Awareness, utility and preferences of campus-based mental health services at tertiary institutions in Harare Zimbabwe: a cross-sectional study.

Mental health (MH) disorders are highly prevalent among university students, with multi-level impacts. Although campus-based mental health services are available, awareness and utilisation rates remain low. This study examined the awareness and utilisation of campus mental health services among Zimbabwean tertiary students, including the barriers, facilitators, and preferences that influence their access to support. This descriptive cross-sectional study recruited 1070 students from five tertiary institutions in Harare, Zimbabwe. Participants completed questionnaires evaluating awareness, utilisation, preferences, and barriers to accessing campus-based mental health services. Data were analysed using descriptive statistics and multivariate logistic regression. The average age of the participants was 21.7 (SD = 2.7). 76.5% of students were aware of campus-based MH services. Awareness of MH services was associated with familial history of MH conditions [AOR= 1.35 (95%CI: 1.05; 1.83), p= .05] and personal experience of a MH condition [AOR= 0.71 (95%CI: 0.52; 0.97), p= .030]. Only 16.5% of students had utilised campus-based MH services. High usage was associated with drug and substance use [AOR= 2.388 (95%: 1.227; 4.644), p= 0.01], availability of psychologist [AOR = 1.69 (95%CI: 1.10; 2.59), p= .017] and availability of campus-wide MH workshops [AOR = 1.62 (95%: 1.00; 2.60), p= .049]. Key barriers to MH service utilisation included lack of resident/institutional MH service providers  [AOR= 2.02 (95%CI: 1.16; 3.51), p=.013], past MH experiences [AOR=  1.53 (95%CI: 1.16;  2.02), p= .002], and friend’s history of MH condition [AOR= 1.44 (95%CI: 1.11; 1.86), p=.006]. Students preferred self-help services, individual therapy, and psychologists for MH support. Universities should promote MH awareness through effective awareness campaigns and workshops, provide tailored services that align with the students’ preferences, and ultimately create a supportive environment that fosters students’ overall mental health service utilisation and well-being.