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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE
A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED HEALTH TEACHING ON
THE KNOWLEDGE AND ATTITUDE OF STUDENTS TOWARDS PERSONS
SUFFERING FROM MENTAL ILLNESS IN SELECTED SCHOOLS IN BANGLORE
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
Mr. MOHAMMED ANWAR
BANGALORE CITY COLLEGE OF NURSING
BANGLORE-560043 (KARNATAKA)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE
SYNOPSIS
PROFORMA
FOR
REGISTRATION
OF
SUBJECTS
FOR
DISSERTATION
1
NAME OF THE CANDIDATE Mr. MOHAMMED ANWAR
AND ADDRESS
I YEAR M.Sc. NURSING STUDENT,
BANGALORE CITY COLLEGE OF NURSING
BANGALORE, KARNATAKA.
2
NAME OF THE INSTITUTION
BANGALORE CITY COLLEGE OF NURSING,
CHELIKERE
MAINROAD,
KALYAN
NAGAR,
BANGALORE, KARNATAKA.
3
COURSE OF STUDY AND
SUBJECT
4
DATE OF ADMISSION TO THE
MASTER OF SCIENCE IN NURSING
( PSYCHIATRIC NURSING )
21-04-2012
COURSE
5
TITLE OF THE SUBJECT
“A STUDY TO ASSESS THE EFFECTIVENESS OF
PLANNED
HEALTH
TEACHING
ON
THE
KNOWLEDGE AND ATTITUDE OF STUDENTS
TOWARDS
PERSONS
SUFFERING
FROM
MENTAL ILLNESS IN SELECTED SCHOOLS IN
BANGLORE”.
2
6. BRIEF RESUME OF INTENTED WORK
Introduction
“Acting is the physical representation of a mental picture and the projection of an
emotional concept.”
- Laurete Taylor
“Good attitudes are magnets for good news. Seen it proven a hundred times.” A mental
disorder or mental illness is a psychological or behavioural pattern generally associated with
subjective distress or disability that occurs in an individual, and which is not a part of normal
development or culture1.
A mental disorder or mental illness is a psychological pattern or anomaly, potentially
reflected in behavior, that is generally associated with distress or disability, and which is not
considered part of normal development of a person's culture. Mental disorders are generally
defined by a combination of how a person feels, acts, thinks or perceives. This may be associated
with particular regions or functions of the brain or rest of the nervous system, often in a social
context2
The recognition and understanding of mental health conditions have changed over time
and across cultures and there are still variations in definition, assessment and classification,
although standard guideline criteria are widely used. In many cases, there appears to be a
continuum between mental health and mental illness, making diagnosis complex According to
the World Health Organisation, over a third of people in most countries report problems at some
time in their life which meet criteria for diagnosis of one or more of the common types of mental
disorder3
Mental illnesses are serious medical illnesses. They cannot be overcome through "will
power" and are not related to a person's "character" or intelligence. Mental illness falls along a
continuum of severity. Even though mental illness is widespread in the population, the main
burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 people
who live with a serious mental illness. Mental illnesses are medical conditions that disrupt a
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person's thinking, feeling, mood, ability to relate to others and daily functioning. Serious mental
illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive
disorder (OCD), panic disorder, post traumatic stress disorder (PTSD) and borderline personality
disorder. The good news about mental illness is that recovery is possible4
.
Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not
the result of personal weakness, lack of character or poor upbringing. Mental illnesses are
treatable. Most people diagnosed with a serious mental illness can experience relief from their
symptoms by actively participating in an individual treatment plan. As a state of complete
physical, mental and social well-being, health is influenced by many interconnecting factors.
Mental health is an essential component of health and is a resource to help us deal with the
stresses and challenges of everyday life. Good mental health contributes to the quality of our
lives as individuals, as communities, and as a society in general5.
Although the benefits of public knowledge of physical diseases were widely accepted,
knowledge about mental illness and effective treatment are vague. Attitude which hinders
recognition and appropriate help seeking behavior is often prevalent. Much of the mental health
information is misleading. Most of the literature suggests that lay people have a poor
understanding mental illness. They are unable to correctly identify mental disorder, do not
understand the underlying causative factors, are fearful of those who are perceived as mentally
ill. They have incorrect beliefs about the effectiveness of treatment, and are often reluctant to
seek help for mental disorders and are not sure to help others. The ability to recognize mental
illness is thought to be important because, the inability to recognize a disorder in oneself or
others could result in delays seeking appropriate treatment6.
