Exploring Access, Utilisation, and Barriers to School Health Systems for Managing Mental Health Challenges: A Case Study of Mapanzure High School, Masvingo District, Zimbabwe.

Introduction: Globally, between the ages of 10 and 19, 15% of teenagers have mental health issues, according to the World Health Organization (WHO). Mental health issues in schools lead to dropouts, poor academic performance, social isolation, and increased substance misuse. Various strategies, including universal screening and raising mental health literacy, have been implemented. However, constraints like limited resources and inadequate training hinder effective management. Therefore, this paper aimed to explore student access to and utilisation of the school health system for mental health challenges, and to identify key barriers to its effectiveness from the perspective of students and staff in Mapanzure Masvingo District. Methods: A mixed-method survey was used with interviews and questionnaires to gather information from key informants and 62 randomly selected students. The key informants were purposively sampled, including two nurses, two teachers, three health masters, and two administrators. Quantitative data was analysed in Excel and SPSS and presented as tables and graphs, while the qualitative data was recorded, transcribed verbatim, coded, and thematically analysed. Results: The study found a high prevalence of self-reported mental health symptoms among students, including attention deficit (62.9%) and low self-esteem (72.6%). This high burden of need contrasted sharply with utilisation of the school health system was low (40.3%), primarily due to a lack of student awareness. This indicates a significant gap between system provision and student access. Key informants identified health clubs and guidance counselling as core components of the system, but their effectiveness was hampered by major barriers like poverty and substance abuse. Conclusion: It can be concluded that students are experiencing mental health issues, and key informants generally view school health systems as helpful. However, there are certain obstacles, such as poverty and substance use and abuse hindering implementation and optimal functioning of school health systems. These results may help create a supportive and inclusive environment that values student health and emotional wellbeing that can lead to improved academic outcomes and positive life for students.