TEACHERS’ KNOWLEDGE, ATTITUDE AND PERCEPTION ON DEPRESSION

AMONG SECONDARY SCHOOL STUDENTS IN LAGOS, NIGERIA

Fehintoluwa O. Aluko
Babcock University
08166205348
alukofe@gmail.com
Abstract
Depression, a state of moodiness and being aversive to activities, is linked to
poor educational fulfillment, hardship at school, drug abuse and suicide
among adolescents. The study, therefore, investigated teachers’ knowledge,
attitude and perception of depression among students in Oshodi-Isolo District,
Lagos, Nigeria. The study employed the cross-sectional type of the descriptive
research design. Multi-stage sampling procedure was used to select 222
public secondary school teachers for the study. A validated semi-structured
questionnaire (r =0.74) was used to collect data. Descriptive statistics and
correlation were used to analyze data. Among the teachers, 59 (26.6%) had 6
to 10 years teaching experience and 131 (59%) were females. Low proportion
of respondents (N=87; 39.2%) taught Art subjects; 180 (81.1%) were Yoruba
and 174 (78.4%) were Christians. Furthermore, most of the teachers (N=176;
79.3%) knew that depression could be prevented and 174 (78.4%) knew that
suicide is a possible consequence of depression. Teachers possess high
knowledge of adolescent depression (mean=6.66±2.64) while 92 (41.4%)
perceived that students who were depressed should not be in school. Also, 85
(38.3%) reported that they do not like teaching dull and inattentive students.
They, however, showed positive attitudinal disposition toward adolescent
depression (mean=18.28±6.43). Although, 82 (32.9%) perceived the school as
the best place to handle or manage depression among adolescents, only 11
(5%) believed they are qualified to counsel students about depression and
mental health (mean=18.39±6.28). There were significant relationships
between teachers’ knowledge about adolescent depression (r= 0.75; p<0.05)
and teachers’ attitudinal disposition towards adolescents’ depression (r=
0.79; p<0.05) and their perceptions. The teachers had high level of knowledge
about adolescents’ depression. They also had high perception and positive
attitude towards adolescent depression but most of them perceived they were
not qualified to counsel students about their mental health. It was
recommended that periodic training programmes should be organized for the
teachers for improved self-efficacy and capacity to provide appropriate
referral services when required.

Keywords: Adolescent depression, Teachers’ knowledge, Teachers’ attitude,

Teachers’ perception

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Introduction
The import of adolescents‟ lifestyles on later adult quality of life especially in terms of
healthy living remains incontrovertible (Ojo, 2019). One of the most important indices of
wellbeing is mental health which covers cognitive and emotional dimensions with particular
relation to how people think, feel or behave (Ajayi, Abayomi & Ojo, 2013). Depression poses
great threats to a person‟s mental health. Depression in adolescence is a serious public health
issue because of its increasing prevalence, considerable burden of disease, suicide risk, other
co-existing psychiatric disorders and the high risk of recurrence. Depression can be expressed
as a state of being moody and aversive to activities (Birmahar, Ryan, Williamson, Brent,
Kaufman & Dahl, 1999). Studies have found that young people suffer from both depressive
symptoms and depressive disorders and this period of adolescence is viewed as critical for the
evolution of depressive disorders (Luby, 2009). According to Collishaw, Thapar and Potter
(2010), depression affects one to six percent of adolescents worldwide, these depressive
symptoms and disorders are common in adolescence and are associated with long-term
mental health, social and educational outcomes. Depression has been identified as the one
major cause of disability just as the World Health Organization (WHO) projected that by
2020, it would be the second most significant disorder as measured in terms of disability and
mortality (Murray & Lopez, 1996; WHO, 2018).