A growing body of research suggests that personal experience with people who have a
mental illness can reduce stigmatizing attitudes towards mental illness. However, the
generalizability of these findings has been restrained by their samples and operational definitions
of contact and stigma. Mental illness is one of the most stigmatized conditions in our society
People with mental illnesses experience all of the key features of the stigma process they are
officially tagged and labeled, set apar, connected to undesirable characteristics, broadly
discriminated against as a result. A central aspect of stigma for people with mental illnesses is
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the perception that they are dangerous and unpredictable. Stigma and discrimination associated
with mental illness are strongly linked to suffering, disability and poverty. In order to protect the
rights of those with mental disorders and to sensitively develop services, it is vital to gain a more
accurate understanding of the frequency and nature of stigma against people with mental illness7.
This study demonstrates the need for community educational programs in Bangalore aimed at
demystifying mental illness. A 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. Despite the many studies of public attitudes toward mental
illnesses, relatively few have examined the views of the youngest generation of citizens. This
study was intended to increase understanding of youths' views of mental illness by developing
and administering measures of knowledge and attitudes of middle school students toward mental
illnesses. In developing countries like India, there are evidences that stigma associated with
mental illness is increasing. As in parts of the developing world, with advancement of
urbanization and rapid industrialization, people tend to react in a very peculiar and biased way
when they confront a mentally ill person. The present study aimed to find out students' opinion
about mental illness8.
6.1 Need for the study
From the time immemorial diseases were an inheritant part of mankind, mental illness
also took its place among them. Unlike any other physical illness, mental illness differed in the
fact that it had a lot of stigma attached to it even making it more difficult for the person as well
as the family members to proceed with the treatment modalities . The purpose of this study is to
find ways that correct ignorance and faculty . If people are given accurate information about
mental illness it can lead to less negative attitudes, which can make it easier for the mentally ill
to have a better quality of life. In July 2009 the DH launched New Horizons, a consultation on a
new vision for mental health and wellbeing9.
Mental illnesses including anxiety disorders and depression are common and under-treated in
many developed and developing countries, with the highest rate found in the United States,
according to a study of 14 countries. Based on face-to-face diagnostic surveys in the homes of
60,463 adults, the study found that mental ailments affect more than 10 percent of people queried
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in more than half the countries surveyed. Rates ranged from 26.4 percent of people in the United
States to 8.2 percent of people in Italy. While Nigerians appeared to have the lowest prevalence
of mental illness 4.7 percent the researchers think the actual number is likely much higher since
residents of the violence-prone West African nation may be hesitant to confide in strangers10.
“In some countries there just is not this tradition of public opinion and speaking your mind,”
said Ronald Kessler, a Harvard Medical School researcher who led the study. Preliminary results
from the world's largest survey on mental health indicate that mental illness is widespread and
undertreated, and that wealthy people with mild illness receive more and better treatment than
poor people with severe illness. From 1 to 5 percent of the populations of most of the countries
surveyed had serious mental illness, according to the findings, being published today in The
Journal of the American Medical Association11.
Around 1.5 million people in the United Kingdom have a learning disability. This equates
to around three in every 100 people. Of these, an estimated 65,000 children and 145,000 adults
have severe or profound learning disabilities. A learning disability affects someone’s ability to
understand new or complex things and to cope independently. Most develop before a child is
born, during birth, or because of a serious illness in early childhood. Mental health is created in
our interactions with the world around us, and is determined by our sense of control in dealing
with our circumstances and by the support we have to help us cope. An individual who has good
mental health is able to realize his or her own abilities, cope with the stress of everyday life,
work productively, and contribute to the community. Good mental health protects us and helps
us to avoid risk taking behaviours that contribute to poor mental health12.
