Abstract The purpose of the study was to determine the mental health knowledge and attitude of secondary school students in Plateau State, Nigeria. In order to achieve the purpose, thirteen specific objectives with corresponding research questions were posed and six null hypotheses were postulated to guide the study. The cross-sectional survey research design was used for the study and the multistage sampling procedure was used to draw a sample of 3456 students. The instruments used for data collection was the questionnaire. The research questions were answered using descriptive statistics such as mean and percentages while the null hypotheses were tested using t-test statistic. The major findings of the study were as follows: the students had low level (35.56%) of knowledge regarding all the dimensions of mental health. The students had average level of knowledge on the cause of mental illness, coping strategies for mental illness, prevention of mental illness. The overall level of knowledge for the various dimensions of mental health for age group 15 – 19 was high (70,5%); overall males (47.8%) and females (47.9%) students had an average level of knowledge. Rural (48.4%) and urban (57.6%) students had average level of knowledge of all the dimensions of mental health. The students’ attitude toward concept of mental health, (
= 2.76), attributes of mentally healthy persons (
= 2.51), cause of mental illness (
= 2.76), coping strategies for mental illness (
 = 2.74), and prevention of mental illness ( = 2.61), was positive. Both age groups, males and females students, and rural and urban students had positive attitude towards all the dimensions of mental health. There was significant difference in the knowledge of students regarding KOCMHI, KOSSMI, KOCSM and KOPMI while there was no significant difference in KOCMI. There was no significant difference between male and female students regarding their level of knowledge in KOCHM, KOCSMI and KOPMI and there was significant difference in KOSSMI. There was significant difference between rural and urban students regarding their level of knowledge in KOCMH, KOCMHI, KOCMI, KOCSM and KOPMI and there was no significant difference between rural and urban students in their KOSSMI. There was no significant difference in attitude of students of rural and urban students regarding all the dimensions of mental health. On the basis of the findings and conclusions, recommendations were made. Among them are that: Ministry of Education, Health and Youth, Sport and Culture should mount seminars and workshops on mental and emotional health towards empowering the students to have high level of knowledge. And that National Health Science Curriculum should be given full implementation.
Introduction
Background to the Study
WHO (2001) opined that mental health is an integral component of health through which one realizes one’s own cognitive, affective and rational abilities. It further stated that with a balanced mental disposition, one is more effective in coping with the stress of life, and working productively and fruitfully, and is better able to make a positive contribution to his or her community. In many parts of the world, mental health is still not acknowledged as important as physical and social health, and it remains a low health priority all over the world despite prevailing cases of mental illnesses that are recorded. Today, 450 million people suffer from mental illnesses or disorders in both developed and developing countries (World Health Organization-WHO, 2004). The rates are as follows: United State 26.4 per cent, Ukraine 20.5 per cent, France 18.4 per cent, Columbia 17.8 percent, Lebanon 16.9 per cent, Netherlands 14.9 per cent, Mexico 12.2 per cent, Belgium 12.0 per cent, Spain 9.2 per cent, Germany 9.1 per cent, BEIJING, China 9.1 per cent, Japan 8.8 per cent, Italy 8.2 per cent and Nigeria 4.7 per cent (Global Study Finds Mental illness widespread www.msnbc.msm.com/u/ 51112021/Access 12/8/2008).
Mental health is the capacity of each of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It involves finding balance in all aspects of our lives, physically, mentally, emotionally and spiritually (WRHA, 2004). That is why, when we wake up from sleep at home and come together as a family, in school as classmates, at work places as colleagues, in recreational centres and play field as playmates among others, we feel satisfy, happy and joyful. This statement indicates the importance of mental health as one of the components of health. Mental health is something that all of us should desire to have for ourselves. It is happiness, peace of mind, enjoyment and satisfaction. Mental health affects people’s everyday life. It affects the work we do and the overall way that people get along with other members of the family, at schools, on the job, at play with their peers, and in the communities. It involves the way that each person balances his or her needs, conditions, abilities, ideas, and feelings in order to meet the demands of every day life. WHO (2001) opined that mental health is a state of wellbeing in which an individual realizes his or her abilities to cope with the normal stress of life.
