|Year : 2012 | Volume
| Issue : 2 | Page : 155-158
Mental health, protective factors and violence among male adolescents: A comparison between urban and rural school students in West Bengal
Amrita Samanta1, Shuvankar Mukherjee2, Santanu Ghosh3, Aparajita Dasgupta4
1 Assistant Professor, Department of Community Medicine, NRS Medical College and Hospital, Kolkata, West Bengal, India
2 Demonstrator, Department of Community Medicine, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
3 Assistant Professor, Department of Community Medicine, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
4 Professor, Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
|Date of Web Publication||21-Aug-2012|
Assistant Professor, Department of Community Medicine, NRS Medical College and Hospital, 238, Maniktala Main Road, Flat No: 32, Kolkata - 700054, West Bengal
Source of Support: None, Conflict of Interest: None
| Abstract|| |
A cross-sectional study was conducted among 199 (104 urban, 95 rural) male students of classes VIII and IX, of two schools, in urban and rural areas of West Bengal to compare the prevalence of protective factors, mental health issues, and violence among the urban and rural adolescents using a self-administered questionnaire. Higher proportion of urban students than rural (67.3% vs. 62.5%) reported that their guardians understood their problems. Mental health issues like loneliness (17.3% vs. 9.8%), worry (17.3% vs. 10.7%), and suicidal thoughts (19.2% vs. 14.1%) were higher among urban students. Physical fight (53.8% vs. 11.6%), bullying (46.4% vs. 17%), physical attack by family members (46% vs. 17%), and by teachers (53% vs. 10.7%) were all more in urban adolescents. Mental health- and violence-related issues were prevalent more among urban students than those among rural students in spite of having more protective factors suggesting the need of frequent supervision, monitoring, and support of adolescents.
Keywords: Adolescent problems, Bullying, Mental health, Protective factors, Suicidal thoughts
|How to cite this article:|
Samanta A, Mukherjee S, Ghosh S, Dasgupta A. Mental health, protective factors and violence among male adolescents: A comparison between urban and rural school students in West Bengal. Indian J Public Health 2012;56:155-8
|How to cite this URL:|
Samanta A, Mukherjee S, Ghosh S, Dasgupta A. Mental health, protective factors and violence among male adolescents: A comparison between urban and rural school students in West Bengal. Indian J Public Health [serial online] 2012 [cited 2017 Sep 22];56:155-8. Available from: http://www.ijph.in/text.asp?2012/56/2/155/99916
Adolescence is a gateway to health promotion since key behavior patterns that influence health and longevity have their origin in adolescence. Well-developed adolescents who were empowered with appropriate life skills had a better chance of becoming healthy, responsible, and productive adults, leading to better potentials for leading successful careers, and increased productivity and progress. 
One of the most reliable and powerful findings in research on adolescence and their families is the importance of adequate regulation of adolescents, measured in terms of supervision, monitoring, rule-setting, and other forms of behavioral control.  Parental bonding and connection is associated with lower levels of depression and suicidal ideation, alcohol use, sexual risk behaviors, and violence. 
For most adolescents, school is the most important setting outside the family. Students' perceptions of the school environment are associated significantly to their health and well-being.  Perceived high-level supports from fellow students is related to lower subjective health complaints, satisfaction with school, and increased physical activity. 
Anxiety disorders, depression and other mood disorders, and behavioral and cognitive disorders are among the most common mental health problems among adolescents. Worldwide, about 4 million adolescents attempt suicide annually, resulting in at least 100,000 deaths. 
Adolescent children often face the problem of violence in the form of physical attack, verbal abuse, and bullying by family members (including parents), teachers, fellow students, and other groups. Victims of bullying have increased stress and a reduced ability to concentrate and are at increased risk for substance abuse, aggressive behavior, and suicidal attempts. 
The objective of the present study was to compare the prevalence of protective factors, mental health issues, and violence among adolescents belonging to a rural and an urban secondary school.
A school-based descriptive study with cross-sectional design was conducted during January-March 2007 among male adolescent students of an urban secondary school, in Kolkata and of a rural secondary school situated at Singur block, Hooghly district in West Bengal. Both schools were selected purposively within the rural and urban field practice area of All India Institute of Hygiene and Public Health, Kolkata respectively. Students of both the schools come from low socioeconomic background.
Prior permission was obtained from appropriate authorities of urban and rural health centers and from headmasters of the schools.
