|Year : 2022 | Volume
| Issue : 3 | Page : 282-286
Mental health knowledge among rural school students
Parveen Kumar1, Deepak Sachidanand Tiwari1, Bhavesh R Kanabar2, Vishal Kanhiyalal Patel3, Nirav Bhupendraderbhai Chanpa1, Disha Alkeshbhai Vasavada1
1 Department of Psychiatry, M.P. Shah Medical College, Jamnagar, India
2 Department of Preventive and Social Medicine, M.P. Shah Medical College, Jamnagar, India
3 Department of Psychiatry, Dr. M.K. Shah Medical College and Research Center, Ahmedabad, Gujarat, India
|Date of Submission||17-Jul-2020|
|Date of Decision||29-Jul-2020|
|Date of Acceptance||09-Aug-2020|
|Date of Web Publication||08-Oct-2021|
Dr. Parveen Kumar
Department of Psychiatry, 2nd Floor, Trauma Building, M.P. Shah Medical College, Jamnagar, Gujarat
Source of Support: None, Conflict of Interest: None
Background: Mental health is an integral and essential component of health. Asian culture shares multiple false beliefs that mental illness occurs as a result of loss of semen or vaginal secretion, less sexual desire, excessive masturbation, God's punishment, possession of spirits, etc., People in rural area think that mental illnesses are untreatable. Less knowledge about mental illness is associated with more social discrimination, less choice for friendship, considering mentally ill persons as dangerous, and unable to maintain regular job. Aims: The present study aimed to explore the knowledge about mental health and related problems among the rural school students of class 9th to 12th standard. Methodology: A total of 3478 students of 9th–12th class from a rural school participated in the study. The mental health knowledge of the students was assessed using the Mental Health Knowledge Questionnaire. Descriptive statistics of different variables were used for analysis. Results: Most of the students have knowledge about the components of health and mental health, age of occurrence of mental disorders, and when psychological services should be sought. Students lack knowledge about causes, prevention, and treatment related to mental disorders. Few students have knowledge about “mental health promotion days.” Conclusion: This study provides an empirical assessment of students' knowledge about mental health and illness. There is a need of education programs to improve the knowledge and attitude of students toward mental illnesses.
Keywords: Knowledge, mental health, school students
|How to cite this article:|
Kumar P, Tiwari DS, Kanabar BR, Patel VK, Chanpa NB, Vasavada DA. Mental health knowledge among rural school students. Indian J Soc Psychiatry 2022;38:282-6
|How to cite this URL:|
Kumar P, Tiwari DS, Kanabar BR, Patel VK, Chanpa NB, Vasavada DA. Mental health knowledge among rural school students. Indian J Soc Psychiatry [serial online] 2022 [cited 2022 Oct 3];38:282-6. Available from: https://www.indjsp.org/text.asp?2022/38/3/282/327824
| Introduction|| |
Health is defined as a state of complete physical, mental, and social well-being and not merely absence of disease, and it is the fundamental right of every human being without distinction of race, religion, political belief, and economic or social condition for attainment of peace and security. Mental health is an integral and essential component of health. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential. It is nearly impossible to define mental health comprehensively from a cross-cultural perspective, however, it is generally agreed that mental health is broader than lack of mental disorders. An understanding of mental health and mental functioning is important for a complete understanding of the development of mental and behavioral disorders.
Mental health literacy is a facet of the health literacy, defined as an “individual's knowledge and beliefs about mental disorders which aid their recognition, management, and prevention.” It has different components such as the ability to recognize specific disorders, knowledge about risk factors and causes of mental illness, ways to seek mental health information, attitude that promotes recognition, and appropriate help-seeking behavior.
Epidemiological studies report the prevalence of psychiatric disorders in India varying from 9.5 to 370 in 1000 population. This high prevalence is because people have no knowledge about the various categories of psychiatric disorders which include depression, panic disorder, dementia, substance abuse, and schizophrenia and lack of awareness regarding bio-medical concept, social restrictiveness, stereotyping, pessimism, stigma, and cultural myths about mental illness. The prevalence rate of mental disorders is also critically influenced by a wide variety of factors, ranging from socioeconomic, environmental determinants, variations in perceived threshold of distress, differences in assessment tools, choice of symptom thresholds in disease definition, and interpretations of results. Low levels of education and income, a low priority on the public health agenda, and institutional care also contribute significantly. Along with this, many standard psychiatric treatments (e.g., antidepressants, antipsychotics, electroconvulsive therapy, and admission to a psychiatric ward) were more often rated as harmful more than helpful, and some nonstandard treatments (increased physical or social activity, relaxation and stress management, and reading about people with similar problems) were rated highly helpful. The type of treatment in the society is also determined by traditional beliefs, religious affiliation, economic factors, and level of modernization.
