PERCEPTIONS OF PUPILS, TEACHERS AND SCHOOL ADMINISTRATORS ABOUT MENTAL HEALTH NEEDS IN PRIMARY SCHOOLS IN IBADAN, NIGERIA

Abstract

Background: Schools have long been considered as an ideal environment where mental health services could be provided in order to fill the mental health service delivery gap. School-based mental health services have been identified to have the likelihood of reaching children in dire need of mental health services. The perspectives of school administrators, pupils and teachers, who are prominent stakeholders in education, on the need for child mental health programs is paramount in implementing school-based mental health programmes. This study explores the perceptions of pupils, teachers and school administrators on the need for mental health programmes in primary schools. Methods: This study was a cross-sectional qualitative study consisting of both key informant interviews and focus group discussions (FGDs). Six primary schools (4 public and 2 private) were randomly selected for the purpose of this study. A total of 8 in-depth interviews and 6 FGDs were conducted with school administrators, pupils and classroom teachers. The convenience sampling technique was used to select pupils, teachers and key informants who participated in this study. All interviews and focus group discussions were audiotaped, transcribed and analysed for identification of emerging themes using interpretative phenomenological analysis Results: A total of 29 pupils, 24 teachers and 8 school administrators were recruited into this study. The mean age of pupils was 10.8years (S.D: 2.7), teachers was 37.8years (S.D: 7.5) and school administrators was 39.6years (S.D: 9.5). Key informants and focus group participants had similar perceptions of mental health problems in children. Stigmatizing words such as ‘insanity' and ‘mentally retarded’ were used by most of the participants to express their perceptions of mental health problems among school children. There was a lack of formal mental health interventions within schools but various informal methods/approaches of managing children with mental health problems such as individual counseling for the child and parental counseling were mentioned. Most of the participants’ perceived the presence of mental health experts in schools, the use of mental health promotion strategies and the implementation of school-based mental health programmes as resources necessary to tackle mental health problems in schools. Stigma, shame, inadequate mental health orientations and trainings as well as exclusions of mental health concepts in school curriculum were identified as barriers to implementation of school-based mental health services. Conclusion: This study contributes to filling the knowledge gap in understanding the current state of using schools as a way of approaching child mental health problems. Current perceptions of stakeholders on the need for school-based mental health programmes could be an indicator of increased mental health awareness in schools. This study also identified the need for more formal training to all stakeholders on child mental health problems by CAMH professionals in all primary schools. There is a need to include mental health in primary school curricula and teachers’ education curricula as well as to include school administrators in the planning and implementation of school based mental health programmes