and Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eScience Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eChristianity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e74.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eOthers\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eEthnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eIgbo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eYoruba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e77.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eOthers\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eHighest level of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eCompleted secondary school (High school)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eAdvanced Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e15.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eTertiary Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e33.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOthers\u003csup\u003ea\u003c/sup\u003e: Atheist and Free thinker, Others\u003csup\u003eb\u003c/sup\u003e: Delta, Edo, Efik, Esan, Igala, Itshekiri, Urhobo\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSource of information and awareness of mental health services\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the respondents, 356 (79%) were aware of mental health services available in Lagos State. The most commonly cited source of information was the internet (84.4%), followed by friends (51.3%). Additionally, the majority of respondents, 380 (84.2%), were aware of Federal Neuropsychiatric Hospital, Yaba, whereas 24 (5.3%) reported being unaware of any of the listed mental health care facilities.\u003c/p\u003e\n\u003cp\u003eTable 2 Description of information sources and awareness of mental health services (n = 450).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eAwareness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e356\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSource of information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eTelevision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e43.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eInternet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e84.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eRadio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e18.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eBillboards\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eFriends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e51.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eLecturer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e45.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eAwareness of mental health facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eFederal Neuropsychiatric Hospital, Yaba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e84.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003ePsychiatric clinic, LUTH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e56.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003ePsychiatric clinic, LASUTH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e19.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003ePrison asylum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eNone of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eLUTH: Lagos University Teaching Hospital, LASUTH: Lagos State University Teaching Hospital\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge of mental health services\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe degree of knowledge of mental health services for each item is listed in Table 3. The majority of the respondents (71.8%) were knowledgeable about mental health conditions such as depression and anxiety. However, approximately half (49.6%) of the respondents knew nothing to very little about how to obtain professional mental health services when needed. Overall, the majority of the students (72%) demonstrated good knowledge of mental health services, with an average score of 12.1\u0026plusmn;3.7.\u003c/p\u003e\n\u003cp\u003eTable 3 Knowledge of mental health services\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge of this statement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExtensive knowledge \u0026nbsp; \u0026nbsp;n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModerate knowledge \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLimited knowledge n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo Knowledge \u0026nbsp; \u0026nbsp; n (%)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eClassified medical/behavioral mental health or psychological disorders e.g., depression, anxiety, schizophrenia, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e133 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e191 (42.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e105 (23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e21 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eThe type of treatment models/clinical interventions (e.g., psychotherapy) used in professional mental health clinics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e59 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e154 (34.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e158 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e79 (17.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eHow to get professional mental health or psychological counseling services when needed (e.g., procedures and requirements)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e64 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e160 (35.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e163 (35.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e63 (14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eCommon drug treatments prescribed to individuals with mental health or psychological problem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e63 (14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e112 (24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e144 (32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e131 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eYour eligibility for mental health care under your current health insurance plan.