There are multiple false beliefs that mental illness occurs as a result of loss of semen or vaginal secretion, less sexual desire, excessive masturbation, God's punishment, and polluted air. People in rural area think that mental illnesses are untreatable, and some believe that keeping fasts or going to faith healers can cure them. Less knowledge about mental illness is associated with more social distancing, less choice for friendship and marriage, considering mentally ill persons as dangerous, and unable to maintain regular job. Mental illness can affect everyone, irrespective of age, gender, residence, and their living standards and if these problems are unrecognized or inappropriately managed, they can compromise the quality of life of individuals and their families.
To the best of our knowledge, we have not found any studies that assess mental health knowledge of school students in India. The current study, therefore, aimed to explore the knowledge about mental illness among rural school students of class 9th to 12th standard.
| Methodology|| |
A cross-sectional study was carried out to investigate mental health knowledge in rural school students from December 2019 to March 2020. Permission from the district education officer was taken after explaining the due nature of the study. A list of rural secondary and higher secondary government and government-aided schools was taken from the district education department. There are a total of 140 schools in all six talukas of Jamnagar district, out of which forty schools were selected by a simple random sampling method. Following this, permission from the principals of the respective schools was taken by telephonic conversation; date and time were discussed to ensure maximum attendance.
All the students from class 9th to 12th who were present on the day of the study were asked to fill the structured questionnaire containing three important parts: (1) demographic details of students, (2) family history of mental illness, and (3) Mental Health Knowledge Questionnaire (MHKQ). The “MHKQ” was translated into Gujarati and back-translated into English by a language expert and validated. Ethical approval was taken from the local institutional ethical committee.
| Materials|| |
The Mental Health Knowledge Questionnaire
The MHKQ is used to evaluate public knowledge and awareness of mental health. It contains twenty self-administered items. Items 1–16 (the first section) require participants to select “true” or “false,” about statements concerning mental health. Items 1, 3, 5, 7, 8, 11, 12, 15, and 16 are “true” statements, whereas 2, 4, 6, 9, 10, 13, and 14 are “false” statements. Finally, responses of items 17–20 which are statements concerning previous knowledge about the “four mental health promotion days” are recorded. The Cronbach's coefficient of MHKQ was reported to be 0.61. The “MHKQ” was translated into Gujarati and back-translated into English by a language expert.
We explained the study objectives to the principals of each school telephonically and asked for the permission to enroll the students of the respective school; date and time were discussed to ensure maximum attendance of students. We visited the students of 9th to 12th class of particular schools and asked them to fill the semi-structured questionnaires containing the following three important parts: demographic details of students, family history of mental illnesses, and MHKQ. We collected all the papers from the students after the designated time.
Data entry and analysis was done using Microsoft Excel and Epi-Info software (Centers for Disease Control and Prevention (CDC), Piedmont, North Carolina, United State). Descriptive analysis was carried out for demographic profile and response of students. The sociodemographic profile, family history of mental illness, and response of participants to the “MHKQ” have been expressed in terms of frequency and percentage.
| Results|| |
A total of 3478 participants participated in our study whose age group ranged from 13 to 18 years, with a mean age of 15.52 ± 1.28 years. Nearly 9.32% of the participants had a family history of mental illness. [Table 1] shows the demographic details of the participants.
