Project – Knowledge, Perception and Utilisation of Mental Health Services among Young Adults: A Study of Selected Tertiary Institutions in Enugu East Local Government Area, Enugu State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Mental health is an essential component of overall health and well-being. It influences how individuals think, feel, behave, relate with others and respond to the demands of everyday life. The World Health Organization (WHO) defines mental health as a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to their communities (World Health Organization [WHO], 2022). Mental health is therefore not merely the absence of mental illness; rather, it represents an important dimension of human functioning and quality of life. Despite its importance, mental health remains one of the areas of health that receives inadequate attention in many low- and middle-income countries, including Nigeria. The WHO’s World Mental Health Report emphasizes that mental health needs are high globally while responses remain insufficient and calls for stronger, accessible and community-based mental health services (WHO, 2022).

Mental health problems constitute a major public health concern because they can affect individuals across the life course. Conditions such as depression, anxiety disorders, substance-use disorders, psychotic disorders and other psychological problems can impair social relationships, academic performance, occupational functioning and general quality of life. The burden of mental disorders is particularly important among young people because many mental health conditions emerge during adolescence and early adulthood. The transition from adolescence to adulthood involves major educational, social, economic and interpersonal changes. For young adults enrolled in tertiary institutions, these transitions may be accompanied by academic pressure, financial difficulties, relationship problems, uncertainty about employment and career prospects, adjustment to independent living, peer pressure and other psychosocial challenges.

Young adulthood is therefore an important period for mental health promotion and early intervention. Individuals in this age group are increasingly expected to make independent decisions about their health, including whether to seek professional assistance when experiencing emotional or psychological difficulties. Unlike younger children who depend heavily on parents or guardians to obtain healthcare, young adults may independently decide whether to acknowledge symptoms, disclose their problems, seek professional help, use informal support systems or avoid care altogether. Consequently, knowledge, perceptions and attitudes toward mental health services can have substantial implications for whether available services are actually utilised.

Knowledge is an important factor in mental health service utilisation. Knowledge refers to an individual’s understanding of mental health, mental disorders, symptoms, causes, treatment options, available services and appropriate sources of professional assistance. Adequate knowledge may enable individuals to recognize early signs of psychological distress and understand when professional assistance is necessary. Conversely, inadequate or inaccurate knowledge may result in misconceptions about mental illness, misinterpretation of symptoms or reliance on inappropriate sources of treatment. Mental health literacy has consequently become an important concept in mental health promotion because it involves the ability to recognize, understand and respond appropriately to mental health problems.

Mental health literacy also includes knowledge of how mental disorders can be prevented and managed and where professional assistance can be obtained. Jorm (2012) argues that mental health literacy encompasses knowledge and beliefs about mental disorders that facilitate their recognition, management and prevention. Individuals with better mental health literacy may be more likely to recognize symptoms and seek appropriate assistance. However, knowledge alone does not necessarily guarantee utilisation because perceptions, stigma, cultural beliefs, cost, availability and accessibility of services can influence whether a person actually seeks care.

Perception is therefore another important component of mental health service utilisation. Perception refers to how individuals understand, interpret and evaluate mental health conditions and the services designed to address them. A person may be aware that counselling or psychiatric services exist but perceive such services as being intended only for people with severe mental illness. Another person may perceive visiting a mental health professional as an indication of weakness, instability or personal failure. Such perceptions may discourage help-seeking even when the individual recognizes a need for assistance.

Stigma represents one of the most persistent barriers to mental health service utilisation. Stigma can involve negative stereotypes, prejudice, discrimination and social distancing toward individuals experiencing mental health conditions. Corrigan et al. (2014) explain that stigma can influence help-seeking by creating fears of rejection, discrimination and negative social consequences. Young adults may be particularly concerned about how friends, classmates, lecturers, family members or potential employers might perceive them if they disclose psychological difficulties or are known to be receiving mental health treatment.

