CHAPTER ONE

1.0 INTRODUCTION

1.1 Background of the Study

In the USA, there is a renewed effort to understand and address barriers to treatment that stop
some students reaching help in the first place. The World Health Organization’s (WHO) World
Mental Health International College Student Initiative (WMH-ICS) aims to provide greater
clarity on the unmet need of this group. In the UK, there has been a policy focus on improving
access to mental health interventions through greater integration between the National Health
Service (NHS) and Universities, and an emphasis on mobilizing university resources towards the
mental health of students. Previous reviews in the USA have looked at which students are most
likely to seek help, however this is obviously confounded by the nature of services available to
them. There are no systematic reviews conducted on the variety of services available to students
internationally, how these integrate with each other and how use varies by types of service that
deliver interventions to support mental health and wellbeing.( Robinson, E, 2008). Studies have
examined individual services such as university counselling centers, external psychological
services, or inpatient settings but have not compared the differential use of these by students with
different clinical presentations.( Whitted, WM, Southward, 2004). Given the developmental
period in which many students attend university these settings are important in contributing to
improving overall population mental health. By understanding where variation occurs could
indicate areas of differential access, highlighting where care pathways could be improved and
inform policy initiatives. There are so many programs gearing towards reducing mental health
allover the world and it has greatly reduce the issue of mental illness.( Dixon-Ward, 2016).

In Bangladesh the mental health of university students is becoming a growing problem

throughout the world . After graduating from higher secondary school (high school in some
developed countries), students may encounter a variety of issues (e.g., dormitory life, study
stress, lack of time management, unhealthy eating habits, sleeping disorders, smoking,
problematic internet usage, and sedentary behavior) in their new academic setting. During this
period of transition, students struggle to deal with the intellectual and social obstacles of
university studies, which is vital for their preparation for professional jobs through the
development of professional knowledge and experience. Even, the development of an
autonomous personal life requires various psycho-social and psychological adjustments for most
undergraduate students. Moreover, the university environment may possess a lot of surprises and
sometimes can be unbearable and bring unexpected problems for some fresher students, and they
may lack the psychological resilience to deal with such situations. (Hasan, F, Foster, 20017).

As a result, after a given period, students may experience severe stress, anxiety, self-harm,
including suicidal ideation or attempt, and so on. In recent years, for example, multiple mental
health-related incidents (e.g., suicidal attempts or suicide) have taken place in several
universities in Bangladesh. Previous research has found that university students throughout the
world, not only in Bangladesh, suffer from high rates of psychological morbidity, including
depression and anxiety. In Australia, poor mental health was found to be marginally connected to
poor test performance and subsequent university dropout. Over 44% of overseas graduate
university students said that they had had an emotional or stress-related problem that had a major
impact on their well-being or academic performance. A study conducted in Yogyakarta,
Indonesia showed that one-third of university students, for example, suffer from a diagnosable
mental illness, and 64% of those who dropped out of college did so because of a mental
condition.

Around 70%–75% of adults have mental health issues, and mental illnesses begin in adolescence
or early adulthood (12–25 years). It accounts for 13% of the worldwide burden of disease as
assessed by disability-adjusted life years. However, it is a little lower in Bangladesh (11.2%) .
According to Global Burden of Disease (GBD) 2017, Bangladesh has a 0.2% schizophrenia
incidence, compared to 0.3 % Asia and 0.3% worldwide. The estimations of epilepsy and bipolar
disorder in Bangladesh are close to regional and worldwide. Depression is more common in
Bangladesh (2.8%) than in the rest of Southeast Asia (2.2%), particularly among women (3.6%
vs 2.7%). In Bangladesh, women commit suicide at a greater rate than males (8.7 vs. 6.8) suicide
deaths per 100,000 population. The prevalence estimates for schizophrenia and associated
psychotic illnesses in the adult population from the Bangladesh household mental health survey
were 1.0% and 6.7%, respectively, which is much higher than the estimation of GBD reports. As
a result, mental diseases are one of the top ten priority health problems in Bangladesh, as
recognized by the government of Bangladesh, In order to reduce the issue in Bangladesh, the
Government empower so many NGO’S to move round the various Universities to bring
awareness to the students about mental health, base on how to prevent and provide possible
solution to mental health.(DR, Cheavens, 2018).

