Survey Study of Current Status of and Need for Mental Health Education Enhancing Protective Factors in the Elementary Schools

Ji-Hyun Lee; Hyeoun-Ae Park

doi:10.12799/jkachn.2016.27.1.9

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Original Article
Survey Study of Current Status of and Need for Mental Health Education Enhancing Protective Factors in the Elementary Schools: Ji-Hyun Lee, Hyeoun-Ae Park; Journal of Korean Academy of Community Health Nursing 2016;27(1):9-20.
DOI: https://doi.org/10.12799/jkachn.2016.27.1.9
Published online: March 12, 2016

College of Nursing, Seoul National University, Seoul, Korea

Corresponding author: Park, Hyeoun-Ae College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8827, Fax: +82-2-765-4103, E-mail: hapark@snu.ac.kr

• Received: January 8, 2016 • Revised: March 17, 2016 • Accepted: March 17, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
References

Abstract

Purpose
The purpose of this study was to survey the current status of mental health education and need for mental health education enhancing protective factors in the elementary schools.
Methods
We surveyed 10 school health teachers and 328 fifth- and sixth-grade students using 19- and 20-item questionnaires, respectively.
Results
All of the teachers and 65.2% of the students replied that they were either teaching or being taught mental health in school. Topics covered suicide, depression, school violence, and Internet addiction. All of the teachers and 84.1% of the students expressed the need for mental health education enhancing protective factors in school. Both groups replied that two sessions are enough. The teachers preferred role play and discussion as teaching methods, and audiovisual materials and computer as instructional media. The students preferred lecture and role play as teaching methods, and audiovisual materials and smartphone as instructional media. Both groups ranked self-esteem, parent-child relationship, peer relationship, and emotional regulation as the most important topics to be covered in the education.
Conclusion
There is a high demand for mental health education enhancing protective factors. Therefore, it is recommended to develop educational programs enhancing protective factors by enabling formal and informal learning using smartphone.
Key Words: School nursing; Health education; Mental health; Needs assessment

Table 1.

General Characteristics of the Study Subjects

Participants	Variables	Categories	n (%)
School health teachers (n=10)	Age	40~44	6 (60.0)
		45~49	4 (40.0)
	Clinical Experience as mental health nurse	Yes	0 (0.0)
		No	10 (100.0)
	Length of teaching career (in year)	≤10	2 (20.0)
		11~15	1 (10.0)
		16~20	5 (50.0)
		≥21	2 (20.0)
	Number of classes	Under 18	2 (20.0)
		Over 18	8 (80.0)
	Number of students	400~499	2 (20.0)
		500~599	1 (10.0)
		600~699	4 (40.0)
		700~799	3 (30.0)
Students (n=328)	Grade	5th	158 (48.2)
		6th	170 (51.8)
	Gender	Boys	148 (45.1)
		Girls	180 (54.9)
	Smart phone ownership	Yes	233 (71.0)
		No	95 (29.0)
	Religion	Yes	180 (54.9)
		No	148 (45.1)
	Parent(s) who live together	Mother & Father	311 (94.8)
		Mother	12 (3.7)
		Father	3 (0.9)
		Other	2 (0.6)
	Relationship with parents	Very good	233 (71.0)
		Good	91 (27.8)
		Bad	4 (1.2)
		Very bad	0 (0.0)
	Relationship with siblings	Very good	119 (36.3)
		Good	146 (44.5)
		Bad	20 (6.1)
		Very bad	3 (0.9)
		No siblings	40 (12.2)
	Family life satisfaction	Very satisfied	209 (63.7)
		Satisfied	109 (33.2)
		Dissatisfied	9 (2.7)
		Very dissatisfied	1 (0.3)
	Relationship with teachers	Very good	172 (52.4)
		Good	152 (46.3)
		Bad	3 (0.9)
		Very bad	1 (0.3)
	Relationship with friends	Very good	187 (57.0)
		Good	140 (42.7)
		Bad	1 (0.3)
		Very bad	0 (0.0)
	School life satisfaction	Very satisfied	166 (50.6)
		Satisfied	155 (47.3)
		Dissatisfied	6 (1.8)
		Very dissatisfied	1 (0.3)
	Major consultant	Mother	202 (61.6)
		Father	7 (2.1)
		Teacher	2 (0.6)
		Friend (same sex)	93 (28.4)
		Friend (opposite sex)	2 (0.6)
		Siblings	10 (3.0)
		Other	5 (1.6)
		No person	7 (2.1)
	Feeling of happiness	Very happy	186 (56.7)
		Happy	130 (39.6)
		Unhappy	11 (3.4)
		Very unhappy	1 (0.3)

Table 2.

