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Impact of Self-Harm Awareness Education on Self-Harm Recognition among University Students in Nigeria

Abstract

Self-harm is an important mental health and public health concern among university students and may be associated with emotional distress, depression, anxiety, trauma, interpersonal difficulties, academic pressures, and other psychological challenges. University students in Nigeria may experience academic demands, financial difficulties, relationship problems, family pressures, social adjustment challenges, and uncertainty about their future, which may contribute to psychological distress and increase vulnerability to self-harm. However, self-harm may remain unrecognized because of stigma, misconceptions, fear of judgment, limited mental health awareness, and reluctance to discuss emotional difficulties. Self-harm awareness education provides an opportunity to equip university students with accurate information about self-harm, including its warning signs, risk factors, misconceptions, appropriate responses, available support services, and circumstances requiring urgent professional assistance. Against this background, this study investigates the impact of self-harm awareness education on self-harm recognition among university students in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and the Theory of Planned Behavior. The Health Belief Model explains how students' perceptions of the seriousness and consequences of self-harm, perceived benefits of awareness education, perceived barriers, and cues to action may influence their ability to recognize self-harm-related concerns. Social Cognitive Theory emphasizes the roles of knowledge, self-efficacy, observational learning, social interaction, and environmental influences in developing recognition and appropriate supportive responses. The Theory of Planned Behavior explains how attitudes, subjective norms, perceived behavioural control, and behavioural intentions may influence students' willingness to recognize self-harm warning signs and respond appropriately. Collectively, these theoretical perspectives provide a suitable framework for explaining how self-harm awareness education may influence self-harm recognition among university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate and postgraduate students enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select states, universities, faculties, departments, and eligible students. Self-harm awareness education will be measured using indicators such as exposure to structured educational sessions, frequency and duration of education, knowledge of self-harm, recognition of warning signs, understanding of risk factors, common misconceptions, recognition of emotional distress, awareness of appropriate communication, supportive responses, stigma reduction, available counselling services, referral pathways, crisis-support resources, and situations requiring urgent professional intervention. Self-harm recognition will be assessed using indicators such as the ability to identify common signs of self-harm, recognize behavioural and emotional warning signs, distinguish self-harm from accidental injury, identify risk factors, recognize changes in behaviour or social functioning, identify situations requiring immediate support, understand appropriate responses to individuals at risk, and identify appropriate professional and emergency support pathways. Data will be collected using structured questionnaires, case-based scenarios, and appropriately validated self-harm recognition instruments administered before and after the educational intervention where a quasi-experimental design is used. Descriptive statistics will be used to summarize students' demographic and academic characteristics, exposure to self-harm awareness education, and recognition levels. Inferential statistical techniques, including paired or independent sample tests, chi-square tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of self-harm awareness education on self-harm recognition. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that self-harm awareness education has a significant positive impact on self-harm recognition among university students in Nigeria. Students exposed to structured self-harm awareness education are expected to demonstrate greater ability to recognize warning signs, understand risk factors, identify misconceptions, distinguish self-harm from accidental injury, recognize situations requiring professional attention, and identify appropriate sources of support compared with their baseline recognition or students without similar educational exposure. Educational approaches involving case-based discussions, guided scenarios, peer education, interactive sessions, and information about available counselling and crisis-support services may strengthen students' ability to recognize self-harm-related concerns in themselves and others. Improved recognition may facilitate earlier communication with appropriate support persons and referral to qualified mental health professionals. However, stigma, fear of judgment, misconceptions about self-harm, concerns about confidentiality, limited counselling services, inadequate mental health personnel, and reluctance to disclose emotional difficulties may reduce the effectiveness and sustainability of awareness education. The study therefore expects accessible, sensitive, culturally appropriate, evidence-based, and sustained self-harm awareness education to contribute significantly to improved self-harm recognition among university students in Nigeria. The study is expected to contribute to the literature on self-harm awareness education, self-harm recognition, university student mental health, mental health literacy, suicide and self-harm prevention, health education, early identification, mental health promotion, and public health in Nigeria. The findings will provide useful information to the National Universities Commission, Federal Ministry of Education, Federal Ministry of Health and Social Welfare, university administrators, student affairs departments, counselling centres, university health services, psychologists, psychiatrists, counsellors, social workers, public health practitioners, student organizations, development partners, and policymakers regarding strategies for strengthening early recognition and support for students experiencing self-harm-related difficulties. The study will also provide evidence-based recommendations for integrating self-harm awareness education into university mental health programmes, strengthening counselling and referral systems, improving staff and peer-support capacity, promoting safe and appropriate communication, reducing stigma, increasing awareness of available support services, and establishing sustainable early-recognition and mental health support programmes across universities in Nigeria.

Keywords: Self-harm awareness education, self-harm recognition, university students, mental health literacy, self-harm prevention, early recognition, student mental health, health education, mental health promotion, counselling services, Nigeria, public health.