According to the research of adolescents, increasing awareness of mental diseases led to more
empathy and sensitivity toward those with mental health problems . Previous research, however,
indicated that public attitudes regarding persons with mental illness had not changed over the last
several decades . This might be due to a lack of mental health knowledge and awareness. For
example, Abol fotouh's study with adults aged 18 or above in Saudi Arabia found that 87.5% of
participants have lack mental health knowledge. According to research conducted among
students at an Indonesian university, 50.23 % were knowledgeable about mental health . Even
among medical students, in their early years, a study identified significant knowledge and
attitude inadequacies .

Insufficient knowledge and associated stigma affect mental health . Moreover, lack of knowledge
of psychiatric diseases may impact stigmatizing attitudes toward mental diseases or create a
barrier to the delivery of mental health care , while engagement with mentally ill persons may
result in positive attitudes and enlightened perspectives. Due to insufficient knowledge, mental
health problems are not often seen as a health issue, and they are rarely given the utmost
attention in healthcare delivery. These problems are more prevalent in low and medium-income
nations than economically developed ones . It is shocking how common depression, anxiety, and
stress symptoms are among university students.

In Gambian tradition, manifestations of mental disorders frequently get ascribed to spiritual

assaults or alleged demonic possession. Unorthodox healing modalities address the presumed
“Spiritual Root Cause” through religious and traditional approaches, such as herbal remedies or
ceremonial purification rituals. Among these methods, traditional healers also practice soaking
and ingesting Quranic verses inscribed on paper. Regrettably, these treatments often disregard
the effectiveness of medical interventions.

Additionally, there is a troubling surge in substance abuse among urban youths, primarily rooted
in mental health challenges. The absence of specialized services for addressing drug and alcohol
addiction exacerbates this issue. Furthermore, the prevalence of prostitution among young and
underage girls, coupled with the underreported and unaddressed problem of sex trafficking,
collectively compound the societal challenges impacting mental health.

Mobee Gambia, a Non-Governmental Organization (NGO) dedicated to assisting University

Students with mental health challenges, has undertaken initiatives to address mental health
concerns in the Gambia. In February 2024, the organization orchestrated an educational event
and mental well-being promotion involving a cohort of young individuals. The event centered
around the theme of drug and alcohol issues impacting the mental well-being of young people in
our communities.( Webster, RK,2030).

Mobee is currently in the planning stages of establishing offices for administrative purposes to
facilitate the implementation of psychoeducation programs to enhance individuals’ physical,
social, psychological and emotional health. Additionally, discussions are underway with the
Gambia Red Cross and Wyce.org.uk. The collaboration aims to deliver mental health services
and programs geared towards enhancing cognitive health in the Gambia.( . Health Psychol 2016).

The mental health crisis among youth has reached alarming levels, with statistics indicating that
one in five adolescents’ experiences mental health disorders, including anxiety, depression, and
behavioral issues. Despite the prevalence of these issues, many young people do not receive the
necessary support or intervention due to the pervasive stigma surrounding mental health. This
stigma often manifests as misconceptions, fear of judgment, and societal pressure, which
discourage open discussions about mental health and prevent youth from seeking help. As result,
many adolescents suffer in silence, leading to increased feelings of isolation, academic struggles,
and, in severe cases, self-harm or suicide.( J Health Commun, 2023).

Moreover in Sierra Leone there are so many mental health awareness programs in various
Universities for instance there was a particular NGO call Mansaray Foundation that was moving
round the various Universities in sensitizing students base on the danger of mental illness and
best way to solve mental illness issues.

Njala has been having several programs of such in try to sensitize the Students about the effects
of mental health issues as it will lead to anxiety and depression and also lead to death. These
programs have so many impacts on the wellbeing of Students live but nevertheless these
awareness programs are sometimes ineffective.
1.2 General Aim

The aim of this research is to investigate Mental Health Awareness Programs and its impacts to
University Students.