Cultural beliefs can also shape perceptions of mental illness and professional mental health care. In many societies, psychological symptoms may be interpreted through spiritual, religious, moral or supernatural explanations. Although religious and cultural support can be valuable components of coping and social support, exclusive reliance on non-medical explanations may sometimes delay professional assessment and treatment. In Nigeria, misconceptions concerning the causes and treatment of mental illness have historically contributed to stigma and treatment-seeking from informal or traditional sources. The existence of such beliefs makes it necessary to understand not only whether young adults possess information about mental health services but also how they perceive those services.

The availability of mental health services is another important consideration. Knowledge and positive perception may have limited effects on utilisation when services are unavailable, unaffordable, geographically inaccessible or poorly integrated into routine healthcare. The WHO emphasizes the importance of community-based mental health services and integration of mental health into primary healthcare as essential components of a responsive mental health system (WHO, 2022). This is particularly relevant in low- and middle-income countries, where specialist mental health personnel and facilities may be unevenly distributed.

Nigeria faces significant challenges in providing adequate mental healthcare to its large and diverse population. The country’s mental health system has historically been characterized by inadequate resources, limited specialist personnel, uneven service distribution and substantial gaps between people who need care and those who receive appropriate treatment. The WHO Mental Health Atlas 2020 country profile for Nigeria documents the country’s mental health system and provides evidence of the continuing need to strengthen mental health services and resources (WHO, 2022).

Evidence from the Nigerian Survey of Mental Health and Well-Being further demonstrates the burden of mental disorders in the country. Gureje et al. (2018) reported that mental disorders constitute a significant public health concern in Nigeria and highlighted the limited availability of nationally representative epidemiological evidence. Their work remains important because it demonstrates that mental disorders occur in the Nigerian population and that the country’s mental health needs require systematic responses.

The challenge is not only the presence of mental health problems but also the extent to which affected individuals receive appropriate care. Historically, a substantial proportion of Nigerians experiencing mental health problems have not accessed specialist mental healthcare. Factors contributing to this treatment gap include inadequate service availability, financial constraints, stigma, poor mental health literacy, cultural beliefs, geographical barriers and reliance on informal or traditional sources of care.

Nigeria has, however, taken important steps toward strengthening its mental health system. The National Mental Health Act 2021 represents a significant legislative development in the country’s mental health sector. The Act provides for the enhancement and regulation of mental health services, protection of the rights of persons with mental health conditions and the development of a coordinated approach to mental healthcare. It also promotes access to integrated mental healthcare and a community-based approach to service delivery (Federal Republic of Nigeria, 2022). The Federal Ministry of Health and Social Welfare lists the National Mental Health Act among Nigeria’s public health policy documents.

The passage and implementation of mental health legislation are important, but legislation alone cannot guarantee service utilisation. The effectiveness of mental health policies ultimately depends partly on whether individuals know that services exist, understand their purpose, perceive them as acceptable and trustworthy, and are willing and able to use them. Consequently, studying knowledge, perception and utilisation among young adults is important for evaluating whether formal mental health services are reaching a population that may experience substantial psychological and social pressures.

Tertiary institutions provide an especially important setting for studying mental health service utilisation among young adults. Universities, colleges of education, polytechnics and other tertiary institutions bring together large populations of young adults who are undergoing significant academic and psychosocial transitions. Students may experience demanding academic schedules, examinations, financial pressures, accommodation problems, relationship difficulties, social adjustment, loneliness and uncertainty about the future. Some may also combine academic responsibilities with employment or family responsibilities. These circumstances can contribute to psychological distress and may influence the need for mental health support.

The tertiary institution environment also presents opportunities for early detection and intervention. Institutions may provide counselling centres, medical centres, psychological services, peer-support programmes, religious organizations and other forms of student support. However, the mere presence of these services does not guarantee that students will use them. A service can remain underutilised if students are unaware of its existence, do not understand its purpose, perceive it negatively, doubt its confidentiality or consider it inappropriate for their problems.

