Erratic electricity supply (Dumsor) and anxiety disorders among university students in Ghana: a cross sectional study

The magnitude of recent electricity supply crisis in Ghana is not unprecedented. However, the frequency of the current power cuts in an environment of a growing middle class, including university students—that have become accustomed to modern amenities which rely on regular electricity supply—is believed to have had an effect on the mental health of Ghanaians in the immediate and long-term [1].

The World Health Organization estimates that globally about 25 percent of a country’s population will suffer from a mental disorder in their lifetime, and at any point in time about 10 percent suffers from a psychiatric condition of which an estimated three percent in Ghana is believed to have severe form of mental disorders at any point in time [2, 3].

In Ghana, it is estimated that about 18 psychiatrists and about 1200 mental health nurses are known to be actively practicing for the estimated 2.5 million Ghanaians who suffer with at least one mental disorder [4]. The shortage of practicing psychiatrists creates a significant gap of about 98 % with regards to accessing mental health care in the country [3, 5]. Despite the staggering estimates of mental disorders in Ghana and for that matter Africa, little emphasis has been put on the country and continent’s public mental health care system.

Many factors are responsible for people experiencing mental disorders in their lifetime. These include physiological, personal history or lived experiences and environmental factors [6, 7]. The latter factor is usually a result of a confluence of many social events in the lives of individuals with mental disorders. These social events may either be influenced by individual, institutional or national measures that could lead to an immediate or remote trigger of mental distress [8].

Ghana is currently experiencing electricity supply crisis, particularly in the highly populated and urban areas, including the Greater Accra Region where many institutions of higher learning are located. The electricity supply crisis has had some impact on the socio-economic wellbeing of people, including students at institutions of higher learning such as the University of Ghana. Students in this university are dependent on the regular electricity supply to carry on with their normal academic and other lifestyle activities. Therefore, the infrequent supply of electricity to the university community would undoubtedly affect the students’ lifestyle, including their mental health and wellbeing. College students are normally confronted with a myriad of issues including academic, social and personal that has potential to influence their mental health. These issues generally would tend to change depending on the students’ socio-demographic factors as well as their progression in age, academic experience and socioeconomic status while living on campus [9].

The electricity supply crisis in Ghana, which is a systemic issue, is believed to have influenced the health and mental wellbeing of tertiary level students even more because the student population is made up of individuals who have become so dependent on modern technology such as smart-phones, tablets, laptops and other personal computers for their routine academic activities. These gargets are themselves, as well as the internet connectivity to enable them to function, heavily dependent on electricity supply for normal functionality. Therefore, the infrequent electricity supply to the university community is likely to impact on the anxiety levels of students who require regular power supply to function effectively.

Generally, there is limited population level research not only on anxiety and stress levels but on mental health as a whole in Ghana [10]. In fact, there is an even greater dearth of scientific evidence in Ghana on mental health of university student population. The few studies available about mental health issues in Ghana have mainly focused on policy related issues, the incarcerated, homeless youth and postpartum women among other issues [11‐16]. The very few known studies on mental health issues among college students discussed socio-cultural differences in suicides and depressive disorders between Ghanaian and American students [8, 17]. In fact, there is only anecdotal evidence linking the recent electricity supply crisis to an increasing level of depression or anxiety in Ghana, and there is lack of scientific evidence to support that perception in the general population or among the student population. There is therefore the need for research to assess the mental health status of the University of Ghana students within the context of the individual and systemic factors that has the potential to influence their mental health and wellbeing. Further, this study aimed to add on to the literature by exploring the proportion of students who may have experienced electricity supply crisis-related anxiety disorders and answer the research question as to whether erratic electricity supply to the university community can influence generalized anxiety disorder among University of Ghana students.

This study aimed to explore the possible link between the erratic electric power supply in Ghana and anxiety levels among tertiary students. It also aimed at contributing to the literature on mental health issues among African university students by exploring the proportion of students who experience electricity supply crisis-related anxiety disorders. This study also answers the research question about how erratic electricity supply to the university community may influence generalized anxiety disorder among University of Ghana students.

Generally, it is believed that the recent electricity supply crisis in Ghana has affected the mental wellbeing of Ghanaians, including students at the tertiary level institutions. Students are believed to be particularly affected because that population is made up of a generation that have become increasingly accustomed to the use of modern technology, which in itself is highly dependent on the availability of uninterrupted power supply from the national grid.