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36 (8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e94 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e129 (28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e191 (42.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttitudes toward mental health services\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe attitudes toward mental health services for each item are listed in Table 4. Approximately two-thirds (67.1%) of the respondents preferred to handle emotional disturbances on their own, and nearly half (47.1%) of the respondents agreed that cultural beliefs about mental illness affect their use of mental health services. Overall, 66.6% of the students had positive attitudes toward mental health services.\u003c/p\u003e\n\u003cp\u003eTable 4 Attitudes toward mental health services\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly agree \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree \u0026nbsp; \u0026nbsp; \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly disagree \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eI feel I can get professional help if I was having a mental breakdown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e148 (31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e203 (45.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e76 (16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e28 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eWhen I am emotionally disturbed, I prefer solving it on my own\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e80 (17.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e222 (49.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e126 (28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e22 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eI feel comfortable talking about my personal problems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e67 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e205 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e118 (26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e60 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eIf I am mentally disturbed, I do not see it as my personal matter but also a threat to my friends and family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e89 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e89 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e253 (56.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e19 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eI do not use mental health services because of the belief that culture has on the mentally ill individuals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e47 (10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e212 (47.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e123 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e68 (15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eI feel the treatment young people receive at mental health clinics make them talk gibberish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e73 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e75 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e261 (58.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e41 (9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eI think individuals diagnosed as mentally ill in mental clinics suffer from its symptoms throughout their life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e62 (13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e164 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e214 (47.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e62 (13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUtilization of mental health services\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe use of mental health services for each item is listed in Table 5. The majority of the respondents (73.8%) indicated that they never utilized mental health services, whereas 20.4% of the respondents reported rare usage. More than half (55.3%) believed that health professionals were not receptive to their needs. Overall, the majority of the students (77%) reported poor utilization of mental health services, whereas 23% reported good utilization of mental health services.\u003c/p\u003e\n\u003cp\u003eTable 5 Utilization of mental health services\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlways \u0026nbsp; \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccasionally n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRarely \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNever \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003eHow often do you use mental health services?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e3 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e23 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e92 (20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e334 (73.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003eI am restricted to the use of mental health services due to the lack of qualified mental health personnel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e25 (5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e39 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e100 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e286 (63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003eI discuss my personal issues with the mental health specialist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e13 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e25 (5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e92 (20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e320 (71.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 136px;\"\u003e\n \u003cp\u003eThe health professionals are receptive to my needs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e36 (8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e58 (12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e107 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e249 (55.