CHAPTER ONE
INTRODUCTION
Background of the study
Mental health is fundamental to good health and quality of life, it is a resource for everyday life and it contributes to the functioning of individuals, families, communities and societies. There is increasing recognition throughout the world of the need to address mental health as an integral part of overall health and well-being. The World Health Organization (WHO) phrase ‘there is no health without mental health’ conveys clearly this positive sense of mental health. According to Onifade (2013), the relationship between health and mental health points to the intertwined nature of physical and mental health and the wider health and social gains that may be achieved through effective mental health promotion and practices. Mental health needs to be recognized as an integral component of population health policy and practice. Alongside the development of a public health perspective on mental health, there is increasing emphasis on the importance of positive mental health practices for well-being and overall development at population levels (Onifade, 2013).
It is an established fact that mental health is a total health. It is a foundation upon which the other health variables like physical, social and spiritual are laid. According to Okankwu (2012), mental well-being is as important as physical health to our quality of life and achievements, because it is central to overall health and well being. As the observance of good personal and environmental hygiene boost good physical health, so a good mental health-related practice could boost and improve individual mental health. To attain an optimum level of mental health, individuals need to observe good mental health attitudes right from childhood. Good mental health practices enables children to develop resilience to cope with pain, disappointments and sadness, while poor mental health practices affect the adolescents’ ability to concentrate at school, home and even make it more difficult for them to learn, communicate and get along with others (Okankwu, 2013). In health care, more emphasis and resources are devoted to screening, diagnosis and treatment of mental illness than mental health. Little has been done to protect and promote the mental health of individuals. According to the Centers for Disease Control and Prevention (CDCP) (2013), researchers suggest that there are indicators of mental health, representing three domains. These include emotional well-being such as perceived life satisfaction, happiness, cheerfulness peacefulness; psychological well-being such as self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction and positive relationships; and social well-being, including social acceptance, beliefs in the potential of people and society as a whole, personal self-worth and usefulness to society and a sense of community (CDCP, 2013).
Mental health is associated with thinking, communication, learning, emotional growth and self esteem. It is very easy to overlook the value of mental health in children until problems surface. Some mental health risk behaviours that are detrimental to mental health are found to be in practice among school children, especially among adolescents. In the National health policy for Nigeria, Schools/Universities who are in charge of the adolescents/young people must; Ensure schools follow good practice guidelines for children with mental, neurological and substance use (MNS), organise training seminar for teachers on MNS promotion, identification of children with problems, basic management at school level, and referral and ensure psychiatrists are familiarised with school health care system (Federal Ministry of Health, 2013). Based on this, the mental health-related practices for adolescent has its focus on the following programmes; sexual behaviour, reproductive health, nutrition, accidents, drug abuse, education, career development, parental responsibilities and social adjustment
In Africa many cultural practices have helped to perpetuate and increase the prevalence of certain mental health problems. High quality information is essential for good mental health, yet many individuals, particularly in low and middle income countries- lack access to information (Smith and Koehlmoos, 2011). Lack of awareness on mental health issues and mental health literacy among adolescents is still a challenge in Nigeria. A general lack of mental health literacy is a practical barrier to mental health hygiene and practices (Izibeloko and Leana, 2013). Based on this, it has become imperative to study the mental health practices of the adolescents as the assessment will reveal mental health status of the adolescent and recommend intervention studies or strategies where necessary.
Statement of the Problem
Mental health is increasingly seen as fundamental to achieving quality of life. It is seen daily as a practical issue in policies. The interplay between mental and physical health determine an outcome of educational achievements and general productivity. The foundation of many mental health problems that endure throughout adulthood are established early in life. The adolescent period is such a stage to screening some of these mental health problems that endure till adulthood. It is however saddening that value is not placed on mental health among the African populace, especially among the adolescent group.
In Africa, adolescence is less spoken about and they constitute a group whose needs are that is poorly identified in the health facilities of African countries and this has lead to their being grouped together with adults thereby being deprived of the care they deserve. The adolescent population is increasing worldwide and presently constitutes one-fifth (1.2 billion) of the world population (Muyibi, Ajayi, Irabor and Ladipo, 2010), Four-fifths of adolescents live in developing countries. Nigerian adolescents constitute about 30% of the total population. With the increasing population of adolescents worldwide, more adolescents will be expected to present to the health care facilities with different illnesses, including mental illness. (Muyibi, Ajayi, Irabor and Ladipo,2010).
Over the past 10 years, huge resources have been targeted at the treatment of adult disease, while relatively less money or effort has been directed and channeled to addressing potential long-term causes of ill health in adolescence, which might be amenable to early intervention (Aasa, 2012). It has also been found that many of the morbidities, which include alcoholism, substance abuse, teenage pregnancy and a host of others, experienced by adolescents are related to high-risk behaviours adverse or inimical to mental health, which are preventable. Estimates vary, but research suggests that 20% of children have a mental health problem in any given year, and about 10% at any given point in time. One in ten children between the ages of one and 15 has a mental health disorder. Rates of mental health problems among children increase as they reach adolescence (Mental health foundation, 2014).
 General orientation towards health promotion and holistic wellbeing available to all young people would assist to increase mental health literacy and contribute to prevention (Cleary, Horsfall, Baines and Happell, 2012). Screening is a preventive strategy and screening  programme are premised on the assumption that early detection of disease will enable earlier and more effective intervention. In Canada, the governments of Alberta and Manitoba, for instance, have called for widespread depression screening in school settings as part of long-term plans to improve youth mental health (Thombs, Roseman,andKloda, 2012). Assessing mental health behavior of secondary school children is also a strategy for screening for mental health risk behaviours in the study population. In Nigeria, there is no documented screening programme in schools to identify adolescents at risk. There is no such study in nursing literature in Nigeria. The present study will therefore provide a baseline study to fill the gap in this area in nursing literature. This prompted the researcher to investigate the mental health practices of secondary school children in the study area.
Purpose of the Study