The prevalence of mental ill-health is not evenly distributed across the country. There are
strong links between mental health conditions and social exclusion. People with mental health
problems tend to have fewer qualifications, find it harder to get work, have lower incomes, and
live in areas with higher socio-economic deprivation. Linked to this, they are also more likely to
experience difficulties in accessing services and receiving a full range of support in line with
their needs. While individuals and communities have the capacity for good mental health, they
require support in order to achieve and maintain it. The process of enhancing protective factors
that contribute to good mental health is called mental health promotion. The following is a
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review of recent mental health promotion literature that synthesizes current general concepts,
evidence of effective interventions, and practice in this growing field13.
New Horizons is focused on the promotion of mental health and wellbeing across the
population, and improving the quality and accessibility of services. Of its key themes tackling
stigma and discrimination, social inclusion and personalisation are particularly pertinent to this
literature review and emerge as key strands in the discussion14.
All over the world, there is an increasing awareness of mental illness as a significant
cause of morbidity. In developing countries like India, there are evidences that stigma associated
with mental illness is increasing. As in parts of the developing world, with advancement of
urbanization and rapid industrialization, people tend to react in a very peculiar and biased way
when they confront a mentally ill person. The present study aimed to find out students' opinion
about
mental
illness.
Indian studies indicate that the public, including the educated urban groups, is largely
misinformed about the various aspects mental health, and information possessed by them
remains uncrystallized15.
The mentally ill are perceived as aggressive, violent and dangerous and not fit for
coexistence in society. A tendency to maintain social distance from mentally ill and to reject
them socially still persists and makes its existence felt. Studies addressing this issue have pointed
out that a great deal of misconceptions, superstitions and ignorance with regard to mental illness
exists
in
our
society,
which
makes
the
picture
more
distorted.
If ignored, mental health problems can impede social development, leaving young people feeling
socially isolated, stigmatized and unhappy. In an attempt to cope with or overcome the
symptoms of these disorders, some young people acquire socially or personally inappropriate
behaviours, such as dropping out of school or becoming heavily involved in the illicit use of
drugs. Mental disorders may also impact the young person’s ability to make and retain a strong
and supportive peer network or appropriate relationships with adults. Teachers represent a
prominent and positive adult role model in the student’s life. It is part of their role to be
7
supportive and aware of student difficulties and direct them to the appropriate resources for help
if needed16
Many people with mental health problems say that the biggest barrier to getting back on
their feet is not the symptoms of illness, but the attitude of other people. In light of this, the
researcher felt the need for educating students and changing their attitude towards mental illness.
Hence the researcher selected this topic17.
6.2 Review of literature
Review of literature is defined as broad comprehensive in depth systematic and critical
review of scholarly publications, un published scholarly print materials, audiovisual materials
and personal communication. The purpose of this study is to assess the effectiveness of
structured teaching programme regarding traditional healing practices of mental illness on
knowledge and attitude among the people of rural villages. The purpose of review at literature is
to obtain comprehensive knowledge base and in depth information of previous studies18.
1. Review of literature related to prevalence of mental illness.
2. Review of literature related to perception of mental illness.
3. Review of literature related to anti stigma initiatives on mental illness.
The 2009 World Mental Health Day global awareness campaign which was celebrated on the
10th of October 2009 focused on the theme “Mental Health in primary care enhancing treatment
& promoting mental health” this has led to the focus on the often neglected fact that mental
health is an integral element of individual’s overall health & well being.
Review of literature related to prevalence of mental illness.
