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

Abstract Background Evidence on the pathway from mental-health awareness to actual use of university services remains limited in Tanzania. This exploratory cross-sectional mixed-methods study described anxiety and depressive symptom burden, awareness of common mental disorders and university services, reported service use, barriers, and user-reported service experience among engineering and science undergraduates at two public universities. Methods A survey of 249 third-year undergraduates from the University of Dar es Salaam and the University of Dodoma was combined with interviews involving six university counsellors and one medical doctor. Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Study-specific items measured awareness, reported use of university mental-health services, barriers among non-users and user ratings among service users. Logistic regression explored associations with reported service use; thematic analysis and a joint display integrated survey findings with professional perspectives. Results Mean GAD-7 and PHQ-9 scores were 6.27 (SD 4.45) and 7.85 (SD 5.31), respectively; 24.9% scored at least 10 on the GAD-7, 31.7% scored at least 10 on the PHQ-9 and 41.0% met either threshold. Awareness of common mental disorders was 86.7%, awareness of university mental-health services was 60.6%, and 31.3% reported service use during enrolment. Use was reported by 35.8% of students aware of university services and 24.5% of those unaware. Awareness corresponded to higher observed adjusted odds of use, but uncertainty was substantial (aOR 1.79, 95% CI 0.98–3.25; p = 0.057) and no prespecified covariate reached conventional statistical significance. Among service users, 55.1% rated accessed services effective or very effective. Among non-users, the most common barrier was limited practical knowledge of services, locations or access procedures (49.1%). Conclusion A marked gap was observed between broad mental-health awareness and reported use of university support. The regression findings are exploratory and do not establish determinants of utilisation. Professional interviews suggested that service navigation, stigma and visibility, staffing, waiting time and continuity may shape access, but these accounts represent provider perspectives rather than direct evidence of students’ motivations. Universities should strengthen service navigation, confidentiality, counselling capacity, referral and safeguarding pathways, and carefully evaluate digital or hybrid access options.