Knowledge, attitudes, stigma and appropriate referral toward mental illness among secondary school teachers in Southwestern Nigeria: a mixed method study

Adeoye Olutayo Oyewole; Adedotun Olutunmise Oyewole; Oluwabunmi Nimata Buhari; Samson Aderemi Ojedokun

doi:10.18203/2394-6040.ijcmph20263582

Authors

Adeoye Olutayo Oyewole Department of Psychiatry, Ladoke Akintola University of Technology Ogbomoso Oyo State, Nigeria
Adedotun Olutunmise Oyewole Federal Ministry of Health, Abuja, Nigeria
Oluwabunmi Nimata Buhari Department of Behavioural Sciences, University of Ilorin, Kwara State, Nigeria
Samson Aderemi Ojedokun Department Chemical Pathology Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20263582

Keywords:

Adolescent mental health, Mixed methods, South West Nigeria, Referral, Help-seeking, Social distance, Teachers, Mental-health literacy, Stigma

Abstract

Background: Adolescent mental-health problems are important public-health and educational concerns. The ability of school teachers to respond appropriately to mental-health challenges may be affected by appropriate attitude, mental-health literacy, stigma, cultural and religious beliefs about mental illness. The study aimed to assess the knowledge, stigma and attitudes toward mental illness among secondary-school teachers.

Methods: The study employed a cross-sectional design involving mixed-methods of quantitative and qualitative approaches. A validated instrument; Community Attitudes towards Mental Illness (CAMI) scale divided into 4 priori subscales including: Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology and Sociodemographic Questionnaire were administered for 125 participants. Focus-group discussions (FGD) and key-informant interviews (KII) explored findings requiring deeper explanations. Data were analysed using SPSS version 20.

Results: The participants had a mean age of 42.05±8.99 years with female preponderance. Most had first degree in education with over 10years of teaching experience. Authoritarianism showed mixed but poor knowledge of mental health while the benevolence social restrictiveness and Community mental health ideology showed harsh reactions towards the mentally-ill. Key informant interview (KII) and focus group discussion (FGD) showed apparent knowledge-gap in description, causes and treatment modalities.

Conclusion: The study identified knowledge gaps as a key determinant of poor teacher mental-health literacy, stigma with poor referral intentions. Findings may inform teacher education, continuing professional development, school mental-health policies, anti-stigma programs and formal referral pathways between schools and mental-health services.

References

Mental health of adolescents. Avaialble at: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health. Accessed on 13 August 13 2025.

Matos MG, Raimundo M, Beito A, Branquinho C, Tomé G, Reis M, Gaspar T. Impact of the youth health offices of the portuguese IPDJ cuida-te program on the quality of life, well-being, and mental health of adolescents and emerging adults: a pre-post analysis over 3 years. Adolescents. 2026;6(5):66.

Jorm AF. Mental health literacy. Public knowledge and beliefs about mental disorders. Br J Psychiatry J Ment Sci. 2000;177:396-401.

Aluh DO, Dim OF, Anene-Okeke CG. Mental health literacy among Nigerian teachers. Asia-Pac Psychiatry Off J Pac Rim Coll Psychiatr. 2018;10(4):12329.

Atilola O, Ayinde O, Obialo FK, Adeyemo SO, Adegbaju D, Anthony R. Towards school-based mental health programs in Nigeria: the immediate impact of a depression-literacy program among school-going adolescents and their teachers. Child Adolesc Psychiatry Ment Health. 2022;16(1):70.

Stigma: Notes on the Management of Spoiled Identity. By Erving Goffman. Englewood Cliffs, New Jersey: Prentice-Hall. Avaialble at: https://academic.oup.com/sf/article. Accessed on 13 August 2026.

Taylor SM, Dear MJ. Scaling community attitudes toward the mentally ill. Schizophrenia bulletin. 1981;7(2):225-40.

CAMI Scale. Homewood Research Institute. 2025. Available at: https://hriresearch.com/cami-scale. Accessed on 13 August 2026.

Ikwuka U, Galbraith N, Manktelow K, Chen-Wilson CH (Josephine), Oyebode F, Muomah R. Attitude towards mental illness in southeastern nigeria: The contradictions of a communitarian culture. J Community Psychol. 2016;44:182-198.

CDC. Mental Health Stigma. Mental Health. 2026. Avaialble at: https://www.cdc.gov/mental-health/stigma/index.html. Accessed August 13, 2026.

Al-Naggar RA. Attitudes towards persons with mental illness among university students. ASEAN J Psych. 2013;14(1):56.

Aluh DO, Dim OF, Anene‐Okeke CG. Mental health literacy among Nigerian teachers. Asia‐Pacific Psych. 2018;10(4):12329.

Prabhu SG, Mallikarjun PK, Palmer A, et al. Mental health literacy in secondary school teachers and interventions to improve it – a systematic review and narrative synthesis. J Ment Health. 2025;34(4):476-95.