The Knowledge and Attitude of Primary School Teachers towards Mental Illness

INTRODUCTION

Mental health is a basic and essential foundation for the emotions, thinking, understanding as well as to carry out a normal and intact life. We are fortunate enough to be blessed with sound mental health, this doesn't mean that all are blessed with the same. Mental health doesn‘t discriminate based on age, gender, economic status, social status, race, nationality or any other cultural identity. Mental illness can occur at any age and to anyone irrespective of the sex. The mental illness can range from mild to severe. Mild mental illness effects minor changes in an individual‘s life as well as an individual‘s great care and there are possible requirement of hospitalization. Intact mental health would help on proper and appropriate functioning of an individual. Mental illness like any other physical illness , are curable when addressed appropriately at the right time. However mental health in India is mostly stigmatized and are always treated in differently. Merrian- Webster defines mental illness as any of a broad range of medical condition that are marked primarily by sufficient disorganization of personality, mind or emotions to impair normal psychological function and cause marked distress or disability and that are typically associated with disruption in normal thinking, feeling, mood behaviour, interpersonal interaction or function. Whereas the mental health arises out of intact daily routine.  Individual carryout their activities without disturbance.  Ability to change with time, place and situation.  Healthy interpersonal relationship. It‘s essential to accept the fact that mental illness are curable and the individual suffering from the same should be given a good mental health services along same should be given a good mental health service along with that family support

important for healthy and sound society. People from ancient times have stigmatized people are scared as people behave indifferently. This is reason people started distancing them from society and started to chain them or lock them up. Especially in country like India where the customs and rituals are over powering even today in certain places needs an orientation regarding the knowledge about mental illness. This might help in lay a strong foundation for future generation to empower them with scientific knowledge and find medical help at the earliest to avoid adverse conditions in the future. Various studies done on mental health suggests that people usually hold negative attitude and stereotype towards people with mental illness. Its very essential to understand the conditions of those suffering from mental illness rather than holding negative attitude towards them. These negative attitudes results in distancing them and pushing their interest to the day and make them suffer even more. With growing health concerns mental health has also gained a prominent place to be recognized and addresses with this 21st century era. The child mental health is taking the front seat. There are various child mental health disorders that we encounter with healthy growing children this could be due to physiological , psychological or say the situational and circumstantial factors. The busy life style and competition to be on the top has pressurized everyone these days and children are no exception. With this idea of being the topper children are pushed to perform above their capabilities. When someone fails to achieve the standards they are criticized and pushed to the level of them being ashamed of their own self. This has arisen to any kind of child mental health issues. The childhood depression, anxiety, phobia. There are certain mental disorders which could prevent those children suffering from it to achieve the heights. The learning disability, mild mental retardation, anxiety, phobia, deselection mutism, stuttering, transient tic disorder to name few. The study focused on the knowledge possessed by teachers in recognizing the children‘s mental problems and ability to guide the parents or guardians to take the right step in the direction of cure. The study also throws light on the attitude that teachers hold towards mental disorders. This is very much essential to grow sound society. This will also help in directing the mass towards the right treatment. The right knowledge regarding mental disorders and chennalising the attitude towards mental disorders in an appropriate way is very certain mental health issues. Being the one responsible to groom the children, teachers should possess good knowledge and uphold the positive attitude.

With growing concern for the child mental health indicates the need to throw some light on how knowledgeable the teachers who are serving in the primary schools with regard to the mental illness in children. There are studies which focused on particular childhood mental disorders done in the western countries. There are very few studies that focus on the awareness of school teachers regarding mental illness and their attitude towards such mental disorders. The research gap in the concerned topic is about 4 years and this study focuses only on the primary school teachers and it is a comparative study between the rural and urban population.