Empirical studies among Nigerian university students support this concern. Idoko, Udo and Idoko (2021), in a study of students in a Nigerian tertiary institution, found that although many respondents expressed positive views about the importance of mental health, substantial gaps existed in their knowledge and perceptions of mental health services. Specifically, 45.6% of respondents were unaware of the availability of mental health services in Enugu, while 66.2% indicated that they would seek orthodox mental health services if necessary. The study also found negative perceptions toward persons with mental illness among a substantial proportion of respondents. The authors concluded that there was a need for improved mental health awareness even among university students.

This finding is particularly relevant to the present study because it demonstrates that being a university student does not necessarily imply adequate mental health literacy. A student may have relatively high educational attainment but still possess misconceptions about mental illness, mental health professionals or the usefulness of professional services. It also demonstrates that awareness of the existence of mental health services may differ from willingness to use them.

Another Nigerian study examined factors affecting mental health service utilisation among undergraduate students and found that utilisation remained poor despite generally positive attitudes and health-seeking behaviour. Among 450 students, 66.7% reported that they had never used mental health services, while more than 64% were classified as having poor utilisation. Important barriers included cost, concerns about confidentiality, lack of time, inadequate knowledge of available mental health services and insufficient social support. The study also found significant associations between source of information, health-seeking behaviour and utilisation (Oladimeji et al., 2022).

The findings of this study illustrate the difference between positive perception and actual utilisation. Students may agree that mental health is important and may even express willingness to seek help, yet relatively few may actually use formal mental health services. This gap between intention and behaviour is important because mental health problems can worsen when individuals delay professional assessment or treatment.

Similarly, Okunaiya and Omovre (2021) examined counselling services and mental health among Nigerian university students and reported high awareness of counselling services but relatively low utilisation. Their study found awareness of counselling services at 86.1%, while only 28% of respondents reported utilisation. This finding suggests that simply increasing awareness may not be sufficient to increase service utilisation. Other factors such as stigma, perceptions of confidentiality, accessibility, perceived usefulness and attitudes toward counselling may also influence behaviour.

More recent Nigerian evidence continues to demonstrate gaps in mental health knowledge and access among university students. Ikpeama, Onalu and Idu (2025), in a qualitative study involving undergraduates of the University of Nigeria, Nsukka, found gaps in access to information about mental health services and identified concerns regarding awareness creation and attitudes toward persons with mental health problems. The researchers concluded that addressing these gaps could contribute to improved utilisation of mental health services among young people.

These findings are important for the present study because the University of Nigeria, Nsukka is located within Enugu State, while the present study focuses specifically on selected tertiary institutions in Enugu East Local Government Area. Although findings from Nsukka provide useful evidence, differences in institutional structures, student populations, socioeconomic characteristics, availability of counselling services and local health systems mean that findings should not automatically be generalized to tertiary institutions in Enugu East.

The relationship between knowledge and utilisation is therefore not straightforward. Knowledge can facilitate recognition of mental health symptoms and awareness of appropriate services, but knowledge may be undermined by negative perceptions. For example, a young adult may know that depression is a treatable condition but still believe that seeking counselling indicates weakness. Similarly, a student may know that a counselling centre exists but avoid it because of concerns about confidentiality or fear of being stigmatized by peers.

Perception of confidentiality is particularly important within tertiary institutions. Young adults may be reluctant to disclose personal problems if they believe information provided to counsellors or health professionals could reach lecturers, parents, classmates or other students. Concerns about privacy can therefore discourage utilisation even when services are physically accessible. The study of Nigerian undergraduates reported substantial concerns regarding confidentiality as one of the factors influencing mental health service utilisation (Oladimeji et al., 2022).

Cost may represent another barrier. Although tertiary institutions may provide some health or counselling services, students may still require payment for consultations, medications, laboratory investigations or external specialist services. Young adults who depend on parents or guardians may be reluctant to request financial support for mental health treatment because of fear of disclosure or because mental health problems may not be regarded as legitimate healthcare needs. Students who live independently may also have limited financial resources.

