Prevalence, Patterns and Predictors of Mental Health Challenges Among Clinical Students – A Mixed Methods Study

Background and Study Aim: Clinical students (CS) navigate a demanding environment characterized by academic pressure, clinical responsibilities, and societal expectations. While this journey fosters significant personal and professional development, it also introduces numerous challenges that can adversely affect mental health and academic performance. This study aimed to assess the prevalence, patterns, and predictors of mental health challenges (MHC) among CS at a Nigerian university. Materials and Methods A total of 211 CS participated in this explanatory-sequential mixed-methods study. MHC, categorized as depression, anxiety, and burnout, were measured using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-item scale, and a burnout questionnaire, respectively. Independent variables included demographic data, academic factors, environmental influences, social relationships, and coping strategies, assessed through validated self-developed questionnaires. Data were analyzed thematically, descriptively, and inferentially at α = 0.05. Results The study revealed a high prevalence of MHC at 97.2%, with burnout being the most prevalent pattern (46.2%). Significant associations were found between MHC and several factors, including gender (χ²=10.355, p = 0.035), familial pressure (r = 0.177, p = 0.011), and access to support services (χ²=27.545, p = 0.006). Exam pressure (r = 0.211, p = 0.002) and fear of failure (r = 0.172, p = 0.014) were notably linked to burnout and depression, respectively. Female gender emerged as a significant predictor of depression (β=-0.899, p = 0.046), while lack of academic clarity (β = 0.575, p = 0.005), low quality of social support (β=-0.434, p = 0.016), and feelings of being misunderstood (β = 0.427, p = 0.011) significantly predicted anxiety. Focus group discussions identified themes related to environmental and interpersonal stressors, coping mechanisms, and the perceived need for enhanced support systems. Conclusion The findings indicate a critical prevalence of MHC among CS, with burnout as the most common manifestation. Key predictors include female gender, lack of academic clarity, inadequate social support, and feelings of misunderstanding. It is essential for clinical training institutions to regularly evaluate these factors and implement strategies to mitigate their impact on student well-being.