12-month substance use disorders among first-year university students in Kenya
Introduction
The period of entry into university represents one of vulnerability to mental health and substance use problems for university students. Several reasons have been postulated for the high levels of mental health and substance use problems among this population including academic pressure, separation from family, transition to living independently, and managing life without parental supervision [1]. In addition, during this period, many students take on adult responsibilities e.g., working for the first time [1]. More importantly, late adolescence, corresponds to the age of onset for most severe mental illnesses [2] and is a peak period for initiation of substance use [3].
It is not surprising then that studies have shown that the first year of university is associated with high rates of harmful substance use. A study conducted in Northern Ireland among first year university students found that the prevalence of alcohol use disorder was 10.7% and that of other substance use disorder was 3.1%. In that study, the diagnosis of other substance use disorder was associated with being a male [4]. In a large cross-national survey (n = 14,371) conducted across eight countries (Australia, Germany, Spain, South Africa, Northern Ireland, United States, Mexico, Belgium), the 12-month prevalence of alcohol use disorder was 6.3%, and that of other substance use disorders was 3.0% among first year students [5]. In Kenya, Musyoka et al. [6] reported that the prevalence of daily alcohol use was 1%, and that of daily use of other substances ranged from 0–0.7% among first-year students at University of Nairobi.
College students who use substances often experience a myriad of problems. One main one is poor educational performance and attainment [7, 8]. Mojtabai et al. [7] analyzed a large dataset collected as part of the National Comorbidity Survey and found that mental illness including substance use among college students in the USA was associated with lower odds of college graduation. Tembo et al. [8] in a study conducted among Australian university students found that harmful alcohol use was linked to increased odds of psychological distress, being late for class, missing classes, inability to concentrate in class, and inability to complete assignments. A study conducted by Atwoli et al. [9] in Kenya found that students who used substances reported problems such as unprotected sex, sex that they regretted the next day, scuffles, loss and damage to property, and quarrels. Even worse is that studies show that substance use during college years persists beyond college [10]. Addressing substance use among college students is therefore of high priority. The World Mental Health-International College Student (WMH-ICS) survey initiative was launched in 2012 with the aim of systematically documenting the burden of mental and substance use disorders among first-year college students to institute appropriate preventive and treatment interventions. As part of this initiative, an online survey to investigate the burden of mental and substance use disorders among first-year university students was conducted across three Kenyan universities. The goal of this paper is to report on the prevalence of substance use disorders among this population. Prior papers emanating from studies conducted as part of the WMH-ICS survey, have focused on other mental disorders to the exclusion of substance use disorders [11]. Further, in this paper, the authors describe the association between substance use disorders and mental disorders among first year College students, an association that has not been reported in prior studies done in Kenya [6]. This paper aligns with target 3.5 of the Sustainable Development Goals which requires that treatment and prevention for substance use disorders is strengthened [12].