Adolescent depression could be unrecognized and untreated in the society especially in

the African social life. Depressive symptoms in adolescents are often misdiagnosed to be
substance abuse issues and neglecting these symptoms can have a tragic effect on them.
Studies have estimated that at least one out of five adolescents has suffered from depression
at some point in their lives and in primary care settings; depression rates in adolescents have
reached a high point of about 28% (Amy, Rachel, Peter, Kareem, Danielle & Ruth, 2007).
Results from a 14-year cohort study of mental disorders in adolescence showed that the
duration of untreated depressive illness is a key factor in predicting recurrence in adult life
(Patton, Coffey, Romaniuk, Mackinnon, Carlin, Degenhardt, Olsson & Moran, 2014).
Depression can be easily identified in adolescents as they show similar symptoms as adults;
this was explained in a study conducted by Hubert (2008) who also stated that depression is
very rare in preadolescent children, affecting but only 1.5% of children. Hubert went further
to discuss the difference in depression rates between male and female adolescents, with an
average ratio of 2:1 to 3:1. The prevalence of adolescent depression in developed countries of

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the world has been estimated to be between 4 and 8% (Costello, Pine, Hammen, March,
Plotsky & Weissman, 2002).

In an expansive international study of 13,000 European young people, researchers

discovered based on self-report that 10% of these young ones display significant depressive
symptoms (Balasz, Miklosi, Kereszteny, Hoven, Carli & Wasserman, 2013). Results from an
epidemiological study conducted in 2012 by Vincente et al., showed that 8.3% of adolescents
between the ages of 12 and 18 suffered major depression in Chile. Chinawa, Manyike, Obu,
Aronu and Odutola (2015) carried out a study in secondary schools in South East Nigeria and
reported that depression cannot be identified in children below 10 years of age. The
prevalence of moderate depression was found to be lowest at age 10 (P= 2.3%) with highest
rates occurring at age 13 (P= 6.2%). They also noted that depression rate for the females were
higher than that of the male participants.

Adewuya, Ola and Aloba‟s (2007) study on major depressive disorder which involved
a characteristic sample of adolescents in Nigeria, revealed a prevalence rate of 6.9% with
5.5% for males and 8.9% for the female participants. In a study conducted in Kenya, 26.4%
of students showed symptoms of depression with higher occurrence in the girls than the boys
(Khasakhala, Ndetei, Mutiso, Mbwayo & Mathai, 2011). These disparities in prevalence of
depression across the two gender groups have been explained with various reasons which
include hormonal distinction, jolt of various social stressors, difference in expectations for
each gender and coping strategies (Huberty, 2010). Yolanda, Hessen, Hutteman, Verhulp and
Mirande (2012) disagreed with this contrast in depression prevalence among girls and boys,
and across the age range. Furthermore, according to the study which was conducted to
investigate if these differences are real or biased, they concluded after carrying out factor
analysis on their results that these differences in developmental patterns were observed due to
measurement bias.

Adolescence is a challenging developmental phase with many stressors resulting from

physical and psychological changes (Ojo & Babalola, 2018). Several factors like family
history of mood disorders and strenuous life situations have been identified as culprits that
multiply the chances of depression occurring in adolescence (Eapen & Erneec, 2012).
Recognizing signs of depression in adolescents is an important step to addressing depression
and will take conscious efforts from parents, teachers, friends, peers and loved ones.
Precisely, studies have shown that the roles and perceptions of teachers are paramount in

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resolving students‟ issues relating to their academic progress (Ogunleye, 2007; Ogunleye,
2008). Depression in adolescence is linked to poor educational fulfillment, hardship at
school, drug abuse and suicide; since adolescents are in school most of the time and difficulty
at school can also contribute to the risk of depression, the school teachers can therefore be
viewed as well placed in noticing and preventing some of the symptoms of depression among
their students. Moor, Maguire, McQueen, Wells, Elton, Wrate and Blair (2007) made a
systematic evaluation and found that training teachers with an educational package about
depression alone did not help to improve their ability to recognize depressed pupils which
emphasizes the need to explore some other factors that can affect teachers in prompt
recognition and prevention of depression and its symptom.

Depressive symptoms when unidentified and handled lightly will most likely have
adverse and extended, long-lived consequences on social, personal and intellectual wellbeing.
Huberty (2010) established that depression and its symptoms are not understood easily and
can be mistaken for a different problem. Özabac (2010) also opined that enhancing early
recognition of depression among adolescents would be an effective strategy to prevent and
manage depression and that the school should be the primary setting for recognition and
management of depression in adolescents. Dana and Hooser (2015) posited that it is
important for professionals in the area of preventive care to fully comprehend the role of
teachers and the reality of their work in classrooms. This also includes teachers‟ roles in the
mental, emotional, physical and social wellbeing of students. Indeed, Ogunleye (2009) found
links between students‟ readiness in a number of challenging traits and their performance in
secondary school subjects. The corollary is that students value the support provided by their
teachers towards their achievement and satisfaction with academic programmes (Okopi &
Ogunleye, 2016). Some studies have also suggested that the school is the best place to tackle
depressive symptoms and that the teachers are in the best positions to observe, recognize and
influence these symptoms (Huberty, 2010), but this will only be possible if the teachers are
well equipped with cognitive, behavioural and instructional skills to deal with adolescent
depression.