Hugo, Boshofts, Traut and Dirwagi (2003), explained that mental health is the level of cognitive; that is knowing through sensation and mental structuring, which creates proper awareness of environmental circumstances to make judgement between right and wrong or emotional wellbeing, that is the inner feelings of the individual which is expressed by outward behaviour, such as anger and happiness. According to Nnachi (2007), mental health refers to the positive condition of the individual’s mental state generated by the positive condition or event of the environment, such as joy, happiness, freedom, love, acceptance, appreciation, recognition, affection, peace and satisfaction. Bob (2008), stated that mental heath is the condition in which an individual thinks normally, reasons well, behaves well, relates well, performs well and does things in realization of the person’s potentials. Applying this in the present study, mental health is the capacity of an individual’s personality and emotional attitude, which enables an individual to live harmoniously with his or her fellow men and women at home, in school, at workplace, among others. Mental health implies an individual’s expression of personal happiness, joy, love, affection, peace and satisfaction. Secondary school students need to have good knowledge of mental health in order to exhibit these attributes.
Knowledge concerning mental health is necessary for everybody including secondary school students in Plateau State, where the present study was carried out. Knowledge is the sum of what is known. Tan (2005), opined that, knowledge is the sum of our conceptions, views and prepositions, which has been established and tested as correct reflection as far as they are objective reality. He further stated that knowledge is the body of information and understanding, which an individual has acquired through life experiences and education. Knowledge according to Gupta and Mahajan (2005), is the factual information that is learned initially and then remembered or internalized. This implies that the root of knowledge lies in the sense of perception, the reliability of which is seen in human practice. Nnachi (2007) explained that knowledge is the ability to understand what one has learned and acquired through experiences. Applying this in the present study, knowledge is the ability to reproduce in memory, facts related to mental health, which is referred to as mental health knowledge.
Mental health knowledge, therefore, is the ability to reproduce what is known about mental health Jorm, Korten, Jacomb, Patricia, Christiana, Bryan, Rodgers and Polite (1997a), explained that mental health knowledge as the ability to recognize specific mental health disorder, risk factors, causes and how to seek mental health information, self treatment and available professional help. Hixson (2004) explained that mental health knowledge is the awareness of mental health needs, ability to identify the causes of mental disorders and to manage mental health problems. According to Royal College of Psychiatrists, London (2006), mental health knowledge is the ability to recognize mental health problems in an individual, family member and in the community at large. Mental health knowledge as used in the present study refers to knowing or acquiring information on concept of mental health, mental illness or disorders (psychosis and neurosis) and their prevention, attributes of mentally healthy person, how to prevent mental illness and coping strategies for mental illness.
Possession of adequate mental health knowledge by secondary school students such as those in Plateau State is of paramount important because this type of correct mental health knowledge will make them to grow up with correct mental health knowledge and to develop positive mental health attitude and behaviour. Having correct mental health knowledge can lead to reduction in mental health problems or disorders or illnesses, and can assist individuals to coping mental stresses of life.
Attitude is person’s affective feelings of likes and dislikes. Attitude emerges out of personal experience and can be positive or negative. It is positive when a person develops a strong attraction of likes for the situation, objects or other persons or groups while it is negative when the person develops a strong dislike for situations, objects, persons, groups or any other identifiable aspect of our environment. Odunukwe (2002) stated that attitude is our strong likes and dislikes for situation, objects, persons, groups or any other identifiable aspects of our environment. Abanobi (2005) opined that attitude is how reality is perceived by the individual or group. He further stated that it is learned and that attitude towards an individual, group or objects develops with time upon when, where and how it all happens. Park (2007) viewed attitude as acquired characteristics of an individual which predisposes him or her to respond in some preferential manner. Attitude when used in relation to mental health is termed mental health attitude.
