Home / Nursing / INTRODUCTION Background to the Study Psychoactive Substance use and dependence cause a significant burden to the individuals and societies throughout the world. The World Health Report (2010) indicated that 8.9% of the total burden of disease comes from the use of psychoactive substances. The report showed that tobacco accounted for 4.1%, alcohol 4%, and illicit drugs 0.8% of the burden of disease in 2010. Much of the burden attributable to substance use and dependence is the result of a wide variety of health and social problems. Data from the (World Health Organization, 2011) show large-scale seizures of cocaine, heroin, cannabis and amphetamine-type stimulants in different parts of the world. Availability of cocaine, heroin and cannabis depends on the level of cultivation in source countries and on the success or failure of trafficking organizations. However, even with increased levels of law enforcement activities, there always seems to be enough available to users. According to (UNODC, 2011) estimates show that about 200 million people make illicit use of one type of illicit substance or another. Psychoactive substance use is a social problem that has spread and increased rapidly in educational institutions especially among secondary school students (Neeraja, 2011). This social problem is considered an issue of serious concern as it adversely affects the lives and performance of students involved as well as the harmonious functioning of the entire structure of the society. Use of psychoactive drugs and other associated problems are inimical to the survival and effective functioning of human societies. A significant number of untimely deaths and accidents have been linked to the activities of persons under the influence of one psychoactive drug or the other (Shelly, 2010). 12 Drug abuse is viewed by different authorities in various forms. Neeraja (2011) defined substance abuse as the dependence on a drug or other chemical substances leading to the effect that are detrimental to the individual’s physical and mental health or the welfare of others. According to Smelzer, Bare, Hinkle, and Cheever (2008) substance abuse is a maladaptive pattern of drug use that causes physical and emotional harm with the potential for disruption of daily life. From these definitions, it can be deduced that substance abuse is the misuse of one or more drugs which could be prescribed by a health practitioner with the intention to alter the way one feels, thinks or behaves and it is associated with consequences which include physical and emotional harm to the person. The African Symposium (2010) viewed substance abuse as the improper use or application of drugs by a person without proper knowledge of the drugs and without due prescription from a qualified medical practitioner. This definition focuses on psychoactive drugs. All drugs can be abused to an extent that it turns into addiction when the drug user is unable to stop the use of the drugs despite the harmful effects on the user’s social, personal and economic lives. The problem of substance abuse is so grave that though it was originally conceived as the problem of a ‘select few’, it has extended beyond the usual characteristics of abusers being males, adults and urban based people, to now include females, youngsters and rural dwellers (Rocha, 2009). These abusers erroneously believe that drugs enhance their performance, put them in good mood etc. The accompanying problems of this act constitute a major threat to the well-being of the society (Ajala, 2009). The youths in Nigeria like many countries of the world are increasingly developing addiction to psychoactive substances. The National Drug Law Enforcement Agency (NDLEA, 2011) collected drugs use and abuse data from schools, records of patients admitted at mental health institutions for drug problems and interview of persons arrested for drug offences. The result 13 showed that youths constitute the high risk group for drug trafficking and abuse. Friends and school mates account for about 90% of the source of influence of the use and abuse of various psychoactive substances. In Nigeria, alcohol and cigarette are legal substances but, the two have been discovered to cause physical damage to human bodies. It has been reported that smoking tobacco causes 90.0% of lung cancer, 30.0% of all cancers, and 80.0% of other chronic lung diseases (Sale 2008). Apart from these health implications, according to Stephen (2010), alcohol and cigarette are said to be “gatew ay drugs” to other more potent psychoactive drugs like marijuana, heroin and cocaine. The future of any community, society, state or nation is tied to the character of the adolescent in that particular place, area or locality. It is also said that “The youth are the leaders of tomorrow”. Therefore responsible youth in the socie ty indicates responsible and brighter future of that society and also the reverse is the case. In our society people are known to have had problems that had made them to adopt various measures to cope with such problems and live successfully within the confines of societal normative values. While some people take solace in lawful ways others resort to unlawful and unhealthy measures such as the use of drugs or psychoactive substances to the extent of abusing them, hence resulting in addiction. According to Edum (2006) the adolescent in our society are not left out in this, as they are either influenced by peer group while others do so because of the easy availability of the abused substances, others also watch on television and films and some read in books and so try to experiment to experience the effects. The effects of specific psychoactive substance vary depending on their mechanism of action, the amount consumed and the history of the user among other factors. 