Status of Mental Health Education from School Health Teacher and Students

Participants	Variables		Categories	n (%)
School health teachers (n=10)	Health education		Yes	10 (100.0)
			No	0 (0.0)
		Number of hours (per year)	5th grader
			Over 17	6 (60.0)
			Under 17	3 (30.0)
			Not applicable	1 (10.0)
			6th grader
			Over 17	4 (40.0)
			Under 17	4 (40.0)
			Not applicable	2 (20.0)
	Mental health education	Teach a class	Yes	10 (100.0)
			No	0 (0.0)
		Number of hours (per year)	5th grader
			3	1 (10.0)
			2	4 (40.0)
			1	4 (40.0)
			Not applicable	1 (10.0)
			6th grader
			3	1 (10.0)
			2	3 (30.0)
			1	4 (40.0)
			Not applicable	2 (20.0)
		Topics^†	Suicide	4 (21.1)
			Depression	3 (15.8)
			School violence	3 (15.8)
			Internet addiction	2 (10.5)
			Friendship	2 (10.5)
			Self-esteem	2 (10.5)
			Emotion	2 (10.5)
			Stress	1 (5.3)
		Teaching method^†	Lecture	9 (39.1)
			Discussion	6 (26.1)
			Role play	3 (13.0)
			Case 'study	4 (17.4)
			Self-directed learning	1 (4.3)
		Instructional media^†	Printed media such as textbook	2 (11.1)
			Audiovisual media such as video	10 (55.6)
			Non-projected media such as real objects	2 (11.1)
			Computer media such as multimedia	4 (22.2)
			Smart media such as smart phone	0 (0.0)
		Source of teaching material^†	Book	2 (10.0)
			Periodical	0 (0.0)
			Internet	10 (50.0)
			Peer school health teacher	8 (40.0)
			Information leaflet	0 (0.0)
		Difficulty^‡	Mental health education
			Low priority	3 (17.6)
			No method and time for feedback	3 (17.6)
			Lack of materials	3 (17.6)
			Lack of capacity of health teacher	3 (17.6)
			Health education
			Lack of time	3 (17.6)
			Excessive school health task	2 (11.8)
Students (n=328)	Mental health education		Yes	214 (65.2)
			No	114 (34.8)
			Never	79 (69.3)
			Don't remember	24 (21.1)
			Other	11 (9.6)
		Topics^†	Response	202 (94.4)
			Internet addiction	120 (43.8)
			Suicide	76 (27.7)
			Depression	37 (13.5)
			Psychosis	14 (5.1)
			Don't remember	14 (5.1)
			School violence	9 (3.3)
			Friendship	1 (0.4)
			Self-esteem	2 (0.7)
			Stress	1 (0.4)
			Non-response	12 (5.6)

^†Multiple responses are possible;

^‡ Free text response.

Table 3.

Needs for Protective factors in Mental Health Education from School Health Teachers (N=10)

Variables	Categories	n (%)
Demand	Extremely Very	10 (100.0) 0 (0.0)
	Moderately Slightly	0 (0.0) 0 (0.0)
	Not at all	0 (0.0)
Goal	Understanding of concept and knowledge Acquisition of attitude and value	0 (0.0) 8 (80.0)
Goal	Practice of health behaviour Development of critical thinking	1 (70.0) 1 (70.0)
Frequency	3	4 (40.0)
	2 1	5 (50.0) 0 (0.0)
	Other	1 (10.0)
Teaching method^†	Lecture Discussion	1 (4.0) 8 (32.0)
	Role play Case study	10 (40.0) 5 (20.0)
	Self-directed learning	1 (4.0)
Instructional media^†	Printed media such as textbook Audiovisual media such as video	1 (5.3) 10 (52.6)
	Non-projected media such as real objects Computer media such as multimedia	2 (10.5) 4 (21.1)
	Smart media such as smart phone	2 (10.5)
Accessibility to information	Very good Good	0 (0.0) 0 (0.0)
	Fair Poor	2 (20.0) 7 (70.0)
	Very poor	1 (10.0)
Issues to consider^‡	Aspect of health education in school
	Enough time for health education	5 (23.8)
	Competency for the school health teacher	4 (19.0)
	Aspect of mental health education Development of the practical teaching materials	7 (33.3)
	Connection with mental health resources Strategies to self-directed learning	3 (14.3) 2 (9.5)

^†Multiple responses are possible;

^‡ Free text response.

Table 4.

