Abstract
Background:
Teachers perception of child mental health problems and their attitude to school-based mental health services helps in designing early intervention strategies aimed at promoting the service. However, little is known in this regard among primary school teachers in Ethiopia. Therefore, this study assessed perceptions and attitude of primary school teachers to child mental health problem and school-based mental health programs in Jimma town, southwest Ethiopia in 2013.
Methods:
A cross-sectional study design was implemented among 568 primary school teachers in Jimma town, from 1 to 30 October 2013. Perceptions and attitude of teachers to children with mental health problems and school mental health related information were assessed using a structured self- administered questionnaire.
Results:
About 40% of teachers recognized the list of psychopathology items presented to them as child mental health problems while 54.4% of them rated child mental health problem as severe. Externalizing behaviors were perceived as the most severe problems. Teaching experience and teaching in public schools were significantly associated with the perception of severe type of child mental health problems. About 95% of teachers acknowledged that school-based mental health programs are important but limited availability was reported.
Conclusion:
Despite the high problem severity ratings, teachers’ perception of the psychopathology as a mental health problem in children was low. There was also a favorable attitude on the importance and the need of school-based child mental health programs. Thus, creating mental health awareness for teachers and establishing school mental health services to intervene in child mental health problem is crucial.
Acknowledgments
The authors would like to thank Jimma University for its financial support to conduct the study. We would like to extend our deepest gratitude to the primary school teachers of Jimma town for their unreserved willingness to participate in the study.
Conflict of interest: The authors declared no conflict of interest.
Authors’ contribution: HK contributed in idea conception, topic selection, write up of proposal for funding, data analysis, write up of results and the manuscript. MA, HB and RF contributed idea generation in title selection, contributed in organizing the references that were important to the study, commented on both the proposal draft and the results as well as manuscript write up.
Appendices
Percentages, mean and standard deviation scores of teachers’ answers concerning the types of child mental health problems that present 1 (no problem), 2 (mild problem), 3 (moderate problem), 4 (severe problem) and 5 (very severe problem) for them and their opinion whether it is a mental health problem (yes) or not (no) among primary school teachers in Jimma town, October 2013.
| Type of child mental health problem | Severity of children’s mental health problems (%) | Mean | SD | MHP (yes) n (%) | ||||
|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||||
| Thinks things out before acting | 5.6 | 18.4 | 30.9 | 39.4a | 5.6 | 3.21 | 0.993 | 155 (30.1) |
| Restless, overactive, cannot stay still for long | 3.5 | 20 | 39.2a | 29.1 | 8.2 | 3.18 | 0.962 | 315 (61.2) |
| Quarreling and bullying other children | 6.4 | 23.5 | 27.6 | 32.6a | 9.9 | 3.16 | 1.094 | 210 (40.8) |