Negative views about individuals with mental illness were widely held. Less than half of the
respondents thought that people with mental illness could be treated outside a hospital or other
health facility, implying a belief that community-based care is unlikely to be feasible and might
even be dangerous for the public. Only about a quarter thought that mentally ill people could
work in regular jobs. Most respondents thought that people with mental illness were mentally
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retarded, were a public nuisance and were dangerous because of their violent behaviour. These
negative views were uniformly expressed by all groups in our study, and there was no clear
gender, age, educational or economic correlate of poor knowledge. Negative views of mental
illness have been reported in some studies to be more common among the poorly educated, those
of low social class and persons aged 50 years and above our study did not identify such
associations20
Review of literature on perception of people towards mental illness,
Mental illness is a serious problem permeating the mental health system. Most evidence for this
is based on statements of mental health personnel. Dr. Yaw Osei when first establishing
psychiatric services in Kumasi at the Komfo Anokye Teaching Hospital, resorted to calling it
“Headache Clinic” as mental illness was considered taboo in the prevailing Ashanti culture. In a
qualitative study, Quinn interviewed family carers of mentally ill persons. He reported that a
recurring topic of the interviews was that many relatives of mentally ill persons were worried
about stigma and negative attitudes from society and the extended family, although supportive
attitudes were also experienced. Regarding the mentally ill, it appears that people respond to the
mentally ill with feelings of fear and rejection. Martin, Pescosolido & Tuch (2000) examined the
effects of descriptions of the targets’ behavior, causal attributions about the source of the
behavior, the target’s perceived dangerousness, labeling and participants’ sociodemographic
characteristics. Twenty percent of the participants labeled a target described with depressed
symptoms as having a mental illness (as compared with 54% for those described with
schizophrenic symptoms or 1% with normal troubles); 37% would be unwilling to interact with
the depressed person (48% for the schizophrenic and 21% for normal troubles); and 33% felt that
the depressed person would do violence to others (61% for the schizophrenic and 17% for the
normal troubles)21
Thus, a common respond to the mentally ill are rejection and fear of violence. Alexander
and Link (2003) examined the stigma of mental illness, perceptions of dangerousness and social
distance in a telephone survey. They found that, as a participant’s own life contact with mentally
ill individuals increased, participants were both less likely to perceive a target mentally ill
individual in a vignette as physically dangerous and less likely to desire social distance from the
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target. This relationship remained after controlling for demographic and confound variables,
such as gender, ethnicity, education, income and political conservatism. They also found that any
type of contact – with a friend, a spouse, a family member, a work contact, or a contact in a
public place – with mentally ill individuals reduced perceptions of dangerousness of the target in
the vignette. Corrigan,
Attitudes of professionals may contribute to stigma Health and mental health care providers have
traditionally played a leading role in developing and delivering educational and anti-stigma
programming. They hold authority with the public and policy planners and are recognised
‘experts’ within the media22
As children grow older, the school becomes the main setting for promoting mental health. The
most successful school-based interventions target many risk factors and health outcomes and
take a long-term, whole-school approach to mental health promotion, with benefits that last long
into adulthood. By building coping and social skills, and by creating a positive, safe environment
that fosters a sense of inclusion, identity and connectedness among students, interventions result
in improved adjustment to school, enhanced competence, self-esteem, increased control and
problem-solving skills, improved school achievement, and decreases in loneliness, learning
problems, bullying and aggression, and depression and anxiety . Engaging students, teachers, and
parents through both curriculum and school policy is more effective at promoting mental health
than short-term interventions that focus solely on specific topics related to self-esteem, selfconcept and individual coping skills. Mental health promotion curriculum in schools can be
supported by programmes that involve parents of children at risk for problems such as
aggression, delinquency, and substance use through a combination of home practice and group
meetings at schools23.
These interventions focus on creating and strengthening a positive home environment
with appropriate supervision and discipline that is conducive to ongoing practice by teachers in
the school environment . As children grow older and have the ability to make choices and spend
more time away from their parents’ supervision, they meet new challenges and face more peer
pressure to engage in the risk-taking behaviours mentioned above, including sexual activity, all
of which can result from and contribute to poor mental health. Building social and emotional
skills is important to maintaining mental health in students in middle and high school, so
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programmes that address these new challenges often combine elements of both promotion and
prevention to reduce the risk factors for poor mental health in adolescence. Because our health is
closely connected to our environments, health promotion takes into account that our health
cannot be separated from the places where we live24
Review of the literature on anti stigma initiatives in mental health
The way we encounter mental illness is a measure of our health as a society. Whether it disturbs
and immobilises us, or engages our humanity and cooperation, depends upon our collective
willingness to open ourselves to its sufferers, and include their experience in what it means to be
human. This is a challenge we are increasingly called on to meet, and one which requires the best
of our resources, intellect, policy, and practice. Not only to understand the dimensions of mental
health and its detriment, but to develop a socially, economically and culturally attuned response.
