3

KNOWLEDGE AND ATTITUDE TOWARDS MENTAL

ILLNESS AMONG TEACHERS IN THE SELECTED
SCHOOLS IN SIVAGANGAI DISTRICT, TAMILNADU

MS. Gnanaguruvammal .G

A DISSERTATION SUBMITTED TO TAMILNADU Dr. M.G.R

MEDICAL UNIVERSITY, CHENNAI, IN PARTIAL
FULFILLMENT OF THE REQUIREMENT FOR THE DEGREE OF
MASTER OF SCIENCE IN NURSING

MARCH – 2010
 2

KNOWLEDGE AND ATTITUDE TOWARDS MENTAL

ILLNESS AMONG TEACHERS IN THE SELECTED
SCHOOLS IN SIVAGANGAI DISTRICT, TAMILNADU

A DISSERTATION SUBMITTED TO TAMILNADU Dr. M.G.R

MEDICAL UNIVERSITY, CHENNAI, IN PARTIAL
FULFILLMENT OF THE REQUIREMENT FOR THE DEGREE OF
MASTER OF SCIENCE IN NURSING

MARCH – 2010
 1

Name :Ms. Gnanaguruvammal.G

Registration No : 30085443

College Name :Matha College of Nursing

Vaanpuram,Manamadurai
Sivagangai.(Dt) TN.
Batch :2008 -2010 (March 2010)

Submitted to : The Tamilnadu

Dr.M.G.R.Medical

University, Chennai
 4

MATHA COLLEGE OF NURSING

(Affiliated to TN Dr.M.G.R. Medical University),
VANPURAM, MANAMADURAI-
630606, SIVAGANGAI DISTRICT,
TAMILNADU.

CERTIFICATE

This is the bonafide work of Ms. Gnanaguruvammal.G M. Sc.,

Nursing (2008 -2010 Batch) II year student from Matha College of Nursing
(Matha Memorial Educational Trust) Manamadurai – 630606. Submitted in
partial fulfillment for the Degree of Master of Science in Nursing Affiliated
to the Tamilnadu Dr. M.G.R. Medical University Chennai.

Signature:

Prof. (Mrs). Jebamani Augustine., M.Sc., (N).,

Principal

Matha College of Nursing

Manamaduari – 630606

College Seal:
 5

KNOWLEDGE AND ATTITUDE TOWARDS MENTAL

ILLNESS AMONG TEACHERS IN THE SELECTED
SCHOOLS IN SIVAGANGAI DISTRICT, TAMILNADU

Approved by the dissertation Committee on:

Prof. (Mrs). Jebamani Augustine., M.Sc., (N),

Principle cum Head of the Department,

Medical Surgical Nursing,

Matha College of Nursing, Manamadurai.

Guide:

Prof. (Mrs). Thamaraiselvi,

Professor In Nursing,

Matha College of Nursing, Manamadurai.

Medical expert:

Dr. S.Ganesh Kumar, M.B.B.S, D.P.M.,

Consultant psychiatrist,

M.S. Chellamuthu Trust and Research Foundation

Madurai.

A DISSERTATION SUBMITTED TO TAMILNADU Dr. M.G.R

MEDICAL UNIVERSITY, CHENNAI, IN PARTIAL
FULFILLMENT OF THE REQUIREMENT FOR THE DEGREE OF
MASTER OF SCIENCE IN NURSING

MARCH – 2010
 6

ACKNOWLEDGEMENT

This research has been a wonderful life experience that I would

always cherish. This experience has not only improved my skills in scientific
enquiry but also molded me into a better person.

A thesis, how significant it is, cannot be claimed as the work of one

individual alone. There are many persons who stood by me in all my efforts
to complete this endeavor successfully. I take this opportunity to thank them
all…

First I praise and thank the Almighty God for his abundant grace,
blessing and unconditional love throughout the study.

I am immensely thankful to Mr.P.Jeyakumar M.A.B.L., Founder,

Chairman and correspondent, Mrs. J.Jeyapakiyam M.A., bursar, Matha
Memorial Educational Trust, Manamadurai for giving me an opportunity to
undertake the post graduation course in this esteemed institution.

I am indebted to professor. Mrs. Jebamani Augustine M.Sc. (N)

Principal, Professor and Head of the Department of Medical Surgical
Nursing, Matha College of Nursing, Manamadurai. She has been a great
source of strength, motivation and support, all through the project.

It gives me great pleasure in extending thanks to Professor Mrs.

Shabera M.Sc. (N) Vice principal, Head of the Department of Maternity
Nursing, Matha College of Nursing Manamadurai. I thank madam for her
insightful research support, timely advices and comments that were helpful
in making this study a rewarding one.
 7

I am grateful to Mrs. Kalaiguruselvi M.Sc. (N), Additional Vice

Principal and Head of the Department of Pediatric Nursing Department
Matha College of Nursing Manamadurai, for her encouragement and
support.

It is a sense of honor and pride for me to place on record my sincere

thanks to my guide Professor Mrs. Thamarai Selvi M.Sc. (N), professor in
nursing, for her constructive criticism, suggestions, comments to this project.

My sincere thanks are due to Mrs. Angel Arputha Jyothi M.Sc. (N)
lecturer Department of Psychiatric nursing for guiding me in perfect way
with constant encouragement and patience which made my study creative.

I’m greatly indebted to Mr. Premkumar M.Sc. (N) lecturer

Department of Psychiatric nursing for his enthusiastic encouragement and
support to complete this project.

It is my bounden duty to express at the outset my heartiest gratitude to

Mr. Thirumalai Head Master O.V.C. school Manamadurai for permitting
me to collect data as required.

I would like to convey my sincere gratitude to head mistress

Government girls’ higher secondary school Manamadurai for her optimistic
outlook about the outcome of this project.

A word of appreciation is extended to Dr. Duraisamy, Ph.D.,

professor, of biostatistics for analyzing my data and guiding me as required
to carry out the study.
 8

I especially want to acknowledge and thank Dr. Shakemnathan Ph.D

for editing and his valuable suggestions.
A word of commendation is extended to all the library staff, Matha
College of Nursing Manamadurai for their help and assistance to obtaining
the needed sources.

I would like to exclusively thank all the participants of the study for
their cooperation, time and enriching my understanding in numerous ways.

I’m indebted to my parents Mr. Gurusamy, Mrs. Adhilakshmi who

gives meaning to my life in many ways.

My special thanks to my sister Mrs. Maheswari M.Sc. (N), and kids

Madhukrishna, Harini whose encouragement keeps me motivated, whose
support gives me strength, whose gentleness gives me comfort.

I express warm appreciation to Ms. Tamilselvi M.Sc. (N) For her

exceptional efforts and cooperation.

I wish to thank my classmates and department mates for their constant

support and help.

I am thankful to Sai Communications for computer assistance.

Owing to the slips in my memory, there might be the possibilities of

having missed the mention of many individuals, who directly and indirectly
have stood up me, in this project.
 9

ABSTRACT

BACKGROUND OF THE STUDY:

This study was designed to examine the knowledge and attitude of

mental illness among school teachers in Manamadurai. A descriptive study
design was used. A total of sixty teachers were included in the study.
Convenient sampling technique was adopted to collect the data. The
knowledge was measured by 20 items of a semi structured questionnaire and
attitude was assessed by modified Orientation towards mental illness scale.
Data was analyzed according to objectives of study using descriptive and
inferential statistics.

OBJECTIVES:

1. To identify the knowledge of teachers towards mental illness.

2. To identify the attitudes of teachers towards mental illness.

3. To find out the relationship between knowledge and attitude of

teachers towards mental illness.

4. To find out the association between the knowledge of teachers

towards mental illness with demographic variables such as age,
gender, education, locality, previous experience with mentally ill
patients.
 1

5. To find out the association between attitude of teachers towards

mental illness with demographic variables such as age, gender,
education, locality, previous experience with mentally ill patients.

HYPOTHESES:

1. There will be a significant relationship between knowledge and

attitude of teachers towards mental illness.

2. There will be a significant association between knowledge of

teachers with selected demographic variables such as age,
gender, education, locality, previous experience with mentally
ill patients.
3. There will be a significant association between attitude of
teachers towards mental illness with selected demographic
variables such as age, education, locality, previous experience
with mentally ill patients.

ASSUMPTIONS:

1. Teachers working in higher secondary schools may have inadequate

knowledge about mental illness and at times may elicit negative
attitudes like fear and violence.

2. The teachers who have previous experience or idea about mental

illness may perceive mentally ill as less dangerous.
 1

3. The knowledge and attitude towards mental illness differs in each

individual.

4. Participants may feel hesitant to reveal true information on the

questionnaires.

MAJOR FINDINGS OF THE STUDY

 Considerable number of teachers 15(25%) were below 30 years,

34(56.7%) teachers were between 31- 40 years, 3(5%) fell in the
category of 50 years and above.

 The gender distribution shows that the male participants were

31(51.7%), and female were 29(48.3%).

 The great majority of teachers were Hindus 46(76.7%), 14(23.3%)

were Christians.

 The percentage of unmarried teachers was 10(16.7%), married

49(81.7%) and widow 1(1.7%).

 With regard to educational status of teachers 18(30%) were

undergraduates and 42(70%) were postgraduates.

 Considering the residence of teachers, 25(41.7%) were from to rural

area and 35(58.3%) were from urban area.
 1

 Place of work reveals 42(70%) teachers were from private school and
18(30%) were from Government school.

 Regarding the previous experience of teachers 34(56.7%) had no

experience 26(43.3%) had known someone with mental illness.

 Majority 59(98.3%) had no family history of mental illness. One

(1.7%) had family history of mental illness.

 Majority of the subjects 40(66.7%) had moderately adequate

knowledge, 16(26.7%) had inadequate knowledge and 4(6.7%) had
adequate knowledge.
 In case of attitude 10(16.7%) had most favorable attitude towards
mental illness, 41(68.3%) had favorable attitude and 9(15%) had
unfavorable attitude towards mental illness.

 There is a positive correlation between knowledge and attitude (r

=.957). It implies that, higher the knowledge, the more the favorable
attitude.

 There was a significant association between knowledge of teachers

toward mental illness and demographic variables such as age,
education, locality, previous experience at the level of p<0.01.

 There was an association between demographic variables and attitude

of teachers regarding mental illness. Significant association found in
age, education, locality, and previous experience at the level of
p<0.01.
 1

RECOMMENDATION:

Based on the findings of the study it recommends that,

 A similar study can be done in a large sample for the purpose of

generalization.

 A study can be done in urban and rural setting and the results
can be compared.

 A comparative study can be done with two groups.

