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Effect of Mental Health First-Aid Education on Mental Health First-Aid Knowledge among University Students in Nigeria

Abstract

Mental health problems are an important public health concern among university students because students may experience academic pressure, financial difficulties, relationship challenges, social adjustment, and other stressors that can affect their mental well-being. Early recognition of mental health problems and appropriate initial support may contribute to timely access to professional care and reduce the potential consequences of untreated mental health difficulties. Mental health first-aid education provides participants with knowledge and practical information on recognizing signs of common mental health problems and psychological distress, responding appropriately to individuals experiencing mental health challenges, providing initial supportive assistance, encouraging professional help-seeking, and responding appropriately to mental health crises. Mental health first-aid knowledge refers to students' understanding of common mental health problems, warning signs, appropriate initial responses, supportive communication, referral pathways, crisis recognition, and appropriate sources of professional and community support. In Nigeria, limited mental health literacy, misconceptions about mental illness, stigma, inadequate awareness of available mental health services, and limited exposure to structured mental health education may affect students' ability to recognize and respond appropriately to mental health problems among their peers. Effective mental health first-aid education may improve students' knowledge, recognition skills, confidence, and understanding of appropriate support and referral procedures. Against this background, this study investigates the effect of mental health first-aid education on mental health first-aid knowledge among university students in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains health-related behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding students' recognition of mental health problems and willingness to provide appropriate initial support. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping health-related behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how structured mental health first-aid education may improve students' knowledge and understanding of appropriate responses to mental health problems. Collectively, these theoretical perspectives provide a suitable framework for explaining how mental health first-aid education may influence mental health first-aid knowledge among university students in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from university students in selected Nigerian universities using a structured self-administered questionnaire and a standardized or researcher-developed mental health first-aid knowledge assessment. A multistage sampling technique will be employed to select universities, faculties or departments, academic levels, and eligible students. Where feasible, selected student groups will be assigned to intervention and comparison groups. Students in the intervention group will receive structured mental health first-aid education covering common mental health problems, signs and symptoms of psychological distress, recognition of mental health crises, appropriate initial responses, supportive communication, basic mental health first-aid principles, referral pathways, professional help-seeking, suicide and self-harm warning signs, and appropriate responses to mental health emergencies. Mental health first-aid knowledge will be assessed using indicators such as recognition of common mental health problems, identification of warning signs, understanding of appropriate first responses, knowledge of supportive communication, awareness of professional referral options, recognition of mental health crises, and understanding of appropriate sources of assistance. Descriptive statistics will be used to summarize students' sociodemographic and academic characteristics, baseline mental health first-aid knowledge, exposure to education, and knowledge levels. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of mental health first-aid education on students' knowledge. Where appropriate, pre-intervention and post-intervention knowledge scores will be compared to determine changes following the educational intervention. Diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, and robustness of the findings. The study is expected to find that mental health first-aid education has a significant positive effect on mental health first-aid knowledge among university students in Nigeria. Students exposed to structured mental health first-aid education are expected to demonstrate improved recognition of common mental health problems, better understanding of warning signs, improved knowledge of appropriate initial responses, and greater awareness of professional mental health support and referral options. Education may also improve students' understanding of mental health crises and appropriate responses to peers experiencing psychological distress. However, the acquisition of knowledge may not automatically translate into appropriate behaviour in all situations because stigma, misconceptions, fear of negative social reactions, limited availability of mental health services, and cultural perceptions of mental illness may continue to influence students' responses. Consequently, mental health first-aid education should form part of broader university mental health promotion programmes that include accessible counselling services, mental health awareness campaigns, referral systems, and supportive campus environments. The study is expected to contribute to the literature on mental health literacy, mental health first aid, health education, student health, mental health promotion, and public health in Nigeria by providing empirical evidence on the effect of mental health first-aid education on mental health first-aid knowledge among university students. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Universities Commission, university management authorities, student affairs divisions, university counselling centres, mental health professionals, public health practitioners, student organizations, development partners, and policymakers regarding strategies for improving mental health literacy among university students. The study will also provide evidence-based recommendations for incorporating mental health first-aid education into university health promotion programmes, strengthening student mental health services, improving mental health referral pathways, expanding mental health awareness initiatives, and equipping university students with appropriate knowledge to recognize and respond to mental health challenges among their peers.

Keywords: Mental health first-aid education, mental health first-aid knowledge, university students, mental health literacy, mental health promotion, psychological distress, mental health awareness, health education, student health, mental health support, public health, Nigeria.