ASSESSING MENTAL HEALTH STATUS IN PRIMARY SCHOOL CHILDREN IN ENUGU EAST LOCAL GOVERNMENT AREA OF ENUGU STATE

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TABLE OF CONTENTS

TITLE             .           .               .           .           .           .           .                         i

APPROVAL  .           .              .           .           .           .           –                         ii

CERTIFICATION     .                 .           .           .           .           .                         iii

DEDICATION           .           .               .           .           .           .                         iv

ACKNOWLEDGEMENT     .           .           .           .           .                         v

TABLE OF CONTENTS       .           .           .           .           .                         vi

LIST OF TABLES     .           .           .           .           .           .                         x

LIST OF APPENDICES   .      .           .           .           .           .                       xii

ABSTRACT   .                  .           .           .           .           .                         xiii

CHAPTER ONE: INTRODUCTION

Background of the Study       .     .           .           .                                        1

Statement of the Problem       .         .           .           .           .             .              5

Purpose of the Study .           ..           .           .           .              .             6

Objective of Study     .                .           .           .           .              .             5

Research Questions     .          .           .           .           .           .              .             7

Research Hypotheses   .             .           .     .            .             .              7      

Significance of the Study       .              .           .           .            .             .             8

Scope of the Study     .                   .           .           .             .            .             8

Operational Definition of Terms            .           .           .             .            .             8

CHAPTER TWO: LITERATURE REVIEW

Concept of mental health          .           .           .           .           .             .            10

Characteristics of Positive Mental Health.                 .           .            11

The  School and  Mental Health of  Children               .          .            .           13

Role of Teachers in Development of positive mental health  in Children     .              .                 .              .             .           .            .           .          15

The home mental development of children    .          .           .            .           17

The society and mental development in children            .             20

Parenting Pattern and their Effect on Mental Health Development  in Children       .           .           .           .           .              .          .             .          21

Authoritarian (Autocratic) Parenting .                  .         .              .          22

Authoritative (Democratic) Parenting         .              .          .             .          22    

Permissive Parenting   .        .           .           .             .          .              .        23

Criteria for Guiding against Negative Mental Behavior in  Children .        24

Factors that can Enhance Good Mental Health

Behaviours in Children         .           .           .           .             .          .            25    Theoretical Framework      .   .           .           .              .          .              .         26 Summary of Literature.   .           .              .              .           .              .        29

Empirical Studies                .           .           .              .           .             .         30

Summary and analysis of Empirical Studies    .         .           .             .         32

CHAPTER THREE: METHODOLOGY

Design        .           .           .           .           .           .           .              .           33

Area of the study           .           .           .           .           .           .              .           33

Population for Study .              .           .           .           .           .              .           34

Sample            .           .           .           .           .           .           .              .           34

Sampling Procedure .  .         .           .           .           .           .              .           35

Instrument for Data Collection           .           .           .           .              .           36

Validity of the Instrument      .    .           .           .           .           .               .          37

Reliability of the Instrument   .          .           .           .           .                .         37

Ethical Clearance        .       .           .           .           .                .         37

Procedure for Data Collection            .           .           .           .                .         38

Method of Data Analysis       .      .           .           .           .                .         38

CHAPTER FOUR: PRESENTATION OF RESULTS                   40

Demographic Characteristics of Respondents             .            .              .          41

Test of Significance    .            .           .           .           .           .              .          46

Summary of Findings              .           .           .           .           .              .          56

CHAPTER FIVE: DISCUSSION AND CONCLUSION

Discussion of Major Findings                .           .           .           .              .          59

Implication of the Findings     .           .           .           .             .             .          67

Peculiarity and limitation of the Study            .           .                 68

Summary            .         .          .            .            .             .       .              68

Conclusion     .            .          .          .            .            .             .         69

Recommendations       .         .           .            .            .             .        70

Suggestions for Further Research           .            .            .             .           71

REFERENCES       .         .           .            .            .             .        73

APPENDIX     .           .            .          .           .           .             .             .       77
                                                   LIST OF TABLES

Table                                    Title                                                               Page

 1:                    Demographic Characteristics of Respondents .         .            41

 2:                   Adjusted mean scores and standard deviations for mental health behaviour .           .           .                 .           42

3:                     The 19 highest scored mental health behaviour items            43

4:                     The 19 Lowest scored mental health behaviour items              44

 5:                    Adjusted mean scores and standard deviations of mental health behaviour of male and female children      .                  .          47

 6:       Multiple t-test comparison of adjusted mean scores for metal health behaviour of male

and female children for each sub-scale           .           .                  .          47

 7:      t-test comparison of mean scores for mental health behaviour of males and female children for all variables      .                  .          48