 A similar study can be carried out and anti – stigma educational

programs and campaigns may be conducted.
 A similar study can be conducted by the use of different attitude
scales.

CONCLUSION:

In India 15million people are battling serious mental health problems.

Nearly 50% of victims suffering serious mental health disorders go
untreated. The fortunate part is most mental illnesses can be successfully
treated. The Government of India also has taken special interest in mental
health care in the form of National Mental Health Programme. Stigma is one
of the major difficulties faced by people with mental illness, due to which
they hesitate in seeking help. The mental health services are not utilized by
the beneficiaries properly. Many of them suffer alone silently. By accident,
we are all responsible for this situation. The researcher strongly believes
appropriate information of the public and positive attitude brings great
change in the life of mentally ill.
 1

TABLE OF CONTENTS

CHAPTERS CONTENTS PAGE NO

CHAPTER – I Introduction 1
Need for the study 5
Problem Statement 9
Objectives 9
Hypotheses 10
Assumptions 10
Operational definitions 11
Limitations 11
Projected outcomes 12
Conceptual Framework 13
Chapter - II Review of literature
Literature related to knowledge towards mental 16
illness.
Literature related to attitude towards mental 19
illness.
Chapter – III Research methodology

Research approach 27

Research design 27

Setting of the study 27

Population 28

Sample size 28
 1

Sampling technique 28

Criteria for selection of samples 28

Technique and tool 29

Development of the tool 29

Description of the tool 29

Score Interpretation. 30

Testing of the tool 31

Pilot study 32

Procedure for Data collection 32

Protection of human rights. 33

Chapter - IV Analysis and interpretation of the data 34

Chapter - V Discussion 51

Chapter - VI Summary and recommendation

Major findings of the study 59

Implication for Nursing Practice 60

Implication for Nursing Education 61

Implication for Nursing Administration 61

Implication for Nursing Research 61

Recommendation 62

Conclusion 62
 1

LIST OF TABLES

TITLE PAGE NO
TABLE NO

Frequency and percentage distribution of 36

1 teachers on the basis of demographic

variables.

Frequency and percentage distribution of 44

2 level of knowledge regarding mental illness
among teachers.

Frequency and percentage distribution of 44

3 level of attitude regarding mental illness
among teachers.

Correlation between knowledge and 46

4 attitude regarding mental illness among
teachers.

Association between the knowledge and 47

5
demographic variables.

Association between the attitude and 49

6
demographic variables.
 1

LIST OF FIGURES

FIGURE
TITLE PAGE NO
NO

1 Conceptual framework 15

2 Distribution of samples in terms of age 39

3 Distribution of samples in terms of gender 39

4 Distribution of samples in terms of religion 40

Distribution of samples according to marital 40

5
status.
Distribution of samples in terms of educational 41
6
status
41
7 Distribution of samples on the basis of locality

Distribution of samples in terms of place of 42

8
work
Distribution of samples on the basis of previous 42
9
experience
Distribution of samples in terms of family 43
10
history
Distribution of samples in terms of level of 45
11
knowledge.
Distribution of samples in terms of level of
12 45
attitude
 1

LIST OF APPENDICES

APPENDICES CONTENTS

Appendices I Letter seeking experts opinion

Letter seeking permission to conduct

Appendices II
study

Appendices III List of experts

Appendices IV Section I Demographic Profile

Section II Questionnaire to assess the

Appendices V knowledge of teachers regarding mental
illness
Section III Orientation towards mental
Appendices VI
illness scale.

Appendices VII Tool in English and Tamil

Planned teaching module in Tamil and

Appendices VIII
English
 1

CHAPTER I

INTRODUCTION:

Mental illness is the term used to describe a broad range of mental and
emotional conditions. Mental illness is also used to refer mental impairments
other than mental retardation, organic brain damage and learning disabilities.
The term psychiatric disability is used when mental illness significantly
interfere with the performance of major life activities such as learning,
thinking, sleeping, eating and communicating among others (World Health
Organization,2001).

Social attitudes towards people with mental disorders dates back to

the prehistoric era, they believed to be ‘possessed by unclean spirits or a
devil’. In American Colonial days they might be burned as witches. People
diagnosed with mental illnesses live in a different space in public perception
from those hospitalized for ‘physical’ conditions such as cancer or heart
disease. It was perceived that mentally ill people not only acted differently
but also looked different. A person hospitalized for mental illness was
assumed to be dangerous, incompetent, and untrustworthy.

Negative attitudes towards people with mental illness are attributed to

stigma. Stigma affects the patient’s interactions and social network,
employment opportunities and quality of life in general. It also lowers the
identified patient’s self esteem and contributes to a disrupted family
relationship. Stigmatization can still happen for individuals whose mental
illness is in remission, even if their behavior is ‘normal’ just because they
 2

have been admitted to a psychiatric hospital. Surprisingly stigma continues

to complicate the lives of the stigmatized even as treatment improved their
illness. Therefore, mental illness was still perceived as an indulgence and as
a sign of weakness.

The National Institute of Mental Health in the United States estimates

that one in five people will experience some sort of mental illness in their
lifetime and one in four people will know someone with mental illness.
Mental illness is treatable and the symptoms of mental illness often can be
controlled effectively through medication and or psychotherapy. But
sometimes the symptoms of mental illness may go into remission, and for
some people it causes continuous episodes that require ongoing treatment
(World Health Organization, 2001).

Even though mental illness affects many people around the world,
mental illness unlike other chronic physical illnesses like heart disease and
hypertension, is associated with a number of misunderstandings and myths.
For example, it is common for people to assume that mental illness is caused
by moral weakness and or is in the possession of evil spirits. Wahass and
Kent while studying the community attitudes towards the causes of auditory
hallucination in Saudi Arabia and United Kingdom found out that Saudi
Arabians considered supernatural causes like possession by the devil for
auditory hallucination. Certain Muslim cultures placed the causes of mental
illness on supernatural origins due to their belief in God’s will as a
determinant of all events in life. At times mental illness is also perceived as
God’s punishment for something bad that the person has done. Razali and
Najib (2002).
 2

In addition, mental illness is often associated with dangerousness and

violence (Phelen, Link, Steuve&Pescosolido, 2000). According to Corrigan,
Rowan, Green and Lundin (2002), public often segregate the mentally ill
from the rest of society thinking they are dangerous and violent. This
attribution of mentally ill with dangerousness and violence is very often due
to the portrayal of mentally ill people as violent and dangerous on the media
(Lyons & Mc Loughlin, (2001).

It was argued by Hyler, Gabbard and Schneider that presentation of

mentally ill people as dangerous and violent have been so frequent in films,
television, novels and comics that people accept them without a second
thought.

Due to the misunderstanding and myths surrounding mental illness,

mentally ill are sometimes stigmatized and may be labeled in stereotypical
names such as ‘madman’, ‘morons’, lunatics’ ‘maniacs’ and ‘psycho’. In
some instances mentally ill may be denied of human rights.

The most devastating and frightening experience the mentally ill has
to undergo is isolation and loneliness. People tend to seclude the mentally ill
from others, the family who once loved and cared for the person suddenly
separates the person from the rest of the family and neglects the needs of the
mentally ill person. Once institutionalized, many families refuse to take back
their mentally ill family members even after recovery from the illness,
forcing these already miserable people to totally lose trust in others and their
condition takes a turn back into its worse. Apart from the above, mentally ill
are also harassed and tortured in ways like chaining them down so that they
cannot move and inflicting other bodily pain and harm (Rotella, Gold &
Adriani, 2002).
 2

The stereotypical labeling of the mentally ill becomes so permanent

that the person is stigmatized with the stereotypical names even after
recovering from the illness. People fail to understand their capabilities
because of an unfortunate illness they encountered and are refused jobs for
which they are qualified. This makes it difficult for the ex-mental patients to
pull themselves up and gain a level of independence in the community.

Psychiatric stigmatization had led to the formation of widespread

negative attitude towards mentally ill among public. Stigma and
discrimination are the main obstacles faced by the mentally ill today and it is
the shame and fear of this discrimination that prevents the mentally ill from
seeking help and care for their disorders (World Health Organization,
2001).

It is important to understand about people’s attitude towards mentally

ill and possible factors which have lead to the formation of these attitudes. It
is very likely that a person’s background and experience may influence
his/her attitude towards mentally ill.

Attitudes to mental illness are deeply rooted in society. Adverse

attitudes affect the delivery of mental health care services. The concept of
mental illness is often associated with fear of the potential threat of patients
with such illness.

As we improve our medical technologies, we should also improve our

attitudes. A little change in attitude in all of us is a small step. Surely a
nation that tries to exercise greater graciousness can exercise a little more
compassion and empathy.
 2

NEED FOR THE STUDY:

Much of the stigma of mental illness is engrained in deep and ancient

attitudes held by virtually every society on earth. The conviction that
mentally ill are a dangerous threat; societies have traditionally scorned
selected individuals, stir of poor scientific evidence. The vast majority of
mentally ill persons never commit a violent crime. In this regard, it is
important to mention the unfortunate role, which the mass media in our
country play, which often shows the mental illness something to ridicule, to
laugh at, or something, which is bizarre, disgusting or frightening. Such
negative attitudes not only affect the person but will also spill-over to the
caregiver and family members of the mentally ill. The mentally ill client,
their care giver, and family, friends and social group-may be shunned,
denied protection and treated as less than human beings because of what the
late American sociologist Erving Goffman called their “spoiled identity”.

The stigma attached to mental illness is the greatest obstacle to the

improvement of the lives of the people with mental illness and their families.
The history of mental illness is long, but it is probable that intolerance to
mental abnormality has become stronger in the past two centuries because of
urbanization and the growing demands for skills and qualification in almost
all sectors of employment.

Startling statistics about mental illness reveals that one in every 4

people, or 25% per cent of individuals, develop one or more mental
 2

disorders at some stage in life. Today, 450 million people globally suffer
from mental disorders in both developed and developing countries. Of
these, 154 million suffer from depression, 25 million from schizophrenia, 91
million from alcohol use disorder and 15 million drug use disorder. Mental
illnesses do not discriminate – they can affect anyone, men, women and
children regardless of gender, race, ethnicity, and socio-economic status.

Mental health problems represent 5 out of 10 leading causes of

disability worldwide; amounting to nearly one-third of the disability in the
world. Leading contributors include depression, bipolar disorder,
schizophrenia, substance abuse, and dementia.

Mental illnesses rank first among illnesses that cause disability in the
United States, Canada, and Western Europe. It is predicted that by 2010,
depression will be the leading cause of disability worldwide, not cancer,
heart disease, diabetes, or AIDS. Mental illness is a serious public health
challenge that is under-recognized as a public burden. (World Health
Organization 2007).