Case Study: Njala University Bo Campus

1.2.1 Specific objectives

The specific objectives of this study are to:

 Examine Demographic Characteristics of the respondents.

 Conceptualize the impacts of Mental Health Awareness Programs and its influence on
Student Wellbeing.
 Explore the relationship between Mental Health Awareness and Stress Level among
Student.
 Evaluate the effectiveness of existing Mental Health Programs on Campus.
 Provide recommendations for enhancing Mental Health support Services.

1.2 Problem Statement

In the past 15 years, considerable amounts of money and time have been spent on mental health
awareness efforts in the UK Universities. These include campaigns run by public health bodies
and charities as well as initiatives run by universities and schools. These efforts promote a
variety of content, such as explaining symptoms, destigmatizing specific disorders, stating that
mental health problems are common and encouraging University student to seek help. Thousands
of social media accounts run by clinicians or lay people promote similar messages. The
overarching aim of these efforts is to convey that anyone can experience problems with their
mental health, that this should not be stigmatized, and that help is available if University student
it.( Evans-Lacko,2018).

On the face of it, these are important, useful messages to disseminate. Some people will
undoubtedly have benefited from this shift in public discourse, and there is evidence that stigma
has reduced since awareness campaigns began. Reference Henderson, Robinson, Evans-Lacko
and Thornicroft. However, beneath the surface, there are a number of issues with mental health
awareness efforts in Universities, which mean that in some cases they may be unhelpful and
perhaps even actively harmful. This must be urgently addressed: some of the funding and time
that is channeled into creating and sharing awareness materials should be spent on understanding
what impact they have. These issues cause the ineffectiveness of Mental Health awareness
programs in Universities.( J Clin Psychol, 2024).

The first issue is that mental health awareness efforts have not been matched by improved access
to treatment. Referrals and waiting lists for mental health services continue to increase,
particularly among University Students . These increases are probably due to a combination of
factors: more people experiencing symptoms, more people seeking help and/or reduced funding
to services. Whatever the explanation, the upshot is the same: people are being told to seek help
and the help is often not there. If someone is made aware that they are experiencing mental
health problems or are encouraged to view their distress in this way, and they ask for help only to
be told there is none, this may exacerbate their distress.( Br J Psychiatry, 2017).

The second issue is that mental health awareness efforts may encourage overpathologising. To
start, some mental health problems are responses to exceptionally difficult external
circumstances (e.g. poverty, bullying).( Cambridge University Press, 2025).

Many awareness campaigns aim to empower University Students to improve their symptoms by
changing the way they think and behave, but this message can inaccurately imply that
individuals are the root cause of their symptoms, ignoring systemic hardships and societal issues
that need addressing instead.( Weinman, J, Rubin,2018).

The third issue with mental health awareness efforts is that they may alienate the very people
they were originally trying to support. Individuals with the most severe mental health problems
feel they have been left out of the public conversation, with all the oxygen taken up by
individuals who have milder symptoms, and they feel that their debilitating disorders are being
misrepresented and dismissed.( Rutter, LA, Howard,2017).
1.4 Scope of the Study

The scope of this study is limited within the confines of Njala University Bo Campus located in
Bo district Southern province, taking into consideration Mental Health Awareness programs in
Sierra Leone and Njala University Bo campus. This study only captures the most prominent
Mental Health Programs in Njala University Bo Campus. This study shall capture the impact of
Mental Health Awareness Programs and its influence on Student’s wellbeing. This study shall
capture the effectiveness of existing Mental Health Programs on Campus taking into
consideration recommendations for enhancing Mental Health support Services . The research
methods that shall be use to obtaining data is questionnaire, this can incorporate both qualitative
and quantitative methods of research depending on the types of questions ask. This work
primarily focuses on two sources of data namely, primary source of data and secondary source of
data. The primary source of data has to do with the information obtained from the people directly
by the researcher which is firsthand information, the secondary data more or less has to do with
information that is gathered elsewhere beyond face-to-face discussion. This research will
incorporate Students, Mental Health Practitioners, Social Workers and Community Stake
holders.

