Assessing Mental Health-Related Practices of Rural and Urban Secondary School Students in Abeokuta North Local Government, Ogun State
Isaiah Dada Owoeye1*, Ngozi Phoebe Ogbonnaya2 and Peace Iheanacho3
1
Department of Nursing Science, College of Medicine & Health Science, Afe Babalola University, Ado-Ekiti, Ekiti state
2
Department of Nursing Sciences, University of Nigeria, Enugu-Campus, Enugu state
3
Department of Nursing Sciences, University of Nigeria, Enugu-Campus, Enugu state
*Corresponding author: [email protected]
ABSTRACTMental health is crucial to adolescent’s life and mental health-related practices aid optimal performances in students. The study investigates mental health-related practices of students in both rural and urban secondary schools. The objectives set for the study were to; Identify the preventive mental health-related practices of students in rural and urban school and determine the promotion of mental health-related practices of students in rural and urban school. A descriptive cross-sectional research design was used for the study. Multistage sampling was employed and 408 sample drawn using power analysis. The instrument used was Adolescent’s Mental Health-related Practices Questionnaire (AMHPQ). The reliability of the instrument was 0.78 using Pearson’s Moment Correlation Coefficient. Data generated was subjected to descriptive statistics and analyzed using Statistical Package for Social Sciences (SPSS) version 21. The study revealed that majority 79.7%
were from the urban school. Urban secondary school students (3.23 ± 0.34) engaged more in preventive mental health-related practices, than the rural secondary school students (3.1 ± 0.3). The urban secondary school students (3.13 ± 0.31) engaged more in promotive mental health-related practices than the rural secondary school students (3.07 ± 0.27). The study concluded that the need to tailor parent-teachers association to meeting the mental health-related needs of the students.
Government is also advised to provided services that foster mental health-related behaviour and practices
INTRODUCTION
Mental health is the basic foundation to good health and quality of life. It is a resource for optimal performance of an individual, family and the society. Mental health is a crucial part of human living and some of the students have issues with it (Parulben, 2017). It is an aspect of health that received little or no attention in the time past, but World Health Organisation has helped to reiterate its importance to the populace for people to take responsibility towards preserving their mental sanity in the face of issues confronting people in the society. The World Health Organisation (WHO) phrase
‘There is no health without mental health’ conveys a positive paradigm of mental health to world.
Sanity is the product of a good health as it helps individual to adjust in situation (Naik et.al, 2015).
The variables in mental health-related practices are dynamics of health descriptor. Some of these practices are but not limited to good hygiene, healthy eating habit, exercise and so on.
Mental health is a topic that is not on a debate in public discussion. It is not an aspect that is not regarded and its sancrosantity cannot be questioned when it comes to defining human health. The world emerging rate of psychological problems arising from people prior to age 14 has been known to having a lifetime repercussion to the victim and the community (Garcia-Carrion,Villarejo-Carballido
& Villarejo-Gallego, 2019). Attention has been drawn to issues related to urban areas and mental health all over the world but less regards are given to cosmopolitan cities of the developing nations (Li & Rose, 2017). However, adult health is given special attention over children’s mental health.
Even though both are not immune to mental illness most psychiatric hospital does not have a special ward for the adolescents. Some of the adolescents with mental illnesses are nursed in an open ward.
