Knowledge, attitudes, stigma and appropriate referral toward mental illness among secondary school teachers in Southwestern Nigeria: a mixed method study

Abstract

Background: Adolescent mental-health problems are important public-health and educational concerns. The ability of school teachers to respond appropriately to mental-health challenges may be affected by appropriate attitude, mental-health literacy, stigma, cultural and religious beliefs about mental illness. The study aimed to assess the knowledge, stigma and attitudes toward mental illness among secondary-school teachers. Methods: The study employed a cross-sectional design involving mixed-methods of quantitative and qualitative approaches. A validated instrument; Community Attitudes towards Mental Illness (CAMI) scale divided into 4 priori subscales including: Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology and Sociodemographic Questionnaire were administered for 125 participants.  Focus-group discussions (FGD) and key-informant interviews (KII) explored findings requiring deeper explanations.  Data were analysed using SPSS version 20. Results: The participants had a mean age of 42.05±8.99 years with female preponderance. Most had first degree in education with over 10years of teaching experience. Authoritarianism showed mixed but poor knowledge of mental health while the benevolence social restrictiveness and Community mental health ideology showed harsh reactions towards the mentally-ill. Key informant interview (KII) and focus group discussion (FGD) showed apparent knowledge-gap in description, causes and treatment modalities. Conclusion: The study identified knowledge gaps as a key determinant of poor teacher mental-health literacy, stigma with poor referral intentions. Findings may inform teacher education, continuing professional development, school mental-health policies, anti-stigma programs and formal referral pathways between schools and mental-health services.