Time and academic commitments can also influence utilisation. Students may consider counselling or mental health appointments difficult to fit into their academic schedules. Those who experience psychological distress may prioritize examinations, assignments or other responsibilities over seeking care. If mental health services have inconvenient opening hours or long waiting periods, utilisation may be further reduced.

Social support can influence help-seeking in either positive or negative ways. Friends and family can encourage a distressed young adult to seek professional assistance, but they can also discourage such behaviour if mental illness is stigmatized or interpreted through negative cultural beliefs. Peer attitudes are particularly important among young adults because social acceptance and belonging are significant aspects of university life.

Digital media also increasingly influences young adults’ understanding of mental health. Students may obtain information through social media, websites, online videos, blogs and other digital platforms. These channels can improve access to mental health information, but they may also expose young adults to misinformation, self-diagnosis and unverified treatment claims. The source and quality of mental health information therefore deserve attention when assessing knowledge and perceptions among young adults.

The importance of information sources is supported by empirical evidence. Oladimeji et al. (2022) found a significant relationship between students’ sources of mental health information and their utilisation of mental health services. This suggests that improving mental health communication in tertiary institutions should involve identifying the information channels through which young adults are most likely to receive and trust mental health information.

The issue also extends beyond students who already have a diagnosed mental health condition. Mental health services may include counselling, psychological assessment, psychotherapy, psychiatric care, crisis intervention, substance-use support, stress-management programmes, suicide-prevention services, psychosocial support and referral services. Young adults may require these services for a wide range of concerns before a diagnosable mental disorder develops. Early and appropriate help-seeking can therefore be considered part of preventive mental healthcare.

The WHO advocates strengthening community-based mental health services and integrating mental healthcare into broader health systems rather than relying solely on specialized psychiatric institutions (WHO, 2022). For tertiary institutions, this principle supports the development of accessible, acceptable and youth-friendly mental health services within or near educational environments.

Enugu State provides a particularly relevant context for such investigation because it has several tertiary institutions and a large population of young adults. Enugu East Local Government Area contains important educational and urban communities, and young adults within the area may access mental health services through institutional counselling centres, health centres, hospitals, private providers, religious organizations, community-based services and other sources. However, the availability and actual use of these services may vary considerably between institutions and individuals.

It is therefore necessary to distinguish between availability, awareness, perception and utilisation. Availability refers to whether a service exists; awareness or knowledge refers to whether young adults know about mental health and available services; perception concerns how they interpret and evaluate those services; and utilisation refers to whether they actually access and use them when needed. A weakness in any one of these stages may reduce the overall effectiveness of the mental health service system.

The present study is consequently anchored on the assumption that improved knowledge and favourable perceptions may encourage appropriate utilisation, whereas inadequate knowledge, stigma, negative perceptions, concerns about confidentiality, cost, lack of information and other barriers may discourage utilisation. Investigating these relationships among young adults in selected tertiary institutions can provide evidence for improving mental health education, counselling services, referral systems and institutional health programmes.

1.2 Statement of the Problem

Mental health problems among young adults represent an important but frequently under-recognized public health challenge. Young adulthood is a period associated with major educational, social, economic and developmental transitions, and many mental health problems emerge during this period. Despite the availability of mental health interventions, a considerable proportion of people who require care do not receive appropriate professional assistance. The WHO continues to identify inadequate access to mental health care, stigma and insufficient investment as major global challenges (WHO, 2022).

The problem is particularly important in Nigeria, where mental healthcare has historically received fewer resources than many other areas of health. Although Nigeria has made progress through the development of mental health policies and the enactment of the National Mental Health Act, significant challenges remain in translating policy commitments into accessible and acceptable services. The National Mental Health Act seeks to promote coordinated mental healthcare, protect the rights of persons with mental health conditions and improve access to quality mental health services (Federal Republic of Nigeria, 2022).