The significant roles of teachers‟ knowledge and attitude in their self-efficacy,

classroom practices and lifelong impact on students‟ success beyond their performance in the
subject matter content have been explored and reported in a recent study by Ogunleye (2019).
It is therefore of vital importance to conduct this study in order to investigate teachers‟
knowledge, attitude and perception on depression among students as major factors that

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influence effective prevention, early recognition and management of the condition. The
relationships of teachers‟ knowledge and attitude with their perception were also tested.

Research Questions

The following questions were answered with this research:

1. What is the knowledge of secondary school teachers on depression among students in

Oshodi-Isolo District, Lagos State, Nigeria?
2. What is the attitude of secondary school teachers to depression among students in
Oshodi-Isolo District, Lagos State, Nigeria?
3. What is the perception of secondary school teachers on depression among students in
Oshodi-Isolo District, Lagos State, Nigeria?
4. What are the relationships between teachers‟ knowledge, attitude and their perception
of depression among students in Oshodi-Isolo District, Lagos State, Nigeria?

Research Methods

The cross-sectional descriptive survey design adopting the correlational approach was
used for this study. A total of 222 teachers from public junior and senior secondary schools
were selected using the stratified random sampling technique from the Oshodi-Isolo
educational district in Lagos State. The instrument for data collection was a semi-structured
questionnaire containing sections evaluating the research variables. This was used to obtain
responses from the teachers and the instrument was categorized into four sections: Section A
contained demographic information such as school, school type and subject taught; Section B
measured the knowledge of teachers about adolescent depression. The scale consisted of 10
items with two-point response format (Yes and No), the highest point for each question was 1
making it a 10-point rating scale. Responses between 0-5 was rated low knowledge and 6-10
as high knowledge. Section C measured the attitude of teachers toward depression among
students. It was a 10-item scale with a five-point response format ranging from Not at All, to
Rarely, to Undecided, to Occasionally and Very Often for 9 of the items while the last item
presented multiple-choice options. Responses between 0-15 were scored as negative attitude
while 16-30 were recorded as positive attitude. Section D measured the perception of teachers
about adolescent depression and it was a 10-item scale with five-point response format
ranging from Strongly Disagree, to Disagree, to Neutral, to Agree, and Strongly Agree.
Responses between 0-15 were rated low perception and 16-30 as high perception. Construct
validity and reliability tests were carried out on the instrument with an alpha value of 0.74.

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 The instrument was administered with the help of trained research assistants. Data
obtained from completed questionnaires were coded and analyzed using the Statistical
Package for Social Sciences (SPSS) Version 23. Descriptive analysis was carried out to
assess the mean scores for knowledge, attitude and perception of the participants. In line with
the prescribed methods for tracing bivariate relationships (Akinsola & Ogunleye, 2004), the
Pearson Correlation was used to test for relationships between the variables.

Results and Discussion

Research Question 1: What is the knowledge of secondary school teachers on

perceived depression among students in Oshodi-Isolo District, Lagos State, Nigeria?

Table 1: Teachers’ Knowledge on Adolescent Depression

N=222
Level Frequency Percentage (%) Mean/SD Prevalence(%)
Low 51 23
High 171 77 6.66(0.17) 66.6

Table 1 shows that the proportion of teachers with low level of knowledge was 51 (23%)
while 171 (77%) had high level of knowledge about adolescent depression. The level of
knowledge measured on a 10-point rating scale showed that the teachers scored a mean of
6.66±2.64 translated to a level knowledge prevalence of 66.6%. The results corroborate the
findings of Martinez et al., (2015) and Özabac (2010) in Turkey, where they reported that
teachers had high of knowledge concerning depression in adolescents. This result may be
attributed to increased social awareness on mental health and depression among students and
the educational backgrounds of the teachers. However, the findings of the study were at
variance with the findings of Parikh et al., (2016) study in India where they reported
inadequate knowledge of teachers about depression.
Research Question 2: What is the attitude of secondary school teachers to depression
among students in Oshodi-Isolo District, Lagos State, Nigeria?