A questionnaire was developed following the guidelines of the core questionnaire of Global School-based Student Health Survey (GSHS) prepared by WHO, UNESCO, UN, CDC Atlanta, and UNICEF in 2001. The GSHS is a school-based survey conducted primarily among students aged 13-15 years. Since 2003, Ministries of Health and Education around the world have been using the GSHS to periodically monitor the prevalence of important health risk behaviors and protective factors among students. The GSHS has got 10 core questionnaire modules, of which modules of mental health, protective factors, and violence and unintentional injury were used to prepare the questionnaire. 
The questionnaire was translated in a local language and was retranslated with the help of two public health experts. After the pilot study in two different secondary schools both in Singur and Chetla, the students of classes VIII and IX were selected as most suitable for the study as most of the students of these classes belong to 13-15 years age group and this is the most suitable age group for the original GSHS tool, with the help which this questionnaire was prepared.
Data were collected on sociodemographics variables, protective factors, mental-health related issues, and violence committed toward the students. There were five questions on protective factors on school absence, perceived social support at school, parental regulation and monitoring and parental bonding, and connection based on recall period of past 30 days. For mental health issues, the five questions were based on common mental health complaints like feeling of loneliness, loss of sleep due to worry, sadness and hopelessness, and suicidal ideation in last 12 months. Violence and bullying against the students measured by asking four questions as how often they have been physically attacked by family members and teachers, how often they have participated in a physical fight, and prevalence and nature of bullying in last 30 days. There were five possible responses for every question and only responses with "always" and "most of the time" in the case of protective factor and mental health issues and positive responses for violence and bullying were considered.
Out of total 215 students of classes VIII and IX from both the schools, 199 (104 urban, 95 rural) were present on prefixed dates and participated in the study. Following instruction with simple language the questionnaire was distributed to them and all students returned completed questionnaires. Data were analyzed by simple proportions.
It was observed that, 56% and 51% of students in the urban and rural schools respectively were from class VIII. Majority of the students (79% in urban and 66% in rural school) belonged to 13-15 year age group with mean age of 14.1 (± 0.87) years for urban and 15.32 (± 0.96) year rural schools respectively. Most of the adolescents, both urban and rural, were Hindu, from a nuclear family (urban 90.4%, rural 87.4%) and had paternal education up to primary level (urban 36.5%, rural 42.1%), followed by middle level. Majority (61% urban and 65% rural) had a per capita monthly family income < 500.
It was seen that urban students (93%) missed more classes than rural students (44%). Involvement of the parents or guardians was found to be higher in the case of urban students than in the case of rural students. Higher proportion of urban students reported that their parents or guardians checked to see if their homework was done (69% vs. 60%), understood their problems (67.3% vs. 62.1%), and really knew their activities in free time (53.8% vs. 50.5%) [Table 1].
Overall higher proportion of urban students felt lonely (17% vs. 10%) and worried about something that they could not sleep at night (17% vs. 11%). It was a matter of grave concern that serious consideration of attempting suicide during the last 1 year was also found to be higher in the urban group (19%) than the rural group (15%) [Table 1].
|Table 1: Distribution of adolescents of urban and rural schools according to the prevalence of protective factors, mental health issues, and violence against them|
Click here to view
Violence and bullying committed against urban students was higher than that against rural students such as bullying (46% urban vs. 17% rural), physical attack by family members (44% vs. 17%) and by teachers (53% vs. 11%) [Table 1].
In India very few similar studies have been conducted so far. A study conducted among classes VIII-XII students of 10 government schools of Chandigarh showed that 13% students self-reported violent behaviors and 60% were engaged in physical fights at a frequency of more than once per week, comparable with the present study findings in urban school.  In similar studies among 14- to 19-year-old adolescents in South Delhi almost one in every two boys reported being involved in a physical fight and 15.8% reported having thought of attempting suicide in past 12 months. , These results were in concordance with the present study findings although the current study was done on only male adolescents and study instruments were different.
GSHS have been conducted in different countries worldwide. The overall physical fight and bullying in the present study was somewhat lower than that found in Jordon national survey but higher than China study results. The prevalence of missing classes and mental health issues like self-reported loneliness and thought of attempting suicide were found in higher proportion in the study population than those in the national averages in China and Jordon. 