A major dimension of the problem is the gap between the existence of mental health needs and the utilisation of available services. Mental health services can only achieve their intended purpose when individuals recognize their need for help, know where assistance can be obtained, perceive the services as useful and acceptable, and actually access them. Where young adults lack adequate knowledge or maintain negative perceptions about mental illness and professional services, they may delay or avoid seeking care.

Evidence from Nigerian tertiary institutions demonstrates this concern. Idoko et al. (2021) found that although many students recognized the importance of mental health and a substantial proportion expressed willingness to use orthodox mental health services, 45.6% were unaware of the availability of mental health services in Enugu. The same study identified substantial negative perceptions toward persons with mental illness. This suggests that educational attainment alone does not eliminate mental health misconceptions or information gaps.

The problem becomes more apparent when awareness is compared with actual utilisation. Okunaiya and Omovre (2021) reported high awareness of counselling services among Nigerian university students but low utilisation. Similarly, Oladimeji et al. (2022) found that most students in their study had poor utilisation of mental health services despite generally positive attitudes toward mental healthcare. Thus, a substantial gap may exist between knowing about mental health services and actually using them.

Several factors may account for this gap. Stigma is one of the most important. Young adults may fear being labelled as mentally ill, weak, unstable or incapable if they seek professional help. In environments where mental illness is associated with shame or negative stereotypes, students may conceal psychological problems and rely instead on friends, family members, religious leaders or self-management.

Another problem is inadequate or inaccurate knowledge. Some young adults may recognize severe psychiatric symptoms but fail to recognize common conditions such as depression, anxiety or problematic substance use. Others may believe that professional mental health services are only appropriate for individuals with severe mental illness. Such misconceptions can delay early intervention and allow psychological difficulties to become more serious.

The problem is further complicated by concerns about confidentiality. Young adults may avoid counselling or mental health services if they believe that their personal information will not remain private. In a tertiary institution, students may be especially concerned that their lecturers, classmates, parents or institutional authorities could become aware of their personal difficulties. Evidence from Nigerian undergraduates has identified confidentiality concerns as an important barrier to mental health service utilisation (Oladimeji et al., 2022).

Financial barriers may also contribute to underutilisation. Some mental health services may require payment for consultations, medication, psychotherapy or referral care. Young adults who depend on family support may be reluctant to disclose mental health concerns because doing so could require them to request additional financial assistance. Students with limited personal income may consequently postpone professional care or rely on informal sources of assistance.

Time and accessibility constitute additional concerns. Tertiary students often have demanding academic schedules and may perceive visiting a counsellor, psychologist or mental health professional as time-consuming. Where services have limited operating hours, long waiting periods or are located far from students’ residences, utilisation may be reduced.

Social and cultural factors may further discourage appropriate service utilisation. Family members, friends and religious communities can strongly influence how young adults understand psychological problems. While these support systems can be valuable, they may sometimes encourage individuals to interpret mental illness solely through spiritual, moral or supernatural explanations. Such interpretations may delay contact with professional mental health services.

The information environment also presents a challenge. Young adults increasingly obtain health information from social media and other digital platforms. Although digital media can improve awareness, inaccurate or misleading information can reinforce misconceptions about mental illness and treatment. Students may also attempt self-diagnosis or rely on unverified online advice instead of seeking professional assessment.

There is therefore a need to examine the extent to which young adults in tertiary institutions possess accurate knowledge about mental health services, how they perceive such services and whether they actually utilise them. This is important because a favourable attitude toward mental healthcare does not necessarily translate into service utilisation, as demonstrated by previous Nigerian studies (Idoko et al., 2021; Oladimeji et al., 2022; Okunaiya & Omovre, 2021).