Fifteen epidemiological studies in India were analyzed. It was

reported that the national all-India prevalence rates for “all mental
disorders’’ as 73(rural +urban) per 1000 population. The National Sample
Survey Organization (NSSO) in 2005 highlighted in a survey on “disabled
persons in India” that 105 people in a lakh suffered some form of mental
illness. A recent report of the World Bank indicates that mental disorders are
responsible for a major proportion of the disability in world and that there
are indications that the situation in this aspect will worsen. More than 40%
of countries have no mental health policy, and over 30% have no mental
 2

health programs. Existing health plans frequently do not cover mental and
behavioral disorders at the same level as other illnesses, creating significant
economic difficulties for patients and their families. One of the identified
reasons for low support for mental health is the stigma attached to mentally
ill individuals.

India, the second most populated country of the world with a

population of 1.027 billion, is a country of contrasts. The population is
predominantly rural, and 36% of people still live below poverty line. There
is a continuous migration of rural people into urban slums creating major
health and economic problems. India is one of the pioneer countries in health
services planning with a focus on primary health care. However, only a
small percentage of the total annual budget is spent on health. Mental health
is part of the general health services, and carries no separate budget. The
National Mental Health Programme serves practically as the mental health
policy. Recently, there was an eight-fold increase in budget allocation for the
National Mental Health Programme for the Tenth Five-Year Plan (2002–
2007). India is a multicultural traditional society where people visit religious
and traditional healers for general and mental health related problems.
However, wherever modern health services are available, people do come
forward. India has a number of public policy and judicial enactments, which
may impact on mental health. (India mental health country profile).

In the past decade, several professional associations have initiated

awareness campaigns on mental illness. In devoting The World Health Day
2001 and the World Health Report 2001 to mental health, the World Health
Organization (WHO) stated that mental illness was ignored and mental
health is essential to the over-all well-being of individuals, societies, and
 2

countries. The American Psychiatric Association Assembly and the Board of

Trustees approved a Position Statement on discrimination against persons
with previous psychiatric treatment to facilitate their full participation in
society.

In India close to 15 million people are battling serious mental health

problems. Some 30 million are suffering mild forms of mental illnesses.
Nearly 50% of victims suffering serious mental disorders go untreated.
Though Government of India has taken special interest in mental health care
in the form of National Mental Health Programme, District Mental Health
Programme, District Hospital Psychiatric Units, and General Hospital
Psychiatric Units, we still have to go a long way in achieving the goal of
“Mental Health for all”. There are several reasons for not achieving the
target, the major one being lack of rural partnership in the mental health
delivery.

No programme is successful without the involvement of its

consumers. The rural partnership can be promoted through the following
members in the community, who always live with the people. Village
leaders, teachers, mahila mandals, youth organizations, health workers,
postman and others. Each one of them can play a unique role in the
promotion of mental health and prevention of mental disorders. (The
Nursing Journal of India).

Fortunately the researcher had an opportunity to come across many

literatures of public awareness concerning mental illness. There was a
modest uncertainty of choosing the population. Long ago, American
sociological association studied perception of mental illness among public
school teachers. The results discovered that teachers are better able than the
 2

general public to identify symptoms of mental illness. The integration of

mental health into primary care also insist that, mental disorders are
identified and directed by anganwadi workers, primary care centre staff,
panchayat members, and school teachers (World Health Report 2008). This
was the motive to the researcher to fix on the problem statement and the
population.

STATEMENT OF THE PROBLEM:

“A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE

TOWARDS MENTAL ILLNESS AMONG TEACHERS WORKING
IN THE SELECTED SCHOOLS OF SIVAGANGAI DISTRICT”.
OBJECTIVES:

1. To identify the knowledge of teachers towards mental illness.

2. To identify the attitudes of teachers towards mental illness.

3. To find out the relationship between knowledge and attitude of

teachers towards mental illness.

4. To find out the association between the knowledge of teachers

towards mental illness with demographic variables such as age,
gender, education, locality and previous experience of mentally
ill patients.

5. To find out the association between attitude of teachers towards

mental illness with demographic variables such as age, gender,
education, locality and previous experience of mentally ill
patients.
 2

HYPOTHESIS:

There will be a significant relationship between knowledge and

attitude of teachers towards mental illness.

There will be a significant association between knowledge of

teachers with selected demographic variables such as age, gender,
education, locality and previous experience with mentally ill
patients.

There will be a significant association between attitude of teachers

towards mental illness with selected demographic variables such as
age, education, locality and previous experience with mentally ill
patients.

OPERATIONAL DEFINITIONS:
KNOWLEDGE:
Information possessed by the teachers regarding the nature of mental
illness and comprehension about mental health which is measured by self
administered questionnaire.

ATTITUDE:
Favorable and unfavorable feelings, concern, opinion and views of
teachers towards mental illness.

MENTAL ILLNESS:
Mental illness is said to be unsuccessful adaptation to stressors from
the environment, evidenced by deviated thoughts, feelings, and behaviors.
 2

TEACHERS:

Individuals are trained to teach in the higher secondary schools of

Sivagangai district.

ASSUMPTIONS:

1. Teachers working in higher secondary schools may have

inadequate knowledge about mental illness and at times may elicit
negative attitudes like fear and violence.

2. The teachers who have previous experience or idea about mental

illness may perceive mentally ill as less dangerous.

3. The knowledge and attitude towards mentally ill differs in each

individual.

4. Participants may feel hesitant to reveal true information on the

questionnaires.

DELIMITATIONS:

1. The study covers those who are working in higher secondary

schools.
2. Those are available and willing to participate at the time of
study.
 3

PROJECTED OUTCOME:

The study gives the clear understanding of the knowledge and

attitudes of teachers towards mental illness. The outcome of the study helps
the mentally ill patients in the community. Teachers formulate appropriate
positive attitudes towards psychiatric patients. Awareness of mental illness
reduces the stigmatization of people with mental disorders.
 3

CONCEPTUAL FRAMEWORK:

The conceptual framework is a group related ideas, statements or

concepts. The term conceptual model is often used interchangeably with
conceptual framework, and sometimes with grand theories, those that
articulate a broad range of significant relationship among the concepts of a
discipline (Kozier Barbara 2005).

The conceptual framework serves as a springboard for theory

development, theoretical and context, the importance of the study, where a
model symbolically represents a phenomenon. The present study is aimed at
assessing the knowledge, attitude regarding mental illness among teachers.

The conceptual framework for this study is based on Health Belief

Model. Health beliefs are person’s opinions and attitude about the health and
illness. They may be based on factual information and using information.

Rosenstock (1974), Beckers Health Belief Model addressed the

relationship between the person’s belief and behavior. It is a way of
perception and understanding of teachers in relation to knowledge and
attitude towards mental illness. This model helps the nurses to understand
various behaviors including individual perception, belief and various
behaviors in order to plan the most effective care in this context the
investigator felt that the Becker’s model is suitable as conceptual framework
for this study.

INDIVIDUAL PERCEPTION

The first component in this model is the individual perception of

susceptibility an illness in this study teachers perception regarding mental
 3

illness are thought to be influenced by age, sex, martial status, educational

status, previous experience with mental ill and family history, year of
experience, individual perception may very with these variables.

MODIFYING FACTOR

In this study modifying factor are the knowledge and attitude

regarding mental illness. These factors can be modified through health
education. The knowledge of teachers about illness was assessed with the
help of questionnaire. Attitude of teachers was assessed with the help of
orientation towards mental illness scale.

The knowledge level of teachers was graded as adequate, moderate

and inadequate knowledge. The attitude level of teachers was graded as most
favorable, favorable and unfavorable.

LIKELIHOOD OF ACTION

It refers to perceived benefit of preventive action minus perceived

threat of preventive action. In this study the individual perception and
modifying factor together influence perceived threat of diseases. The health
education should also be given based on teacher’s level of knowledge and
attitude. Therefore the investigator planned a health education using
different aids to improve teacher’s knowledge regarding mental illness.
 33

MODIFYING FACTORS.
INDIVIDUAL
CUES
PERCEPTION TO
ACTION

ADEQUATE
KNOWLEDGE

NURSING FOCUS:
DEMOGRAPHIC
VARIABLES: ASSESSMENT
MODERATELYADEQUATE HEALTH EDUCATION ON:
OF
KNOWLEDGE
AGE TEACHERS
MENTAL ILLNESS,
KNOWLEDGE
GENDER CAUSES OF MENTAL ILLNESS:
INADEQUATEKNOWLEDGE
EDUCATIONAL  MODIFYING FACTORS
QUALIFICATIO
N  NON MODIFYING
FACTORS
MARITAL
STATUS IMPORTANT INFORMATIONS
MOST FAVORABLE ATTITUDE ABOUT MENTAL ILLNESS.
RELIGION
MYTHS & MISCONCEPTIONS
LOCALITY ASSESSMENT
OF MENTAL ILLNESS.
OF TEACHERS
PREVIOUS ATTITUDE. FAVORABLE ATTITUDE
EXPERIENCE

FAMILY
UNFAVORABLE ATTITUDE

FIGURE 1. CONCEPTUAL FRAMEWORK BASED ON ROSENSTOCK’S (1974)

HEALTH BELIEF MODEL.
(MODIFIED)
 3

CHAPTER II

REVIEW OF LITERATURE

This chapter presents a review of selected literature relevant to the

present study. Review of literature is an important step in the development of
the research project, and in broadening the understanding and developing an
insight into the problem area. It further helps in developing the broad
conceptual context, in which the problem fits, methodology, construction of
tool, analysis of data.

The information gathered is categorized under the following heading:

Sec A: Literature related to knowledge towards mental illness
Sec B: Literature related to attitude towards mental illness.

SECTION A:

LITERATURE RELATED TO KNOWLEDGE TOWARDS

MENTALILLNESS:

Kaoru Yamamoto and Henry F.dizney (2005) conducted a study on

mental health knowledge among student teachers in two universities namely
university of Oregon and Lowa. A total of 180 student teachers were selected
using a four item questionnaire to assess their mental health knowledge.
Females gave consistently higher estimates than males, although both sexes
were ascribed incidence figures not significantly different from each other.
These results suggest needed improvement in the mental health education of
teachers.

Oye Gureje et al., (2005) carried out a community study of knowledge

and attitude to mental illness in Nigeria. A multistage clustered sample of
household respondents was studied in three states in the Yoruba – speaking
 3

parts of Nigeria. A total of 2040 individuals participated. Poor knowledge of

causation was common. Negative views of mental illness were widespread, with
as many as 96.5% believing that people with mental illness are dangerous
because of their violent behavior. Most would not tolerate even basic social
contacts with a mentally ill person. 82.7% would be afraid to have a
conversation with a mentally ill person and only 16.9% would consider
marrying one. There is widespread stigmatization of mental illness in the
Nigerian community. Negative attitudes to mental illness may be fuelled by
notions of causation that suggest that affected people are in some way
responsible for their illness, and by fear.