[Table 2] shows that 90.68% of the students know that mental health is a component of health, 61.87% know about other components of mental health, 79.18% of the participants reported that mental disorder can occur at any age , but 65.38% of students believed that people do not realize it. Students believed that psychological services should be sought if one suspect mental disorder and they can occur at any age, as reported by 85.05% and 79.18% of the students, respectively. Nearly 39.56% of the students reported that mental disorders cannot be prevented, whereas 63.20% reported that mental disorders cannot be cured. Students reported that mental disorders are caused by bad temperaments, whereas 67.71%, 52.62%, and 30.62%, respectively, of the students believed that incorrect thinking, external stressor, and psychological stress of major life events result in mental illness.
|Table 2: Response rate of the participants using the Mental Health Knowledge Questionnaire|
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Table 2 also shows that only 40.2% of the students were aware of the “International Mental Health Day” and 23.5% were aware of the “International Day Against Drug Abuse and Illicit Drug Trafficking.” Similarly, 24.5% of the participants knew about the “International Suicide Prevention Day,” whereas only 17% of the respondents knew about the “World Sleep Day.”
| Discussion|| |
In our study, we found that most students have knowledge about different components of health and mental health, age of occurrence of mental disorders, and the situation when psychiatrist services for mental illness should be consulted. Students lack knowledge about the causes, prevention, and treatment related to mental disorders. Few students have knowledge about “mental health promotion days.” Gureje et al. (2005) assessed 195 senior secondary school students' awareness and attitude toward mental health disorders at the Local Government Area of Bayelsa State, Nigeria, and revealed an equal lack of knowledge and understanding about mental illness. Our findings are consistent with those of Wahl et al.'s study which measured knowledge and attitude toward mental illnesses of 193 middle school students in the USA and found that students were well-informed about the unfavorable treatment but lack knowledge about the symptoms of specific mental disorders and misconception that schizophrenia involves multiple personalities. A different study by Youssef et al. on 673 students from the University of the West Indies campuses in Jamaica, Barbados, and Trinidad and Tobago using self-reported questionnaire demonstrated that knowledge was particularly inaccurate in the area of etiology and many participants were not able to recognize the underlying cause of mental illnesses.
Role of teacher in educating students about mental illness is critical, however a study conducted by Parikh et al. on English medium secondary and higher secondary school teachers from Ahmadabad revealed lack of knowledge regarding the prevalence, causative factors, symptoms, treatment of mental illness, and substantial negativity toward mentally ill patients in all of them. A study by Ganesh about knowledge and attitude toward mental illness from the general public of southern India reported that participants' knowledge about mental illness was quite poor and they responded adversely toward statements related to mental illness. This may be possibly due to difference in recognition rate, information on nature, and causes of mental illness in the community.
Stuart and Arboleda-Flórez conducted a random-digit telephone survey among 1653 respondents (aged 15 years and above) of the rural and urban region of Alberta by collecting information on their experiences with people having mental illness or schizophrenia and found that most respondents were relatively well-informed about understanding and treatment of schizophrenia and knew that it can be cured outside the hospital and needs prescription drugs to control its symptoms. The more tolerant attitude toward illness may be due to less social desirability pressures on the telephonic survey.
We assume that the lack of knowledge about the treatment of mental illness is due to the prevalence of belief in the faith healing system among the rural population. This assumption can be proved from the study by Kishore et al. which reported that the mental disorders were thought to be because of God's punishment for their past sins as answered by 39.6% of the rural population and they believed that keeping fasting or consulting a faith healer can cure them from mental illnesses.
There is a need of education programs to improve knowledge as well as attitude of students toward mental illness. Research on the view of young people regarding mental health disorders shows positive change after exposure to educational programs. Educating adolescent people in secondary schools about mental health disorders improves their own knowledge as well as knowledge of their friends, neighbors, and family members regarding mental health and also promotes a positive attitude and helps in reducing stigma.
| Conclusion|| |
This study provides an empirical assessment of students' knowledge about mental health and illness. The results suggest good knowledge of rural school students about mental health-seeking behavior as well as the role of positive attitude, good interpersonal relationship, and healthy lifestyle in maintaining mental health. However, they are lacking in knowledge about the causes, prevention, and treatment of mental disorders. Majority of students were also not aware of the mental health promotion days.
Limitation and future scope
- As this is the first of its kind study in India to explore mental health knowledge among school students, similar studies can be planned in other parts of the country
- This study was limited to school students of rural area only, further studies are needed to explore knowledge in both rural and urban areas
- This was a descriptive study; interventional studies are needed to know the knowledge after posteducational program.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]