OGONNA STEPHEN OPARA

Background: Medical students experience disproportionately high rates of psychological distress, including depression, anxiety, and burnout, yet mental health service utilization remains strikingly low. At the University of Benin, despite the availability of counselling and psychiatric services, little empirical data exists on students' awareness, accessibility perceptions, utilization patterns, and barriers to care. Objective: To examine the awareness, accessibility, utilization, and perceived barriers related to mental health services among medical students at the University of Benin. Methods: A descriptive cross-sectional study was conducted among 550 medical students selected through stratified random sampling from all six years of the MB;BS program. Data were collected using a structured, self-administered questionnaire assessing socio-demographic characteristics, awareness of mental health services, perceived accessibility, utilization patterns, and barriers to care. Descriptive statistics, chi-square tests, and binary logistic regression were employed for analysis, with statistical significance set at p < 0.05. Results: The mean age was 22.4 years (SD ± 3.1), with a slight female majority (52.2%). Good overall awareness of mental health services was observed in 59.3% of students, with 76.7% aware that University of Benin provides mental health services. However, practical knowledge gaps existed: only 55.8% knew service locations and 58.2% understood confidentiality provisions. Perceived accessibility was positive among 91.8% of students, though only 48.5% found operating hours convenient. Actual utilization was extremely low (12.9%), with peer support groups (45.1%) and helpline/online support (45.1%) being the most used services. Academic pressure (11.3%) and depression (7.0%) were the commonest reasons for seeking ~ xvi ~ Commented [NM1]: Awareness of what? help. Barriers were widely endorsed: confidentiality fears (79.1%), fear of judgment (78.7%), perceived ineffectiveness of services (77.4%), and lack of time (76.3%). Significant predictors of good accessibility and awareness included: male sex (aOR = 0.51, 95% CI: 0.27–0.98, p = 0.042) for lower odds of good accessibility, and monthly allowance below ₦60,000 (aOR = 0.69, 95% CI: 0.48–0.98, p = 0.037) for lower odds of good awareness. Conclusion: Despite goodawareness and favorable accessibility perceptions, mental health service utilization among medical students at the University of Benin is critically low, driven by intersecting stigma-related, practical, and cultural barriers. Urgent institutional interventions are required to address confidentiality concerns, time constraints, and socio-demographic inequities to bridge the treatment gap. Keywords: Mental health services, medical students, awareness, accessibility, utilization, barriers, University of Benin, Nigeria.