14 An ugly fact that is with us in the recent time is road traffic accident related to psychoactive substance use as well as increased crime rate in Nigeria, though a number of measures are put in place to check this menace. This includes the establishment of the National Drug Law Enforcement Agency (NDLEA) through Degree 48 of 1989 and 33 of 1990. However, in spite of these measures people especially the adolescents continue to use psychoactive drugs illicitly with its attendant problems. Kano state is the most populated state in Northern Nigeria (NPC, 2006). The use of psychoactive Substance in this state is the order of the day, evidence by increase in crimes of different nature, failure at examination, abandoning school and poor performance in all aspects of life etc. Dala local government is the largest, most populated local government Area of Kano State. One myth about the youth and adolescents in Dala local government is drug and substance use evidently shown by increase in crime, abandoning and inconsistencies in school, as well as failure in examination. These reasons encouraged and motivated the desire to investigate the prevalence and pattern of psychoactive substance use among the senior government secondary school students of the largest local government area in the middle of Kano City, Dala Local Government Area of Kano State, Nigeria. Statement of the Problem Substance use is not a strange phenomenon; the global, regional and national dimension of it are documented. It is in recognition of the complexity of the problem that 26th June of every year has been declared as the International Day Against Abuse and illicit trafficking by United Nations. In its June, 2003 report, the United Nations Children and Education Fund 15 (UNICEF) stated that the problem of HIV/AIDS is inextricably connected to a range of problems, among which is drug abuse among children and young people. Similarly, the United Nations Office on Drugs and Crime (UNODC) pointed out that drug abuse among “area boys” in Nigeria has been reported as the cau se of delinquent behaviours and crime. The World Health Organization (WHO, 2010) believes that young people are more vulnerable to suffering physical, emotional and social harm from their own or other people’s drug use. It also identifies strong links between the high rate of drinking, violent sexual behaviour, traffic and other accidents and drug use. In relation to tobacco, World Health Organization also estimates that about 250 million children and adolescents who live in developing countries like Nigeria are likely to be killed by tobacco (Stephen, 2010). The United Nations office on Drug and Crime (UNODC) partly attributes the prevalence of drug use in Nigeria to street hawking of drugs and pharmaceutical preparation. The prevalence rate of adolescent’s substance and drug abuse in our society poses a great concern to health care providers as some end up as addicts. This is quite substantial in Kano state. According to NDLEA (2010) reports, Kano State is the highest in terms of people arrested with the case of drug trafficking’ and suspected drug addicts (638 arrested suspects) followed by Katsina (411) and Rivers (347) etc. According to NDLEA (2010) most of the people arrested in Kano state for drug addicts and trafficking are from Dala local government and neighboring communities and majority constitutes secondary school drop outs. Therefore based on the foregoing reasons, the researcher deemed it necessary to determine the prevalence and patterns of psychoactive substance use among the senior secondary school students in Dala LGA, Kano State Nigeria. 16 Purpose of the Study The main purpose of the study is to determine the prevalence and pattern of psychoactive substance use among Government senior secondary school students in Dala LGA of Kano State, Nigeria. Objectives. The Specific Objectives are to 1. Identify the characteristics of students who use identified substances 2. Establish the prevalence of substance use among the senior secondary school students in Dala Local Government. 3. Identify the patterns of substance use among the senior secondary students. 4. Identify the substances commonly used by the Senior Secondary students 5. Identify the sources of influence of drug use among secondary school Students 6. Determine the age of onset of substance use among secondary school student 7. Identify the reasons why senior secondary school students use drugs Research Questions 1. What are the characteristics of students who abuse drugs? 2. What is the prevalence rate of psychoactive substance use among the senior secondary school students in Dala Local Government, Kano State? 3. What are the patterns of substance use among senior secondary school students? 4. What are the substances commonly used by the senior secondary school students? 5. What are the sources of influence of drug use among senior secondary school in Dala? 17 6. What is the age of onset of substance use among secondary school student in Dala local government? 7. What are the reasons senior secondary school students used drugs? Hypothesis 1. There is no significant difference between Male and Female in secondary school in drug abuse. 2. There is no significant difference in pattern of drug abuse in days per month based on Psychoactive Substances 3. There is no significant relationship of respondents age range at the first use based on life time use of psychoactive Significance of the Study The present study will reveal the prevalence, pattern, types and sources of psychoactive substances used by secondary school children. It will also reveal the characteristics of the students who use drugs and the problems students encounter as a result of drug use. These findings are essential as they will help in understanding the overall social, academic and drug problems of the students and youth in Kano state. This finding would be useful to the parents, teachers, police and the drug law enforcement agency (NDLEA) as well as other bodies concerned with checking drug abuse problems in Dala LGA of Kano state and Nigeria at large. The findings will provide a source of reference for intervention programmes in Kano state. It is also hoped that the findings of this st

