Article Type: Short Communication
Title: Need for routine mental health training and evaluation of school teachers
Year: 2022; Volume: 2; Issue: 4; Page No: 9 – 11
Authors: Swathi Shenoy1, Karpaga Priya Prabakaran2*, Gouri Kumari Padhy3
Affiliations: 1Junior Resident Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
2Senior Resident, Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
3Additional Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Dr Karpaga Priya P,
Department of Community and Family Medicine,
All India Institute of medical Sciences,
Email ID: firstname.lastname@example.org
Cell No: +91 7639199700
Article Summary: Submitted: 09-October-2022; Revised: 25-November-2022; Accepted: 17-December-2022; Published: 31-December-2022
Background: In working towards the goal of Universal Health Coverage, mental health is often neglected in terms of awareness, human resources, and health care facilities. This pandemic has increased the awareness regarding the importance of mental health.
Methods: Every occupation is subjected to mental stress, but a field of particular importance is a teacher. During the ages 5-15, the teacher’s effect on the growing child is unique as they take part in building the academics and the personality of a student.
Results: Teachers themselves are often subjected to high work pressure, low pay, and other challenges and their mental health is often overlooked. Hence there is a profound need for training the teachers on detection of early signs of mental disorder and also incorporating their routine mental health examination. The close bonding between the teachers and students can be utilized to generate awareness and help in early diagnosis.
Conclusion: From this we have concluded that the preserving the teacher’s mental health will benefit the teacher and their students the future of the nation.
Keywords: teachers mental health, teachers-student dyad, training of teachers, mental disorders
The World Health Organization (WHO) defines health as complete physical, mental, and social well-being and not merely the absence of disease or infirmity.  The human race is going through a transition phase due to various socio-demographic, lifestyle, and behavioral changes. These changes have led to a drastic increase in various health disorders, of which mental health disorders are being brought under the limelight at a faster pace.
According to the National Mental Health Survey (NMHS) 2015-16, 10.6 % of the population were diagnosed with a mental illness, with a lifetime prevalence of 13.7%. The impact of mental disorders in the lives of both the patient and the caretakers are significant. According to the Global Burden of Disease (GBD) 2000, depression alone accounts for 4.46% of the total Disability Adjusted Life Years (DALYs) and 12.1% of the whole Years Lost to Disease (YLDs). 
On average, we spend most of our time with our family and the remaining part at work. Thus, work plays an essential factor in our daily living and hence also affects our mental health. Many studies have been done to find the specific prevalence rates of mental disorders concerning the occupation. Of the various fields, one that is of particular importance is the job of a teacher. They play a vital role in shaping and bringing up their students’ life.
Role of teachers
From nursery school till a student graduates, the teacher plays the role of the second mother. In the kindergarten and primary school days, along with guiding the students in their academic and extracurricular activities, the teacher also imparts good values, forms the student’s personalities, and prepares them to face future challenges.
When the child reaches high school, they undergo various changes of adolescence. During these times, the role of the teachers turns from being a second mother to a guide. Queries related to menstruation, the development of secondary sexual characters, safe sex practices, and abstaining
from abusive substances that arise among them are often discussed with the teachers as students feel safe. The teacher, in turn, mentors the students and puts them on the right path.
The importance of a good teacher is very well understood by the students specially those who live away from home for educational purposes. In addition to the academic pressure, some students also deal with grief due to separation from family, relationship problems, self-responsibility issues, and peer pressure. All this may lead to the experience of first mental health problems.  Few issues students feel cannot always be shared with their parents and are often handled by the teachers. Hence the importance of good teachers gets highlighted.
Importance of teachers’ mental health
Since it is established that teachers form the country’s backbone, their health is thus of grave importance as they can also get sick physically and mentally. Annual health checkups help in keeping the teaching fraternity at par with their physical health. But the mental health status is more often overlooked. The prevalence and risk of mental health disorders in the teaching fraternity are on a sharp rise.  Mentally, the teacher is subjected to unpredictable stress, rebellious students, low pay, work overload, role ambiguity are some of the critical factors.  With the busy schedule of the school/college, keeping a check of one’s mental health often goes out of hand. Aside from the challenges they face every day, they are also confronted with exhibiting positive work habits and high teaching performance, which sometimes do get affected. 
