A Phenomenon On Mental Health As A Challenge To Youth Development In Nigeria And It’s Counseling Implications

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A Phenomenon On Mental Health As A Challenge To Youth Development In Nigeria And It’s Counseling Implications


Abstract


The purpose of this qualitative study was to identify how counselors are currently addressing the increasing mental health issues of their youths so that they can have proper personal development. To accomplish this goal, three research questions were formulated to guide this study: 1) What are the experiences of counselors who provide support to learners who struggle with mental health issues?; 2) In what ways do counselors perceive their role as shifting as they work with these youths?; and 3) How do guidance and counseling services and programs support the development achievement of youths struggling with mental health issues? Sample were chosen from suburban towns Ikeja, Lagos, and currently serve as the chair or director of the town’s Guidance Department. Data was collected from three sample through a series of semi-structured, in-depth interviews. Data was analyzed using general inductive analysis, and was coded using multiple strategies, including open and axial coding. From the findings of this research, three noteworthy conclusions were drawn. First, in order to support all youth’smental development, towns must support all youths emotionally, providing further support for the relationship between development achievement and mental health. Second, the model of town counseling services has not progressed as our knowledge of how to support youths has evolved. And finally, programmatic intervention can work for general education youths when they are systematically need-based and focus on relationship building.


Chapter One


Introduction

1.1 Background of the Study

Mental health is a health issue that is in circulation, specifically among Nigerian youths. The information on the abnormal behavior has been given as one of the biggest issues facing every country, of which Nigeria and the young people are not an exception of both the challenges and the risks. It has been reported that the issue of mental health are now common in youths, with an estimate of one in five facing some form of emotional disorder. Previous research works showed that 50% of all lifelong mental health problems start from the age 14 and 75% by age 24.

Irrespective of the development evidence of the need of mental health to make sure economic, social and human capital, negative perceptions proceed to be linked with mental health disorders and the related mental health services and professionals. In our society, we see the mentally disordered people as the people that cannot be employed by any organization, as people who cannot maintain any job, depend on themselves and as those who have no hope of survival. This is a misconception, and it can have influence on individuals living with the disorders which can result in poor follow-up care and recovery, and further worsens the stigma and discrimination. It has been proven that medical forecast of doctor’s judgment for mental health disorders can enhance through early detection and treatment.

Resolving the problem of discrimination and stigma needs to occur both formally and informally, especially among children and young adults, some of whom will one day require making use of such services. Okeke opined that orienting or informing young people in and out of secondary schools about mental health disorders and ways to prevent it, not only affects their understanding of mental health but that their family, friends and neighbors. Furthermore, schemes introduced for the purpose of increasing young people’s knowledge of mental health through contact and education have given positive outcomes in minimizing negative attitudes towards people with such challenges. Previous studies showed that unfair feelings about mental health disorders or its victims was majorly because of ignorance, and that people who are well informed about such disorders are less likely to endorse negative attitude.

Another study also showed that members of the public who have contact with a victim of mental disorder are less likely to endorse stigmatizing attitudes. For this reason, education is a powerful tool for growing and solidifying knowledge and minimizing unwanted or displeasing attitudes towards mental health disorders and the victims. Research on youth perceptions of mental health disorders show positive changes after exposure to educational programs. Studies on awareness and education about mental health disorders in teenagers showed that there is a significant reduction of stigma after gaining new information about such conditions.

Another study on changing attitude of high school students towards peer with mental health disorders showed positive changes in their attitudes, and also that discrimination and the tendency towards social restriction were minimized six months after an attitudinal change program was introduced. Also, short educational workshops gave rise to a positive change in youths perceptions of mental health disorders. For this reason, there is an inadequacy of research in some regions of Nigeria considering creating awareness and attitudes of youths towards mental health disorders. This study aims to find out the impact mental health challenge has on youth development in Nigeria.


1.2 Statement of the General Problem

The poor development of the Nigerian youth physically, educationally, socially and mentally has been a source of concern for the nation considering the fact that these youths are the leaders of tomorrow. The mental state of most youths has precipitated to poor educational development and has also been muted to be the fundamental challenge to youth development and advancement in all areas of life. The major implication of the problem on the Nigerian youth is propensity of making disastrous decisions as a result of poor mental health which would naturally making counseling efforts by guardian and teachers futile.


1.3 Aims and Objectives of the Study

The major objectives of the study are to examine mental health as a challenge to youth development and its implications on counseling. Other specific objectives of the study include;

  1. To examine the state of mental health of youths.
  2. To determine the importance of youth development on nation building.
  3. To assess the benefit of counseling to youth development.
  4. To examine the factors affecting mental health of youths in Nigeria.
  5. To determine the impact of mental health on youth development and counseling.