In other to keep the adolescents in an optimum state of mental health, healthy mental health behaviours could be adopted. Some of these behaviours reinforce psychosocial resilience to mental breakdown, examples of which are appropriate time schedule, feeling of positive self concept and
relationship with society that has a role to play in an individual’s psyche determination. Promotion of mental health and prevention of mental illness are important variables to be considered in mental practices. Promotion of mental health is imperative among the adolescents as over half of mental illness that prolonged to adulthood manifest around that age (Garcia-Carrion,Villarejo-Carballido &
Villarejo-Gallego, 2019). These are cost-effective and are not too demanding on an individual’s like when people broke down mentally and need treatment to get back on track. However, in the rural setting, the dwellers are not benefiting from most of the mental health-related activities due to the location of their settlement (Hickey, 2017). One of the key objectives of the WHO is to establish the protocol for promotion and prevention in mental health. The Action Plan set in place to meeting the objectives is the collaboration of governments, national and international organisation (WHO, 2018) Mental health-related activities are adopted to aid the promotion of mental health and prevention of mental illness. The mental health-related practices resources are cheaper to achieve. However, proper education and orientation are needed to inculcate the practices in the adolescent in order to prevent the occurrence of mental illness in the future. Adigeb, Anake & Undie (2017), on need for counselling, stated the need to involve students actively in the school environment. Many school authorities are not cognisance of these and parents are also neglecting this important part of mental health. There has been a variation in the adoption of these mental health-related practices in some countries of the world but Nigeria has not fully integrating the concept to safeguard the future of the adolescent through mental health-related practices, especially in the rural schools. Quite a number of individuals have abandoned rural setting in pursuance of quality of life that seems to be available in the cities (Li &
Rose, 2017). According to Chen, Pei & Lin et al., (2019), no regard is paid to the mental health of the students in the rural settings. A 10-year review that lasted till 2016 stated that, in spite of steady development, there is still an imbalance between the rural and urban dwellers (Li & Rose, 2017). The present study therefore seeks to investigate the phenomenon under study.
OBJECTIVES OF THE STUDY
1. To identify the preventive mental health-related practices of students in rural and urban school.
2. To determine the promotion of mental health-related practices of students in rural and urban school.
METHODOLOGY
The study adopted a descriptive cross survey design. A sample size of 408 was drawn from a total population of 8,074 using power analysis with 10% non response rate. A multi-stage sampling procedure was adopted for recruitment of the respondents. The instrument for data collection was the researcher self constructed instrument named Adolescent’s Mental Health-related Practices Questionnaire (AMHPQ). It contains section A and B which are demographic data and questions on mental health-related practices respectively. The instrument was validated by three experts in the Department of Nursing Sciences, University of Nigeria. The reliability of the instrument was established using test re-test and computed using. Pearson’s Moment Correlation Coefficient which yielded a coefficient of 0.78. Data generated was subjected to descriptive statistics and analyzed using Statistical Package for Social Sciences (SPSS) version 21. Probability value less than 0.05 was considered statistically significant. Ethical approval from the Ogun State Ministry of Education, Science and Technology (Department of Planning Research & Statistics) with reference numberPL.19/180. Ethical clearance was from the Ethics & Research Committee of Neuropsychiatric Hospital Abeokuta, Ogun state with reference number PRO25/15.
RESULTS
The study revealed that majority of the students 79.7% were from the urban school. 90.8% of the students lived with their parents and 52.2% of their mothers and 65.5 % of their fathers had tertiary education. The study showed that urban secondary school students (3.23 ± 0.34) engaged more in preventive mental health-related practices, than the rural secondary school students (3.1 ± 0.3). I eat during the school break time rural (3.09 ± 0.71) urban (3.31 ± 0.73), I always have money as a student (2.83 ± 0.89) urban (3.06 ± 0.89), I think positively about myself and others (3.13 ± 0.77) urban (3.40
± 0.72) (Table 2). The urban secondary school students (3.13 ± 0.31) engaged more in promotive mental health-related practices than the rural secondary school students (3.07 ± 0.27), I watch
television at home (2.98 ± 0.7) urban (3.19 ± 0.79), I prepare for examination ahead of time (3.3 ± 0.56) urban (3.54 ± 0.66) and I go to early (3.07 ± 0.75) urban (2.79 ± 0.96) (Table 3)
Table 1: Demographic distribution of the students N=403
Demographic Characteristics No of Respondents Percentage Age Group
10 – 12years 147 36.5%
13 – 15years 195 48.4%
16 – 18years 61 15.1%
Sex
Male 217 53.8%
Female 186 46.2%
Class
Junior Secondary School 213 52.9%
Senior secondary School 190 47.1%
Institution type
Private 39 9.7%
Government 364 90.3%
School Location
Rural 82 20.3%
Urban 321 79.7%
Who do you live with?
