Most Tanzanian Students Know About Mental Health Services, Few Actually Use Them

At two of Tanzania’s largest public universities, most engineering and science undergraduates can recognize the signs of anxiety and depression, yet fewer than one in three has ever set foot in the campus counseling services designed to help them. That striking disconnect between knowing and doing is the central finding of a new mixed-methods study published in Discover Mental Health, which followed 249 third-year students at the University of Dar es Salaam and the University of Dodoma. The research, led by Upendo Jonas of the Mwalimu Nyerere Memorial Academy together with Bernadetha Rushahu and Lwimiko Sanga of the University of Dar es Salaam, offers one of the most detailed portraits to date of how mental health awareness translates, or fails to translate, into actual help-seeking behavior among students in sub-Saharan Africa.

The numbers reveal a substantial and largely invisible burden of psychological distress. Using the Generalized Anxiety Disorder-7 scale, a widely validated seven-item screening instrument, the researchers found a mean anxiety score of 6.27 with a standard deviation of 4.45. Nearly a quarter of the students, 24.9 percent, scored at or above the clinical threshold of 10, the cutoff commonly used to flag moderate anxiety warranting further assessment. Depression, measured with the nine-item Patient Health Questionnaire, painted an even heavier picture: the mean PHQ-9 score was 7.85 with a standard deviation of 5.31, and 31.7 percent of students crossed the threshold of 10. When the researchers combined the two screens, 41 percent of the surveyed undergraduates met at least one of the clinical cutoffs, meaning that roughly two in five future engineers and scientists were carrying symptoms consistent with clinically significant anxiety or depression while pursuing some of the most demanding degree programs in the Tanzanian university system.

Against that backdrop of widespread distress, the awareness data told a story of partial success. A remarkable 86.7 percent of students demonstrated awareness of common mental disorders, suggesting that years of public health messaging and informal campus conversation have penetrated deeply into the student population. Awareness of the universities’ own mental health services was considerably lower at 60.6 percent, meaning that even on paper, four in ten students did not know that counseling existed on their own campuses. The most sobering figure, however, was the utilization rate: only 31.3 percent of students reported ever using university mental health services during their enrollment. Even among the students who knew the services existed, just 35.8 percent reported using them, compared with 24.5 percent of those who were unaware. Knowledge, in other words, was only weakly connected to action.

To quantify that connection, the team ran a logistic regression model examining whether awareness of university services predicted reported use, adjusting for a set of prespecified covariates. The adjusted odds ratio came out at 1.79, with a 95 percent confidence interval stretching from 0.98 to 3.25 and a p-value of 0.057. The point estimate suggests that aware students had nearly twice the odds of using services, but the confidence interval crosses one and no covariate in the model reached conventional statistical significance. The authors are careful to label these findings exploratory, emphasizing that the analysis does not establish determinants of service utilization. That statistical honesty matters: in a sample of 249 students, the study was powered to describe patterns, not to pin down causal drivers, and the wide confidence interval is a transparent reminder of that limitation.

What actually keeps students away from the counseling office? The survey asked non-users directly, and the most common answer was strikingly mundane: 49.1 percent cited limited practical knowledge of the services, their locations, or the procedures for accessing them. Not fear of stigma, not disbelief in the effectiveness of treatment, but a simple navigation failure. Students did not know where the counseling unit was, how to book an appointment, or what to expect when they arrived. This finding reframes the problem in a way that is potentially far easier to fix than deep-seated cultural attitudes. If half of the non-using students are blocked primarily by informational friction, then better signage, orientation-week introductions, clear referral pathways, and visible service information could move the needle substantially.

