SCHOOL-BASED MENTAL HEALTH PROGRAMS IN WEST AFRICA: A NARRATIVE REVIEW OF EVIDENCE AND POTENTIAL APPLICABILITY IN THE CONTEXT OF NIGERIA

Abstract

Introduction: Adolescents make up about 10% - 20% of the population globally. Mental health issues constitute about 16% of the global disease burden among adolescents. In West Africa where adolescents and young adults constitute 30–35% of the population, 14% suffer from psychological distress. In Nigeria, adolescents constitute about 22.3% of the population, and a report shows that more than 20% of children and adolescents have mental health problems in varying degrees. Against this background, addressing the mental health needs of adolescent is essential, and school-based mental health interventions have proven to be successful in some settings. However, such programs are rarely implemented in West Africa. This study explores the literature on school-based mental health interventions in West Africa and make recommendations for practice in Nigeria. Methods: A desk-based narrative review of the literature was performed with a focus on school-based mental health interventions in West Africa. Electronic search was done on PubMed, Google Scholar, and WHO website. A total of 36 papers were identified through PubMed, 48 through google scholar and 2 through other websites, after which 7 were selected for final review. Findings: The review showed that the types of intervention across all seven studies were mainly educational, making use of cognitive behavioral therapy, mental health education training and awareness programs and interventions employed in the studies were effective on most of the outcomes evaluated, except for one study which showed no effectiveness of the intervention, focused on a guidance and counselling unit. All studies showed statistically significant difference in the post-intervention outcomes, compared to pre-intervention ones, with a focus on depression symptoms, self-esteem increased and there was significant increase in knowledge after training interventions. Conclusion: The review of literature shows that it would be very important to integrate SBMH programs in the curricula for the schools in Nigeria based on the needs and potential impact revealed through the pilots’ studies that have been conducted. However the overall evidence on how to do that and its effectiveness is limited, therefore more research is needed on how to successfully implement SBMH programs in Nigeria.