 8:        Adjusted mean scores and standard deviations for mental health behaviour of children of Mothers with formal education and those with no formal education   .           .           .                 .           50

 9:       Multiple t-test comparison of adjusted mean scores for mental health behaviour of children of Mothers who had and those who hadn’t  formal education         .           .           .           .           .                  .          51

 10  :                t-test comparison of mean scores for mental health behaviour of children of Mothers who had and those who hadn’t Formal education       .            .           .           .           .                   .         52

 11:      Adjusted means and standard deviations for mental health behaviour of rural and urban children            .           .                   .      54

 12:   Multiple t-test comparison of adjusted sub-scale mean scores for mental health behaviour of rural and urban children  .                   .      55

 13      t-test comparison of mean scores for mental

health behaviour of rural and urban children .           .                    .     55

                                          LIST OF APPENDICES

Appendix                                Title                                                    Page

 1:                     List of Primary Schools in Enugu East Local Government Area.     .         77

 2:                     Calculation of Sample Size        .           .           .          80

 3:                     Mental Health Assessment Questionnaire     .           .          81

4:                     Letter of Introduction     .           .           .           .          89

5:                     Approval from Enugu State Universal Basic Education Board         .          90

 6:                    Mean and Standard Deviations of the 57 items of the MHAQ.       .           91

 7:                    Mean and Standard Deviation of the 57 items according to Gender   .        95

 8:                    Mean and Standard Deviation of the 57 items according to

                         Mother’s Education Level                   .           .          .         97

 9:                     Mean and Standard Deviation of the 57 items according to

                         Location of Schools    .                    .            .          .         99

10:                    Map of Enugu State Showing location of LGAs   .          .       101  
                      

ABSTRACT

 The purpose of the study was to assess mental health status of primary school children in Enugu East Local Government Area of Enugu State. The descriptive survey design was adopted for the study while the simple random sampling method was used to select the sample size of 308 pupils.  A self reporting Mental Health Assessment Questionnaire (MHAQ) was used to collect information on mental health status of the children. The face validity of the instrument was done by project supervisor and two Professors in psychology. The factor analysis was done using statistical package for social sciences (SPSS) version 17.0.  The reliability index was established using a split half method. The scores obtained were correlated using Pearson Product Moment Correlation to obtain a coefficient of 0.85 at 0.05 level of significance. The researcher with the help of four research assistants administered the questionnaire to the children individually in an interview over a period of four weeks and retrieved the questionnaire on the spot.  Data collected were analyzed. Data analysis for objective one was done item by item yielding mean and standard deviation for each item and for each subscale.  T-test analysis was also employed to test for the three hypothesis set for the study.  Findings showed that the children involved in the study had positive mental health behaviour as over 84.21% of the measuring scale items attracted responses that indicated positive mental behavior.  It was also discovered that there is no significant difference in the mental health status of boys and girls (t = 0.105, NS).  No significant difference in the mental health status of children whose mothers had formal education and those whose mothers hadn’t formal education (t = 0.194, NS). The result also showed no significant difference in mental health status of the children from rural and urban schools (t = 0.43, NS). Based on the findings, the following recommendations were made. That the Primary School Management Board (PSMB) should, through their office adopt and plan a mental health programme for primary school children in both urban and rural areas., to sustain and enhance the positive mental health behaviours that are in primary school children. Possibly, efforts should be made to include such programmes and subjects into the syllabus of the schools in Enugu East Education Zone. Adequate health education of the general public on how to treat the children to foster development of positive mental health behavior should be carried out in earnest.

CHAPTER ONE

INTRODUCTION

Background to the Study

Mental health behaviour is about how people think, feel, act and react to issues. People with good mental health tend to have positive attitude, feel good about themselves and others, act responsively in relationships, have positive attitude towards things and react reasonably to issues.  Good mental health enables every one including children to develop resilience to cope with pain, disappointments and sadness, while poor mental health affects children’s ability to concentrate at school, home and even makes it more difficult for them to learn, communicate and get along with others (Tidyman 2005).

 It is very easy to overlook the value of mental health in children until problems surface.  Yet from early childhood until death, mental health is the spring board of thinking and communication skills, learning, emotional growth and self esteem. Success in school, at work, in parenting and in relationships all rest on a foundation of good mental health. (Tidyman 2005).

Contrary to popular belief, young children can and do experience serious emotional problems that are comparable in severity to what we observe in older children and adults and can have lasting effects (Aggarwal 2003).  And in most cases the foundations of many mental health problems that endure throughout adulthood are established early in life due to significant adversity in early life that can change the architecture of the developing brain and increase the likelihood of significant mental health problems that may emerge either early or years later.  Also life circumstances associated with family stress such as persistent poverty, threatening neighborhoods and very poor child care conditions raise the risk of serious mental health problems and undermine healthy functioning in early years. Early childhood adversity of this kind also increases the risk of adult health and mental health problems because of its enduring effects on the body and brain development.

