Strategies to promote mental health among students in higher education institutions in Ethiopia

Abstract

Pieces of evidence show that due to various factors mental health problems are on the rise among students in higher education institutions globally and particularly in Ethiopia. The level of positive mental health and associated factors among students in higher education are not widely known. There are limited evidences on mental health programs or strategies that help to promote the mental well-being of learners in higher institutions in Ethiopia. The purpose of this study was to develop and describe strategies for the promotion of students’ mental health in higher education in Ethiopia. A sequential exploratory mixed-method design was used in three phases. In phase I: the qualitative phase, in-depth interviews were conducted among 28 purposefully selected students and key informants from different categories and genders. Translation to English, verbatim transcription of recorded audio files, coding, and finally thematic analysis was employed for qualitative data management and analysis. In phase II: the quantitative phase, a cross-sectional study was conducted among systematically selected 805 students who filled out a self-administered questionnaire. Data were cleaned and entered into EPI-data version 3.1.1 and analysed using SPSS version 26. Univariate analysis and bivariate logistic regression were employed for quantitative data management. Statistically, a significant association was determined by OR and CI of 95% with a p-value <0.05. In phase III of this study, the mental health promotion strategy for students in higher institutions was developed and described. The findings of the qualitative phase of the study indicated five interrelated and connected themes which were generated from the coding of all transcripts and thematic analysis. These themes include mental health problem experiences and potential causes, mental health problem effects on students, help sought for their problem and mental health programs, suggested approaches for mental health promotion strategies, and roles of different individuals and institutions. The result of the qualitative study was also utilized for the development of a questionnaire for the quantitative phase and as input for the development of the mental health promotion strategy of students in higher education in Ethiopia. In this study, 303 (37.6%) of the respondents have not flourished positive mental health with a confidence interval of CI (34.2, 41.0); while 502 (62.4%) of the respondents have flourishing positive mental health with a confidence interval of CI (59.0, 65.8). Current family breakdown of students’ biological parental marital condition, 500-1000km distance of university from family hometown, having had a history of substance use in the last 12 months, having low perceived social support, having low daily spiritual experiences, and not having any monthly financial support showed statistically significant negative association to flourishing positive mental health. A strategy for the promotion of the mental health of learners in higher education institutions was developed and described. The study reveals substantially low flourishing positive mental health among the students due to different factors in a higher institution. The absence of mental health programs was also indicated as a major problem. The developed strategies will empower students to maintain psychological well-being and enable higher institutions to promote the well-being of the learners by establishing safe and supportive learning and campuses.