1.5 Justification/Rationale of the study

The significance of this study is to objectively examine Mental Health Awareness Programs and
its impacts to Students. Information and education to the Students populace is key in this
research. This research shall also be relevant to the Government in knowing the various Mental
Health issues faced by students in Sierra Leone and Njala University Bo Campus Students to be
specific. For a country like Sierra Leone to be developed Government must try to ensure
different mental health programs to reach students because mental issues most times lead to
death and there will be a decrease in Human capital development.

This research shall also be relevant to the study area which is Njala University Bo Campus as
they shall also know the impacts of those mental health programs to students. Also they shall be
able to know about the different mental issues students faced on campus, and also the
effectiveness of those various mental health programs.
In addition, the scholarly community shall benefit from this work because it has to be circulated
on the internet for public consumption, this in turn shall help many within the realm of academia
to understand how community radio stations and farmers promote agriculture activities. For the
purpose of intellectual exercise, individuals who find pleasure in doing research shall equally
benefit from this work because it shall serve as reference material upon which they can anchor
their research. This shall increase their knowledge on mental health programs impacts on
students. Researchers shall use this book to solicit relevant information regarding mental health
programs, this shall help them and facilitate their research work at the preliminary stage and
other subsequent stages of their academic exercise.
Lastly and most importantly, this research shall serve as a partial fulfillment for the award of the
degree of B.Sc. Hons Social work which I'm here to attain at Njala University Bo Campus. It is
also consequential to note that since I'm here to get a degree, this work shall provide me the
opportunity to be graded which shall constitute an integral aspect of my degree. This exercise
shall help to stretch and improve my knowledge with regards mental health awareness programs.

1.6 General Hypothesis

Mental Health Awareness Programs has an impact on Students Well-being.

1.6.1 Specific Hypothesis

The specific Hypothesis of this study includes

Ho An increase in Mental Health Awareness Programs shall lead to increase in Students Well-
being.

H1 A decrease in Mental Health Awareness Programs shall lead to decrease in Students Well-
being.
 CHAPTER THREE

RESEARCH METHODOLOGY

3.0 Introduction

This chapter shall now describe the various methodologies that shall be use in this study, as it
presents a clear picture of the methods that shall be use throughout this study. On that basis
therefore, they are arranged under the following subheadings:

 Description of study area.

 Research design.
 Sample size Selection techniques.
 Sources of data collection.
 Data analysis methods and techniques

3.1 Description of study area

Njala University Bo Campus is located at Bo district Sothern province, the University has two
campuses one is call Torwama campus and another Kowama Campus. Torwama campus
comprises of 2 Schools. The first School is School of Social Sciences and Law and courses
under this School are Banking/Finance, Accounting, Social work/Sociology, Business
Administration etc. School of Education comprises of courses like Political Science, Linguistics,
e.t.c. Kowama campus has one School which is call School of Medicine and Community Health
Sciences, courses under this school are Medicine, Nursing, Public Health e.t.c.
3.2 Research Design

Research design is the plan structure of investigation conceived with a view to obtain answers
that fit the research objectives. In the course of conducting this research about Mental Health
Awareness Programs to Students, it shall use a combination of Quantitative and Qualitative
research design (Mixed-research design).

3.3 Sample Size selection technique

Sampling is the process of selecting units (e.g., people, organizations) from a population of
interest so that by studying the sample we may fairly generalize our results back to the
population from which they were chosen or selected to participate in the research (Taherdoost,
2016).

The selected individuals for this study shall be generalize for the whole population. Reducing the
number of individuals in a study, apart from reducing the cost and workload of the research, also
makes the exercise easier. However, care shall be taken to ensure that a sizable number is
selected in other to be generalize to the whole population. It is often necessary to use sampling
because researchers usually do not have the time, energy, money or resources to study the whole
population. The purposive sampling techniques shall be used to select respondents; not every
individual in the study area have an equal chance of being selected to participate in this study.
The sampling size for this logical investigation shall be 80 respondents; selection procedure shall
be base on those who have knowledge about the topic.