Vital to constructing that response, I am very pleased to welcome this comprehensive and
informed literature review, bringing world best practice and emerging research to bear on mental
illness and social inclusion in our context. As the review makes clear, our journey forward is as
much about learning as about ‘unlearning’; disavowing the conscious or unconscious stigmas we
indulge, and the attitudes that negate or obstruct our progress. We need to begin afresh, with a
model that accounts for the rights, opportunities, dignity, and contribution of every person; that
makes room for everyone in our public conscience and our private consciousness. Behind this
review are the leadership and determined energy of the Queensland Alliance, and of the sibling
organizations in each state, who together make up a strong network, encouraging dialogue,
teamwork, advocacy, research, information and knowledge sharing, policy and strategy
development, negotiation with government, liaison with community25.
To this strategic and timely intervention in a national discussion about mental illness,
they bring the experience and resilience of daily confrontation with complex, demanding, and
heartbreaking issues. Their commitment, perseverance, courage, and compassion will lead us
forward as we build a stronger, richer, more inclusive and cohesive Australia. And in most of the
countries, 9 to 17 percent of those interviewed had had some episode of mental illness in the last
year, whether serious or less severe, said the study, by researchers from the World Health
11
Organization and Harvard Medical School. Around the world, the authors found, mental illness
causes as many lost days of work as any physical problem like cancer, heart attack or back pain26
''The level of role impairment we found to be associated with serious mental disorders
was staggering more than a month in the past year when the respondents reported being totally
unable to work,'' said one chief author, Dr. Ronald C. Kessler, a professor of health care policy at
Harvard School curriculum meets mental health promotion. Our study demonstrates the need for
community educational programs in Bangalore aimed at demystifying mental illness. A 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 persons27
Despite the many studies of public attitudes toward mental illnesses, relatively few have
examined the views of the youngest generation of citizens. This study was intended to increase
understanding of youths' views of mental illness by developing and administering measures of
knowledge and attitudes of middle school students toward mental illnesses. Stigma and
discrimination associated with mental illness are strongly linked to suffering, disability and
poverty. In order to protect the rights of those with mental disorders and to sensitively develop
services, it is vital to gain a more accurate understanding of the frequency and nature of stigma
against people with mental illness. Little research about this issue has been conducted in SubSaharan Africa. Our study aimed to describe levels of stigma in Malawi28
The negative views expressed by respondents were indicative of the degree of tolerance
they might have of people with mental illness. In particular, views such as those of
dangerousness and low intelligence have been found to fuel community resentment of people
with mental illness (Hayward & Bright, 1997; Corrigan & Watson, 2002). Consequently, the
attitudes of our survey respondents to people with mental illness were not surprising. We found
that most people in the community would be afraid to have a conversation with someone known
to have a mental illness and only a few would consider such a person for friendship. The closer
the intimacy required for the interaction, the stronger the community’s desire to keep a distance.
Thus, less than 4% would consider marrying anyone with mental illness29
12
Here again, the associations with demographic or residential features were very few
indeed. Other than a somewhat more tolerant attitude to people with mental illness shown by
respondents residing in urban areas and by men, there was no interpretable relationship between
negative attitudes to those who are mentally ill on the one hand, and age, education or income on
the other hand. Previous studies of selected groups in Nigeria have suggested that negative
attitude to mental illness may be less pervasive among the well educated30.
Our findings suggest that the attitudes of such groups do not reflect those of the
community at large. The purpose of this paper is to review the current literature in relation to
mental illness and criminal behaviour. The material presented for discussion was selected from
forensic and general psychiatric literature. However, a number of important publications, policy
documents and independent reports were used to explore the debate surrounding this subject.
Contemporary studies of prison populations in the UK and abroad illustrated the difficulty in
relating mental illness to crime. Papers presenting research in the UK revealed important
implications for mental health policy and the way in which the penal system deals with mentally
disordered offenders31
The literature reviewed provided arguments for and against an association between
mental illness and criminal behaviour. Methodological problems associated with criminological
and psychiatric research were addressed in relation to the exploration of whether people
suffering from a mental illness are more dangerous or violent than other people. Stigma and
discrimination associated with mental illness are strongly linked to suffering, disability and
poverty. In order to protect the rights of those with mental disorders and to sensitively develop
services, it is vital to gain a more accurate understanding of the frequency and nature of stigma
against people with mental illness. The review covers all those falling within these definitions,
regardless of whether they have been formally diagnosed, or are accessing professional support
or treatment for their condition32
Direct personal contact with people who experience mental illness is the best approach.