1.4 Research Questions

  1. What is the state of mental health of youths?
  2. What is the importance of youth development on nation building?
  3. What are the benefits of counseling to youth development?
  4. What are the factors affecting mental health of youths in Nigeria?
  5. What is the impact of mental health on youth development and counseling?

1.5 Significance of the Study

The study would be of immense benefit to educational sector, the Nigerian public and the general public as it attempts to unravel the impact of mental health on youth development and counseling. The study would also benefit students, researchers and scholars who are interested in developing further study on the subject matter.


1.6 Scope and Limitation of the Study

The study is restricted to mental health as a challenge to youth development and its implication on counseling using youths in Ikeja Lagos as a case study.


1.7 Limitation of the Study

Financial constraint

Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint

The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.


Chapter Five


Conclusions and Recommendation

Three significant conclusions were drawn from the research findings: a) in order to support all youths mental development, towns must support all youths emotionally; b) the model of town counseling services has not progressed as our knowledge of how to support youths has evolved; and c) programmatic interventions can work for general education youths when they are systematically need-based and focus on relationship building.


5.1 Conclusions

Conclusion 1: In Order to Support All Youth’s Mental development, Towns Must Support All Youths Emotionally.

The first conclusion of this study is that in order to support all youthsmental development, towns must support youths emotionally, which supports previous research about the relationship between development achievement and mental health (Hoagwood, Olin, Kerker, Kratochwill, Crowe & Saka, 2007; Dix, Slee, Lawson & Keeves, 2012). In outlining individual cases of struggling youths, sample identified significant barriers to learning, including mental illness and family dysfunction, which made development achievement almost impossible.

As the youth’s history was discussed, each participant highlighted the necessity of emotional support so that the youth could have mental development successful. Successful support could have been as comprehensive as a programmatic intervention or as simple as individual weekly counseling session with the guidance counselor. By utilizing either end of the support spectrum, counselors treated the social-emotional needs of the youth as a significant and crucial factor in his or her development outcomes. Sample were also asked what they would have foreseen for the youth if that support had not been provided, and each participant predicted poor outcomes, such as dropping out of town or failing grades. While youths with attendance issues present a unique set of difficulties in regards to development outcomes, the basic philosophy of support is the same. Sample indicated that while there are development accommodations to be utilized, none of them will be helpful without also addressing the social-emotional needs of the youths.

Barriers to learning are problems or situations that make it difficult for youths to concentrate and learn, and therefore find development success. With one in five youths suffering from some sort of mental health issue, many more suffering from non-clinical issues (or issues that are not diagnosable), and the incidence of mental health in youths continuing to rise (Evans, Foa, Gur, Hendin, O’Brien, Seligman & Walsh, 2005), mental health is a significant issue and barrier to learning. Moreover, few youths receive care through the mental health system (Knopf, Park &Mulye, 2008) due to the stigma surrounding getting help, lack of insurance, and/or unstable living conditions, such as homelessness (Schwarz, 2009). So, while some towns question whether it is their responsibility to address youths’ mental health issues, towns are an important setting for mental health support to address this barrier to learning and promote success for all youths (Gresham, 2004).

While addressing barriers to learning is not a new concept, recent research shows that providing emotional support can have a positive impact on development outcomes (Hoagwood, Olin, Kerker, Kratochwill, Crowe & Saka, 2007; Dix, Slee, Lawson & Keeves, 2012). The research indicates that emotional support that is intensive and targets youths, families and teachers (Hoagwood et al., 2007), and is implemented with fidelity and consistency (Dix et al., 2012) lead to the most significant gains in development achievement. Nabors, Reynolds and Weist (2000) also concluded that utilizing mental resources in town led to positive outcomes and increased competencies for youths.

Sample in their research also indicated that consistency of services were critical to youth success. Froiland (2011) verified that emotional support can be the solution to development underachievement. He detailed two youth cases that demonstrated that when the social-emotional issues were addressed, positive development outcomes followed.
Findings from this current study provide support for previous research indicating that emotional support positively impacts development achievement (Hoagwood, Olin, Kerker, Kratochwill, Crowe & Saka, 2007; Dix, Slee, Lawson & Keeves, 2012). Sample discussed first-hand experiences of providing support for individual youths that ended up being crucial to their eventual positive outcome. In some cases, it was programmatic support, and in others, support was individual counseling. All sample predicted poor outcomes, in some cases as extreme as dropping out, if the emotional support had not been utilized. In fact, in two cases, even though the emotional support was offered, the youth did not always take advantage of it and still struggled mental development. Unfortunately, sample also mentioned that while they do the best they can, due to the nature of their responsibilities and large caseloads, there are still groups of youths whose needs are not known or are not addressed.