A.F. Jorm (2000) has done a study on public knowledge and beliefs
about mental disorders in Australia. A narrative review within a conceptual
framework method was used. The result shows that many members of the
public cannot recognize specific disorders or different types of psychological
distress. They differ from mental health experts in their beliefs about the causes
of mental disorders and the most effective treatments. Attitudes which hinder
recognition and appropriate help-seeking are common. Much of the mental
health information most readily available to the public is misleading. However,
there is some evidence that mental health literacy can be improved. In
conclusion, if the public's mental health literacy is not improved, this may
hinder public acceptance of evidence-based mental health care. Also, many
people with common mental disorders may be denied effective self-help and
may not receive appropriate support from others in the community.

Maureen Mickus, et al., (2000) the study explored knowledge of mental

health benefits and preferences for providers among the general public. Analysis
was based on a telephone survey of 1,358 adults randomly sampled throughout
Michigan in 1997–1998. The result shows a large proportion of the respondents
were uninformed about their mental health benefits. One-quarter of the sample
 3

were unsure if their health plan even included mental health services. Forty-
three percent of the sample believed that mental health benefits were equal to
benefits provided for general medical services. In answer to a survey question
that summarized payment restrictions for psychiatric services and counseling
under Medicare, nearly a quarter of older respondents indicated that they would
not seek care even when needed. In the overall sample, the majority of
respondents said they would initially seek care from their primary care
physician for a mental health problem, although responses varied by age.
Persons over age 65 were significantly more likely to seek assistance from their
primary care doctor than were younger persons. The study concludes the general
public lacks information about important mental health benefits, and this lack of
information may represent a barrier in their seeking care when needed. Given
the overriding preference for primary care providers to treat mental health
problems, particularly among older adults, mental health issues should be given
more attention at all levels of primary care education.

SECTION B:

LITERATURE RELATED TO ATTITUDE TOWARDS MENTALLY

ILL PEOPLE.

Pol Merkur Lekarski, (2009) completed a study on stigma and related

factors in Poland. In his study the most important socio – demographic factors
influencing attitudes towards mentally ill people exemplified them by scientific
literature on mental illness stigma. Profession, frequency of contact with
mentally ill persons, level of mental health literacy, own experience, education
level, culture - related factors, over all orientation, gender and age are the most
 3

relevant factors which influence perception of people suffering from mental

disorders. Majority of campaigns concerning change of attitude towards
mentally ill people consist in enhancement of mental health awareness in
society.

Mansouri et al; (2009) have done a study on the change in attitude and
knowledge of health care personnel and general population in the Iran Medical
University. Electronic bibliographic databases were used. The result of the
study shows that six articles met the inclusion criteria and entered the review.
All of these studies showed an improvement in the attitude and knowledge of
the studied population. It is concluded that a short term training improved
knowledge and attitude of the population and health personnel immediately
after the intervention. There is also evidence for a long term change in the
attitude and knowledge of general population after short term training.

Adewuya Ao, Makanjuola ro. (2008) has done a study on social

distance towards people with mental illness in southwest Nigeria. A cross –
sectional survey was carried out in which 2078 samples were selected from
three different communities. Social distance towards people with mental illness
was measured with a modified version of the Bogardus Social distance Scale.
The study findings showed that level of desired social distance towards the
mentally ill was seen to increase with the level of intimacy required in the
relationship, with 14.5% of the participants categorized as having low social
distance, 24.6% as having moderate social distance and 60.9% as having high
social distance towards the mentally ill. There is an emerging evidence of a high
level of social distance and stigmatization of mental illness in sub – Saharan
Africa. There is need to incorporate anti – stigma educational programmes into
the mental health policies of countries in Sub – Saharan Africa. Such policy
 3

should include community education regarding the causation, manifestation,

treatment and prognosis of mental illness.

Des Courtis N et al., (2008) made a study on Beliefs about the mentally
ill: a comparative study between healthcare professionals in Brazil and in
Switzerland. Mental health professionals presented a case vignette describing a
person suffering from a major depression as well as related treatment proposals.
Furthermore, general attitudes towards people with mental illness were
assessed. Study finding shows that both samples had scores for social
acceptance. Brazilian mental health professionals displayed a more positive
attitude towards community psychiatry whereas the Swiss sample showed more
stigmatization and social distance, and a more positive attitude towards
psychopharmacology. Recognition of the case vignette was significantly better
in Brazil than in Switzerland (94.7% versus 71%). Mental health professionals
in Brazil were more conservative/medically oriented in their treatment
propositions whereas professionals from Switzerland also proposed social
interventions and alternative treatment strategies. It is identified that there are
some major differences in attitudes towards people with mental illness between
mental health professionals in Switzerland and Brazil. With respect to
therapeutic interventions, the different healthcare systems as well as the cultural
differences seem to have an impact.

Adewuya Ao, Oguntade AA, (2007) completed a study on Doctor’s

attitude towards people with mental illness in Western Nigeria. Total of 312
Medical Doctors from eight select health institutions participated in this study.
It had been suggested that those more knowledgeable about mental illness are
less likely to endorse negative or stigmatizing attitudes. The study reports that
beliefs in supernatural causes were prevalent. The mentally ill were perceived as
dangerous and their prognosis perceived as poor. High social distance was
found amongst 64.1% and the associated factors include not having a family
 4

member /friend with mental illness (OR 7.12, 95% CI 3.71- 13.65), age less
than 45 years (OR 2.33, 95% CI 1.23- 4.40), less than 10 years of clinical
experience (OR 6.75, 95% CI 3.86- 11.82) and female sex (OR 4.98, 95% CI
2.70- 9.18). Significant finding of this study in culturally enshrined beliefs
about mental illness were prevalent among Nigerian doctors. A review of
medical curriculum is needed and the present anti-stigma campaigns should
start from the doctors.

Angermeyer Mc, Dietrich s. (2006) prepared a review of population

based attitude research in psychiatry during the past 15 years. An electronic
search of the literature was carried out for studies on public beliefs about mental
illness and attitudes towards the mentally ill published between 1990 and 2004.
Thirty three national studies and 29 local and regional studies were identified,
mostly from Europe. Although the majority are of descriptive nature, more
recent publications include studies testing theory – based models of the
stigmatization of mentally ill people, analyses of time trends and cross –
cultural comparisons, and evaluations of anti stigma interventions. Their review
reveled that attitude research in psychiatry has made considerable progress over
15 years. The authors concluded that there is much to be done to provide an
empirical basis for evidence – based interventions to reduce misconceptions
about mental illness and improve attitude towards persons with mental illness.

R.A. Olade (2006) had done a comparative study on attitudes towards

mental illness among post – basic nursing students with science students in
Canada. Totally 37 registered general nurses from the Faculty of Medicine and
15 science students from the Faculty of Science participated. Responses on the
OMI scale questionnaire items on attitudes towards mental illness were
examined. The study result shows that nurses scored higher on interpersonal
etiology and mental hygiene ideology.
 4

Bell et al. (2006) completed a comparative study on pharmacy students’

attitudes toward types of mental illnesses and provision of services in Florida.
Convenient sampling technique was used. Pharmacy students at two urban
schools of pharmacy were recruited. A total of 314 students were participated in
this study. Study results show that students have less stigma for depression and
schizophrenia than others in pharmacy .Students significantly more willing to
provide services to those with asthma than mental illness. Findings of the study
clearly indicate the need for developing effective strategies to reduce stigma of
mental illness among pharmacy students.

Buizza C, et al, (2005) carried out a study on Community attitudes

towards mental illness and socio – demographic characteristics in Italy. This
study aimed to assess the association between socio – demographic
characteristics and community attitudes towards mentally ill people. Stratified
sampling method was used. Totally 280 subjects were selected and conducted
by telephone. Finally, 174 subjects expressed their willingness to collaborate.
The instruments used were: a semi structured interview; the Community
Attitudes to the mentally ill (CAMI) inventory, which is composed by 40
statements. The results of this study outline the need to promote interventions
focused to improve the general attitude towards people with mental illness and
to favor specific actions in order to prevent or eliminate prejudices in subgroups
of the population.

Lauber C, Carlos N, Wulf R. (2005) study on Lay believes about

treatments for people with mental illness and their implications for anti stigma
strategies. Survey method was used to cover the total subjects of 1737. The
result of this study shows that medical treatment proposals are influenced by
adequate mental health literacy; however, they are also linked to more social
distance toward people with mental illness.
 4

Angermeyer and Matschinger, (2004) examined if public attitudes have

improved over the last decade or not. In 2001, a representative survey was
carried out among the adult population of the “old” Federal Republic of
Germany using the same methodology as in a previous survey in 1990.
Regarding emotional reactions of the respondents towards people with
depression, the findings were inconsistent. While there was an increase in the
readiness to feel pity and also a slight increase in the tendency to react
aggressively, the expression of fear remained unchanged. The public’s desire
for social distance from people with depression was as strong in 2001 as it had
been in 1990.

Ahmad H, Mas Ayu, Rawiyah R (2004) conceded a comparative study

on attitudes of paramedics towards mentally ill patients at University of Malaya
Medical centre, Kuala Lumpur. The study was carried out at two hospitals. The
samples comprised of 95 paramedics from a general hospital and 69 paramedics
from a mental institution. The two dependent measures (social distance scale
and dangerousness scale) were used to assess the attitude of paramedics towards
mental illness. The results of the study suggested that before the paramedics can
educate the public about mental illness, they themselves must be able to
understand and must not have a negative attitude towards the mentally ill.

Mohammed Kabir et al, (2004) had done a study on perception and

beliefs about mental illness among adults in northern Nigeria. Totally 250 adults
participated in this study. A cross sectional study design was used. The study
result shows that almost half of the respondents harbored negative feelings
towards the mentally ill. Literate respondents were seven times more likely to
exhibit positive feelings towards the mentally ill as compared to non – literate
subjects (OR = 7.6, 95% confidence interval = 3.8 – 15.1). This study
 4

demonstrates a that better understanding of mental disorders among the public

would allay fear and mistrust about mentally ill persons in the community as
well as lessen stigmatization towards such persons.

Mistic and Turan, (2003) examined the opinions and attitudes of first
and final year medical students towards mentally ill patients in order to compare
the attitudes of the two groups to see the effects of medical education and
confronting of the patients, and to evaluate the stigmatization of the mentally ill
by future medical professionals. A questionnaire comprising 19 questions
regarding opinions and attitudes towards mental illness was administered to the
first and final year medical students. There were 308 students who filled out the
questionnaire, which was 81% of the total of first and final year students.
Observation and talking were the most common preferred choices in both of the
groups, for recognizing a psychiatric patient. The final year student’s felt more
indifferent, less fear, and less compassion when they saw a psychiatric patient.