Needs for Protective Factors in Mental Health Education from Students (N=328)

Variables	Categories	Boys	Girls	Total
Variables	Categories	n (%)	n (%)	n (%)
Demand	Extremely	86 (58.1)	107 (59.4)	193 (58.8)
	Very	34 (23.0)	49 (27.2)	83 (25.3)
	Moderately	24 (16.2)	20 (11.1)	44 (13.4)
	Slightly	3 (2.0)	2 (1.1)	5 (1.5)
	Not at all	1 (0.7)	2 (1.1)	3 (0.9)
Frequency	3	31 (20.9)	52 (28.9)	83 (25.3)
	2	74 (50.0)	81 (45.0)	155 (47.3)
	1	37 (25.0)	36 (20.0)	73 (22.3)
	Other	6 (4.1)	11 (6.1)	17 (5.2)
Teaching method^†	Lecture	59 (39.9)	58 (32.2)	117 (26.0)
	Discussion	55 (37.2)	53 (29.4)	108 (24.0)
	Role play	38 (25.7)	77 (42.8)	115 (25.6)
	Case study	26 (17.6)	29 (16.1)	55 (12.2)
	Self-directed learning	17 (11.5)	38 (21.1)	55 (12.2)
Instructional media^†	Printed media such as textbook	15 (10.1)	20 (11.1)	35 (7.1)
	Audiovisual media such as video	109 (73.6)	126 (70.0)	235 (47.7)
	Non-projected media such as real objects	25 (16.9)	23 (12.8)	48 (9.7)
	Computer media such as multimedia	34 (23.0)	41 (22.8)	75 (15.2)
	Smart media such as smart phone	41 (27.7)	59 (32.8)	100 (20.3)

^† Multiple responses are possible.

Table 5.

Priority of Topics Enhancing Protective Factors in Mental Health Education

Participants	Topics	Rank							Weighted score	Overall priority
		1	2	3	4	5	6	7
		n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
School health teachers (n=10)	Parent-child relationship	4	1	3	1	0	1	0	5.5	2
	Parent-child relationship	(40.0)	(10.0)	(30.0)	(10.0)	(0.0)	(10.0)	(0.0)
	Peer relationship	1	4	1	1	2	0	1	4.7	3
	Peer relationship	(10.0)	(40.0)	(10.0)	(10.0)	(20.0)	(0.0)	(10.0)
	Self-esteem	5	2	2	1	0	0	0	6.1	1
		(50.0)	(20.0)	(20.0)	(10.0)	(0.0)	(0.0)	(0.0)
	Self-efficacy	0	0	1	1	5	1	2	2.8	5
		(0.0)	(0.0)	(10.0)	(10.0)	(50.0)	(10.0)	(20.0)
	Emotional regulation	0	2	0	4	2	2	0	3.8	4
	Emotional regulation	(0.0)	(20.0)	(0.0)	(40.0)	(20.0)	(20.0)	(0.0)
	Optimism	0	1	0	1	0	4	4	2.2	7
		(0.0)	(10.0)	(0.0)	(10.0)	(0.0)	(40.0)	(40.0)
	Resilience	0	0	3	1	1	2	3	2.9	6
		(0.0)	(0.0)	(30.0)	(10.0)	(10.0)	(20.0)	(30.0)
Students(n=271)	Parent-child relationship	96	65	43	29	14	18	6	5.5	1
	Parent-child relationship	(35.4)	(24.0)	(15.9)	(10.7)	(5.2)	(6.6)	(2.2)
	Peer relationship	45	70	54	31	25	12	34	4.7	2
	Peer relationship	(16.6)	(25.8)	19.9)	(11.4)	(9.2)	(4.4)	(12.5)
	Self-esteem	70	29	40	32	44	32	24	4.5	3
	Self-esteem	(25.8)	(10.7)	(14.8)	(11.8)	(16.2)	(11.8)	(8.9)
	Self-efficacy	14	29	36	61	61	33	37	3.6	5
	Self-efficacy	(5.2)	(10.7)	(13.3)	(22.5)	(22.5)	(12.2)	(13.7)
	Emotional regulation	26	39	42	46	44	39	35	3.9	4
	Emotional regulation	(9.6)	(14.4)	(15.5)	(17.0)	(16.2)	(14.4)	(12.9)
	Optimism	9	23	30	38	42	74	55	3.1	6
	Optimism	(3.3)	(8.5)	(11.1)	(14.0)	(15.5)	(27.3)	(20.3)
	Resilience	12	17	27	34	40	62	79	2.9	7
	Resilience	(4.4)	(6.3)	(10.0)	(12.5)	(14.8)	(22.9)	(29.2)

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