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e450 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAssociations of selected knowledge, attitudes and utilization items with some sociodemographic variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUndergraduate students in the medical field were significantly more likely to have good knowledge of mental health services (\u0026chi;\u0026sup2; = 24.3, p \u0026lt; 0.001). Additionally, sociodemographic variables such as female sex (\u0026chi;\u0026sup2; = 6.4, p \u0026lt; 0.012), Christianity (\u0026chi;\u0026sup2; = 10.9, p \u0026lt; 0.004), Yoruba ethnicity (\u0026chi;\u0026sup2; = 9.2, p \u0026lt; 0.026), and having a university diploma with the highest level of education (\u0026chi;\u0026sup2; = 12.2, p \u0026lt; 0.007) were significantly associated with good utilization of mental health services.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study was conducted among undergraduates at the University of Lagos, Nigeria, to evaluate the knowledge, attitudes and utilization of mental health services. A total of 450 interviewer-administered questionnaires were correctly administered and analyzed.\u003c/p\u003e\n\u003cp\u003eThe majority of participants (63.3%) were female, which is consistent with findings from the United States (20), where over 55% of the student population was female, and a Nigerian university, where females accounted for 52.4% of the student population (13). This trend may be attributed to females' greater inclination to participate in studies related to mental health than males do (21). Most respondents (72%) had good knowledge of mental health services. This is similar to a study conducted at a university in the United States (22), where 68% of participants demonstrated limited knowledge in this area.This differs from a study conducted among Arab Muslims (19), where only 35% of respondents had adequate knowledge of mental health services. This could be attributed to differences in the economic, cultural and educational levels of respondents in different regions.\u003c/p\u003e\n\u003cp\u003eThe majority of respondents (79%) were aware of the mental health services available in Lagos State. This percentage is lower than that reported in a study conducted in Lagos, which reported an awareness level of 94% (23). However, it is higher than that reported in studies conducted in India (24) and Enugu \u0026nbsp; State (18), where the awareness levels were 28% and 54.4%, respectively. This variation may be due to differences in local awareness campaigns and study populations. The internet was the most commonly cited source of information about mental health services (84.4%), followed by friends (51.3%) and lecturers (45.6%). This is similar to a study conducted among university students in the United States, where friends and the internet were the primary sources of information (22). However, it differs from a study in which the majority of participants cited friends (35.5%), followed by radio (17.4%) and television (16.1%) as their main sources of information (18). The difference in findings could be attributed to varying access to technology and media platforms in different regions.\u003c/p\u003e\n\u003cp\u003eOur results showed that the majority of respondents (66.6%) had a positive attitude toward utilizing mental health services. This finding is consistent with a study conducted at a Nigerian university, which reported that 85% of participants exhibited a positive attitude toward mental health services (13). This may be due to a growing awareness of mental health issues, improved education, and a reduction in stigma surrounding mental health. Despite the growing awareness of mental health challenges among undergraduate students, the majority of the respondents (77%) in our study reported poor utilization of mental health services. This finding aligns with a study among Nigerian university students, where 64.4% of participants reported poor use of mental health services (13). Similarly, a study among college students in the United States reported that 64% had limited engagement with mental health services (9). The gap between knowledge/attitude and utilization aligns with Andersen’s behavioral model, which posits that healthcare access is influenced by predisposing (e.g., stigma), enabling (e.g., cost), and need-based (e.g., symptom severity) factors. In this study, stigma and lack of trust in providers (Table 4) likely acted as predisposing barriers, whereas the limited availability of qualified personnel (Table 5) represents an enabling barrier.\u003c/p\u003e\n\u003cp\u003eIn our study, females (52.9%) demonstrated better utilization of mental health services than males did (47.1%). This aligns with findings from a Nigerian university where females were more likely to exhibit good utilization of mental health services (13). This difference may be attributed to factors such as greater health-seeking behavior, better emotional awareness, and reduced stigma associated with seeking mental health support among females. Recent studies suggest that men seek mental health support less often than women do, potentially because of societal gender roles. Traits such as seeking help, prioritizing health, and expressing emotions are often associated with traditional ideals of femininity (25).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOwing to the cross-sectional study design, this study may not establish a temporal relationship between the dependent and independent variables. Like in previous studies (13,18), we did not apply a standardized, interviewer-rated, or formally validated questionnaire because no existing tool adequately captured the specific variables of interest in our study population. Despite these limitations, this study provides new data on university students' knowledge, attitudes, and utilization of mental health services and identifies critical areas for future research and interventions.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe study revealed that while university students generally had good knowledge and a positive attitude toward mental health services, utilization of these services remained low. Few students engaged with these services regularly, revealing a gap between awareness and actual usage. This study underscores the critical need for multilevel interventions\u0026mdash;addressing stigma through education, expanding telehealth access, and training campus-based counselors\u0026mdash;to bridge the gap between mental health awareness and service utilization among Nigerian undergraduates.