Studies on the knowledge and attitude of primary school teachers towards mental health. A study by M.S. Gnanaguruvammal.G (2010) examined the knowledge and attitude possessed by the primary school teachers towards mental illness in Manamadural. The data regarding the same was collected by convenient sampling techniques and the collected data was analysed as per the descriptive and inferential statistics. The study focused on the demographical details that would influence the knowledge and attitude that teachers hold towards mental illness, the relationship between the two. The study has also focused on the demographical details that would influence the knowledge and attitude that teachers hold towards mental illness. Amanda Goncalves, Simoes Soares (2012) a study conducted by them with the title ―Public school teacher‘s perceptions about mental health. The study has focused on acquiring the knowledge regarding public school teacher‘s understanding regarding the general health and mental health of school children. The qualitative study was conducted on 31 primary and secondary school teachers. The study focused on the understanding of mental and general health. It also focused on the source of information for the knowledge possessed. The data collected by the study indicate that there is a need to provide more accurate information regarding mental health. Melissa. L. Pierce (2012) the study focused on the relationship between the knowledge possessed regarding any mental illness say schizophrenia, anxiety would reduce the stigma associated with the disease. As well as more confidence regarding the knowledge possessed would hamper the learning regarding mental illness. On a whole adequate and reliable knowledge about mental health reduces the stigma. Rohan Dilip Mendonsa, Ismail Shihabudden ,‖mental health litracy among elementry school teachers in rural south India ( October 2018). The knowledge possessed towards mental illness of rural children is very essential for early identification and treatment. So that the teachers should have appropriate knowledge to identify students with special needs. The study focused on the elementry school teachers knowledge in identifying the general mental disorders and the specific disorders of mind among the children and adolescent in the rural villages of Mangalore. 89teachers from 134 schools were administered with knowledge and mental illness awareness questionnaire. The teachers age was considered and it was known that the youngfer teachers possessed better knowledge and were well aware when compared to older teachers. However the knowledge possessed by the elementary school teachers in general was very limited. Kutcher S, et al. Glob Ment Health (Camb), ― Improving Malawian teachers‘ mental health knowledge and attitudes an integrated school mental health literacy approach. The study was conducted on 32 school teachers using before and after study design was used where the teachers were assessed and the results were cross checked with the previously obtained data. There should a significant difference between the two. The awareness programme had made a great differenece in knowledge and attitude obtained by the teachers. Aya .M. Abd El Latifl, Maha Mohamed El Gaafaryl, et.al , ―Role of School Teacher in Pupils‘ Meental health Promotion‖, April 2016. the role of teachers in identifying the mental health issues of students is the very essential to promote healthy school environment. The study used multistage random sampling technique to identify the barriers that teachers may encounter the mental health of students. The self-administered questionnaire which consisted of the demographical details as well as knowledge aspect of mental issues. 95.5% teachers agreed that teachers play a great role in identifying the mental health issues. 93.5% agreed that schools hold unique position in positively affecting the mental health of pupils. Habtamu Kerebih,Hailay Abrha, Reiner Frank and Mubarck Abera ( September 2,2016)―Perception of primary school teachers to school children‘s mental health problems in south Ethiopia‖. The main focus of the study was to high light the necessity to school teachers of Southwest Ethiopia hold towards children‘s mental health.So as to take measures of implementing the awareness service program mes. The study had utilized cross sectional study design among 1568 primary section teacher in Jlmma town. Teachers were administered a questionnaire which reflected the concern of the study. The results were analyzed and it was concluded that 40% of the teachers were able to recognize and were aware about the, mental health problems among the primary school children. At the same time 95% agreed that there is an insufficient knowledge regarding the mental health issues as well as they agreed that there is the need for many more mental health awareness programmes to increase the awareness. Dr. Nimesh Parikh, ―Knowledge and attitudes of secondary and higher secondary school teachers towards mental illness in Ahmedabad‖, 2016. The need to accesses the knowledge among the teachers towards mental health is very essesntial in India when compared to the west, where the concept of mental health is very prevalent. The early identification of possessed attitude and the stigma that teachers told will help in design the programmes required to train teachers in the particular are and promote mental health. The study was conducted in the schools of Ahemedhabad to understand the gender difference as well as to measure knowledge and attitude that the teachers hold. The study population belongs to the English Medium Schools of Ahemedabad out of which 520 teachers administered a 25 item questions where 15 measured the knowledge 10 item screened for stigma.77.5% of the population were the female teachers and they were below the age group of 45. where 76% teachers scored less than 7 in the attitude scale which indicates inadequate attitude at the same time 63.6% scored more than 5 in negative attitude questionnaire. The study concluded that the female teachers are better able to understand the symptoms when compared to male but then there were no significant difference between the male and female teachers and the knowledge possessed was inadequate and had negative attitude towards mental illness. Omainaezzat Mohamed 1, Amelabdelazim Mohamed 2, Ahmed Emadeldin Arafa , ― Impact of awareness programme on knowledge of primary school teachers regarding mental disorders among school children. The main aim of the study was to assess the knowledge obtained by primary school teachers as well as an awareness programme was conducted for these teachers and then results of the assessment prior to the awareness programme and the after the awareness programme were evaluated. The school teachers possessed a good score. They were assessed on 4 different area which are as follows: risk, symptoms, causes and

increment in its scores after the awareness programmes. Maria, E. Loades and Kiki Mastroyamnopoulon, ―Teachers recognition of children‘s mental health problems‖ (2018). the study focused on measuring the knowledge and ability of teachers in recognizing the emotional and behavioral problems. The self-administered test was followed by an interview where the teachers were asked about the recognition and help seeking. They were better able to recognize the physical symptoms more easily than the emotional symptoms. However problem recognition is affected by the gender of the child.