Table 2: Teachers’ Attitudinal Disposition towards Adolescent Depression

N=222
Attitude Frequency Percentage(%) Mean/SD Prevalence(%)
Negative 77 34.7 18.28(0.43) 60.9
Positive 145 65.3

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The teachers‟ attitudinal disposition measured on a 30-point rating scale showed that the
respondents scored a mean of 18.28±6.43 translated to attitudinal disposition prevalence of
66.9%. The proportion of the teachers with negative attitude was 34.7%.
One can infer from Table 2, that majority of the teachers had positive attitude of about
adolescent depression (N=145). This finding was in line with the findings of Mizuta et al.,
(2016) and Martinez et al., (2015) who reported that teachers had positive attitude towards
adolescents‟ depression. These similarities may be ascribed to how teachers view themselves
as not just people who impart knowledge but also as care givers and guardians to the
students.
Research Question 3: What is the perception of secondary school teachers on
depression among students in Oshodi-Isolo District, Lagos State, Nigeria?

Table 3: Teachers’ Perception of Adolescent Depression

N=222
Perception Frequency Percentage (%) Mean/SD Prevalence
Low 64 28.8
High 158 71.2 18.39(0.42) 61.3

The perception of the teachers measured on a 30-point rating scale showed that the
respondents scored a mean of 18.39±6.28 translated to a perception prevalence of 61.3%. The
proportion of the teachers with high perception was 71.2% and only 64 had low perception of
adolescent depression. Although, high perception was reported, an independent view of
teachers perceived self-efficacy under the perception section of the instrument showed that
only 49 (22.1%) thought teachers were well equipped to recognize and manage depression
among their students. This was corroborated in Bella, Omigbodun and Atilola‟s study (2011)
where they reported they reported teachers feel they are not equipped for handling
psychological issues. The similarities in findings could be because the teachers have not
received training on counseling students with mental or emotional issues.

Research Question 4: What are the relationships between knowledge, attitude and
their perception of secondary school teachers on depression among students in Oshodi-Isolo
District, Lagos State, Nigeria?
Table 4: Relationships between Teacher’s Level of knowledge, Attitude and Perception
of Adolescent Depression
N=222
Perception R p value Remarks
Knowledge 0.75 0.00* Significant

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Attitude 0.71 0.00* Significant

The result of the correlation analysis on Table 4 above showed that teachers‟ knowledge
(r=.75; p<.05) and attitude (r=.71; p<.05) had strong positive and significant correlations with
perception. This finding is confirmed in a study conducted by Quick (2018) in USA and is
probably because our level of knowledge about a phenomenon influences our perceptions and
views about such. Since the respondents had high level of knowledge, this could be
responsible for their high perception of adolescents‟ depression.
Conclusion
This study has established that teachers have adequate knowledge about adolescent
depression and positive attitude towards adolescent depression which explains the high level
of perception. Although the level of perception was high, only few of them viewed
depression as a serious condition which could affect the lives of the students in the future.
Furthermore, most of the teachers did not think they were qualified handle mental and
emotional issues of the students which can be regarded as their perceived self-efficacy.
Managing depression at school may however not improve in these schools because majority
of the teachers did not think it would benefit the school in terms of reduction in violence,
gang related issues and absenteeism.
Recommendations
Based on the findings of this study, training programmes and workshops need to be
organized to empower teachers with the basic skills needed to identify and manage depressed
adolescents effectively in school. Health education programmes that will focus on the benefit
of healthy lifestyle choices and developments of skills needed in making informed and
responsible decision should be incorporated into the school curriculum to enable them handle
stressors better. Periodic training programs should be organized for the teachers to improve
their self-efficacy, empower them to handle these symptoms of depression in students and
know when to refer the students to the experts, these training programs should focus on
strengthening the capacity of the teachers in managing depression among students. In order
to ease the burden of teachers, increase the teacher-student ratio and improve teacher-student
relationship, more teachers should be employed in the schools. Seminars should be organized
to educate teachers on their pivotal roles in the total health and wellbeing of students, the
benefits of managing depression and the severity of adolescent depression.

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