Samir Al – Adwi et al, (2002) did a comparative study on perception of

and attitude towards mental illness among medical students and the relatives of
psychiatric patients in Oman. The study found no relationship between attitudes
towards patients with mental illness, and demographic variables such as age,
education level, marital status, sex and personal exposure to people with mental
illness. Both medical students and the public rejected a genetic factor as the
cause of mental illness; instead they favored the role of spirits as the etiological
factor for mental illness. There were favorable responses on statements
regarding value of life, family life, decision making – ability, and the
management and care of mental illness. In conclusion, this study largely
supports the view that the extent of stigma varies according to the cultural and
sociological backgrounds of each society.
 4

Chung Kf, Chen Ey, Liu CS., (2001) conducted a study on University
students’ attitudes towards mental patients and psychiatric treatment in Hong
Kong. Random sampling techniques were used and totally 308 university
undergraduates participated in this study. The study finding shows that greater
social distance was associated with non medical field of study, no previous
contact with the mentally ill and female gender. Subjects without previous
contact with mentally ill individuals kept greater distance from a discharged
mental patient receiving psychiatric care than a mental patient who did not
require medications or psychiatric follow - up. They have concluded that
reducing stigmatization was discussed.

Kai – Fong Chan (2000) carried out a study on sex differences in

opinion towards mental illness of secondary school students in Hong Kong. A
total of 2,223 secondary school students, drawn by a random sample, completed
a 45 – item questionnaire on Opinion about Mental Illness in Chinese
Community with a six point Likert Scale. Results showed that girls scored
higher regarding benevolence. Boys were found to have more stereotyping,
restrictive, pessimistic, and stigmatizing attitudes mental illness.
 4

CHAPTER III
RESEARCH METHODOLOGY

This chapter deals with the description of different steps which are taken
by the investigator for the present study. It includes research approach, setting,
and sampling, sampling techniques, tools for data collection, pilot study and
plan for data collection.

RESEARCH APPROACH:
Research approach used for this study is quantitative approach.

RESEARCH DESIGN:
The research design used for the study is descriptive design.

SETTING OF THE STUDY:

The study was conducted at selected schools in Sivagangai District.
Totally two school teachers participated in this study.
The okur velayan chettiyar (O.V.C.) higher secondary school is
approximately 4 km away from Matha College of Nursing. The student strength
is around 750. The school comprise of 46 teachers. The 30 male teachers + 16
female teachers. It is a co - education school consists of 37 sections from 6 th to
12th standard. The school functions from 9am to 4.30pm.

The Government Girl’s Higher Secondary School at Manamadurai. This

is about 6- 8 km away from Matha College of Nursing. Total students strength
is roughly 2500. There are 50 teachers out of which 10 are male and the
remaining 40 are female teachers. There are about 30 sections from 6th to 12th
standard. The school functions from 9am to 4.30pm.

POPULATION:
The target population selected for this study comprised of teachers
working in higher secondary schools.
 4

SAMPLE SIZE:
The aggregate of 60 teachers were selected for this study.

SAMPLING TECHNIQUE:
The sampling technique used in the study is convenient sampling. This
entails the use of most readily available teachers in study until the desired
sample size is reached. Considering the short span of time available for
research the investigator used this method of sample selection so that the
required sample size is achieved.

CRITERIA FOR SAMPLE SELECT

INCLUSION CRITERIA:
1. Teachers who work in higher secondary schools.
2. Teachers of both sexes.
3. Those are willing to participate.
4. Those who have more than two years of experience as a teacher.

EXCLUSION CRITERIA:
1. The subjects who are recently appointed.
2. Those who are not willing to participate in the study.
3. Teachers who are not available and on long leave.

TECHNIQUE AND TOOL:

According to Treeca T. the instrument selected in the research should as
far as possible be the vehicle that would best obtaining data for drawing
conclusions pertinent to the study.

DEVELOPMENT OF THE TOOL:

The knowledge questionnaire constructed by the researcher is based on

the facts about mental illness. This consists of causes, treatment, facilities,
 4

human rights, law related to mental illness and rehabilitation. Totally 20 items
are used to assess the knowledge. In order to assess the attitude towards mental
illness ORIENTATION TOWARDS MENTAL ILLNESS SCALE (PRABHU 1983)
was modified and used. Expert’s opinion and suggestions were also taken for
the development of the tool.

DESCRIPTION OF THE STUDY TOOL:

SECTION I
Demographic variables such as age, religion, educational status,
occupation, place of work, years of experience.

SECTION II

PART I

Semi structured questionnaire was used to assess the knowledge towards

mental illness.

PART II

ORIENTATION TO THE MENTAL ILLNESS SCALE (OMI) (PRABHU,

1983). MODIFIED:

The tool was developed by Prabhu (1983). It is a 67-item scale, was

modified by the researcher which aims at measuring the individual’s orientation
to mental illness. It is most useful while measuring the orientation of an Indian,
urban, literate, English speaking, and lay population. It taps various aspects of
orientation to mental illness. The original scale provides scores on 13 factors,
which can be grouped into four areas. The modified scale consists of 30 items.
It has 22 negative statements, 4 positive statements, 4 no opinion statements.
The 5 point Likert scale has been used to measure the ratings. This scale has a
maximum score of 150.
 4

SCORE INTERPRETATION:
SECTION I

The demographic variables are not scored, but used for descriptive
analysis.

SECTION II

PART I

The knowledge questionnaire consists of 20 items. The format is true or

false. In this 1 indicates the correct response and 0 indicates incorrect response.
Based on the score knowledge were categorized as adequate knowledge,
moderately adequate knowledge, and inadequate knowledge. Those scored
above 12 consider as people of adequate knowledge, the score of 10 – 12
consider as people of moderately adequate knowledge and the score of below 10
regarded as inadequate knowledge.

PART II

The attitude was scored on a 5-point Likert format ranging from 1-5, where
one indicates complete disagreement; five indicates complete agreement and
three indicates uncertainty with the item. The higher the score, the greater the
degree of favorable orientation towards mental illness indicated. Approximately
25 minutes is needed for the administration of scale. Based on the score it has
been categorized as most favorable attitude, favorable attitude and unfavorable
attitude. The score of above 106 regarded as most favorable attitude, the score
of 80 – 106 measured as favorable attitude, and below 80 regarded as
unfavorable attitude towards mental illness.
 4

TESTING OF THE TOOL:

VALIDITY:

The constructed tool along with blue print and objectives of the study
were given to five experts for content validity. After establishment the validity
of the tool was translated into Tamil and again translated into English to
validate the language.

RELIABILITY:
The test retest method was used to establish the reliability of the
questionnaire to assess the problems faced by teachers. The knowledge score
reliability was r = 0.46. The modified form of orientation scale reliability r =
0.49. This ‘r’ values was found to be reliable.

PILOT STUDY:
The pilot study was conducted with the Government Higher Secondary
School teachers. The study was carried out on six teachers who fulfilled the
inclusion criteria of the sample. It was carried in the similar way as the final
study would be done. In order to test the feasibility and practicability, it was
conducted after obtaining permission from the school. The results were
analyzed based on the score obtained by the teachers and the study was found to
be feasible.

PROCEDURE FOR DATA COLLECTION:

The data was collected for a period of six weeks in Manamadurai schools.
The time scheduled for data collection was from 10am to 3pm. Before the data
collection the investigator obtained the formal permission from the Head
Masters of each school. The investigator entered the staff room at 10am. The
available teachers were explained about the purpose of the study the consent
was obtained. The questionnaire was circulated and collected back within 25
minutes. In a day the investigator could able to collect 3 – 4 teachers. The
 5

teacher’s knowledge was assessed through interview by using semi structured

knowledge questionnaire. Similarly the attitude of teachers was assessed by
using modified form of orientation towards mental illness scale. A total of 60
subjects participated who fulfilled inclusion criteria. The average time taken for
the interview was approximately 25 minutes. On completion of the
questionnaire each one has given time to clarify one’s doubts.

DATA ANALYSIS:
The data were statistically analyzed by using descriptive (frequency,
percentage, mean) and inferential statistics. Descriptive statistics was used to
find the level of knowledge and attitude. Chi square test was used to find out the
association between demographic variables and knowledge, attitude.
Correlation co – efficient ‘r was computed to find out the relationship between
knowledge and attitude.

PROTECTION OF HUMAN SUBJECTS:

The study was done after the approval of the dissertation committee.
Permission was obtained from the Head Masters of each school. Verbal consent
was obtained from the subjects and assurance was given to the subjects that
confidentiality would be maintained.
 5

CHAPTER IV

DATA ANALYSIS AND INTERPRETATION OF DATA:

This chapter deals with statistical analysis. Statistical analysis is a method

of rendering quantitative information in meaningful and intelligible manner.
Statistical procedure enables the researcher to organize, analyze, evaluate,
interpret and communicate numerical information meaningfully.

OBJECTIVES:
1. To identify the knowledge of teachers towards mental illness.
2. To identify the attitudes of teachers towards mental illness.
3. To find out the relationship between knowledge and attitude of teachers
towards mental illness.
4. To find out the association between the knowledge of teachers towards
mental illness with demographic variables such as age, gender, education,
locality, previous experience with mentally ill patients.
5. To find out the association between attitude of teachers towards mental
illness demographic variables such as age, gender, education, locality,
previous experience with mentally ill patients.

PRESENTATION OF DATA:
The data about knowledge and attitude of mental illness among teachers
were collected and was tabulated, analyzed and interpreted under the following
sections.
 5

SECTION I
Distribution of demographic variables of teachers.

SECTION II
 Frequency and percentage distribution of knowledge regarding
mental illness among teachers.

 Frequency and percentage distribution of attitude regarding mental

illness among teachers.

SECTION III
Relationship between knowledge and attitude regarding mental illness
among teacher.

SECTION IV:
Association between knowledge and demographic variables.

SECTION V:
Association between attitude and demographic variables.
 5

SECTION: I
TABLE I
Frequency and percentage distribution of teachers on the basis of
demographic variables.