CONCLUSION 2: The Model of Town Counseling Services Has Not Progressed As Our Knowledge Of How To Support Youths Has Evolved.

The second conclusion from this research is that how towns are offering services to youths has not progressed as our knowledge of how to support youths has evolved through previous research and literature. Sample indicated that the demands of the profession and the volume of work have increased in recent years, yet how they support youths has not changed. In some cases, there is no additional support staff, leaving all counseling and coordination of youth services to the guidance counselor. Sample indicated that they have not implemented any universal preventive interventions to support all youths, and that their services focused mostly on more intensive support for those youths who are already having difficulty. In addition, while sample were aware of the Response to Intervention model, they did not have the time, resources or training in order to implement it. Moreover, sample indicated that myriad responsibilities, large caseloads of youths, and scheduling issues did not leave room for anything other than reactive services. Finally, sample mentioned that there is a lack of understanding of the training and skill set that counselors have, which makes advocating for and implementing changes difficult.
Another factor that is playing into the lack of change is the perception of the role of the counselor and a general lack of understanding about youth mental health and its impact on achievement. For some sample, the administrator’s perception of the counselor’s role and responsibilities is very different than the counselor’s perception, as has been discussed in previous research (Brown, Dahlbeck & Sparkman-Barnes, 2010). In the best case scenario, the perception was incomplete, and in the worst case scenario, the perception was a lack of awareness of competencies. Sample indicated that they have the skills and experience to address almost any issue that they encounter and provide the necessary emotional support, with a few exceptions. Sample also identified that there continues to be a lack of investment from the district in additional time and resources.

Literature over the past few decades has made recommendations on how to better address youths’ mental health issues through prevention science (Coie, Watt, West, Hawkins, Asarnow, Markman, Ramey, Shure & Long, 1993), and the use tiered interventions and the Response to Intervention model (Gresham, 2004; Gresham 2007). Moreover, defining the counselor role and identity and changing the model of town counseling services have been suggested by several important national organizations, including the American Counselor Association (ASCA) and the Center for Mental Health in Towns at UCLA. ASCA (2003) states that town counseling programs are preventive in design, developmental in nature and driven by data with consistent monitoring of youth progress. In addition, for towns, ASCA recommends that counseling programs be focused on delivering services through an almost equal amount of time with individual youth planning, responsive services, and classroom or group work. Only a small amount of time should be spent on indirect service support.

This description of services is similar to that of the Response to Intervention model, which proposes preventive interventions to counteract risk factors and reinforce protective factors, such as resiliency and prosocial skills, of youths to promote mental health (Gresham, 2004). In other words, it is not just about addressing the issues that arise, but ensuring that all youths have the emotional support they need in order to have mental development successful. In addition, the model utilizes data of individual’s lack of response to an intervention as the basis for more intensive intervention. The Center for Mental Health in Towns at UCLA (February, 2011) takes it a step further to propose a comprehensive intervention framework that proposes that community and family involvement is an equally critical component of child and youth mental health. In both frameworks, preventive interventions and data are utilized to promote prosocial behaviors and identify those needing more intensive intervention. Current literature argues that effective mental health services have two critical components, a focus on the prevention and treatment of dysfunction, as well as the promotion of positive adaptive functioning (Kazdin, 1993).

Existing research shows that universal preventive interventions can have a positive impact on youth functioning, especially when they are focused on mental health promotion as opposed to prevention, used a whole-town approach and were implemented over a longer period of time (Wells, Barlow & Stewart-Brown, 2003). Moreover, the most effective interventions target youths, parents, and teachers, and focus on multiple contexts (Hoagwood et al., 2007). However, the literature also highlights some of the challenges to successful implementation, including teacher turnover, busy curriculum schedules, and inconsistent execution (Weist, Stiegler, Stephan, Cox & Vaughan, 2010). Previous research has shown that a systemic, tiered intervention model can be effective in towns (Eber, Sugai, Smith & Scott, 2002; Weist, Stiegler, Stephan, Cox & Vaughan, 2010; Stormshak, Conell, Veronneau, Myers, Dishion, Kavanagh & Caruthers, 2011), as can targeted interventions to address particular issues (Augustyniak, Brooks, Rinaldo, Bogner, & Hodges, 20009; Froiland, 2011; Dix, Slee, Lawson, & Keeves, 2012; Erickson & Abel, 2013). Even with a national push to accurately define the role and change the model of counseling services in towns, there continues to be a disconnect between administrators’ and counselors’ perception of competence (Brown, Dahlbeck & Sparkman-Barnes, 2010).