Mental Attitude, therefore, refers to the person’s feeling or opinion about something or someone or a way of behaving that follows from the disposition of people towards events, issues and material things, with some degree of favour or disfavour. Applying this to the present study, mental health attitude is the feelings, beliefs and actual action people have toward people, events, issues, materials relating to mental health with some degree of favour or disfavour or likes or dislikes. One of the tasks of this study is to determine the mental health attitude of secondary school students. Mental health attitude in the present study can be measured by determining the degree of agreement or disagreement to certain attitudinal statement. The Likert attitude measurement scale modified by Osuala (2005), Enyi (2006) and Nwargu (2006) as Strongly agree (SA)= 4, Agree (A)= 3, Disagree (D)= 2 and Strongly disagree (SD)= I, on the positive side; and on the negative side will be strongly agree (SA)= I, Agree (A)=2, Disagree (D)= 3, and strongly disagree (SD)= 4. This modified attitude measurement scale will be applied in this present study to measure the mental health attitude of secondary school students in Plateau state, Nigeria.
Hornby (2005) stated that a student is a person who is studying in a school especially a secondary school. This may also include those studying in secondary schools in Plateau State of Nigeria. They consist of junior secondary one to three (JS1- JS3) and senior secondary one to three (SS1- SS3) students. Secondary school students require considerable information about mental health. A student who possesses accurate knowledge or information on mental health should be able to apply the facts acquired to the solution of his or her mental health problems. Jorm (2001) emphasized this point when he opined that it is the people’s knowledge of mental health that gives meaning to their emotional attitude and fixed habits about mental health and also strengthens them. They should also be able to live happily, peacefully and satisfactorily with self and others. They are also expected to be knowledgeable in the various components of mental health and mental illnesses or disorders which are wellness, psychosis and neurosis.
Okafor and Okafor (1998) spelt out two broad components of mental health thus: Psychosis and Neurosis. They stated that psychosis is a mental illness in which the person’s ability to distinguish between what is real and what is imaginary is seriously affected to the extent that the person starts hearing people saying something to him or her while in the real sense nobody is speaking to him or her. They further stated that the person might develop strong persistent beliefs or delusions which are unbelievable to others around him or her who knows him or her. Roper (1999) maintained that psychosis is the major mental disorder or illness in which a person’s ability to think, respond, remember, communicate, interpret reality and behave normally are not there or seriously affected. Psychosis is further sub- divided into schizophrenia, manic depressive psychosis, delusion, hallucination, social phobia, Schizotypal Personality Disorder (Glossary, 2001).
Schizophrenia is a psychotic disorder characterized by a loss of touch with reality, it is disordering of thought process leading to withdrawal from reality and personal relationships. Manic-depressive psychosis also known as bipolar disorder causes a person’s mood to alter between being very energetic, euphoric, exaggerated and/or irritable to being very depressed, and occasionally psychotic. Delusion is a false belief or opinion inconsistent with the individual’s culture, and level of intelligence, which cannot be altered by argument or reasoning. Hallucination is a false perception occurring without any true sensory stimulus. It includes imaginary voices that give commands or insults to the person.
Okafor and Okafor (1998) viewed neurosis as a mental illness or disorder in which a person suffers strong feelings of fear and worry that has been produced by frustrations and conflicts. Neurosis, according to Surgeon General Report [1999], is the collection of all diagnosable mental disorders; characterized by alteration in thinking, mood or behaviour associated with distress or impaired functioning. It also has subgroups as anxiety, reactive depression, and hysteria; obsess ional neurosis, depression, post traumatic stress disorder, social phobia, and anorexia nervosa among others. Tabor (2006) described anxiety as fearfulness or uneasiness that arises from anticipation of danger. The anxiety may be focused on a certain thing or situation or it may be generalized, or may also be experienced in periods of sudden onset of fear and accompanied by physical symptoms like panic attack. Reactive depression is a persistent unhappiness with decreased energy, loss of appetite, change in sleep patterns, withdrawal and suicidal thoughts. Hysteria usually arises from mental conflict and repression and is characterised by the production of a diversity of physical disorder such as paralysis. Obsess ional neurosis is the state in which a person’s mind is completely filled with thoughts of one particular thing or person in a way that is not normal or consists of a feeling of compulsion to perform repeatedly a simple task or event; example, hand washing, touching door knobs and so on. It can be argued that when adequate knowledge on mental health is acquired by secondary school students it will help them to avoid situations which can lead to mental illness as well as develop measures for the control and prevention of mental illness.