Parents 366 90.8%
Grandparents 18 4.5%
Relatives 15 3.7%
Friends 3 0.7%
With an unrelated person/family 1 0.2%
Mother’s highest educational level
No formal education 14 3.5%
Primary education 43 10.7%
Secondary education 136 33.7%
Tertiary education 210 52.1%
Father’s highest educational level
No formal education 6 1.5%
Primary education 31 7.7%
Secondary education 102 25.3%
Tertiary education 264 65.5%
Mother’s occupation
Housewife 15 3.7%
Nursing 26 6.5%
Business 71 17.6%
Lawyer 1 0.2%
Medical Doctor 4 1.0%
Trading 168 41.7%
Teacher/Lecturer 61 15.1%
Farmer 3 0.7%
Civil Servant 39 9.7%
Others (artisan) 15 3.7%
Father’s occupation
Nursing 1 0.2%
Business 119 29.5%
Lawyer 5 1.2%
Demographic Characteristics No of Respondents Percentage
Medical Doctor 15 3.7%
Trading 43 10.7%
Teacher/Lecturer 42 10.4%
Farmer 16 4.0%
Civil Servant 104 25.8%
Others (artisan, technician and professionals) 58 14.4%
Table 2: The preventive mental health practices of rural and urban secondary school students ITEMS Rural Secondary School Students
(n=82)
Urban Secondary School Students (n=321)
t-test P- value SA A D SD Mean Stdev SA A D SD Mean Stdev
I eat before going to
school
28 39 11 4 3.11 0.82 12
6 12
0
55 20 3.10 0.90 0.121 0.904
I eat during the school break time
20 53 5 4 3.09 0.71 14
0 14
9
23 9 3.31 0.73 -
2.498
0.01 3*
I allow school programme to disrupt my
meal
15 30 32 5 2.33 0.85 62 14
9
62 48 2.30 0.95 0.263 0.793
I draw a programme of
activities before I carry
them out
19 36 19 8 2.80 0.91 81 12
5
70 45 2.75 0.99 0.424 0.67
2
I tackle my daily demands
without postponing
them
21 40 18 3 2.96 0.79 10
4
131 57 29 2.97 0.93 -
0.021
0.98 3
I always have money as a
student
19 37 19 7 2.83 0.89 11
3
130 63 15 3.06 0.86 -
2.183
0.030
*
I spend money only
on what I need.
29 41 8 4 3.16 0.79 14
2 13
6
35 8 3.28 0.76 -
1.322
0.187
I discuss my problems and
anything I don't understand
with my parents for
advice
34 42 4 2 3.32 0.68 17
3 11
0
23 15 3.37 0.81 -
0.582
0.56 1
Most of the times, I get things done with my
24 49 5 4 3.13 0.73 12
6 15
8
29 8 3.25 0.72 -
1.320
0.188
initiative I think positively of
myself and others
26 45 7 4 3.13 0.77 16
6 12
7
20 8 3.40 0.72 -
3.004
0.00 3*
I like to do my school
work regularly
31 48 3 0 3.34 0.55 18
8
123 9 1 3.55 0.57 -
3.005
0.00 3*
I respect my parents and
teachers always
40 39 3 0 3.45 0.57 22
0
94 5 2 3.66 0.54 -
3.037
0.003
*
I work hard to make the best of my time
and opportunities
34 46 2 0 3.39 0.54 19
3
118 7 3 3.56 0.59 -
2.379
0.018
*
I obey school rules and regulation.
40 40 2 0 3.46 0.55 20
2
104 15 0 3.58 0.58 -
1.675
0.095
Mean of means
3.11 0.34 3.23 0.34 -
2.770
0.006
*
* P<0.05 (Significant)
Table 3: The promotive mental health practices of rural and urban secondary school students ITEMS Rural Secondary School Students
(n=82)
Urban Secondary School Students (n=321)
t-test P- value SA A D SD Mean Stdev SA A D SD Mean Stdev
I watch television at home.
15 54 9 4 2.98 0.70 11
8 16
2 2 4
17 3.19 0.79 -
2.21 3
0.02 7*
I prepare a scale of preference of my needs (I arrange my
need in order of priority)
25 47 9 1 3.17 0.66 11
4 16
6 3 1
10 3.20 0.73 -
0.28 6
0.7 75
I prepare for examination ahead
of time.