DEMOGRAPHIC
S.NO. FREQUENCY PERCENTAGE %
CHARACTERISTICS
1. AGE IN YEARS:
1. Below 30 years. 15 25
2. 31 – 40 years. 34 56.7
3. 41 – 50 years 8 13.3
4. 50 and above 3 5
2. GENDER:
1. Male 31 51.7
2. Female 29 48.3
3. RELIGION:
1. Hindu 46 76.7
2. Christian 14 23.3
3. Muslim - -
4. Others - -
4. MARITAL STATUS:
1. Unmarried 10 16.7
2. Married 49 81.7
3. Widow 1 1.7
4. Divorced - -
5. EDUCATIONAL STATUS:
1. Undergraduate 18 30
2. Postgraduate 42 70
 5

6. LOCALITY:
1. Rural 25 41.7
2. Urban 35 58.3
7. PLACE OF WORK:
1. Private school 42 70
2. Government school 18 30
8. PREVIOUS EXPERIENCE:
1. Yes 26 43.3
2. No 34 56.7
FAMILY HISTORY:
9. 1. Yes 1 1.7
2. No 59 98.3

Table I reveals that out of 60 teachers 15(25%) were below 30 years,

34(56.7%) teachers were between 31- 40 years, 3(5%) fell in the category of 50
years and above.

The gender distribution shows that the male participants were 31(51.7%),
and female were 29(48.3%).

The great majority of teachers were Hindus 46(76.7%), 14(23.3%) were

Christians.

The percentage of unmarried teachers was 10(16.7%), married 49(81.7%)

and widow 1(1.7%).
With regard to educational status of teachers 18(30%) were
undergraduates and 42(70%) were postgraduates.

Regarding the residence of teachers 25(41.7%) belonged to rural area

and 35(58.3%) were from urban area.
 5

Place of work reveals that 42(70%) teachers were from private school and
18(30%) were from Government school.

With respect to previous experience of teachers, 34(56.7%) had no

experience with mental illness 26(43.3%) had known someone with mental
illness.

Majority of 59(98.3%) had no family history of mental illness. And

1(1.7%) had family history of mental illness.

Figure 2: Distribution of the samples in terms of age in years.

 5

Figure 3. Distribution of the samples in terms of gender.

Figure 4. Distribution of samples according to religion.

 5

Figure 5. Distribution of samples according to their marital status.

Figure 6. Distribution of samples according to their educational status.

 5

Figure 7. Distribution of samples on the basis of locality.

Figure 8. Distribution of samples on the basis of place of work

 5

Figure 9. Distribution of samples on the basis of previous experience.

Figure 10. Distribution of samples in terms of family history.

 6

SECTION: II
TABLE II - LEVEL OF KNOWLEDGE:
Frequency and percentage distribution of knowledge regarding mental illness
among teachers.

LEVEL OF FREQUENCY
PERCENTAGE
S.NO. KNOWLEDGE N=60

Low 16 26.7
1.
2.
Medium 40 66.7
3.
High 4 6.7

Table II reveals that majority of the subjects 40(66.7%) had moderately

adequate knowledge, 16(26.7%) had inadequate knowledge and 4(6.7%) had
adequate knowledge.

TABLE III – LEVEL OF ATTITUDE:

LEVEL OF FREQUENCY
PERCENTAGE
S.NO. ATTITUDE N=60
1. Unfavorable 9 15
2. Favorable 41 68.3
3. Most favorable
10 16.7

Table III shows that 41(68.3%) had favorable attitude towards mental
illness, 10(16.7%) had most favorable attitude and 9(15%) had unfavorable
attitude towards mental illness.
 6

Figure 11. Distribution of samples in terms of level of knowledge

Figure 12. Distribution of samples in terms of attitude.

 6

SECTION III:

TABLE IV – CORRELATION BETWEEN KNOWLEDGE AND

ATTITUDE REGARDING MENTAL ILLNESS AMONG TEACHERS.

STATISTICAL
S.NO. VARIABLES
RESULTS
r = .957**
1. Knowledge and Attitude

Table IV indicates that, there is a positive correlation between knowledge

and attitude (r =.957). It implies that, the higher the knowledge, the more
favorable attitude. There is a significant relationship between the knowledge
and attitude. The research hypothesis accepted.
 6

SECTION IV:

TABLE V – ASSOCIATION BETWEEN THE KNOWLEDGE AND

DEMOGRAPHIC VARIABLES:

S. KNOWLEDGE
NO. Chi-
DEMOGRAPHIC VARIABLES LOW MEDIUM HIGH Square
% %
F F F %
1. AGE:
1) Below 30 years 11 18.3 4 6.7 0 0
2) 31 – 40 years 3 5 31 51.7 0 0 49.146**
3) 41 – 50 years 1 1.7 5 8.3 2 3.3
4) 50 years and above. 1 1.7 0 0 2 3.3
GENDER:
2. 1) Male 8 13.3 19 31.7 4 6.7 4.038
2) Female 8 13.3 21 35.0 0 0 #
3. RELIGION:
1) Hindu 11 18.3 31 51.7 4 6.7 1.793
2) Christian 5 8.3 9 15 0 0 #
4. MARITAL STATUS:
1) Unmarried 3 5 7 11.7 0 0 1.404
2) Married 13 21.7 32 53.3 4 6.7 #
3) Widow 0 0 1 1.7 0 0
5. EDUCATIONAL STATUS:
1) Undergraduate 12 20.0 6 10.0 0 0
2) Postgraduate 4 6.7 34 56.7 4 6.7 21.429**

6. LOCALITY:
1) Rural 14 23.3 11 18.3 0 0
2) Urban 2 3.3 29 48.3 4 6.7 19.989**

7. PLACE OF WORK:
1) Private School 10 16.7 28 46.7 4 6.7 2.143
2) Government school 6 10.0 12 20.0 0 0 #
8. PREVIOUS EXPERIENCE:
1) Yes 2 3.3 21 35.0 3 5.0 9.197**
2) No 14 23.3 19 31.7 1 1.7
9. FAMILY HISTORY:
1. Yes 0 0 1 1.7 0 0 .508
2. No 16 26.7 39 65.0 4 6.7 #

NOTE: ** Indicates highly significant.

# Indicates not significant.
 6

Table V shows that, there is a significant association between knowledge

of teachers toward mental illness and demographic variables such as age,
education, locality, previous experience at the level of p<0.01. The above
findings support the research hypothesis.

Unexpectedly, there is no consistent association observed between the

knowledge and demographic variables such as gender, religion, marital status,
place of work, family history at the level of p>0.05. The above findings fail to
support the research hypothesis so the researcher accepts the null hypothesis.
 6

SECTION V:
TABLE VI – ASSOCIATION BETWEEN THE ATTITUDE AND
DEMOGRAPHIC VARIABLES:

ATTITUDE
S.
DEMOGRAPHIC LOW MEDIUM HIGH Chi-
NO.
VARIABLES %
Square
F % F F %
1. AGE:
1. Below 30 years 7 11.7 7 11.7 1 1.7
24.122**
2. 31 – 40 years 2 3.3 28 46.7 4 6.7

3. 41 – 50 years 0 0 5 8.3 3 5.0

4. 50 years and above. 0 0 1 1.7 2 3.3

2. GENDER:
1. Male 5 8.3 19 31.7 7 11.7 1.866
#
4 6.7 22 36.7 3 5.0
2. Female
RELIGION:
3. 1. Hindu 6 10.0 32 53.3 8 13.3 .609
#
2. Christian 3 5.0 9 15.0 2 3.3

4. MARITAL STATUS:
1. Unmarried 3 5.0 7 11.7 0 0

2. Married 6 10.0 34 56.7 9 15.0 8.512

#
3. Widow 0 0 0 0 1 1.7

5. EDUCATIONAL
STATUS:
9 15.0 8 13.3 1 1.7
1. Undergraduate 25.052**
0 0 33 55.0 9 15.0
2. Postgraduate
 6

6.
LOCALITY:
1. Rural 9 15.0 15 25 1 1.7 17.161**
2. Urban 0 0 26 43.3 9 15.0

7. PLACE OF WORK:
8 13.3 25 41.7 9 15.0
5.024
1. Private school
1 1.7 16 26.7 1 1.7 #

2. Government school
8. PREVIOUS
EXPERIENCE:
1. Yes 0 0 18 30.0 8 13.3 12.363**

2. No 9 15.0 23 38.3 2 3.3

9. FAMILY HISTORY:
0 0 1 1.7 0 0
1. Yes
.471
9 15.0 40 66.7 10 16.7 #
2. No

NOTE: ** Indicates highly significant.

# Indicates not significant.
Table VI shows the association between demographic variables and
attitude of teachers regarding mental illness. Significant association found in
age, education, locality, and previous experience at the level of p>0.01. The
above findings support the research hypothesis.

There were also inconsistent association between the attitude and

demographic variables such as gender, religion, marital status, place of work,
family history at the level of p<0.05. The above findings fail to support the
research hypothesis so the investigator accepted the null hypothesis.
 6

CHAPTER V
DISCUSSION

The aim of the research was to identify the knowledge and attitude
towards mental illness among teachers. The study was descriptive in nature. A
total of 60 teachers participated. A quantitative approach was used for the
present study. A convenient sampling technique was used to select the samples.
The data collection tools used were demographic profile, semi structured
knowledge questionnaire and modified form of orientation towards mental
illness scale (PRABHU 1983). The content validity and reliability was obtained
for the entire tool. The pilot study was done on 6 teachers who met the sampling
criteria.

The findings of the study have been discussed in terms of objectives and
hypothesis stated for the study.

The first objective was to identify the level of knowledge of teachers

towards mental illness.
In this study analysis shows that majority of the subjects 40(66.7%) had
moderately adequate knowledge, 16(26.7%) had inadequate knowledge and
4(6.7%) had adequate knowledge.

The present study was supported by the study conducted in the University
of Ibadan, Nigeria (2006). Erroneous beliefs about causation and lack of
adequate knowledge have been found to sustain deep – seated negative attitudes
about mental illness. Conversely, better knowledge is often reported to result in
improved attitudes towards people with mental illness. A belief that mental
illnesses are treatable can encourage early treatment seeking and promote better
outcomes. Thus, one can speculate that improved knowledge about causation
may lead to improved overall knowledge about mental illness and promote a
more tolerant attitude to the mentally ill.
 6

In conclusion, this study marks that poor knowledge about the cause and
nature of mental illness is common in the community. It is indicated among 60
teachers that only 16(26.7%) had adequate knowledge towards mental illness.

Even though there are many steps taken by the Indian Government to
treat and rehabilitate the mentally ill, stigma continue to persist and it’s still a
barrier for people with mental illness.

In a survey intended to examine changes in public beliefs about social

and environmental variables as risk factors for mental disorders in Australia and
Japan over an 8 year period.

Also, the Nigerian study reports that knowledge of mental illness was
generally poor. Consistent with the generally poor knowledge, attitudes to the
mentally ill were predominantly negative.