| Often lies or cheats | 5.8 | 22.3 | 32.4a | 32.4a | 7.0 | 3.12 | 1.025 | 145 (28.2) |
| Constantly fidgeting or squirming | 9.3 | 23.2 | 27.2 | 31.8a | 8.3 | 3.07 | 1.121 | 232 (45.0) |
| Often does not offer to help others (parents, teachers, children) | 7.8 | 24.1 | 37.9a | 25.6 | 4.7 | 2.95 | 0.997 | 122 (23.7) |
| Poor attention span, does not see work through to the end | 8.7 | 27.2 | 36.1a | 23.7 | 4.3 | 2.88 | 1.009 | 189 (36.7) |
| Often complains of headaches, stomach-aches or sickness | 6.2 | 27.4 | 43.7a | 18.3 | 4.5 | 2.87 | 0.932 | 138 (26.8) |
| Easily distracted, concentration wanders | 9.1 | 26.0 | 38.1a | 23.5 | 3.3 | 2.86 | 0.99 | 176 (34.2) |
| Not kind to younger children | 9.7 | 27 | 35.9a | 23.7 | 3.7 | 2.85 | 1.011 | 147 (28.5) |
| Often unhappy, depressed or tearful | 8.7 | 28 | 36.5a | 23.7 | 3.1 | 2.84 | 0.984 | 195 (37.9) |
| Uses obscene words | 15.0 | 27.6a | 24.7 | 25.6 | 7 | 2.82 | 1.178 | 107 (20.8) |
| Often loses temper | 9.1 | 29.3 | 36.5a | 21.4 | 3.7 | 2.81 | 0.995 | 283 (55.0) |
| Picked on or bullied by other youth | 10.7 | 26.4 | 38.6a | 20 | 4.1 | 2.80 | 1.009 | 132 (25.6) |
| Would rather be alone than with other children | 8.3 | 30.9 | 36.7a | 20.6 | 3.5 | 2.80 | 0.975 | 291 (56.50) |
| Generally not well behaved, usually does not do what adults request | 7.8 | 31.3 | 36.9a | 21.4 | 2.7 | 2.80 | 0.955 | 193 (37.5) |
| Many fears, easily scared | 8.5 | 37.3a | 35.9 | 14.2 | 4.1 | 2.68 | 0.959 | 195 (37.9) |
| Nervous in new situations, easily loses confidence | 11.3 | 33.0 | 37.1a | 15 | 3.5 | 2.66 | 0.983 | 152 (29.5) |
| Generally not liked by other children | 10.7 | 35.5a | 35.0 | 15.3 | 3.3 | 2.65 | 0.972 | 138 (26.8) |
| Not helpful if someone is hurt, upset or feeling ill | 11.1 | 32.8 | 38.4a | 15.3 | 2.3 | 2.65 | 0.949 | 131 (25.4) |
| Many worries or often seems worried | 13.0 | 30.5 | 39.0a | 14.2 | 3.3 | 2.65 | 0.985 | 156 (30.3) |
| Has not at least one good friend | 9.7 | 40.4a | 30.9 | 14.8 | 4.3 | 2.63 | 0.992 | 149 (28.9) |
| Refuse to share readily with other youth, e.g. books, games | 9.3 | 34 | 43.7a | 11.7 | 1.4 | 2.62 | 0.859 | 198 (38.4) |
| Gets along better with adults than with other youth | 14.2 | 33.2 | 36.3a | 13.8 | 2.5 | 2.57 | 0.978 | 149 (28.9) |
| Is untidy in personal hygiene | 17.1 | 33.2 | 34.8a | 11.3 | 3.7 | 2.51 | 1.018 | 113 (21.9) |
| Not considerate of other people’s feelings | 21 | 25.8 | 38.8a | 12.8 | 1.6 | 2.48 | 1.01 | 314 (61.0) |
| Truancy from school | 24.5 | 33.8a | 29.1 | 10.7 | 1.9 | 2.32 | 1.021 | 116 (22.5) |
| Spelling problems | 23.7 | 48.3a | 21 | 5.4 | 1.6 | 2.13 | 0.888 | 114 (22.1) |
| Mathematics problems | 26.2 | 47.4a | 18.1 | 6.4 | 1.9 | 2.10 | 0.93 | 111 (21.6) |
| Writing problems | 29.7 | 48a | 14.6 | 5.6 | 2.1 | 2.03 | 0.928 | 120 (23.3) |
| Steals from home, school or elsewhere | 38.3a | 32.6 | 21.4 | 6.6 | 1.2 | 2.00 | 0.983 | 122 (23.7) |
| Speech and language problems | 31.5 | 48.7a | 13.2 | 4.1 | 2.5 | 1.97 | 0.915 | 115 (22.3) |
| Reading problems | 30.5 | 50.7a | 12.2 | 5.2 | 1.2 | 1.95 | 0.861 | 120 (23.3) |
| Substance use (cigarette, khat, etc.) | 51.7a | 24.7 | 14.4 | 6.4 | 2.9 | 1.84 | 1.075 | 147 (28.5) |
| Is suspicious | 49.5a | 27.4 | 16.3 | 4.3 | 2.5 | 1.83 | 1.014 | 150 (29.1) |
| Day time wetting of clothes | 74.4a | 13.6 | 5.6 | 3.3 | 3.1 | 1.47 | 0.967 | 155 (30.1) |
n=515, aDegree of mode, MHP=Mental health problems, SD=standard deviations.