3.4 Sources of Data

Data collection in research involves gathering data from the sample so that the research
objectives shall be met [Bryman, 2008]. In this study, a mixed model approach shall be use
which is a combination of qualitative and quantitative methods. On that basis therefore, the
mixed methods shall be further divided into two main sources of data which include primary and
secondary sources of data. These two methods (mixed method) shall be use by the researcher to
solicit relevant information from the respondents relating to the subject matter.
3.4.1 Primary Sources of Data

Primary sources of data are the various research techniques which could either be quantitative or
qualitative, that are used to collect the first-hand evidence or data of a research. In other words,
the primary source of data refers to the first-hand information received by a researcher in the
field. These sources are records of events or evidence as they are first described or actually
happened without any interpretation or commentary. It is information that is shown for the first
time or original materials on which another research is based. Primary sources display original
thinking, report on new discoveries, or share fresh information.

3.4.1.1 Questionnaires

In order to solicit first hand data for this study, questionnaires shall be prepared and administer
among the various institutions and individuals that make up the sample frame for this study. The
questionnaire shall be design in accordance with the research objectives. These questionnaires
shall be administered on the self-administer bases to ensure that respondents provide realistic
answers to questions that are not influence by the researcher’s presence

3.4.1.2 In-depth Interviews

For the purpose of this study, in-depth interviews shall be use. In-depth interviews in this study
shall be personal and unstructured interviews, whose aim shall be able to identify participant’s
emotions, feelings, and opinions regarding this study. The purpose of this technique in this study
is to involve personal and direct contact between the interviewer and the interviewees, and to
also eliminate non-response rates.

3.4.2 Second source of Data

Secondary Sources of data is any other source, other than the primary sources of data collection,
which could either be from the past or present research works, through which data is collected
for a study. The researcher in this study shall review related literatures on the research topic from
textbooks; government or private institutions’ documents; newspapers; magazines; online
published papers and articles. This is done to acknowledge and get ideas from people who have
done research of this nature. Secondary data is the data that has already been collected through
primary sources and made readily available for researchers to use for their own research. It is a
type of data that has already been collected in the past. A researcher may have collected the data
for a particular project, then made it available to be used by another researcher. The data may
also have been collected for general use with no specific research purpose like in the case of the
national census.

3.4.2.1 Libraries

For the purpose of this research the data tools or instrument that shall also be used to solicit
secondary source of data is Libraries. Libraries are one of the best, cheapest, and reliable
sources. There is at least one community library in every town. Otherwise, there are libraries in
school or colleges which provide books for reading either free of cost or at very minimal
charges. From the books available in the library, you can collect good quality of secondary data.
Moreover, the information provided in the books are authentic and gone through much analysis.

3.4.2.2. Internet

This particular instrument or data tools shall be use to solicit information for the purpose of this
research. Internet is a platform that provides you an abundance of data within a second. On the
internet, you will find both published and unpublished secondary data on any topic. However,
the data gathered from the internet is not reliable as there is nobody who regulates or check the
validity of data being uploaded on the internet. However, one should take the utmost care from
choosing the platform to get secondary data to be use in research. There are plenty of authorized
websites which provides secondary data on various research problem both paid and unpaid, and
there are individuals who post the information that they have collected from their research on
their website or blog.
3.5 Data Analysis Methods and Techniques

The data shall be collected from the two main sources of data in the form of questionnaire, in-
depth interview, and relevant literatures, libraries internet shall be analyzed quantitatively and
qualitatively.

3.5.1 Quantitative analysis

Quantitative data that shall be collected through the questionnaire shall be analyzed by the
researcher using the Statistical Packages for Social Sciences [SPSS] in an endeavor to meet the
objectives of this study. The results shall be presented in tables and figures using percentages and
frequency to facilitate comparisons and further analysis.

3.5.2 Qualitative analysis

Qualitative data that shall be obtain through in-depth interviews and observations with the study
population shall be edited to correct potential errors and ensure the data fits the requirement of
the research objectives. The data shall further be coded in order to have a meaningful category to
bring an essential pattern of the responses.