1. To measure the knowledge and the attitude of primary school teachers regarding the mental illness. 2. To find out the relationship between the knowledge possessed regarding mental illness and the attitude towards mental illness.

KNOWLEDGE: An awareness or familiarity gained by experience of fact or situation. ATTITUDE: Refers to set of emotions, beliefs and behavior toward a particular object, person, thing or event. In this case it refers to the mentally ill patients MENTAL ILLNESS: Mental illness is said to be unsuccessful adaptation to stressors from the environment, evidenced by deviated thoughts, feelings and behaviour. TEACHER: Individuals who are trained to teach in the primary schools.

► The knowledge regarding mental illness will minimize the stigma. ► There is a significant relationship between the knowledge possessed and the attitude towards mental illness. ► The knowledge possessed by the teachers in rural area differs from the teachers in urban areas.

 Geographical area- rural and urban  Age

 Knowledge  Attitude

The research design used for the study is between group design, correlative study design

The sampling technique used in the study is purposive sampling.

The data was collected from the primary school teachers in Bangalore urban and rural areas. Before the data collection the investigator obtained the formal permission from the Head Masters of each school. The available teachers were explained about the purpose of the study the consent was obtained. The questionnaire was circulated and collected back within 25 minutes. The teacher‘s knowledge was assessed through interview by using semi structured knowledge questionnaire. Similarly, the attitude of teachers was assessed by using modified form of orientation towards mental illness scale.

 Data were statistically analysed using the descriptive statistics. The t test t was computed to find out the difference between the knowledge possessed and stigma held by urban and rural primary school teachers.  Correlation coefficient r was computed to find out the relationship between the knowledge and attitude possessed by the teachers.

The table 1 shows the descriptive statistics for knowledge and attitude possessed by primary school teachers in urban area. The total number of urban teachers were 100. The minimum score obtained by urban teachers in knowledge possessed is 2.00 and maximum value is 19.00 . The mean value possessed is 12.89 with the standard deviation of 3.67. The minimum score value possessed for the attitude of urban primary school teachers towards mental health is 65.00 and maximum value is 163.00 which has the mean score of 99.30 with the standard deviation of 17.23.

The table 2 shows the descriptive statistics for knowledge and attitude possessed by primary school teachers in rural area. The total number of urban teachers were 100. The minimum score obtained by rural teachers in knowledge possessed is 2.00 and maximum value is 30.00. The mean value possessed is 10.06 with the standard deviation of 3.00.The minimum score value possessed for the attitude of rural primary school teachers towards mental health is 42.00 and maximum value is 106.00 which has the mean score of 68.55 with the standard deviation of 14.41.

The table 3 shows the minimum score in knowledge possessed by primary school teachers in both rural and urban area the value is 2.00 and the maximum value is 30.00 with the mean value being 11.47 with its corresponding standard deviation of 3.63. The minimum value possessed in attitude towards mental health is 42.00 and the maximum value being 163.00 with the mean value being 83.92 with its corresponding standard deviation of 22.10.

The table 4 shows the mean value of the group who possess less knowledge is 62.04 with standard deviation of 11.32 and mean value possessed by group who possess more knowledge is 107.34 with standard deviation of 14.51. the t value is -19.99 and its significance value is 0.000. The lesser the mean value possessed indicates the greater stigma and the higher the obtained mean value indicates the less stigma. This proves the first hypothesis where the higher knowledge towards mental illness will decrease the stigma towards mental health. This is because the less knowledge makes a person not well aware about the real causes for the mental problems its quite easy to stigmatize people with mental health problems whereas when people possess more knowledge then the underlie cause could be made know so it will not lead to the stigma towards mental illness.this has been proved in several research where the tests were conducted to measure the effect of awareness programme. This proves that with increase in knowledge stigma decreases.