A list of child mental health problems categories.
| Children mental health categories | Symptoms or items of child mental health problems |
|---|---|
| Emotional problems | Often complains of headaches, stomach-aches or sickness |
| Often unhappy, depressed or tearful | |
| Many fears, easily scared | |
| Nervous in new situations, easily loses confidence | |
| Many worries or often seems worried | |
| Peer-relationship problems | Picked on or bullied by other youth |
| Would rather be alone than with other children | |
| Generally not liked by other children | |
| Has not at least one good friend | |
| Gets along better with adults than with other youth | |
| Hyperactivity problems | Thinks things out before acting |
| Restless, overactive, cannot stay still for a long time | |
| Constantly fidgeting or squirming | |
| Poor attention span, does not see work through to the end | |
| Easily distracted, concentration wanders | |
| Conduct problems | Quarreling and bullying other children |
| Often lies or cheats | |
| Often loses temper | |
| Generally not well behaved, usually does not do what adults request | |
| Steals from home, school or elsewhere | |
| Pro-social deficit problems | Not considerate of other people’s feelings |
| Not kind to younger children | |
| Not helpful if someone is hurt, upset or feeling ill | |
| Refuse to shares readily with other youth, e.g. books, games | |
| Often does not offer to help others (parents, teachers, children) | |
| Learning problems | Spelling problems |
| Mathematics problems | |
| Writing problems | |
| Reading problems | |
| Other problems | Uses obscene words |
| Truancy from school | |
| Untidy in personal hygiene | |
| Speech and language problems | |
| Substance use | |
| Suspicious | |
| Day time wetting of clothes |
References
1. The World Federation for Mental Health. Emotional and behavioral disorders of children and adolescents. A global mental health education program of the world federation for mental health. World Mental Health Day, 2003.Search in Google Scholar
2. Patel V, Flisher AJ, Nikapota A, Malhotra S. Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry 2008 49:313–34.10.1111/j.1469-7610.2007.01824.xSearch in Google Scholar
3. Myron LB. Child and adolescent mental disorders: the magnitude of the problem across the globe. J Child Psychol Psychiatry 2008;49:226–36.10.1111/j.1469-7610.2007.01855.xSearch in Google Scholar PubMed
4. U.S. Public Health Service. Report of the surgeon general’s conference on children’s mental health: a national agenda. Washington, DC: Department of Health and Human Services, 2000.Search in Google Scholar
5. World health organization and ministry of health of Ethiopia. A WHO-AIMS report on mental health system in Ethiopia. Addis Ababa, Ethiopia, 2006.Search in Google Scholar
6. Mulatu MS. Prevalence and risk factors of psychopathology in Ethiopian children. J Am Acad Child Adolesc Psychiatry 1995;34:100–9.10.1097/00004583-199501000-00020Search in Google Scholar PubMed
7. Tadesse B, Kebede D, Tegegne T, Alem A. Childhood behavioural disorders in Ambo district, western Ethiopia. Prevalence estimates. Acta Psychiatr Scand Suppl 1999;100:92–7.10.1111/j.1600-0447.1999.tb10700.xSearch in Google Scholar
8. Desta M. Epidemiology of child psychiatric disorders in Addis Ababa, Ethiopia, in division of Child and Adolescent Psychiatry, Department of Clinical Sciences. Umeå: Umeå University, 2008.Search in Google Scholar
9. Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet 2007;369: 1302–13.10.1016/S0140-6736(07)60368-7Search in Google Scholar PubMed
10. World Health Organization. Caring for children and adolescents with mental disorders. Geneva: World Health Organization, 2003.Search in Google Scholar
11. World Health Organization. Promoting health through schools: report of a WHO expert committee on comprehensive school health education and promotion. World Health Organization, 1997.Search in Google Scholar