We found in this study that overall, nearly 26 % of the students that participated in the study indicated that they felt nervous, anxious or on edge “almost daily”. This suggests that the erratic power supply in the country influenced the mental wellbeing of more than a quarter of the tertiary level students. We also found that more than 30 % indicated having the same feeling on “several days” due to the erratic power supply situation in the country. Additionally, 23.1 % of the students in this study were found to have had severe generalized anxiety disorder as a result of the erratic power supply. This finding is higher than those classified in a sub-threshold with high severity of GAD symptoms that Kanuri et al. [19] found in their study in which they evaluated anxiety screening in college students that met the diagnostic and statistical manual of mental disorders, Fifth edition (DSM-V) clinical criteria for GAD [19].

Since our findings in this study suggests a link between the erratic electricity power supply and anxiety level among university students in Ghana, it could be due to a number of factors, including students’ inability to carry on with their routine academic activities such as conducting online search, completing class assignments and overall academic work that is increasingly becoming technology dependent in Ghana. The students’ anxiety level could also be influenced by the fact that the electricity disruption impacted their ability to prepare meals. This is because some students on Ghanaian university campuses tend to prepare their own meals in their halls of residence, unlike their counterparts in places like the U.S. where students on university campuses obtain their meals already prepared by vendors [20]. Therefore, any disruption in the flow of electricity, which affects their ability to prepare meals, can be very challenging. The link between poor electric supply and students’ anxiety level found in this study corroborates other finding on drought-induced disrupted electric power supply and its effect on the overall health of individuals who are dependent on constant electricity supply for survival [6]. Therefore, regardless of what the causes are, with regards to disrupted power supply, those who rely on the consistent supply of electricity are more likely to suffer from a mental health condition as a result of any power supply disruption.

Although in this study we found that female students had a slightly higher prevalence level of moderate anxiety, compared to their male counterparts, there was no such difference in the prevalence level in the severe anxiety category when both sexes were compared. The higher prevalence of moderate level of anxiety found in female students compared to their male counterparts in our study was somewhat similar to what other studies found [21, 22].

Despite the fact that the electricity power supply company, the electricity company of Ghana (ECG), had made an attempt to publish a schedule of when and where there would be power outage for each community so that people can plan ahead or anticipate disruption, the students on the university campus were still found in this study to have experienced some amount of generalized anxiety disorder, especially among the undergraduate level students. In fact, we found that in all the undergraduate student class levels, including levels 100–400 (freshmen–seniors), there were self-reported moderate (18.3–24.8 %) and severe (16.5–27.4 %) prevalence levels of GAD.

Although our overall finding of more than a quarter of students that felt nervous, anxious or on edge nearly every day due to the disrupted electricity supply seem consistent with the World Health Organization’s estimates that of any given population, about 25 % will suffer from a mental disorder, it is important to note that our study population lived in an environment that was characterised as a crisis moment of electric power supply. As discussed earlier, several factors contribute to individuals developing either episodic or chronic mental disorders and for that matter, the electricity supply crisis was found in this study to influence the university students’ feeling of GAD. This therefore goes to suggest that in spite of efforts by the power company to minimize any impact of the infrequent power supply to the Ghanaian population through the publication of outage schedule, the university students’ level of anxiety resulting from the outages was still apparent.

This study on the mental health effect, especially on anxiety levels, influenced by erratic power supply has some local, national and global implications. First, it provides important opportunity for policy development and implementation that will address the potential for health related effects of poor electric power supply in Ghana and elsewhere in Africa. This is particularly relevant now because other African countries, including in South Africa, have recently begun electric power rationing and for that matter the health and mental wellbeing of their population will likely be affected by this systemic electric supply issue as it is in Ghana.

The findings are also very important to the university administrators who now have the scientific research information to enable them to plan and put in place measures to minimize and/or address the mental health effect of the erratic electric power supply to the student population. This we believe can be done through evidence-based informed planning to enable them to institute screening, brief intervention and referral to treatment for those that may be impacted by the poor electric power supply.

Further, our research is in line with one of the objectives of the World Health Organization’s “Mental health action plan: 2013–2020” that includes strengthening evidence and research on mental disorders, especially since there is dearth of research on mental disorders, including on students in low-middle income countries like Ghana [23].

This exploratory study provided valuable information on the link between disrupted power supply at a national level and its impact on the health of the population, particularly for groups that are heavily reliant on constant electric power supply for their daily activities. In fact, the study underscores the point that even in resource-poor countries including Ghana, where it is often not expected for issues such as irregular electricity supply to have an impact on the mental well-being of the people, it may indeed have an influence on certain groups of the population, including students whose anxiety levels are now known to be associated with power supply crisis.