Mental health: Many universities lack support units for students

In Africa, suicide is the second-leading cause of death among young people between the ages of 15 and 29, and those in universities are within that age group. Suicide prevention policies as part of mental health programmes for students, as well as mental health support centres, or desks, can help to avoid tragedies.

A nursing student at Havarde College of Science, Business and Management Studies in Ogun State, Nigeria, sank into a depression that reached a tipping point earlier this year.

She decided to end it and, on the evening of 19 February, upon arrival at a hospital, was confirmed dead.

Her classmates said she became depressed after realising the course she was studying had not been accredited by the Nursing and Midwifery Council of Nigeria (NMCN) and, amid her worries, her boyfriend had got her pregnant.

“She complained bitterly that her parents spent all their money to send her to school, yet there would be nothing to show for it in the end. Things got worse when she discovered she was pregnant,” said a fellow student, who preferred to remain anonymous.

The institution was consequently shut down for failing to secure NMCN accreditation by the Ogun State Ministry of Health and members of the state Nursing and Midwifery Committee.

What do the figures look like?

Her death was the fourth reported suicide involving Nigerian students in the first quarter of 2024, raising concerns over the alarming rate of depression and suicide among students and poor mental health services in the country’s higher education institutions.

A study titled, ‘Suicide in Nigeria: Observations from the content analysis of newspapers’, revealed that 117 – representing 33.6% – of 350 suicide cases reported in the country in a decade (between January 2010 and December 2019) involved students, the highest among the population categories analysed in the study.

Suicide has reached a crisis point in Nigeria and Africa, in general, particularly among young people, said Taiwo Lateef Sheikh, a professor of psychiatry at Ahmadu Bello University, Zaria, and a member of the advisory board of the Africa Centre for Disease Control, Non-Communicable Diseases, Injuries and Mental Health.

“Globally, the estimated suicide rate, according to the WHO [World Health Organization], is about nine per 100,000 people. In Nigeria, it’s between 5.5 and six per 100,000 population across all age groups. In Africa, it’s about 11.2 to 100,000 people, which is above the global average – and, among young people, it’s even higher. Of the deaths linked to suicide globally, 78% occur in low- and medium-income countries, and across the world, suicide is the fourth-leading cause of death among young people.

“In Africa, suicide is the second-leading cause of death among young people between the ages of 15 and 29, and those in universities are within that age group. So, it is a huge problem.

“Things considered to be social determinants of suicide are over-represented among young people, and access to mental health services is very poor. Young people are moving around with untreated mental health conditions, which represent about 90% of suicide cases,” Sheikh told University World News.

A 2022 survey on risk and protective factors associated with depression among students showed that 59% of the 1,591 participants (students at the University of Nigeria, Nsukka) had had contact with a depressed person, while 45.1% had experienced depression.

The report indicated that fewer than half of the participants (47.3%) had a good knowledge of the risk factors related to depression in young people.

“Therefore, educational interventions aimed at improving students’ knowledge of depression, especially regarding factors that could trigger depression, are strongly recommended.

“The managements of universities should consider initiating student mental health services to mitigate depression tendencies among students,” the study stated.

Students’ coping strategies

Several students told University World News of the hit-or-miss approaches they adopted to deal with depression. A student at the University of Jos, Philip, said he resorted to taking alcohol, recreational drugs and doing meditation.

“Factors that led to my depression are numerous, but some that stand out include poor academic performance, a lack of motivation and the feeling of being overwhelmed by life.

“It had a negative impact on my studies and life, generally. I can’t say I received help from the school’s mental health services, but some of my lecturers as individuals have been instrumental in counselling me and rendering other forms of help,” he said.

A sociology student, Jessica, became a recluse due to depression, lost concentration, missed classes and tests, had many ‘carryovers’ – a colloquial term for failing exams in Nigerian higher institutions – and nearly committed suicide, but for the intervention of a friend, she said.

“I always found myself crying and sulking, thinking the world was better off without me. I came up with a solution to end it on 15 January 2023. I eventually tried talking to a friend who helped me, and we prayed about it.

“A voice kept ringing in my head, saying: ‘You’re enough; you’re wonderfully made; you’re designed for great things; don’t give up’,” Jessica added.

What can universities do?

The first step is for universities to formulate suicide prevention policies and mental health programmes for students over a period of time, which must include how the programmes will be executed and evaluated to determine their effectiveness, Sheikh advised.

“There should be crisis lines that students, who are suicidal, can call to get help by speaking to an expert who can scale down the crisis, make them feel better, and then fix an appointment for them. The third is to educate students about suicide, its determinants, and how they can prevent it.

“Social media is very useful to students, but can also be detrimental. It can teach them ‘copycat suicide’. Universities should have rules that govern the use of social media in a way that does not negatively impact suicide.

“They should regulate how students share information about suicides to promote prevention. And, of course, we must have well-equipped mental health units,” he said.

Professor Cosmas Adomeh of Ambrose Alli University in Edo State said that, although many Nigerian universities lack proper mental health units, they have guidance and counselling as well as psychology departments, which need to be upgraded to serve students better.

“For starters, students battling depression should be able to visit those units on a regular basis to seek help,” Adomeh, a professor of guidance and counselling and former chairman of the university’s admission board, said.

“Guidance and counselling and psychology departments are supposed to have functional students’ service units and students should be aware of them. Also, there should be staff in those units to attend to students regularly,” he added.

Hauwa Bello, a psychotherapist and chief executive officer of Mumtaz Mind and Wellness Studio in Abuja, urged universities to engage more professionals, such as counsellors, psychologists and social workers, in light of an acute shortage of psychiatrists in the country.

To curb suicides, Bello said, lecturers should be trained to identify signs of distress in students and provide timely interventions.

She said: “There is no excuse why a university should not have a proper mental health unit run by trained professionals. The unit should be able to assess students and make appropriate referrals in cases it cannot handle.

“We also need mental health support groups in all universities to be manned by professional psychotherapists and clinical psychologists to serve as a support system for students.”

“Universities should carry out mental health screening for students with their consent to be able to identify who is vulnerable among them; who has adverse childhood experiences, and begin interventions early. Universities can equally choose a mental health day when students can talk about mental health in a non-judgmental way to avoid stigma,” said Bello.

Establish the causes

A clinical psychologist at the University College Hospital, Ibadan, Dr Olugbemi Olukolade, lamented that student support centres in several Nigerian universities are inactive because they are mostly run by lecturers with core responsibilities of teaching and research.

“Psychotherapy is a long-term process. Some sessions can last as long as 36 weeks if the session is administered every week. And that is for one person in a university of 5,000 to 10,000 students.

“Universities need to employ psychologists or therapists who can take over those units. They must be totally different from academics.

“We also need to look at where the problems come from. Do we have bullies as lecturers? Are students doing all sorts of jobs to be able to pay their school fees and survive? Stress can predispose such students to depression, so universities should provide opportunities for them to work on campus and make money.

“Universities should have a sexual abuse desk where students can report harassment anonymously, seek help, and find resolution to the matter. A lot of universities don’t have [sexual abuse desks] and most times when students report sexual harassment, they don’t get justice. This can lead to depression,” he said.