INTRODUCTION Background to the Study Psychoactive Substance use and dependence cause a significant burden to the individuals and societies throughout the world. The World Health Report (2010) indicated that 8.9% of the total burden of disease comes from the use of psychoactive substances. The report showed that tobacco accounted for 4.1%, alcohol 4%, and illicit drugs 0.8% of the burden of disease in 2010. Much of the burden attributable to substance use and dependence is the result of a wide variety of health and social problems. Data from the (World Health Organization, 2011) show large-scale seizures of cocaine, heroin, cannabis and amphetamine-type stimulants in different parts of the world. Availability of cocaine, heroin and cannabis depends on the level of cultivation in source countries and on the success or failure of trafficking organizations. However, even with increased levels of law enforcement activities, there always seems to be enough available to users. According to (UNODC, 2011) estimates show that about 200 million people make illicit use of one type of illicit substance or another. Psychoactive substance use is a social problem that has spread and increased rapidly in educational institutions especially among secondary school students (Neeraja, 2011). This social problem is considered an issue of serious concern as it adversely affects the lives and performance of students involved as well as the harmonious functioning of the entire structure of the society. Use of psychoactive drugs and other associated problems are inimical to the survival and effective functioning of human societies. A significant number of untimely deaths and accidents have been linked to the activities of persons under the influence of one psychoactive drug or the other (Shelly, 2010). 12 Drug abuse is viewed by different authorities in various forms. Neeraja (2011) defined substance abuse as the dependence on a drug or other chemical substances leading to the effect that are detrimental to the individual’s physical and mental health or the welfare of others. According to Smelzer, Bare, Hinkle, and Cheever (2008) substance abuse is a maladaptive pattern of drug use that causes physical and emotional harm with the potential for disruption of daily life. From these definitions, it can be deduced that substance abuse is the misuse of one or more drugs which could be prescribed by a health practitioner with the intention to alter the way one feels, thinks or behaves and it is associated with consequences which include physical and emotional harm to the person. The African Symposium (2010) viewed substance abuse as the improper use or application of drugs by a person without proper knowledge of the drugs and without due prescription from a qualified medical practitioner. This definition focuses on psychoactive drugs. All drugs can be abused to an extent that it turns into addiction when the drug user is unable to stop the use of the drugs despite the harmful effects on the user’s social, personal and economic lives. The problem of substance abuse is so grave that though it was originally conceived as the problem of a ‘select few’, it has extended beyond the usual characteristics of abusers being males, adults and urban based people, to now include females, youngsters and rural dwellers (Rocha, 2009). These abusers erroneously believe that drugs enhance their performance, put them in good mood etc. The accompanying problems of this act constitute a major threat to the well-being of the society (Ajala, 2009). The youths in Nigeria like many countries of the world are increasingly developing addiction to psychoactive substances. The National Drug Law Enforcement Agency (NDLEA, 2011) collected drugs use and abuse data from schools, records of patients admitted at mental health institutions for drug problems and interview of persons arrested for drug offences. The result 13 showed that youths constitute the high risk group for drug trafficking and abuse. Friends and school mates account for about 90% of the source of influence of the use and abuse of various psychoactive substances. In Nigeria, alcohol and cigarette are legal substances but, the two have been discovered to cause physical damage to human bodies. It has been reported that smoking tobacco causes 90.0% of lung cancer, 30.0% of all cancers, and 80.0% of other chronic lung diseases (Sale 2008). Apart from these health implications, according to Stephen (2010), alcohol and cigarette are said to be “gatew ay drugs” to other more potent psychoactive drugs like marijuana, heroin and cocaine. The future of any community, society, state or nation is tied to the character of the adolescent in that particular place, area or locality. It is also said that “The youth are the leaders of tomorrow”. Therefore responsible youth in the socie ty indicates responsible and brighter future of that society and also the reverse is the case. In our society people are known to have had problems that had made them to adopt various measures to cope with such problems and live successfully within the confines of societal normative values. While some people take solace in lawful ways others resort to unlawful and unhealthy measures such as the use of drugs or psychoactive substances to the extent of abusing them, hence resulting in addiction. According to Edum (2006) the adolescent in our society are not left out in this, as they are either influenced by peer group while others do so because of the easy availability of the abused substances, others also watch on television and films and some read in books and so try to experiment to experience the effects. The effects of specific psychoactive substance vary depending on their mechanism of action, the amount consumed and the history of the user among other factors. 