The qualitative arm of the study added professional context to these survey numbers. The researchers interviewed six university counselors and one medical doctor, then used thematic analysis and a joint display technique to weave the providers’ perspectives into the quantitative findings. Those interviews pointed to a cluster of structural factors that may shape access: the difficulty of navigating services, the persistent weight of stigma and the low visibility of counseling units, inadequate staffing levels, long waiting times, and gaps in continuity of care when students need follow-up. The authors are explicit that these accounts represent provider perspectives rather than direct evidence of what motivates or deters students themselves, but they converge neatly with the survey data. A counselor who cannot see all the students who need help, working in a unit that students cannot easily find, sits at the center of exactly the awareness-to-use gap the numbers describe.

For the minority of students who did make it through the door, the news was moderately encouraging. Among service users, 55.1 percent rated the services they accessed as effective or very effective. That means a slim majority found real value in the support, but it also means that nearly half of those who sought help did not rate the experience as effective. Combined with the counselors’ reports of understaffing and waiting times, this user feedback suggests that the problem is not merely getting students to show up but ensuring that the services they reach can deliver meaningful, sustained care once they arrive. A counseling system that leaves half of its users unsatisfied risks reinforcing the very reluctance it is trying to overcome, as dissatisfied students share their experiences with peers.

The study’s methodology deserves attention for how it was assembled. The cross-sectional survey targeted third-year undergraduates in engineering and science programs, a population chosen deliberately because these disciplines combine heavy workloads with high stakes and, in many contexts, strong cultural pressure to project competence and self-reliance. The researchers combined validated screening instruments with study-specific items measuring awareness, reported use, barriers among non-users, and satisfaction ratings among users. Ethical oversight was layered and thorough: the broader project, titled The Effectiveness of University Support Services in Addressing Common Mental Disorders among University Students in Tanzania, was approved by the School of Education Postgraduate Studies and Research Committee at the University of Dar es Salaam in February 2025, with subsequent clearances from the university’s Vice-Chancellor’s office, the Dodoma Regional Secretariat, and the Dodoma City Council. All participants were adults who gave written informed consent, and interview quotations were anonymized with participant codes.

The implications reach well beyond the two campuses studied. Universities across low- and middle-income countries face a common squeeze: student mental health needs are rising, counseling services are chronically under-resourced, and the cultural stigma surrounding psychological help remains potent even as general awareness grows. The Tanzanian data suggest a specific sequence of interventions. First, universities should treat service navigation as a design problem, embedding clear information about locations, procedures, and confidentiality guarantees into orientation, course syllabi, and digital platforms. Second, they should strengthen counseling capacity and referral pathways so that waiting times do not erode the trust that outreach builds. Third, they should safeguard confidentiality rigorously, since the counselor interviews flagged stigma and visibility as live concerns. The authors also recommend carefully evaluating digital or hybrid access options, which could lower the threshold for a first contact among students hesitant to walk into a visible counseling office.

Perhaps the most important lesson is about the gap itself. Awareness campaigns have done their job: nearly nine in ten students know what anxiety and depression are. But awareness of a problem is not awareness of a solution, and neither is a gateway to using it. With 41 percent of students screening positive for clinically significant symptoms and only 31 percent ever using campus services, the arithmetic of unmet need is stark. The study’s authors frame their conclusion as a call for universities to strengthen navigation, confidentiality, counseling capacity, referral and safeguarding pathways, and to test new access models with the same rigor they apply to any other institutional service. For the thousands of engineering and science students whose futures depend on both their minds and their training, closing the distance between knowing that help exists and actually receiving it may be one of the highest-yield investments a university can make.

Subject of Research: Awareness and utilization of university mental health services among engineering and science undergraduates in Tanzania

Article Title: Awareness and use of university mental health services among engineering and science undergraduates at two public universities in Tanzania

Article References: Jonas, U., Rushahu, B., & Sanga, L. (2026). Awareness and use of university mental health services among engineering and science undergraduates at two public universities in Tanzania. Discover Mental Health. https://doi.org/10.1007/s44192-026-00621-2

Image Credits: AI Generated

DOI: 10.1007/s44192-026-00621-2

Keywords: mental health services, service utilization, help-seeking, university students, Tanzania, GAD-7, PHQ-9, anxiety, depression, mixed methods, higher education, counseling