At the time of interview few teachers had shown interest to know about
mental illness. Others were keen on answering the questions asked but none of
them was clear about mental illness. The government motto is to integrating
public into the care of people with mental illness.

The second objective of the study was to identify the attitudes of teachers
towards mental illness.

The data analysis shows that 41(68.3%) had favorable attitude towards
mental illness, 10(16.7%) had most favorable attitude and 9(15%) had
unfavorable attitude towards mental illness.

The study statement tends to accept the World Mental Health Day
(WMHD) which falls on October 10th 2009, was created to educate and spread
vital information about mental health and forms of mental illnesses; the
 6

objectives of WMHD also seek to dispel myths and misconception, and to

remove the stigma surrounding mental illnesses. “Mental Health in Primary
Care: Enhancing Treatment and Promoting Mental health” forms the themes of
World Mental Health Day 2009.

The objectives seek to recognize the need to integrate mental healthcare

into mainstream healthcare to ensure universal access. This assumes all the
more importance in the light of the recent prediction made by the World Health
Organization, that in the next two decades, Depression is likely to be the
number one illness affecting millions of people worldwide. Mental illness is just
like any other illness – it needs medical care and support, not stigma.

The literate people like teachers are not much aware of mental illness and
its nature. For instance, the attitude scale has a question that if every mental
hospital must be surrounded by high fence and walls, for which most of the
respondents agreed and a few even strongly agreed. This scenario indicates
people do not dare to understand and care.
Contrary to expectation, this study shows negative attitudes towards
mental illness to be highly prevalent across many different groups in the
community.

The third objective was to find out knowledge and attitude of teachers
towards mental illness.

The subsequent hypothesis was there will be a significant relationship

between knowledge and attitude of teachers towards mental illness.

The study analysis marks that, there is a positive relationship between

knowledge and attitude (r =.957) It implies that, the higher the knowledge,
more the favorable attitude.
 7

The recent study supported by the report of Stigma in developing

countries – Srilanka revels that, stigmatizing attitudes may be encountered even
amongst educated groups of people. Stigmatization of the mentally ill is still a
very pertinent issue that has to be addressed worldwide and more community
based research needs to be done. Also poor knowledge about mental illness
seemed to pervade all segments of the community.

The fourth objective was to find out the association between the knowledge
of teachers towards mental illness with demographic variables such as age,
gender, education, religion, marital status, previous experience, family
history of mental illness.

The corresponding hypothesis was there will be a significant association

between knowledge of teachers with selected demographic variables such as
age, gender, education, locality, previous experience with mentally ill patients.
There is a significant association between knowledge of teachers toward
mental illness and demographic variables such as age, education, locality,
previous experience at the level of p<0.01.

Unexpectedly, no consistent association was observed between the

knowledge and demographic variables such as gender, religion, marital status,
place of work, family history at the level of p>0.05.

More recent research supports this objective. People with mental illness
are seen as ‘different’ - hard to talk with, and unpredictable. Gender makes no
difference to attitudes, nor does personal contact leads to more tolerant
attitudes.

The fifth objective was to find out the association between attitude of
teachers towards mental illness demographic variables such as age, gender,
education, locality, previous experience with mentally ill patients.
 7

The corresponding hypothesis was there will be a significant association

between attitude of teachers towards mental illness with selected demographic
variables such as age, education, locality, previous experience with mentally ill
patients.

There was a significant association between demographic variables with

attitude of teachers regarding mental illness, such as age, education, locality,
and previous experience at the level of p>0.01.

There were also inconsistent association between the attitude and

demographic variables such as gender, religion, marital status, place of work,
family history at the level of p<0.05.
This current study is supported by, Shusrut Jadhav et al’s (2007) study on
Stigmatization of severe mental illness in India. This study shows greater stigma
and a punitive attitude among rural Indians as compared to urban Indians. It also
represents Urban Indians reported a more liberal and tolerant attitude but were
also more excluding of those with mental illness at work.

This small scale project is the reflection of public knowledge and attitude
towards mental illness. Dr. Narendranath Wig is an eminent Psychiatrist from
Chandigarh. He highlights that, the first step in promoting mental health is to
encourage awareness among public about the importance of mental health in
life. Secondly, stigma and prejudice associated with mental disorders should be
reduced.

The status of mental health is not very encouraging in India. Primarily

because of stigma attached to the problem. To get more people to access mental
health care there is urgent need for education and information about mental
health problems.
 7

CHAPTER VI
SUMMARY, FINDINGS, IMPLICATIONS, RECOMMENDATIONS,
AND CONCLUSION

The aim of the study was to investigate the knowledge and attitude of the
school teachers towards mental illness, specifically causes of mental illness,
treatment and misconceptions.

The study design was discriptive. Semi structured knowledge

questionnaire and modified form of attitude scale were used with a group of
teachers. After assessing the knowledge a self instructional module was set to
create awareness about mental illness. The data was grouped and analyzed using
descriptive statistics and inferential statistics.

OBJECTIVES OF THE STUDY:

The objectives of the study were;
1. To identify the knowledge of teachers towards mentally illness.
2. To identify the attitudes of teachers towards mental illness.
3. To find out the relationship between knowledge and attitude of
teachers towards mental illness.
4. To find out the association between the knowledge of teachers
towards mental illness with demographic variables such as age,
gender, education, locality and previous experience with mentally ill
patients.
5. To find out the association between attitude of teachers towards
mental illness demographic variables such as age, gender, education,
locality and previous experience with mentally ill patients.
 7

HYPOTHESIS:
The level of significance chosen for all the hypothesis was 0.05 level and
samples selected for the study purpose were teachers those are working in
higher secondary schools.
H1: There will be a significant relationship between knowledge and attitude
of teachers towards mental illness.

H2: There will be a significant association between knowledge of teachers with

selected demographic variables such as age, gender, education, locality,
previous experience with mentally ill patients.

H3: There will be a significant association between attitude of teachers towards

mental illness with selected demographic variables such as age, education,
locality, previous experience with mentally ill patients.

Conceptual framework used for the study was based on Health Belief
Model of Rosenstock (1974). A quantitative approach was used for the present
study. The study population comprised of teachers working in Sivagangai
District. A convenient sampling technique was used to select samples. The data
collection tools used were demographic profile, self administered knowledge
questionnaire, and modified form of attitude scale. The content validity and
reliability was obtained for the entire tool. The pilot study was done on 6
teachers who met the sampling criteria.

Analysis of the data was done on the basis of the objectives. The
descriptive and inferential statistics (SPSS) were used to analyze the data.
 7

MAJOR FINDINGS:
 Considerable number of teachers 15(25%) were below 30 years,
34(56.7%) teachers were between 31- 40 years, 3(5%) fell in the category
of 50 years and above.

 The gender distribution shows that the male participants were 31(51.7%),
and female were 29(48.3%).

 The great majority of teachers were Hindus 46(76.7%), 14(23.3%) were

Christians.

 The percentage of unmarried teachers was 10(16.7%), married 49(81.7%)

and widow 1(1.7%).

 With regard to educational status of teachers 18(30%) were

undergraduates and 42(70%) were postgraduates.

 Considering the residence of teachers, 25(41.7%) were from to rural area

and 35(58.3%) were from urban area.

 Place of work reveals 42(70%) teachers were from private school and
18(30%) were from Government school.

 Regarding the previous experience of teachers 34(56.7%) had no

experience 26(43.3%) had known someone with mental illness.

 Majority 59(98.3%) had no family history of mental illness. One (1.7%)

had family history of mental illness.
 7

 Majority of the subjects 40(66.7%) had moderately adequate knowledge,

16(26.7%) had inadequate knowledge and 4(6.7%) had adequate
knowledge.

 In case of attitude 10(16.7%) had most favorable attitude towards mental

illness, 41(68.3%) had favorable attitude and 9(15%) had unfavorable
attitude towards mental illness.

 There is a positive correlation between knowledge and attitude (r =.957).

It implies that, higher the knowledge, the more the favorable attitude.

 There was a significant association between knowledge of teachers

toward mental illness and demographic variables such as age, education,
locality, previous experience at the level of p<0.01.

 There was an association between demographic variables and attitude of

teachers regarding mental illness. Significant association found in age,
education, locality, and previous experience at the level of p<0.01.

IMPLICATIONS TO NURSING PRACTICE:

Nursing practice is moving towards multiple care settings that are based
in institutions, community and home care. Psychiatric nursing is a specialized
area of nursing practice employing theories of human behavior as its scientific
aspect and purposeful use of self as its art. It is directed toward both preventive
and corrective impacts upon mental illness and is concerned with the promotion
of optimum health for society.

NURSING EDUCATION:
The present study has implication on nursing education. Discrimination
against and the stigma of people with experience of mental illness is widespread
 7

(Sayce 1998; Crisp, Gender et al 2000). Discrimination occurs when a person is

treated differently from another person in similar circumstances. Therefore
nurses have to educate the public psychological underpinnings of psychiatric
disorders and about the value of human beings. A better understanding of these
disorders amongst the public would presumably lessen the stigmatization and
encourage the use of currently available and effective interventions.

NURSING ADMINISTRATION:
The findings of the study can help the administrators in preparing nurses
for counseling and teaching the public about mental illness and its management.
Policies can be made where the nurse plays an important role in raising
awareness, reinforce positive attitudes towards mental illness.

NURSING RESEARCH:
Attitude research in psychiatry made considerable progress over the past
15 years in developed countries. However, it is our culture and in our
institutions that the stigmatism of mental illness continues to persist. Continuing
research increase the general knowledge of the community with regard to
mental illness with the hope that their attitudes to the mentally ill can be
improved.

RECOMMENDATIONS:
 A similar study can be done in a large sample for the purpose of
generalization.
 A comparative study can be done with two groups.
 A study can be done in urban and rural setting and results can be
compared.
 A similar study can be carried out and anti – stigma educational
programs and campaigns may be conducted.
 A similar study can be conducted by the use of different attitude
scales.
 7

CONCLUSION

In India 15million people are battling serious mental health problems.