14 An ugly fact that is with us in the recent time is road traffic accident related to psychoactive substance use as well as increased crime rate in Nigeria, though a number of measures are put in place to check this menace. This includes the establishment of the National Drug Law Enforcement Agency (NDLEA) through Degree 48 of 1989 and 33 of 1990. However, in spite of these measures people especially the adolescents continue to use psychoactive drugs illicitly with its attendant problems. Kano state is the most populated state in Northern Nigeria (NPC, 2006). The use of psychoactive Substance in this state is the order of the day, evidence by increase in crimes of different nature, failure at examination, abandoning school and poor performance in all aspects of life etc. Dala local government is the largest, most populated local government Area of Kano State. One myth about the youth and adolescents in Dala local government is drug and substance use evidently shown by increase in crime, abandoning and inconsistencies in school, as well as failure in examination. These reasons encouraged and motivated the desire to investigate the prevalence and pattern of psychoactive substance use among the senior government secondary school students of the largest local government area in the middle of Kano City, Dala Local Government Area of Kano State, Nigeria. Statement of the Problem Substance use is not a strange phenomenon; the global, regional and national dimension of it are documented. It is in recognition of the complexity of the problem that 26th June of every year has been declared as the International Day Against Abuse and illicit trafficking by United Nations. In its June, 2003 report, the United Nations Children and Education Fund 15 (UNICEF) stated that the problem of HIV/AIDS is inextricably connected to a range of problems, among which is drug abuse among children and young people. Similarly, the United Nations Office on Drugs and Crime (UNODC) pointed out that drug abuse among “area boys” in Nigeria has been reported as the cau se of delinquent behaviours and crime. The World Health Organization (WHO, 2010) believes that young people are more vulnerable to suffering physical, emotional and social harm from their own or other people’s drug use. It also identifies strong links between the high rate of drinking, violent sexual behaviour, traffic and other accidents and drug use. In relation to tobacco, World Health Organization also estimates that about 250 million children and adolescents who live in developing countries like Nigeria are likely to be killed by tobacco (Stephen, 2010). The United Nations office on Drug and Crime (UNODC) partly attributes the prevalence of drug use in Nigeria to street hawking of drugs and pharmaceutical preparation. The prevalence rate of adolescent’s substance and drug abuse in our society poses a great concern to health care providers as some end up as addicts. This is quite substantial in Kano state. According to NDLEA (2010) reports, Kano State is the highest in terms of people arrested with the case of drug trafficking’ and suspected drug addicts (638 arrested suspects) followed by Katsina (411) and Rivers (347) etc. According to NDLEA (2010) most of the people arrested in Kano state for drug addicts and trafficking are from Dala local government and neighboring communities and majority constitutes secondary school drop outs. Therefore based on the foregoing reasons, the researcher deemed it necessary to determine the prevalence and patterns of psychoactive substance use among the senior secondary school students in Dala LGA, Kano State Nigeria. 16 Purpose of the Study The main purpose of the study is to determine the prevalence and pattern of psychoactive substance use among Government senior secondary school students in Dala LGA of Kano State, Nigeria. Objectives. The Specific Objectives are to 1. Identify the characteristics of students who use identified substances 2. Establish the prevalence of substance use among the senior secondary school students in Dala Local Government. 3. Identify the patterns of substance use among the senior secondary students. 4. Identify the substances commonly used by the Senior Secondary students 5. Identify the sources of influence of drug use among secondary school Students 6. Determine the age of onset of substance use among secondary school student 7. Identify the reasons why senior secondary school students use drugs Research Questions 1. What are the characteristics of students who abuse drugs? 2. What is the prevalence rate of psychoactive substance use among the senior secondary school students in Dala Local Government, Kano State? 3. What are the patterns of substance use among senior secondary school students? 4. What are the substances commonly used by the senior secondary school students? 5. What are the sources of influence of drug use among senior secondary school in Dala? 17 6. What is the age of onset of substance use among secondary school student in Dala local government? 7. What are the reasons senior secondary school students used drugs? Hypothesis 1. There is no significant difference between Male and Female in secondary school in drug abuse. 2. There is no significant difference in pattern of drug abuse in days per month based on Psychoactive Substances 3. There is no significant relationship of respondents age range at the first use based on life time use of psychoactive Significance of the Study The present study will reveal the prevalence, pattern, types and sources of psychoactive substances used by secondary school children. It will also reveal the characteristics of the students who use drugs and the problems students encounter as a result of drug use. These findings are essential as they will help in understanding the overall social, academic and drug problems of the students and youth in Kano state. This finding would be useful to the parents, teachers, police and the drug law enforcement agency (NDLEA) as well as other bodies concerned with checking drug abuse problems in Dala LGA of Kano state and Nigeria at large. The findings will provide a source of reference for intervention programmes in Kano state. It is also hoped that the findings of this st