The table 5 shows the Pearson correlation of knowledge and attitude possessed by primary school teachers in both the rural and urban areas. Out of 200 samples the average knowledge possessed by them is 11.47 with the standard deviation of 3.63 whereas the average attitude possessed by the primary school teachers is 83.92 with the standard deviation of 22.10 the r value is 0.511 which is highly significant. This proves the second hypothesis There is a significant relationship between the knowledge possessed and the attitude towards mental illness. The exposure to the knowledge would provide an individual with a clear ideas regarding towards mental illness and any kind of superstitions towards mental illness could be answered by the sufficient knowledge which will in turn reduce the negative attitude towards mental illness.

The above table-6 shows the descriptive statistics and t value of knowledge possessed by primary school teachers towards mental health both in the rural and urban areas. As shown in the table total samples participated is 100 each from rural and urban area. Teachers belonged to both private and the government schools located in different part of Karnataka. The mean value obtained by the urban population is 12.89 and the mean value obtained by the rural population is 10.06 with their corresponding standard deviation of 3.67 and 3.00 respectively t value is 5.96 and the significance value of 0.002 which show that there is a significant difference between the knowledge possessed by the primary school teachers from urban and rural areas.as per the study the knowledge possessed by people of rural area is less when compared to knowledge possessed by people in urban area. People in rural the various new frontiers more easily and it could be easily accessible to Urban population. This proves the third hypothesis The knowledge possessed by the teachers in rural area differs from the teachers in urban areas.

The above table-7 shows the descriptive statistics and t value of attitude possessed by primary school teachers towards mental health both in the rural and urban areas. As shown in the table total samples participated is 100 each from rural and urban area. Teachers belonged to both private and the government schools located in different part of Karnataka. The mean value obtained by the urban population is 99.30 and the mean value obtained by the rural population is 68.55 with their corresponding standard deviation of 17.23 and 14.41 respectively with mean standard error of 1.72 and 1.44 respectively and t value is 13.68 and the significance value of 0.000 which show that there is a significant difference between the attitude possessed by the primary school teachers from urban and rural areas. This might be influenced by the cultural backwardness and the knowledge possessed by them is not so adequate. This proves the 4th hypothesis which states that there is a significant difference in the attitude possessed by teachers in urban and rural areas.

THE SUMMARY AND CONCLUSION

The purpose of this research was to assess the knowledge possessed by teachers towards mental health and the stigma that they hold toward mentally ill. The( Hypothesis 1) states that The knowledge regarding mental illness will minimize the stigma.(Hypothesis 2) There is a significant relationship between the knowledge possessed and the attitude towards mental illness. (Hypothesis 3) states The knowledge possessed by the teachers in rural area differs from the teachers in urban areas.(Hypthesis-4)The attitude possessed by the teachers in rural area differs from the teachers in urban areas. The between group design, correlative study design is used to conduct the research. The attitude scale was developed by Prabhu (1983). both from rural and urban areas from different parts of Karnataka by using purposive sampling technique. Detailed instructions were given to the participants and the responses were obtained which was later scored. The obtained scores were subjected to statistical analysis using SPSS version 20. Descriptive statistics were used to summarize the broad aspect of the data obtained such as mean and standard deviation. Independent sample t test was used to find the difference between the knowledge and attitude possessed by teachers in rural and urban areas. The correlation was used to find the relationship between the knowledge possessed and the attitude towards the mental illness.

1) Higher the knowledge minimizes the stigma which proves the first hypothesis. 2) There is a significant relationship between the knowledge possessed and the attitude towards mental illness which proves the second hypothesis. 3) The knowledge possessed by the teachers in rural area differs from the teachers in urban areas which proves the third hypothesis. 4) The 4th hypothesis which states that there is a significant difference in the attitude possessed by teachers in urban and rural areas.

1) This research was conducted on teachers in urban Bangalore and some parts of rural Ramanagara district and rural Udupi district the test may differ in results when single place taken into consideration. 2) Since, the participants responded at their leisure intervening variables could have had an impact such as personal circumstances, health, emotions, fatigue, distraction and time could have also played a role. 3) The samples are not in equal numbers with regard to the gender of the teachers. 4) Age and experience of the teachers are not taken into consideration under this study.

1) This study is useful in educational set up where the knowledge regarding mental 2) This study will help in propagating the positive attitude towards mental health in the society. 3) The results of this study could be used as implementation of psychological concepts in the B.Ed syllabus. 4) This could be used to create awareness programme among the general masses in the society.

1) Future studies could focus on the equal number of male and female teachers as their sample. 2) The studies could be carried on the age and experience of the teachers. 3) The study could be carried in different demographical areas. 4) Higher primary teachers could also be taken as the sample along with the primary school teachers. 5) Large group of samples could be taken for the generalization of the study.

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Student, Department of Psychology, Bangalore University, Bangalore