29 49 4 0 3.30 0.56 19
8 10
3 1 5
5 3.54 0.66 -
2.94 8
0.00 3*
I go to bed early 23 45 11 3 3.07 0.75 82 12 9
7 1
39 2.79 0.96 2.47
2
0.01 4*
At school, I go for counselling.
11 33 32 6 2.60 0.81 42 100 10
8
71 2.35 0.97 2.11
5
0.03 5*
I feel inferior to some of my mates
and friends
16 39 20 7 2.22 0.86 66 106 89 60 2.45 1.02 -
1.84 9
0.06 5 I am interested in
my environment.
27 48 4 3 3.21 0.70 13
3 15
6 1 9
13 3.27 0.75 -
0.73 0
0.46 6
I am satisfied with 38 40 3 1 3.40 0.63 19 96 1 8 3.51 0.72 - 0.19
my body structure (body physique,
e.g. fatness, thinness, tallness,
shortness)
9 8 1.29
0
8
I engage in sports/game at my
leisure time (e.g.
football, swimming, etc)
29 33 13 7 3.02 0.93 12
7 11
3 5 3
28 3.06 0.95 -
0.27 0
0.78 7
I engage in craftwork (e.g.
making basket, cane chair, broom,
needle work, etc)
17 27 31 7 2.66 0.91 53 93 10
3
72 2.40 1.01 2.1
46
0.03 2*
I belong to a club/society in my school (e.g. Drama society, Art club,
French club, Literacy and Debating society, Science club, etc)
21 31 25 5 2.83 0.89 99 65 99 58 2.64 1.10 1.45
2
0.1 47
I belong to a voluntary organization in my
school (e.g. Boys Scout, Girls Guide,
Red Cross, etc)
15 29 30 8 2.62 0.90 77 45 11
2
87 2.35 1.12 2.0
47
0.04 1*
I like to pursue a career that will give
me opportunity to help people.
31 43 8 0 3.28 0.63 19
2 11
4 1 3
2 3.55 0.61 -
3.49 6
0.00 1*
I relate well with other people (teachers, parents,
siblings, friends, mate etc.)
34 44 3 1 3.35 0.62 183 121 13 4 3.50 0.64 -
1.92 6
0.0 55
I sleep in the afternoon (siesta)
after school
8 36 31 7 2.55 0.79 57 92 11
3
59 2.46 0.99 0.77
3
0.44 0 I actively
participate in youth and other activities
in my church
27 35 17 3 3.05 0.83 15
3
95 4
3
30 3.16 0.98 -
0.90 7
0.36 5
I always do what my parents wants
me to do
35 43 3 1 3.37 0.62 17
9 13
1 1 1
0 3.52 0.57 -
2.21 0
0.02 8*
I am a happy person 37 44 1 0 3.44 0.52 21 5
97 7 2 3.64 0.56 -
2.87 3
0.00 4*
I love and care about people
37 42 2 1 3.40 0.61 19
1 12
7
2 1 3.58 0.53 -
2.68 6
0.00 8*
I feel happy when others help or show
me some concern
31 44 6 1 3.28 0.65 202 107 10 2 3.48 0.61 -
4.11 0
0.00 0*
I love my parents and siblings
43 36 2 1 3.48 0.61 247 73 1 0 3.77 0.43 -
4.96 2
0.00 0*
I identify with my mates, peers and
friends
26 48 7 1 3.21 0.64 162 144 14 1 3.45 0.60 -
3.30 3
0.00 1*
Mean of means 3.07 0.27 3.13 0.31 -
1.76 7
0.07 8
* P<0.05 (Significant) DISCUSSION
Majority of the students 79.7% were from the urban school. This is not in line with the study by Chen, Pei & Lin, X. et al.(2019) where 72% of the students were from the rural area. 90.8% of the students lived with their parents. More than half of the students 210 (52.1%) had their mother with tertiary educational level, so also their fathers 264 (65.5%). Almost half of the students 195 (48.4%) were 13- 15years old, and the number of male and female were approximately equal i.e. 217 (53.8%) and 186 (46.2%) respectively. Majority of the students 364 (90.3%) were from government school, while only 39 (9.7%) of them were from private school.