Mental morbidity often leads to high levels of disability, which is seen across the individual’s family, social, and work life. This disability is not restricted to severe mental disorders but also ]includes common mental disorders.  The findings of one study showed that out of the Brazilian teachers of sample 236, 34.8% met with criteria for CMDs.  A mother’s mental health may affect the child; similarly, the teacher’s mental health may affect the student. Higher levels of depressive symptoms in teachers were associated with poorer student well-being and psychological distress.  A study done to find the indicators of teachers’ well-being and their outcomes showed that one of the critical outcomes of teachers’ well-being was their student’s well-being. The study found that students of “happy schools” felt more supported by the teachers and this often makes the students feel more safe and secure in the school environment, which in turns leads to increasing productivity. 
One teacher affects the lives of a minimum of 60 individuals. By this calculation, if the teacher’s mental health is distorted, it affects the growing child and eventually affects the country’s productivity. A study done to find an association between the teacher’s mental health and learning resource development found that mental health significantly affects the learning resource development.  Studies have found that low mental health often leads to under-performance, affecting how the student feels in a school environment. Under-performance has been linked with the inability of a teacher to maintain good relations with the student. The study also found that teachers’ absence and underperformance were associated with poorer student well-being. The same study found that a better teacher-student relationship led to lower psychological distress in students. 
There have been very few studies that have assessed the prevalence of mental health disorders in the teaching fraternity. In one of the studies, the prevalence of mental health disorders among the teachers was 15%.  A systematic review and meta-analysis conducted showed an overall prevalence of anxiety to be 17%, depression 19% (CI: 15-24%), and stress to be 30% (CI: 17-46%) among teachers.  Based on Figure-1 there is a need for more research in this area.
Figure 1: Funnel plot showing various mental disorders affecting the teaching fraternity
Teachers’ role in monitoring students’ mental health:
The prevalence of mental disorders in the adolescent population of India has been researched, and the prevalence of mental disorders among children and adolescents was found to be 3-38%.  If the prevalence of common mental disorders among adolescents are so high, then there is a need that they are identified at an early stage either by their own family or by the schoolteachers. A study done to check the accuracy of teachers in identifying students with depression found that the variables like those with more years of teaching experience, those with specific training on identification of mental disorders and those who had a prior history or had a friend suffering from depression had high correlation with the teachers’ ability to identify the student suffering from any kind of mental disorder. 
Training teachers in the screening of mental health disorders:
According to the NMHS 2016-2017, despite the increasing prevalence and the continuous efforts for increasing mental health care delivery in India, a treatment gap still exists, ranging from 28-83% for mental disorders. There are numerous causes for this gap, most commonly being a lack of awareness and resources.
Annual mental health evaluations should be added to the regular master health checkups. All those in need of treatment shouldn’t be discriminated against; instead, they should be treated just like any other form of physical illness, and adequate medical leave should be granted as per the physician’s recommendations. This evaluation can be integrated as a part of the routine school health checkups. Along with the checkups for the students, the teachers should also be included as the beneficiary of the program. Since teachers will be the health and wellness ambassadors, they will be trained as a part of school health programs. All the teachers undergo a physical and mental health evaluation before getting trained for the program. Wellness programs can be started which will also focus on the mental aspects of health. These could include preventive interventions like health education classes, individual counseling, support groups.  Such programs have to coordinate with the national mental health program, school health program, and Ayushman Bharat’s comprehensive primary health care delivery. Twice a year, self-care days should be included in the curriculum for both students and teachers, wherein a psychologist can be linked for providing the necessary counseling and a psychiatrist for screening, treatment, and early referral.
Teachers are the most respected and looked upon by the students and their parents. Only when a teacher is mentally sound will they nurture the growing students, help in early identification and recognition of common mental health disorders, and, if trained well, help manage a few minor cases. In this way, teachers can help reduce the stigma and provide mental health education and counselling, which will help fill the treatment gap present in our mental health program.
Conflict of Interest: The authors not having any kind of conflict of interest in this study.
Source of funding: We didn’t receive any kind of financial support from any institutions.
Author Contributions: SS, KPP, GKP – Concept and designed, wrote the full paper, and checked the article by all authors.
Here, SS – Swathi Shenoy, KPP – Karpaga Priya Prabakaran, GKP – Gouri Kumari Pandhy
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