Direct contact is the best approach to changing attitudes and behaviours, particularly when there
is a relationship of equal status; a context of cooperation, an opportunity for discussion; and
13
credible presenters who disabuse myths of dangerousness, incompetence, and incapacity. Stigma
has been the subject of intense research and the literature is replete with studies defining,
describing, and measuring the negative impact of stigma on people’s social, vocational, and
economic functioning. The psychological, sociological, structural, and interpersonal forces,
which create, support and maintain stigma has been dissected and moderating theories explored33
Much of this research is theoretical and has limited utilitarian application for program
development. However, understanding stigma as a phenomenon is helpful in explaining the
process of ‘labeling’ and how people react to being ‘marked’. Stigma has come to represent a
mark of shame or degradation. Thornicroft describes stigma as ‘any attribute, trait or disorder
that marks an individual as being unacceptably different from the ‘normal’ people with whom he
or she routinely interacts, and that elicits some form of community sanction. Mary O’Hagan
refers to stigma as the internal feelings and attitudes, discrimination as the external behaviour
and institutional arrangements that deny people their rights or limit social inclusion. Stigma and
discrimination are seen as major barriers to citizenship and social inclusion. Corrigan describes
stigma arising from three inter-relatedproblems: 1) A lack of knowledge of mental
healthproblems leading to ignorance. 2) Ignorance leads tothe formation of negative attitudes or
prejudice and when knowledge is replaced by myths. 3) Discriminationis the behavioural result
of prejudicial attitudes, which results in people excluding or avoiding contact with those who are
identified as mentally ill. Corrigan reports that this negative cycle can be interrupted by:
providing education on the experience of having a mental health issue and the personal
experience of discrimination – not education to improve knowledge of mental illness; by
increasing positive contact with competent, capable people who to challenge stereotypes
attitudes; and by promoting human rights and protesting against acts of discrimination. Studies
show Australians are not well informed about mental illness and believe mental health is a
significant issue for which 90% feel they lacked a clear understanding. Good practice in
providing services34
There is a strong body of literature which highlights good practice in providing services
for people with mental health conditions and/or learning disabilities, particularly from the field
of social care. One of the strong over-arching themes is the emphasis on personalising services.
14
This includes giving individuals more choice and control over what support and help they access
and how they access it. It also includes providing more flexible and coordinated support which is
tailored to the needs of the individual. Some of the literature highlights that delivering welfare
rights advice in a primary care setting can improve access to this advice for hard-to-reach groups,
including people with mental health problems, and older people in particular. The literature
suggests that GPs are often quite resistant to increased availability of benefits help and advice in
their practices , although these authors suggest that ‘they might be persuaded to change their
minds if they were made aware that, for example, over half of the patients likely to use the
service were eligible for disability benefit, and therefore, that advice services can help to reduce
health and social inequalities locally’. Some of the literature is more sceptical about the value of
increasing access to benefits advice within GP practices, suggesting that people with mental
health problems are not necessarily heavy users of GP-based services(Abbott and Hobby, 2003).
Education to build understanding Public education is the most frequently used approach to
reducing stigma35
There is a vast amount of user friendly information available, which describes in detail
the diagnostic classification and treatment approaches for common mental illnesses. Educational
conferences, workshop, forums, awareness campaigns, print, web, self surveys, and multi-media
resources explaining the signs and symptoms of illness and emphasising the importance of
treatment are broadly available. However, the research indicates this is not the information that
achieves positive lasting attitudinal and behavioural change. Education has the greatest
resonance when the information provided builds understanding of the human experience of
living with and overcoming mental health problems. A prevailing orthodoxy on how to reduce
stigma and discrimination has been to increase the public’s understanding of mental illness and
bring it into closer alignment with medical opinion36
15
STATEMENT OF PROBLEM
A study to assess the effectiveness of planned health teaching on the knowledge and attitude of
students towards person suffering from mental illness in selected schools in Bangalore.
6.3 OBJECTIVES OF THE STUDY:
1. To assess the existing knowledge of students towards mental illness through pretest.
2. To assess the attitude of students towards mental illness
3. To assess the effectiveness of planned teaching programme regarding mental illness through
post test.