 

Table Of Contents


1.INTRODUCTION

2.THEORETICAL FRAMEWORK

2.1.     Mental health

2.2.     Developing country

2.3.Mental health education for nurses

3.PURPOSE AND RESEARCH QUESTIONS

4. RESEARCH METHODOLOGY

4.1.     Literature review

4.2.Database Search

4.3.Exclusion and Inclusion Criteria

4.4. Data Collection

4.5. Data analysis

5. RESULTS

5.1. State of mental health

5.2. Promoting Mental Health teaching

6. ETHICS AND VALIDITY

6.1.Honesty

6.2.Objectivity

6.3.Direct quotations

7. DISCUSSION

8. CONCLUSION

9. REFERENCES


Thesis Abstract

The purpose of this thesis was to explore more about mental health and mental health nursing plus education in developing countries with more emphasis on Africa. The aim is to find out how mental health teaching can be promoted in developing countries and how to assist people with mental illness, have more productive and autonomous lifestyles since it is ignored. The thesis was carried out using the literature review methodology. The authors used electronic search engines available at the Turku university of applied sciences website (Finna) and other search engines like Academic Search Elite (EBSCO), Cinahl complete, Cumulative Index to Nursing and Allied Health Literature, SAGE publications and E-Library. WHO Software used RefWorks for bibliography and for importing references. The other articles and journals used were the World Health Organisation (WHO 2016), psychiatric-mental health nursing education (PMHNE) programs that mainly focused on Botswana and Nigeria. Mental illness cases are linked to imbalances of neural transmitters in the brain, Traumatic Brain Injury (TBI) in certain parts of the socioeconomic factors like disease, political instability, violence and any other kind of addiction. The results show that there are poorly enacted policies directed towards mental health education by the policy makers in the various African countries. Secondly, the funds that are meant to be invested in the education of mental health in the various countries are not sufficient enough. Because of this, education for nurses is still poor.

Thesis Overview

1. INTRODUCTION

Mental health promotion is frequently overlooked as an integral part of health promotion since its one of the most complex and demanding areas of nursing in developing countries. At least one in three people is thought to suffer some form of mental health problem. (Jenkins ym 2011.) Among most people, mental illness is as a result of the crisis they suffer in life or in the day to day experiences which they can’t cope with (Seedat ym 2008). There is quite a wide range of mental health conditions in developing countries, these include:- neuroses, psychoses, psychological and personality disorders, political instabilities effects like after war trauma, eating disorders and substance misuse (Barley ym 2016).

Modern mental health nursing requires a lot of knowledge, experience and competence, in developing countries. Nurses need effective communication skills, a caring and compassionate nature as well as respect for the dignity and safety of others. Even though in developing countries they take dignity as important as possible, it is the opposite for mental health patients in some countries. (Adejumo et al 2001, 223.)

Mental health is generally described as a situation where individuals discover their ability, can perform normal daily tasks in a productive manner, and they are able to make positive changes to the communities they live in and their surroundings (WHO 2001a, 1).

It is of great concern that in practice, mental health promotion is frequently overlooked in health promotion programs especially in developing countries, although the World Health Organisation defines mental health as an integral part of health. It is suggested that more attention should be given to addressing the determinants of mental health in terms of protective and risk factors for both physical and mental conditions among individuals, particularly in developing countries. (WHO 2005.)

 

2.THEORETICAL FRAMEWORK

2.1Mental health

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease of infirmity” (WHO 2001, 1). The World Health Organisation further defines health promotion as “actions that support people to adopt and maintain healthy lifestyles and which create supportive living conditions or environments for health (WHO 2005).

Mental health is also defined as a state of well-being where an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her own community (Lal ym 2014).

Other definitions of mental health refer to the individual’s subjective feelings of well-being, optimism and mastery, the concepts of ‘resilience’ or the ability to deal with adversity, and the capacity to be able to form and maintain meaningful relationships(Jansen ym 2015).

2.2.Developing countries

A developing country can also be referred to as a Less Developed Country (LDC) or an under developed country. There are a series of definitions for a developing country though there are no agreed criteria used to define the above. This is usually a country with an industrial base that is developing at a gradual rate. The Human Development Index (HDI) is low as is compared to other countries. These countries are usually in the process of transformation from their old traditional lifestyles moving towards the modern lifestyle that began in the 18th and 19th century as a result of the industrial revolution.

A developing country is often characterized by having people with a lower life expectancy rate, the education levels and literacy rates are low, and people’s income levels are very low usually below the poverty line.


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