Mental health and help-seeking behaviour among secondary school adolescents in Nsukka, Nigeria: a cross-sectional survey

Globally, depression and anxiety remain a public health concern among adolescents. Understanding the role of help-seeking behaviour in predicting the prevalence of depression and anxiety among adolescents is important for designing effective interventions. This study investigated the relationship between help-seeking behaviour and the prevalence of depression and anxiety among school adolescents in Nsukka, Nigeria. A descriptive cross-sectional study was conducted among randomly selected adolescents aged 10–19 from three secondary schools in Nsukka, Nigeria. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7) Scale, and General Help-seeking Questionnaire (GHSQ) were used for the data collection. Using stratified random sampling technique, 394 respondents were recruited for this study. All participants provided informed consent prior to the study initiation. The data obtained were analyzed using descriptive statistics, chi-square test, and multivariate logistic regression. The level of significance was set at p < 0.05. A total of 394 school adolescents participated in this study, yielding a response rate of 88.5%. Most students were female (n = 272, 69.0%) and aged 14–17 (n = 233, 59.1%). The prevalence of moderate to severe symptoms of depression and anxiety were 22.1% and 21.3%, respectively. The most frequent source of help for depression or anxiety among adolescents were the parents (n = 284, 72.1%). The indifferent attitude to help-seeking from friends (OR = 2.125, 95%CI = 1.243–3.635, p = 0.006), school counsellor (OR = 2.953, 95%CI = 1.334–6.537, p = 0.008), and religious leaders (OR = 2.037, 95%CI = 1.002–4.142, p = 0.038) were associated with a higher prevalence of depression. Similarly, being neutral or indifferent about seeking help from school counsellors (OR = 2.485, 95%CI = 1.160–5.320, p = 0.019) and religious leaders (OR = 2.171, 95%CI = 1.090–4.324, p = 0.027) were associated with higher odds of developing anxiety compared to those more likely to seek help from these sources. In this study, one in five adolescents has moderate to severe symptoms of depression and anxiety. Indifferent attitude to help-seeking from friends, school counsellors, and religious leaders were associated with higher prevalence of depression and anxiety among school adolescents. Therefore, school-based mental health education and literacy programs is recommended as a way of improving early detection and care for adolescents with psychological issues.