4. To associate the pre test scores of students with selected demographic variables.
5. To associate the post test scores of students with selected demographic variables.
6.4 OPERATIONAL DEFNITIONS
Knowledge: In this study, knowledge means the level of awareness of students about mental
illness measured by using Questionnaire
Attitude: In this study, attitude means the settled opinion or way of thinking of students towards
mental illness measured by modified attitude scale.
Mental Illness: Mental illness is clinically significant condition characterized by alteration in
thinking, mood and behavior associated with personal distress and confusion.
Effectiveness It means the extent to which planned health teaching pogramme as measured by
knowledge questionnaire
Students:
High school Students refer to early adolescent under the age group of 13-15 years.
6.6 HYPOTHESIS:
H1:
There will be significant difference between the pretest and posttest knowledge score
H2:
There will be significant relationship between the knowledge and attitude scores
H3:
There will be significant association between the knowledge score and selected
demographic variables
H4 : There will be significant association between the attitude score and the selected
demographic variables.
16
6.7 VARIABLE UNDER STUDY
6.7.1 INDEPENDENT VARIABLE
It is the condition or character manipulated by researcher. Planned health teaching programme
among students towards mental illness is the independent variable in this study.
6.7.2 DEPENDENT VARIABLE
These are the characteristics that appear or disappear of change as the researcher introduces
removes or change independent variable. Dependent variable is the knowledge of high school
student’s towards mental illness
EXTRANEOUS VARIABLE
The age, gender, religion, marital status, education, experience and source of previous
knowledge.
6.5 ASSUMPTIONS:
1. Students may have basic knowledge towards mental illness to and may show interest to
learn further.
2. Planned health teaching programme will improve the knowledge of students towards mental
illness.
6.8 MATERIAL AND METHODS
6.8.1 SOURCE OF DATA:
Students who attend high schools.
6.8.2 .METHOD OF DATA COLLECTION :
Prepared questionnaire
6.9 RESEARCH DESIGN:
One group pre test post test design is planned for research study.
17
7. RESEARCH SETTING
This will be conducted in selected high schools at Bangalore, Karnataka.
7.1 POPULATION
A population is an aggregate of elements showing some commonest of criteria.
Population of the study includes high school students who are studying in the high schools at
Bangalore.
7.2 SAMPLE
Sample is a subject of population selected to participate in research studies. it includes
high school students who are studying in the high schools at Bangalore who have fulfilled the
inclusion and exclusion criteria.
7.2.1 SAMPLE SIZE
50 High school students who are studying in the high schools at Bangalore.
7.2.2 SAMPLING TECHNIQUE
Non Probability convenient sampling method by using simple random technique. Sample
selected for data collection are those who fulfill the inclusion and exclusion criteria laid down for
the study.
7.3 CRITERIA FOR SAMPLE SELECTION
Inclusion criteria
1. Students who are present at the time of data collection
2. Students who are willing to participate.
3. Students who are studying at high schools.
4. Students who are studying in college
Exclusion criteria
1. Students who are in the primary schools.
2. Students who are in the pre university college.
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7.4 LIMITATIONS OF THE STUDY.
This study limited to,
1. 50 High school Students in a selected high schools at Bangalore, Karnataka.
2. Study limited to a period of 4 weeks.
7.4.1 SIGNIFICANCE OF THE STUDY
This study will help the researcher to find out the high school Students knowledge on
mental illness and this will Increase the knowledge of Students regarding causes and prevention
of mental illness. Hence this helps them to identify the factors contributing to the onset of
mental illness and preventing or modifying them.
7.4.2 COLLECTION OF DATA
Data will be collected by a structured questionnaire.
7.4.3 TOOL OR INSTRUMENTS
Section I: Demographic Performa which includes Age, gender, religion, marital status,
education, experience and source of previous knowledge.
Section II: Structured questionnaire regarding knowledge of students on mental illness.
Section III: Attitude scale measuring students perception towards mental illness
7.5 DATA COLLECTION METHOD:
Permission will be obtained from the concerned authorities. The purpose of the study will be
explained to the subjects, an informed consent will be taken, pre test will be conducting to
evaluate the knowledge of Students regarding mental illness by a self instructional module,
followed by administration of planned self instructional module on
mental health, then
conducting a post test by the same questionnaire after 7 days.
7.6 PLAN FOR DATA ANALYSIS
The analysis of data will be based on research hypothesis and by using descriptive and inferential
statistics.