Aggarwal (2003) identified common characteristics of a mentally healthy person as including having adaptable and resilient mind, conscious control of life, cheerful and optimistic outlook, well regulated instincts and habits, emotional balance, insight into one’s own conduct, enthusiasm and reasonable freedom, capacity to think independently, calm and good temperament, ability to care for self and others, socially adaptable, realistic imagination and definite philosophy of life. Also Layman (2002) also delineated characteristics of a mentally healthy person to include having peace of mind, relative freedom from tension and anxiety, security, a sense of self worth and ability to deal constructively with reality, ability to enjoy human contacts, capacity for mutual satisfaction in social relationships, integration around socially useful values, flexibility and appropriate balance between self-sufficiency, willingness to accept help from others, capacity to give and receive affection and ability to direct hostile feelings into creative and constructive channels. Furthermore, the individual has the ability to accept frustrations for future gain, spontaneity and capacity to enjoy life.

Good mental health is important to everyone across life span. In children, if mental health is ignored, problem may occur and this can interfere with their learning, development, relationships and physical health (National Association of School Psychology 2006). To attain optimum mental health, it is important that one observes good mental attitudes right from childhood.  Just as observing good personal hygiene boosts good health, practice of good mental behaviour is necessary for good health.

Nnaka (1997) noted that good mental health is important for any child to succeed in school; therefore they deserve to learn all the tasks and behaviour that will allow them to develop friendship, loving alliance and positive mental health status.

Mental health is not simply the absence of mental illness, but having the skills necessary to cope with life’s challenges (NASP 2006).  (WHO 2001) also defined mental health as a state of well-being in which the individual realizes his or her own abilities, cope with normal stresses of life, work productively and fruitfully and is able to make meaningful contributions to his or her community.

Positive mental health status is of utmost importance in overall mental well being which is reflected in peace of mind, ability to give and receive love, freedom from anxiety, sense of security, sense of self worth and the ability to deal constructively with reality (Layman 2002).  This means that a person should enjoy human contacts, have mutual satisfaction in social relationship, be flexible and be able to balance work and play, willing to accept help from others, give and receive affection, and the ability to direct hostile feelings into creative or constructive channels.

But it has been observed by the researcher that in recent times children are very restive and their restiveness has resulted in wanton attitude that are detrimental to health and well-being.  It has also been observed by the researcher that poor mental attitude has led to school problems such as poor academic performance, truancy and school dropout.  This has posed a lot of questions as to whether the children are responsible for such behaviors or whether they are not properly understood and cared for by homes, schools and society.

According to Ladd (2000) children who do not have basic level of social competence by the age of 6 years may have problem with relationships in adult life. Also poor interaction with others may lead to poor mental health, low academic achievement and other school difficulties (Katz and Maclellan 1997). This has made it more and more imperative for children to be understood from the point of view of those elements that make for good mental health that should be properly inculcated in them through enhancement of positive mental health practice.  So as to prevent poor mental health and maladjustment in later life, because as noted by (Deserlais 1995), poor mental health is common among people with relative social disadvantages, and the primary school has a mixture of these children.

Broverman (1995) also commented that gender is influential in determining the standards of mental health in children.  Thus gender, school type and educational level of the mothers or child rearers may differ regarding children’s mental health status.

It is important to study the mental health status of primary school children especially now that mental health promotion has become an integral part of public health (WHO 2001).  Again adequate exposure to positive mental health practices will enhance good mental health status which are necessary for the children to be responsible learners as well as being able to achieve maximally from school programmes and grow up to be responsible adults that the society will require in future, as well as avert the burden of mental illness. Because analysis has shown that in Britain alone an estimated 180,000 are affected with mental illness. (Beers.2002). According to Mind (2003), in U.S. 2 out of 4 persons would experience a mental problem at one point or the other in life. Here in Nigeria, one would wonder if about the same number would not suffer from mental problem.  Primary school children can equally be affected leading to disruption of functioning at home and in school.  This, according to Carnona (2003), could result in school failure, family conflicts, drug abuse, violence and suicide. To overcome these, assessment of mental health status in children becomes imperative as the children require optimum level of good mental health to be able to cope with life stresses. Assessment will reveal mental health status of children and prescribe intervention studies or strategies where necessary.

Statement of the Problem

ASSESSING MENTAL HEALTH STATUS IN PRIMARY SCHOOL CHILDREN IN ENUGU EAST LOCAL GOVERNMENT AREA OF ENUGU STATE