Assessing the determinants of mental health services utilization among adolescents aged 18–24 years in Kicukiro district, Rwanda

Introduction: Mental health disorders are a growing public health concern, particularly among adolescents aged 18–24 years. Despite increased awareness, utilization of mental health services in Rwanda remains low, highlighting the need to understand factors influencing help-seeking behaviors in this population. Objectives This study aimed to assess the determinants of mental health service utilization among adolescents aged 18–24 years in Kicukiro District, Rwanda, focusing on socio-demographic characteristics, knowledge, attitudes, and access to services. Methodology: A quantitative analytical cross-sectional design was employed. A total of 384 adolescents were recruited using multistage sampling from schools, youth centers, and community settings. Data were collected via structured questionnaires covering socio-demographics, mental health knowledge, attitudes, and service utilization. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were conducted using SPSS 25 to identify factors associated with service use. Results Overall, 35.4% of adolescents reported having accessed mental health services, with depression (87.5%), anxiety (66.2%), and stress (55.9%) as the main reasons. Awareness of services was high (83.6%), but knowledge of specific access points, particularly digital platforms, was limited. Utilization was significantly associated with age, gender, and attitudes toward mental health. Adolescents aged 21–23 years were 3.8 times more likely to use services compared to those ≤ 20 years (AOR = 3.753; 95% CI: 1.861–7.570), while males had higher utilization than females (AOR = 5.810; 95% CI: 3.249–10.389). Positive attitudes strongly predicted service uptake. Conclusion Despite high awareness, the majority of adolescents in Kicukiro District do not access mental health services. Interventions should target attitude change, stigma reduction, and improved accessibility through community, school, and digital platforms to enhance adolescent mental health service utilization in Rwanda.