Nearly 50% of victims suffering serious mental health disorders go untreated.
The fortunate part is that most mental illnesses can be successfully treated. The
Government of India also has taken special interest in mental health care in the
form of National Mental Health Programme. Stigma is one of the major
difficulties faced by people with mental illness, due to which they hesitate
seeking help. The mental health services are not utilized by the beneficiaries
properly. Many of them suffer alone silently. By accident, we are all responsible
for this situation. The researcher strongly believes that appropriate information
of the mentally ill to the public and positive attitude would brings great changes
in the life of the mentally ill.
 7

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 8

INTERNET RESOURCES:

www.goole.com
 www.yahoo.com
 www.pubmed.com
 www.mentalhealth.com
 www.mentalhelp.net
 www.medline.com
 www.psychiatricnursing.com
 8

APPENDIX IV
PART – I DEMOGRAPHIC DATA
INSTRUCTIONS TO TEACHERS:
Read carefully, and give appropriate response in each column.
1. Age
a. Less than 30 years [ ]
b. 31-40 years [ ]
c. 41-50 years [ ]
d. 50 years and above [ ]
2. Gender
a. Male [ ]
b. Female [ ]
3. Religion
a. Hindu [ ]
b. Muslim [ ]
c. Christian [ ]
d. Others [ ]
4. Marital status
a. Single [ ]
b. Married [ ]
c. Divorced [ ]
d. Widow [ ]
5. Education
a. Undergraduate [ ]
b. Postgraduate [ ]
6. Locality [ ]
a. Rural [ ]
b. Urban
7. Place of work
a. Government school [ ]
b. Private school [ ]
8. Do you have any previous exposure with mentally ill patient
Yes / No
9. Do you have any family member suffering with mental illness
Yes / No
 8

APPENDIX V
PART – I
KNOWLEDGE QUESTIONNAIRE

Read the following statements carefully. If you feel the statement is correct put

a tic mark. If you feel the statements are incorrect put an (x) mark in the

bracket.

S.NO. KNOWLEDGE QUESTIONNAIRE YES NO

1. Mental health and physical health are like two of the

coin sides.

2. Mental illness is hereditary.

3.
Anybody under stress can become mentally ill.

4. By coming and contact with or living with mentally ill, on

mentally ill.

5. Only poor people suffer from mental illness.

6. Excess heat can cause severe mental illness.

7. It is safe to keep mentally ill persons inside the mental hos

8. A treated mentally ill person can work with responsibility

9. In addition to drugs, mental patients need love and encour

10. Mental illness can be treated in local hospital.

11. Once the drugs are prescribed patients need not consult th
again.
 8

S.NO. KNOWLEDGE QUESTIONNAIRE YES NO

12. Government Rajaji Hospital facilitates the treatment for

mentally ill.

13. There is a government mental hospital is located at

ayyanavaram Tamilnadu.

14. Alcohol and drug abuse also treatable in psychiatric unit.

15. Beating and locking the patient in a room is violation

against human rights.
16. If a person feels that he needs a psychiatric aid he/she
can admitted by self.
17. The person with unsound mind cannot give will/
witness.

18. Erwadi tragedy awakens the law makers of our country.

19. Medias portray mentally ill in a negative fashion.

20. There are rehabilitation centers for chronic and destitute

people.
 8

APPENDIX VI

PART III

ATTITUDE SCALE

ORIENTATION TOWARDS MENTAL ILLNESS SCALE

(PRABHU 1983) MODIFIED FORM:

On the following pages you will find a number of statements about

mental health problems. I want to know how much you agree or disagree with
each statements. To the right of each statement you will find a scale.

Disagree Agree
1 2 3 4 5
The points along the scale (1, 2, 3, 4 and 5) can be interpreted as follows.
1) Completely or strongly disagree
2) Disagree
3) Cannot say or do not know.
4) Agree
5) Completely or strongly agree

If you agree completely with a statement, than circle the number ‘5’
that is there on the right of the statement (but not completely disagree). Then
place the circle around the number ‘2’ in the scale. In this way you can indicate
whether you agree or disagree with each of the statement on the following
pages.

Like everyone else, you will probably feel that you cannot give an answer
to some of the statement. When that occurs make the guess that you can.
 8

Strongly No
Orientation scale Disagree Agree Disagree
S.No. Disagree Opinion
2 4 5
1 3
1 The cause of mental illness is divine
displeasure.
2 After an attack of mental illness, these
individual become very antisocial.
3 Practice of yoga prevents mental
illness.
4 After an attack of a mental illness the
patients loss a lot of weight.
5 Patients who had been a mental
hospital will never be their old selves
again.
6 Mentally ill individual are not at all
trust worthy.
7 To treat mental patient effectively, it
costs too much money.
8 Taking mentally ill to holy places
cures them.
9 Unmarried persons are less likely to
develop mental illness than married
persons.
10 Mental patients commit lot of crimes.
11 Those that have lost the parents during
childhood have a greater risk of
developing mental illness.
12 People look much older after they
recover from mental illness.
13 Every mental hospital must be
surrounded by high fence and walls.
14 Mentally ill persons are dangerous to
those around them.
15 Fasting cures mental illness.
16 The sexual habits of mentally ill
persons are very perverse.
Strongly No
Orientation scale Disagree Agree Disagree
S.No. Disagree Opinion
2 4 5
1 3
17 Regardless of have you look at it,
 8

patients with mental illness are no

longer really human.
18 Religious ceremonies help the patients
to come out of mental illness.
19 To treat a mental patient, the most
important thing is to teach him how to
control his emotions.
20 Ayurvedic medicines are very effective
in treating the mentally ill.
21 Mental illness is due to damaged or
diseased brain.
22 People become mentally ill when they
come under the influence of evil stars.
23 Mental illness is caused by the
influence of the moon.
24 Brain operation alone can cure mental
illness.
25 Electric shock therapy is the only
effective method of treatment available
to treat the mentally ill persons.
26 Mentally ill persons are incapable of
taking even minor decisions.
27 A person who had mental illness
cannot be a good partner.
28 Mental hospital must be situated far
away from the city.
29 Saliva usually dribbles from the mouth
of mentally ill persons.
30 If a person is dominated by others, he
is likely to develop mental illness.
 9

APPENDIX II

MATHA COLLEGE OF NURSING

VAANPURAM, MANAMADURAI, SIVAGANGAI Dt-630606

LETTER SEEKING PERMISSION TO CONDUCT STUDY IN

SIVAGANGAI DISTRICT.

To
The Head Master,
O.V.C. Higher Secondary School,
Manamadurai.

Respected Sir/Madam,
Sub: Project work of M.Sc (Nursing) student at selected schools in
Manamadurai

I am to state that Ms.Gnanaguruvammal.G is a final year M.Sc.,

Nursing student has to conduct a project, which is to be a partial fulfillment of
university requirement for the degree of Master of Science in Nursing.

The topic of research is “A study to assess the knowledge,

attitude towards mental illness among school teachers at Sivagangai
District.

Kindly permit her to do the research work in your esteemed institution

under your valuable guidance and suggestion.

Thanking you.

Prof. JEBAMANI AUGUSTINE, M.SC. (N)

PRINCIPAL
 9

APPENDIX I
LETTER SEEKING EXPERT’S OPINION FOR CONTENT VALIDITY

From
MS.Gnanaguruvammal.G
M.Sc., Nursing II year
Matha College of Nursing,
Manamadurai,

To

Respected sir/madam,

Sub:
Requesting opinion and suggestion of experts for content validity of “A
study to assess the knowledge, attitude towards mental illness among school
teachers at Sivagangai District.

I request you to kindly validate the tool and give your opinion for
necessary modification and also I would be very great full, if you could refine
the problem statement and the objectives.

ENCLOSURES:
 Statement of the problem
 Objectives
 Hypothesis
 Research tool

Thanking you.
 9

APPENDIX III
LIST OF EXPERTS CONSULTED FOR THE CONTENT VALIDITY
OF RESEARCH TOOL:
1. Prof. JEBAMANI AUGUSTINE M.SC. (N),
Principal,
Matha College of Nursing,
Manamadurai.
2. Dr. ARUN,
Senior Resident,
Department of Psychiatry,
NIMHANS
3. Dr. K. REDDAMMA, Ph.D,
Professor and Head,
Department of Nursing,
NIMHANS
Bangalore.
4. Dr. RAMACHANDRA,
Assistant professor,
Department of nursing,
NIMHANS
Bangalore.
5. Dr. NAGARAJAIAH,
Associate professor,
Department of nursing,
NIMHANS
Bangalore.
6. Dr. JAMUNA,
Assistant professor,
Department of mental health & social psychology,
NIMHANS
Bangalore.
7. Mr. RADHA KRISHNAN, M.sc.(N)
Principal,
Bharatesh College of nursing,
Belgam
 9

APPENDIX VIII
SELF INSTRUCTIONAL MODULE ON KNOWLEDGE AND
ATTITUDE TOWARDS MENTAL ILLNESS SOME FACTS ABOUT
MENTAL ILLNESS:

Good Morning,

Dear Teachers...

Indian Government has taken imperative steps to promote mental health and to
prevent mental illness. Practically mental health services are not utilized by the
beneficiaries properly. The reason behind is improper information and negative
attitude towards mentally ill. Partnership of local members and appropriate
information helps in the promotion of mental health and prevention of mental
disorders in the society.

CAUSES OF MENTAL ILLNESS:

MODIFIABLE FACTORS:

1. Excessive stress
2. Loneliness
3. Divorce
4. Frustration
5. Unemployment
6. Urbanization

NON MODIFIABLE FACTORS:

1. Hereditary
2. Those have lost the parents during childhood.
3. Childhood insecurities.
 9

4. Changes in the brain chemicals.

5. Personalities.

ESSENTIAL INFORMATION RELATE TO MENTAL ILLNESS:

 There is a government mental hospital is located at ayyanavaram

tamilnadu.
 Government Rajaji hospital at Madurai facilitates the treatment for
mentally ill.

Alcohol and drug abuse also treatable in psychiatric unit.

 9

 Beating and locking the patient in a room is violation against human

rights.
 If a person feels that he needs a psychiatric aid he or she can admitted by
self. This is called as voluntary admission. It is also encouraged by
psychiatric team.
 According to Indian constitution the person with unsound mind cannot
give will/ witness.
 The practice of yoga is not only for physical health, also necessary for
mental health.
 We must regard as mentally ill also human beings.
 Additional to electric shock therapy numerous treatment modalities are
also available.

MYTHS AND MISCONCEPTIONS ABOUT MENTAL ILLNESS:

 Mental illness is caused by supernatural power or evil spirit or curse.

 After an attack of mental illness, these individuals become very

antisocial.
 To treat mental patient effectively, it costs too much money.
 Mental hospitals must be surrounded by high fence and walls.
 Fasting cures mental illness.
 9

 Brain operation alone can cure mental illness.

 Saliva usually dribbles from the mouth of mentally ill persons.
 Mental patients commit lot of crimes.
 They are dangerous to those around them.

As a community member, we need to arm ourselves with information

concerning mental illness in order to assist the massive ill population in all
corners of the country. Societies have to remove the taboo status from mental
illness and learn acceptance and tolerance. The literate people like teachers must
assist mentally ill people to seek professional solutions as necessary.

This fraction of information may play a pivotal role in the life of a mentally
ill in our society.

THANK YOU.