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Health Research and Ethics Committee of Lagos University Teaching Hospital with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Health Research and Ethics Committee of Lagos University Teaching Hospital (ADM/DCST/HREC/APP/796). The survey was anonymous, and data confidentiality was maintained. Electronic informed consent was obtained before survey participation, and participants could withdraw from the study at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available as a supplement file “QUESTIONNAIRE”\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work has received no funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Roheemah Odunfa and Ajayi-Segun Boluwatito for their contributions to this project's data collection and all of the participants who contributed to our work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors and Affiliations\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eCollege of Medicine, University of Lagos, Lagos, Nigeria\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eOlumide A. Noah\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003col start=\"2\"\u003e\n \u003cli\u003eDepartment of Community Health \u0026amp; Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eOluwatosin J. Akinsola\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003col start=\"3\"\u003e\n \u003cli\u003eTernopil State Medical University, Ternopil, Ukraine\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eIfeoluwa Sandra Bakare\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003col start=\"4\"\u003e\n \u003cli\u003eCollege of Medicine, University of Lagos, Lagos, Nigeria\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eDaniella M. Olu-Festus\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003col start=\"5\"\u003e\n \u003cli\u003eDepartment of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eFoluke Adenike Olatona\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConception of the study: OAN. Data collection: OAN. Data analysis: OAN. Writing of first draft: OAN, OJA, and ISB. Manuscript revisions: OAN, OJA, OFA, and ISB. All the authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eMental health [Internet]. [cited 2025 Feb 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response\u003c/li\u003e\n \u003cli\u003eMental Health Service - an overview | ScienceDirect Topics [Internet]. [cited 2025 Feb 28]. Available from: https://www.sciencedirect.com/topics/psychology/mental-health-service\u003c/li\u003e\n \u003cli\u003eLipson SK, Lattie EG, Eisenberg D. Increased rates of mental health service utilization by U.S. College students: 10-year population-level trends (2007-2017). Psychiatric Services [Internet]. 2019 Jan;70(1):60\u0026ndash;3. Available from: https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800332\u003c/li\u003e\n \u003cli\u003eHailu GN. Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study. BMC Psychiatry [Internet]. 2020 Apr 15 [cited 2025 Feb 28];20(1):162. Available from: https://doi.org/10.1186/s12888-020-02574-4\u003c/li\u003e\n \u003cli\u003eAguirre Velasco A, Cruz ISS, Billings J, Jimenez M, Rowe S. What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review. BMC Psychiatry [Internet]. 2020 Jun 11 [cited 2025 Feb 28];20(1):293. Available from: https://doi.org/10.1186/s12888-020-02659-0\u003c/li\u003e\n \u003cli\u003ePetrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College Students: Mental Health Problems and Treatment Considerations. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry [Internet]. 2015 Oct;39(5):503. Available from:/pmc/articles/PMC4527955//pmc/articles/PMC4527955/?report=abstract https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527955/\u003c/li\u003e\n \u003cli\u003eCampbell F, Blank L, Cantrell A, Baxter S, Blackmore C, Dixon J, et al. Factors that influence mental health of university and college students in the UK: a systematic review. BMC Public Health [Internet]. 2022 Sep 20 [cited 2025 Mar 4];22(1):1778. Available from: https://doi.org/10.1186/s12889-022-13943-x\u003c/li\u003e\n \u003cli\u003eGulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry [Internet]. 2012 Jul 16 [cited 2025 Feb 28];12(1):81. Available from: https://doi.org/10.1186/1471-244X-12-81\u003c/li\u003e\n \u003cli\u003eEisenberg D, Hunt J, Speer N, Zivin K. Mental Health Service Utilization Among College Students in the United States. The Journal of Nervous and Mental Disease [Internet]. 2011 May [cited 2025 Feb 28];199(5):301. Available from: https://journals.lww.com/jonmd/abstract/2011/05000/mental_health_service_utilization_among_college.3.aspx\u003c/li\u003e\n \u003cli\u003eIbrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research [Internet]. 2013 Mar 1 [cited 2025 Feb 28];47(3):391\u0026ndash;400. Available from: https://www.sciencedirect.com/science/article/pii/S0022395612003573\u003c/li\u003e\n \u003cli\u003eStallman HM. Psychological distress in university students: A comparison with general population data. Australian Psychologist [Internet]. 2010 Dec 1 [cited 2025 Mar 2];45(4):249\u0026ndash;57. Available from: https://doi.org/10.1080/00050067.2010.482109\u003c/li\u003e\n \u003cli\u003eAina BA, Adebowale DK. Knowledge and prevalence of depression among students on College of Medicine University of Lagos. European Journal of Public Health [Internet]. 2020 Sep 1 [cited 2025 Mar 2];30(Supplement_5):ckaa166.1048. Available from: https://doi.org/10.1093/eurpub/ckaa166.1048\u003c/li\u003e\n \u003cli\u003eKukoyi O, Orok E, Oluwafemi F, Oluwadare T, Oni O, Bamitale T, et al. Factors affecting the utilization of mental health services among undergraduate students in a Nigerian University. Heliyon [Internet]. 2022 Nov 1 [cited 2025 Feb 28];8(11). Available from: https://www.cell.com/heliyon/abstract/S2405-8440(22)02764-5\u003c/li\u003e\n \u003cli\u003eKhombo S, Khombo K, Stoddart RS, Sifelani I, Sibanda T. Knowledge, attitudes, and uptake of mental health services by secondary school students in Gweru, Zimbabwe. Front Psychol [Internet]. 