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Descriptive statistics
It includes percentage; frequency, mean and standard deviation will be used to depict the
demographic data as well as the knowledge scores of high school teachers regarding adolescent’s
mental illness.
Mean median percentage and standard deviation will be used for pretest and posttest level of
knowledge.
Inferential statistics
It include paired ‘t ’test, chi-square test for the assessment of knowledge and to associate the
socio-demographic variable is planned
7.7 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO
THE CONDUCTED ON STUDENTS TOWARDS MENTAL ILLNESS
This study is conducting in selected high schools at Bangalore, Karnataka.
7.8 ETHICAL CONSIDERATION
Does the study require any intervention to be conducted on high school Students?
Yes, Informed consent will be taken from the respondent.
Has ethical care be obtained from your institution?
Yes, ethical care will be obtained from our institution.
Has ethical care be obtained from the institution where the study will be conducting?
Yes, ethical care will be obtained from the concerned authority at the time of study.
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8. LIST OF REFERENCES (VANCOUVER STYLE)
1. Ahuja neeraj.”A short text book of psychiary.”Sixth edition. New Delhi:J.P Brothers Medical
Publishers PVT(Ltd);2004 .
2.Johnson Schoen Barbara. Child Adolescent& Family Psychiatric Nursing. First
Edition.Philadelphia:J.B.Lippincot company:1995 5-7.
3.http://brainblogger.com/2011/mentalhealth-prevalent-among-youth-worldwide.
4.Townsend.C.Mary.Psychiatric Mental Health Nursing. Fifth Edition. New Delhi: J.P Brothers
Medical Publishers company: 1997 13-16.
5. http://encyclopedia.wilkipedia.org.Prevalence of mental disorder.
6. Ankur Barva.Need for a realistic programme in India. Indian Nursing Journal Psychological
Medicine.2009 January: Volume31.page No.348-49. 7.Ganesh Kumar.S.Prevalence and Pastern
of mental disability in Karnataka. Indian Journal of Psychiatry.2008; Volume5o.page No.23-25.
15. http://sancd.org/disability.South Asian Network for Chronic Diseases
8.Lalitha.K.Mental Health and Psychiatric Nursing. First Edition Bangalore: Gajanana Book
Publishers; 1999 Page No 21-22.
9. Basavanthapa.B.T.Nursing Resaerch.Second Edition. New Delhi: J.P.Brothers Medical
Publishers PVT (Ltd); 2003.page No.92.
10. Kabir.M.Perceptions and Beliefs about Mental illness. International Health And Human
Rights.2004 Augest; page no.698.
11. http://epubs.surrey.ac.uk/1623/1/fulltext.pdf. Claudine Fox. Children’s Knowledge of the
Causes and Consequences of Mental Illness
12. Susan.A.Gaumd. A 3-Year Panel Study of Mental Disorders among Adolescents in Taiwan.
American Journal of Psychiatry.2005July; Volume. 162:1344-135
13. emdr.nku.edu/emdr.Amya Wason.Changin Adolescents attitude on mental illness.
14. http://bjp.rcpsych.org/content/177/5/396.full A. F. JORM, DSC Mental health literacy
Public
knowledge
and
beliefs
about
mental
disorders
15..berkeley.edu/news/media/releases/2007/01/16_stigma.shtml.Stigma toward mentally ill.
16. www.nida.nihgov.com.Saviha Malhothra.Child And Adolescent Mental Illness drug abuse
statistics.
17. archpedi.ama-assn.org/cgi/reprint/158/8/781.pdf Michelle M. Garrison 2004.Mental
sIllness&Hospialization of youth.
18. 20.icmr.nic.in/mentalhealth.Dr.Narender Kumar. Indian council of medica
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9.
Signature of the candidate.
10.
Remarks of the guide.
11.
Name and designation of (in block letters )
11.1. Guide
Good, Feasible to conduct.
Mrs. Velvizhi
Asst. professor
Mental health Nursing Department
11.2. Signature
11.3. Co-guide (if any)
11.4. Signature
11.5. Head of the department.
Mrs. Velvizhi
HOD of Mental Health Nursing
11.6. Signature.
12.
12.1. Remarks of the chairman and principal.
12.2. Signature.
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