The findings from this study indicate that the Response to Intervention model has not been realized in some towns yet, even though counselors were aware of the model and its recommendations. While the old model may have worked in the past, the increasing number of youths needing support has made the old model inefficient and has left counselors feeling overwhelmed. Unfortunately, while all sample were aware of the need for town-wide, universal preventive interventions, no programs have been implemented them due to systemic and logistical challenges. Thus, even though the current literature and research points to the necessity and success of these types of interventions, towns have not made the investment in time or staff to implement them. Therefore, not all youths are getting the emotional support they need in order to promote prosocial behaviors and prevent dysfunction.
Counseling programs are also not utilizing a full range of tiered interventions to address the range of youth issues. In addition, counselors are not measuring youths’ responses to interventions to identify where adjustments need to be made. As mentioned above, sample are aware of Response to Intervention and the benefits of tiered interventions, however, there is little support from the district to implement any additional support services. Instead, counselors have limited resources to utilize, leaving the counselor alone in trying to solve the youth’s issues. In other words, counselors are feeling overwhelmed and unsupported, which has left many youths underserved. Without adjustment to funding priorities and the model of services to better manage the demand, this conclusion is likely to continue.

CONCLUSION 3: Programmatic Interventions Can Work For General Education

Youths When They Are Systematically Need-Based And Focus On Relationship Building. The third conclusion of this study is that programmatic interventions can work for general education youths when they are systematically need-based and focus on making connections. This conclusion further supports the notion of the Response to Intervention model that the intensity of the intervention must match the intensity of the presenting issue (Gresham, 2004). Two of the three sample, Lisa and Nancy, discussed programs within their town that youths can utilize. Jim’s town does not offer any programmatic interventions. At Lisa’s town, the programs offered are only available for special education youths and have been an effective resource for the youths to utilize. However, her town does not offer any programmatic interventions for general education youths. Nancy’s town offers a program that both general and special education youths can use. In both cases, the small classroom environment, access to counseling, and the opportunity for check-ins were the interventions the youths needed in order to overcome their barriers to learning. In both cases, though, these programmatic interventions did not always work. Interestingly, Nancy stated that the same program that had been so successful for one youth was not successful for another. It was not an appropriate match for the some youths’ needs. In addition, all sample indicated that there were not enough programs within their town for youths with mental health issues, especially at the second tier of intervention. Moreover, according to sample, those programs that towns have are overburdened with too many youths and not enough staff, and are addressing too many different issues to be effective for all youths that need additional support.

In other words, one programmatic intervention cannot address all of the needs that are presented. Whether or not programmatic interventions were available, all sample discussed the importance of making connections in relation to a youth’s success. In discussing individual cases, sample identified that successful interventions all fostered relationship building and making connections with an adult. For many of these youths, there was significant family dysfunction and stress, and therefore, a lack of a role model and connection at home. Whether the connection was with a guidance counselor, a support staff member in a program, or an outside therapist, this connection seemed to be one of the key components to a successful intervention.

Each participant indicated one group of youths that needs programmatic intervention immediately is those who have attendance issues. Some youths returning to town after an extended absence, are expected to begin attending classes immediately, which can worsen already heightened levels of anxiety and depression. Youths who are not expected to return to class immediately spend their days in the guidance department or another safe space. In both cases, the youths receive little emotional or development support, which are critical to a successful transition back to town. In addition, sample indicated that the counselor caseload and daily responsibilities are too numerous for individual counselors to be able to monitor this transition. The theoretical framework that guided this study indicates that interventions must be conceptualized based on intensity level and purpose, and that the goal is to match the intensity of the intervention with the intensity of the presenting problem (Gresham, 2004). By using this framework, towns may reduce the need for more expensive intervention and treatment later. Interventions at the secondary tier are utilized to give short-term assistance to individuals to help them deal with their current difficulties better than if they had faced them alone, and focuses on group rather than individual intervention (Caplan, 1964). The tertiary level of intervention is reserved for those individuals who have an established mental illness. All three levels of care, including the first level of primary prevention, create an effective care framework. Current literature supports these levels of intervention to support youth mental health in towns (Gresham, 2005; Augustyniak, Brooks, Rinaldo, Bogner & Hodges, 2009; Froiland, 2011; Saeki, Jimerson, Earhart, Hart, Renshaw, Singh & Stewart, 2011).