2023 Feb 1 [cited 2025 Feb 28];14. Available from: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1002948/full\u003c/li\u003e\n \u003cli\u003eConsequences of Student Mental Health Issues \u0026ndash; Suicide Prevention Resource Center [Internet]. [cited 2025 Feb 28]. Available from: https://sprc.org/settings/colleges-and-universities/consequences-of-student-mental-health-issues/\u003c/li\u003e\n \u003cli\u003eOswalt SB, Lederer AM, Chestnut-Steich K, Day C, Halbritter A, Ortiz D. Trends in college students\u0026rsquo; mental health diagnoses and utilization of services, 2009-2015. J Am Coll Health. 2020 Jan;68(1):41\u0026ndash;51.\u003c/li\u003e\n \u003cli\u003eUniversity of Lagos. In: Wikipedia [Internet]. 2025 [cited 2025 Feb 28]. Available from: https://en.wikipedia.org/w/index.php?title=University_of_Lagos\u0026amp;oldid=1277726332\u003c/li\u003e\n \u003cli\u003eIdoko CA, Udo K, Idoko CI. A Nigerian Tertiary Institution Students\u0026rsquo; Knowledge and Attitude to Mental Health and Services. International Journal of Medicine and Health Development [Internet]. 2021 Dec [cited 2025 Feb 28];26(3):183. Available from: https://journals.lww.com/ijmh/fulltext/2021/26030/a_nigerian_tertiary_institution_students_.6.aspx\u003c/li\u003e\n \u003cli\u003eAloud N. Factors Affecting Attitudes Toward Seeking and Using Formal Mental Health and Psychological Services Among Arab-Muslims Population. Ohio State University; 2004. book.\u003c/li\u003e\n \u003cli\u003eHunt J, Eisenberg D. Mental Health Problems and Help-Seeking Behavior Among College Students. Journal of Adolescent Health [Internet]. 2010 Jan 1 [cited 2025 Mar 3];46(1):3\u0026ndash;10. Available from: https://www.jahonline.org/article/S1054-139X(09)00340-1/fulltext\u003c/li\u003e\n \u003cli\u003eThompson AE, Anisimowicz Y, Miedema B, Hogg W, Wodchis WP, Aubrey-Bassler K. The influence of gender and other patient characteristics on health care-seeking behavior: a QUALICOPC study. BMC Family Practice [Internet]. 2016 Mar 31 [cited 2025 Mar 19];17(1):38. Available from: https://doi.org/10.1186/s12875-016-0440-0\u003c/li\u003e\n \u003cli\u003eYorgason JB, Linville D, Zitzman B. Mental Health Among College Students: Do Those Who Need Services Know About and Use Them? Journal of American College Health [Internet]. 2008 Sep 1 [cited 2025 Mar 3];57(2):173\u0026ndash;82. Available from: https://doi.org/10.3200/JACH.57.2.173-182\u003c/li\u003e\n \u003cli\u003eAhimie, B. Awareness, accessibility and utilization of mental health care services among youths in Lagos State, Nigeria. Shodh Sari-An International Multidisciplinary Journal [Internet]. 2023;02(02):99\u0026ndash;118. Available from: https://doi.org/10.59231/SARI7577\u003c/li\u003e\n \u003cli\u003eNirmala, Snehalatha Reddy and Ramya B. Exploring the Awareness Gap: A Study on Mental Health Service Awareness Among Primary Caregivers of Mentally Ill Patients in Bapuji Hospital, Davangere. International Journal of Advanced Research [Internet]. 2023 [cited 2025 Mar 3]; Available from: journalijar.com/article/46979/\u003c/li\u003e\n \u003cli\u003ePrevention and promotion in mental health [Internet]. [cited 2025 Mar 3]. Available from: https://www.who.int/publications/i/item/9241562161\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"mental health services, undergraduates, university students, Nigeria, knowledge, attitudes, utilization, mental health","lastPublishedDoi":"10.21203/rs.3.rs-6335742/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6335742/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: There is an increasing burden of mental health issues,and these issues often emerge in early adulthood, affecting many university students; however, mental health services remain underutilized due to stigma and limited awareness. the best of our knowledge, studies on the knowledgeattitudes and utilization of mental health services in this area are scarce. Therefore, this study aimed to assess the level of knowledge, attitudesand utilization of mental health services among undergraduates at the University of Lagos, Nigeria.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A cross-sectional study was conducted withundergraduate students at the University of Lagos from August to November 2024. A multistage random sampling technique was used to select 450 students. Tests of association were assessed using chi-square tests (p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e:Most of the respondents (72%) had good knowledge of mental health services, and medical students demonstrated significantly better knowledge (94.4%, score ≥50% on knowledge metrics) nonmedical students did (69.2%). Most of the respondents (66.6%) exhibited a positive attitude toward mental health services. Despite this, mental health service utilization was generally low, with only 23% of respondents reporting good utilization of these services. The study also identified gender, religion, ethnicity, highest level of education, and academic department as significant factors influencing mental health service utilization among university students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The study revealed that while university students generally had good knowledge and a positive attitude toward mental health services, utilization of these services remained low. Few students engaged with these services regularly, revealing a gap between awareness and actual usage. The findings highlight the need for targeted interventions to improve service accessibility, promote help-seeking behavior, and address stigma and other barriers to the utilization of mental health services.\u003c/p\u003e","manuscriptTitle":"Knowledge, attitudes, and utilization of mental health services among undergraduates at the University of Lagos, Nigeria: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-09 06:24:36","doi":"10.21203/rs.3.rs-6335742/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d954de15-2778-41ab-a394-e4e958f3be5c","owner":[],"postedDate":"May 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-29T05:40:05+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-09 06:24:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6335742","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6335742","identity":"rs-6335742","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}