12. Rockville. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health. Mental Health: A Report of the Surgeon General. National Institute of Mental Health, 1999.Search in Google Scholar
13. The president’s new freedom commission on mental health. The final report. Achieving the Promise: Transforming Mental Health Care in America, USA; 2003.Search in Google Scholar
14. Leigh M, David V, Stan K. Mental health in schools: how teachers’ have the power to make a difference. Sun Life Financial, Dalhousie University and IWK Health Centre.Search in Google Scholar
15. Teachers’ attitude mental health articles. Available at: http://mhliteracyplc.commons.hwdsb.on.ca/files/2011/09/Teacher-Attitudes-Mental-Health-articles Accessed: 21 August 2013.Search in Google Scholar
16. Mandy L, McLennan JD. Teacher perceived mental and learning problems of children referred to a school mental health service. J Can Acad Child Adolesc Psychiatry 2010;19:94–9.Search in Google Scholar PubMed
17. Reinke WM, Stormont M, Herman KC, Puri R, Goel N. Supporting children’s mental health in schools: teacher perceptions of needs, roles, and barriers. Sch Psychol Q 2011;26:1–13.10.1037/a0022714Search in Google Scholar
18. Dong HA, Yun YK, He JJ, Kang WY. Teachers’ needs for mental health of elementary school children. Psychiatry Invest 2004;1:76–7.Search in Google Scholar
19. Al-Obaidi A, Nelson BD, AlBadawi G, Hicks MH, Guarino AJ. Child mental health and service needs in Iraq: beliefs and attitudes of primary school teachers. Child Adolesc Ment Health 2012;18;171–9.10.1111/j.1475-3588.2012.00670.xSearch in Google Scholar PubMed
20. Oshodi OY, Aina OF, Adeyemi JD, Oduguwa TO, Ogundipe OA. Perceived needs for school mental health among stakeholders in districts of South-west Nigeria. J Public Health Epidemiol 2013;5:153–9.Search in Google Scholar
21. Maria P, Brahm N. Teachers’ perceptions of students with emotional and behavioral difficulties: severity and prevalence. Eur J Spec Needs Educ 2000;15:171–87.10.1080/088562500361600Search in Google Scholar
22. Borg MG. Secondary school teachers’ perception of pupils’ undesirable behaviors. Br J Educ Psychol 1998;68:67–79.10.1111/j.2044-8279.1998.tb01275.xSearch in Google Scholar PubMed
23. Borg MG, Falzon JM. A factor analytic study of teachers’ perception of pupils’ undesirable behaviours: a rejoinder to Langfeldt (1992). Br J Educ Psychol 1993;63:513–8.10.1111/j.2044-8279.1993.tb01075.xSearch in Google Scholar PubMed
24. Borg MG, Falzon JM. Teacher’s perception of primary schoolchildren’s undesirable behaviors: the effect of teaching experience, pupil’s age, sex and ability stream. Br J Educ Psychol 1990;2:220–6.10.1111/j.2044-8279.1990.tb00939.xSearch in Google Scholar PubMed
25. Akpan MU, Ojinnaka NC, Ekanem E. Behavioural problems among schoolchildren in Nigeria. S Afr J Psychiatr 2010;16:50–5.10.4102/sajpsychiatry.v16i2.220Search in Google Scholar
26. Constantinos MK, Georgia P, Aggeliki MD. Perceived seriousness of pupils’ undesirable behaviours: the student teachers’ perspective’. Educ Psychol 2004;24:109–20.10.1080/0144341032000146458Search in Google Scholar
27. Chris K, Humphrey R. Teachers’ perceptions of pupils’ behavior problems at a comprehensive school. Br Educ Res J 1994;14:167–73.10.1080/0141192880140206Search in Google Scholar
28. Ibeziako P, Bella T, Omigbodun O, Belfer M. Teachers’ perspectives of mental health needs in Nigerian schools. J Child Adolesc Ment Health 2009;21:147–56.10.2989/JCAMH.2009.21.2.6.1014Search in Google Scholar PubMed
29. Pius NN, Julie MB. Perceptions of teacher preparation and attitudes regarding students’ mental health in Kenya. Adv Sch Ment Health Promot 2012;5:63–74.10.1080/1754730X.2012.664863Search in Google Scholar
30. Outcomes of Expanded School Mental Health Programs. Center for School Mental Health Assistance, 2003.Search in Google Scholar
31. Jerry BH. Teacher ratings of problem behaviors: which student behaviors “concern” and “disturb” teachers? Psychol Sch 2006;21:417–538.Search in Google Scholar
©2018 Walter de Gruyter GmbH, Berlin/Boston