PREVENTIVE MENTAL HEALTH-RELATED PRACTICES
The urban secondary school students (3.23 ± 0.34) engaged more in preventive mental health-related practices, than the rural secondary school students (3.1 ± 0.3). I eat during the school break time rural (3.09 ± 0.71) urban (3.31 ± 0.73). In a study by Hickey (2017), stemming up the access to delivering of beneficial food materials to schools in the rural areas students are strategies to increase adolescents’
nutritional needs. In a study by Li & Rose (2017), deprivation of access to basic infrastructures are issues contributing to imbalance in the village and city system of settlement. I always have money as a student rural (2.83 ± 0.89) and urban (3.06 ± 0.89). This is in line with a study by Chen, Pei & Lin et al.,(2019), which documented a lesser amount of family per capital income among the rural students unlike that of those in the urban area, this stated with statistics of 11.6% for rural and 72.8% for the urban students. I think positively about myself and others (3.13 ± 0.77) urban (3.40 ± 0.72). In a study by Chen, Pei & Lin et al., (2019), most pupils 69.4% from rural school were revealed not to be well adjusted in coping with their teachers. In study by Li & Rose (2017), there is a tangible report illustrating the aspect of socio-demographic variables as the challenges that could pose a threat on the mental health of individuals in the village settings. The study further stated dysfunctional self appraisal is a key figure in the mental state of the individuals. 82% of the literature searched revealed the positive influence of preventive programmes in stemming down the rate of occurrence of mental illness among the youth (Garcia-Carrion,Villarejo-Carballido & Villarejo-Gallego, 2019)
PROMOTIVE MENTAL HEALTH-RELATED PRACTICES
The urban secondary school students (3.13 ± 0.31) engaged more in promotive mental health-related practices than the rural secondary school students (3.07 ± 0.27). Inequalities in resource allocation between rural-urban institutions has negative influenced the standard of learning in the rural settings (Kihwele, Taye & Sang, 2019). This is in contrast to a study by Parulben(2017) where it was revealed that students from rural area had better mental health unlike those from urban schools.
Discrimination along settlement plays role in interaction with the world and could inform the dynamics of mental health status of the individual (Li & Rose,2017). Pupils who are dwelling in the rural area are challenged with lower academic report and reduced parental affection that adversely impacted their learning processes (Kihwele, Taye & Sang, 2019). I watch television at home (2.98 ± 0.7) urban (3.19 ± 0.79). Lack of access to Information Communication Technology brings about deprivation of Knowledge to keeping abreast with latest information and these make learners to settle on resource materials that are less valid (Adigeb, Anake & Undie, 2017). I prepare for examination ahead of time (3.3 ± 0.56) urban (3.54 ± 0.66). According to Zhang, Li & Xue, (2015), there is a
reduction in academic achievements of children from villages than those from the cities, this differences are linked to the personality profile and nutritional status of the children. Lack of willingness of teachers to working in the rural setting coupled with lower pay package informed the performance below expectation among the children from rural areas(Kihwele, Taye & Sang, 2019). I go to bed early (3.07 ± 0.75) urban (2.79 ± 0.96). I engage in craftwork (e.g. making basket, cane chair, broom, needle work, etc) (2.66 ± 0.91) urban (2.40 ± 1.01). Educational institution is an arena that could foster the maintenance of mental health attributes by adopting adjustment programmes to suit the need of the students (Garcia-Carrion,Villarejo-Carballido & Villarejo-Gallego, 2019). In a study by Chen, Pei & Lin et al.,(2019), pupils from rural areas have increased level of emotional features which is manifested as behavioural problems(p<0.01)
CONCLUSION
The study concluded that most of the students were from the urban schools and majority of their parents were educated. Students from the urban secondary schools engaged more in preventive mental health-related practices and promotive mental health related services that their counterpart from the rural secondary schools. It can be deduced that education of the parents have more role in the mental health-related practices of the students as the parents could serve as role model to the children and also teach their wards to behave in like manner. There is a need to strategize mental health-related education needs of the students to meeting the students need for performance in the school. Parent- teacher association’s meetings should be strengthened while should fund the schools in provision of school meal services, counselling services, recreational activities and other co-curricular activities in the school.
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