Although existing Nigerian research has examined mental health knowledge and service utilisation among university students, important contextual gaps remain. Studies conducted in other institutions or locations cannot automatically be generalized to selected tertiary institutions in Enugu East Local Government Area because institutions differ in their counselling infrastructure, student composition, institutional policies, socioeconomic characteristics and availability of mental health personnel.

The geographical gap is particularly important. Existing evidence from Enugu has demonstrated information gaps among tertiary students, while newer evidence from the University of Nigeria, Nsukka has continued to identify gaps in mental health information and access among undergraduates (Idoko et al., 2021; Ikpeama et al., 2025). However, there remains a need for current empirical evidence specifically focusing on selected tertiary institutions in Enugu East Local Government Area.

Furthermore, there is a need to examine knowledge, perception and utilisation together. Studying knowledge alone may reveal whether young adults understand mental health, but it may not explain why they do or do not use services. Examining perception without measuring utilisation may similarly fail to establish whether favourable perceptions translate into actual behaviour. An integrated assessment can provide a more comprehensive understanding of the factors influencing mental health service utilisation among young adults.

The consequences of underutilisation can be considerable. When psychological difficulties are not identified and appropriately managed, they may interfere with academic performance, interpersonal relationships, substance-use behaviour, social functioning and general quality of life. Delayed care may also increase the severity or persistence of some mental health problems. Early recognition and appropriate referral are therefore important components of public health prevention.

The problem is consequently not simply that mental health services may be insufficient; it is also that existing services may not be adequately known, trusted or used by the young adults who need them. There is a need to determine whether young adults know what mental health services are available, whether they perceive them positively, whether stigma and misconceptions influence their decisions, and whether they have actually utilised formal mental health services when experiencing emotional or psychological difficulties.

It is against this background that this study seeks to investigate Knowledge, Perception and Utilisation of Mental Health Services among Young Adults: A Study of Selected Tertiary Institutions in Enugu East Local Government Area, Enugu State. The study will generate evidence that may assist tertiary institutions, health professionals, policymakers and other stakeholders in strengthening mental health awareness, reducing barriers to help-seeking and improving the utilisation of appropriate mental health services among young adults.

1.3 Purpose of the Study

The general purpose of this study is to examine the knowledge, perception and utilisation of mental health services among young adults in selected tertiary institutions in Enugu East Local Government Area, Enugu State.

Specifically, the study seeks to:

1. assess the level of knowledge of mental health and available mental health services among young adults in the selected tertiary institutions;
2. determine the perception of young adults toward mental health conditions and mental health services;
3. assess the level of utilisation of available mental health services among young adults;
4. identify the major sources of information about mental health and mental health services among the respondents

1.4 Research Questions

The following research questions will guide the study:

1. What is the level of knowledge of mental health and available mental health services among young adults in the selected tertiary institutions?
2. What are the perceptions of young adults toward mental health conditions and mental health services?
3. What is the level of utilisation of mental health services among young adults in the selected tertiary institutions?
4. What are the major sources of information about mental health and mental health services among young adults?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between knowledge and perception of mental health services and their utilisation among young adults in selected tertiary institutions in Enugu East Local Government Area, Enugu State.

1.6 Significance of the Study

The findings of this study will be useful to young adults, tertiary institutions, mental health professionals, public health practitioners, policymakers, parents and guardians, researchers and academic institutions.

Young adults: The study may help young adults understand the importance of mental health, recognize common mental health problems and appreciate the value of seeking professional assistance when necessary. Increased awareness may encourage earlier help-seeking and reduce reliance on misconceptions about mental illness.

Tertiary institutions: The findings may help universities, polytechnics, colleges of education and other tertiary institutions assess the adequacy and accessibility of their mental health and counselling services. Institutions may use the findings to strengthen counselling units, improve referral systems and develop student-focused mental health programmes.

Mental health professionals: Psychologists, psychiatrists, psychiatric nurses, counsellors, social workers and other mental health professionals may benefit from information about the perceptions and barriers experienced by young adults. This may help professionals design services that are more acceptable, confidential, accessible and responsive to students’ needs.

