Assessing Gaps in Adolescent Mental Health Care in Rural Ghana: A Quantitative Study Among Senior High School Students in Jaman North District
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Abstract
Background: Adolescent mental health disorders in rural sub-Saharan Africa are not recognized and valued. There are limited data on depression, mental health literacy and care barriers among Ghanaian senior high school (SHS) students.
Method: The study adopted a cross sectional survey of 217 students of the SHS in Jaman North District, Ghana aged between 15 and 19 years. Depressive symptoms were screened using the PHQ-9. A semi-structured interview was used to evaluate mental health knowledge, help-seeking behaviors, barriers to service, and perceptions of school-based mental health support through a questionnaire. Data analysed with SPSS v28 descriptive and bivariate analysis.
Results: Probable depression (PHQ-9 ≥10) prevalence was 25.8% (95% CI: 20.4–32.1). 84.8% of the students were familiar with the term mental health, but 27.2% were able to correctly define it. The main source of information was school (59.9%). Leading barriers for students who never sought help (68.7%) included not knowing where to go (57.0%), fear of social judgment (24.2%) and lack of nearby services (20.1%). Only 23.5% of students had used counselling, whereas 55.8% of schools provided it. The majority of students (83.4%) agreed that mental health should play a central role in schools, while 54.8% of students preferred mental health education.
Conclusion: Adolescent mental health care gaps in rural Ghana are compounded, include poor accurate knowledge and high burden of depression. School-based interventions, particularly mental health education and structured counselling, are a cost-effective approach. District mental health should be incorporated into school health protocols.
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