Existing research shows that interventions at both the secondary and tertiary level can be effective. Durlak and Wells (1998) found that secondary prevention programs produced positive effects, with sample experience reduced problems and increased social competencies. Augustyniak et al. (2009) showed that group counseling interventions found a significant decrease in internalized distress for youths that participated. In addition, Cheney, Flower and Templeton (2008) found that many youths who participated in a daily Check In/Check Out intervention, showed positive gains on behavior ratings for general education youths. This study also indicates the importance of connections and relationships to development and socialemotional outcomes. At the tertiary level of intervention, Froiland (2011) showed the power of individual interventions that had a lasting impact on the social-emotional functioning of the youths.

The findings of this study support the current research that interventions at different tiers of support can be effective for general education youths when they are designed to address a targeted issue. More specifically, this study showed that effective programmatic interventions can eliminate the need for a referral to special education, as well as reduce the effect and duration of mental health issues. In addition, the current study indicates that programs that try to address too many different issues or too many youths at once are ineffective. This study also suggests that making connections and building relationships is critical to youth success. Finally, the findings indicate that implementing programming at the second tier of intervention can give the support to guidance counselors they need in order to address the needs of all of their youths, not just the neediest youths.


5.2 Recommendations for Future Research

The findings of this study identify the gap between literature and practice in supporting youth mental health needs in towns by highlighting the counselor experience. There are several areas where additional research is necessary in order to continue the conversation of town guidance services.

  1. This study only included three sample, which allowed for several interviews with each in order to reach a deeper level of understanding of their experiences. This would not have been achieved with more sample and fewer interviews with each. However, a small number of sample limits the generalizability of the counselor’s experience in supporting youths with mental health issues. Future research should focus on identifying the experience of counselors in different settings, including urban and rural towns, and sampleshould represent different states across the nation. Current literature and research continues to talk at counselors, however this future research will bring their voice to the forefront.
  2. One voice and perspective that was missing from this research is the district- and/or town-level administrator. This research highlighted differences between counselor and administrator perspectives on the role of the counselor in the town, and a lack of understanding about youth issues and their impact on town success. Future research should focus on youth mental health from the administrator’s perspective, and why service delivery is slow to change even though current research and literature advocate for it. Identifying why change is so difficult to achieve, and where ideas differ and overlap between administrators and counselors will be critical to future changes.
  3. Another area to focus on is towns that already utilize the Response to Intervention framework for mental health issues. This research can focus on the framework’s implementation in practice, and highlight some of the benefits and challenges associated with its usage. Moreover, questions surrounding its origins are significant – Who introduced the idea? How long did it take to implement? What steps did the town take to do so? What systemic changes were necessary to support this change, if any? Another option would be to conduct a case study or action research study to detail the framework’s implementation in one town. This research could highlight
    best practices and potentially lead to an implementation manual for towns to utilize as they move towards using this framework.
  4. Each participant indicated that in-town programmatic interventions will allow them to change the focus of their daily work to support all youths. One potential area of research is to interview counselors and administrators in towns that offer programs for youths. This research could focus on the programs they offer, what issues they address, and why these interventions work. With descriptions of the programs and their benefits and challenges, researchers could create a resource for other towns to utilize as they consider implementing programs. Sharing ideas, instead of reinventing the wheel, is always easier considering the restraints on administrators’ and counselors’ time.
  5. A final area of further research should be a quantitative analysis of implementing universal prevention and programmatic interventions. Special education costs are rising, which puts a strain on the rest of the district’s budget. This research could examine the cost analysis of hiring additional staff to run programs versus the cost of sending youths to out of district placement. Can more youths with significant issues be kept in-house with programmatic interventions, thereby saving the district money? With money being a significant factor in town counseling service delivery, this would give counselors and town-level administrators hard data to advocate for their budgetary needs with town committees.

5.3 Final Conclusion

As youth mental health issues continue to rise, towns will continue to be called upon to provide services to support their youths emotionally so that they can achieve mental development. This research highlights that even though current literature and research have proposed new ways of supporting this growing number of youths through proactive and systemic support, some town counseling departments continue to only be able to respond reactively to youth needs. The Response to Intervention framework offers one way for towns to address the social-emotional needs of their youths proactively, however, implementation will require substantial systemic change. Counselors and social-emotional learning must be given the same focus and support as teachers and development learning. If changing the system allows counselors to more effectively support and advocate for their youth, then it is imperative for town leaders to discuss how it can be realized in their towns. It is my hope that this research will be the first step in helping to create that change.


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