Public health practitioners: Public health professionals may use the findings to develop mental health promotion and disease-prevention programmes targeted at young adults. The findings may also assist in designing educational interventions addressing stigma, misconceptions and poor help-seeking behaviour.

Policymakers: The study may provide local evidence useful for implementing Nigeria’s mental health policies and the National Mental Health Act. Evidence concerning service utilisation can assist policymakers in identifying gaps between policy intentions and actual access to mental healthcare.

Parents and guardians: The findings may improve understanding of the challenges young adults face when seeking mental health support. Parents and guardians may become better positioned to provide supportive environments that encourage appropriate help-seeking rather than stigmatizing mental health problems.

Researchers: The study will add to the growing Nigerian literature on mental health literacy, perceptions and healthcare utilisation among young adults. It may provide a basis for further studies involving different populations, institutions and geographical areas.

Academic institutions: The study may serve as a useful academic resource for students and lecturers in public health, psychology, nursing, medicine, sociology, social work, guidance and counselling and related disciplines.

1.7 Scope of the Study

The study focuses on knowledge, perception and utilisation of mental health services among young adults in selected tertiary institutions in Enugu East Local Government Area, Enugu State.

The content scope covers knowledge of mental health and mental health conditions, awareness of available mental health services, perception toward mental illness and professional mental healthcare, utilisation of counselling and other mental health services, sources of mental health information and barriers to service utilisation.

The study will focus on young adults enrolled in the selected tertiary institutions. For the purpose of the study, young adults will generally refer to individuals within the age range of 18–35 years.

The geographical scope is limited to selected tertiary institutions located within Enugu East Local Government Area of Enugu State. The findings will therefore primarily apply to the selected institutions and should not automatically be generalized to all tertiary institutions in Enugu State or Nigeria.

1.8 Operational Definition of Terms

Knowledge: The level of accurate understanding possessed by respondents concerning mental health, mental health conditions, their symptoms, causes, prevention, treatment and available mental health services.

Mental health: A state of mental well-being in which an individual can cope with normal life stresses, function effectively, maintain relationships and contribute meaningfully to society (WHO, 2022).

Mental health condition: A clinically significant disturbance in an individual’s cognition, emotional regulation or behaviour that may impair functioning and well-being.

Mental health service: Any organized professional or institutional service designed to promote mental well-being, prevent or identify mental health problems, provide assessment, counselling, psychotherapy, psychiatric treatment, psychosocial support, crisis intervention or referral.

Mental health service utilisation: The actual use of formal mental health services by an individual, including counselling, psychological services, psychiatric services, mental health clinics or other recognized professional services.

Perception: The way young adults understand, interpret, evaluate and form opinions about mental health conditions and mental health services.

Young adult: For this study, a person between 18 and 35 years of age.

Tertiary institution: An institution of higher learning such as a university, polytechnic, college of education or other recognized post-secondary institution.

Mental health literacy: Knowledge and beliefs concerning mental health and mental disorders that facilitate their recognition, prevention, management and appropriate help-seeking.

Stigma: Negative attitudes, stereotypes, prejudice or discriminatory behaviour directed toward individuals because they have, or are perceived to have, a mental health condition.

Help-seeking behaviour: The actions taken by an individual to obtain assistance, advice or treatment when experiencing a health or psychological problem.

Counselling: A professional helping process in which a trained counsellor assists an individual to understand and manage personal, emotional, social, educational or psychological difficulties.

Barriers to utilisation: Factors that discourage or prevent young adults from accessing or using mental health services, including stigma, cost, lack of information, concerns about confidentiality, accessibility, time constraints and negative perceptions.

Formal mental health services: Mental health assistance provided by trained and recognized professionals or established healthcare/counselling institutions

Project – Knowledge, Perception and Utilisation of Mental Health Services among Young Adults: A Study of Selected Tertiary Institutions in Enugu East Local Government Area, Enugu State