The study result showed that mental health and violence-related issues were more among urban students in spite of having more protective factors than those in rural students suggesting the need of frequent student, teacher, and parent interactions ensuring supervision and monitoring of students for development of a healthy school environment. However these findings could not be applicable to all schools and more in-depth studies involving both sexes of adolescents from all socioeconomic strata of community are needed to get correct picture of these issues of adolescent health.
| Acknowledgments|| |
The authors would like to extend heartfelt thanks to the following for their continuous support and valuable suggestions to carry out the present study: Dr. R. Biswas, Professor and Head of the Department of Preventive and Social Medicine, AIIHPH, Dr. Sushil Sen, Public Health Officer Grade-I, Department of Epidemiology, UHC, Chetla, Dr Madhumita Bhattacharya, In-Charge of School Health Department, UHC Chetla, Dr. Anil Kumar, Officer-in-charge, Singur, RHU and TC and Head Masters of both the schools.
| References|| |
|1.||World Health Organization. Adolescent peer education in formal and non-formal settings. Report of an inter-country workshop, Monastir, Tunisia 6- 9 December 2004. Cairo: World Health Organization Regional Office for the Eastern Mediterranean; 2005. Available from: http://www.who.int/WHO-EM/WRH/042/E 03.05/500.pdf. [Last accessed on 2006 Dec 20]. |
|2.||Barber BK, Olsen JE, Shagle SC. Associations between parental psychological and behavioral control and youth internalized and externalized behaviors. Child Dev 1994;65:1120-36. |
|3.||Barber BK. Regulation, connection, and psychological autonomy: Evidence from the Cross- National Adolescent Project (C-NAP). Paper presented at the WHO-sponsored meeting regulation as a concept and construct for adolescent health and development. Geneva, Switzerland: WHO Headquarters; 2002. |
|4.||Eccles JS, Midgefield C, Wigfield A, Buchanan CM, Reuman D, Flanagan C, et al. Development during adolescence: The impact of stage-environment fit on young adolescents' experiences in schools and in families. Am Psychol 1993;48:90-101. |
|5.||Samdal O, Dur W. The school environment and the health of adolescents. In: Currie C, Hurrelmann K, Settertobulte W, Smith R, Todd J, editors. Health and health behavior among young people - health behaviour in school-aged children: A WHO Cross-National Study International Report. Copenhagen, Denmark: WHO Regional office for Europe; 1998. |
|6.||Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Co-morbidity Study Replication. Arch Gen Psychiatry 2005;62:593-602. |
|7.||Anti-Bullying Centre. School Bullying: Key Facts. Dublin: Trinity College; 2002. Available from: http://www.abc.tcd.ie/school.htm. [Last accessed on 2007 Jan 5]. |
|8.||World Health Organization. Global school-based student health survey (GSHS). Available from: www.who.int/entity/chp/gshs/methodology/en/index.html. [Last accessed on 2009 Dec 25]. |
|9.||Ray M, Malhi P. Adolescent violence exposure, gender issues and impact. Indian Pediatr 2006;43:607-12. |
|10.||Sharma R, Grover VL, Chaturvedi S. Suicidal behavior amongst adolescent students in south Delhi. Indian J Community Med 2008;33:85-8. |
|11.||Sharma R, Grover VL, Chaturvedi S. Risk behaviors related to inter-personal Violence Among School and College-going Adolescents in South Delhi. Indian J Psychiatry 2008;50:30-3. |
|12.||WHO GSHS country report. China global school based student health survey, 2003. Jordan global school based student health survey, 2004. Available from: http://www.who.int/entity/chp/gshs_jordan_report.pdf. [Last accessed on 2009 Dec 25]. |
|This article has been cited by|
||Self-Reported Psychosomatic Complaints In Swedish Children, Adolescents, and Young Adults Living in Rural and Urban Areas: An Internet-Based Survey
| ||Katarina Laundy Frisenstam,Matilda van den Bosch,Yun Chen,Peter Friberg,Walter Osika |
| ||JMIR Public Health and Surveillance. 2017; 3(1): e9 |
|[Pubmed] | [DOI]|
||Risk of Mental Health Problems in Adolescents Skipping Meals: the Korean National Health and Nutrition Examination Survey 2010-2012
| ||Gyungjoo Lee,Kyungdo Han,Hyunju Kim |
| ||Nursing Outlook. 2017; |
|[Pubmed] | [DOI]|
||Family factors associated with adolescent self-harm: a narrative review
| ||Sarah Fortune,David Cottrell,Sarah Fife |
| ||Journal of Family Therapy. 2016; 38(2): 226 |
|[Pubmed] | [DOI]|
||Nutritional and lifestyle risk behaviors and their association with mental health and violence among Pakistani adolescents: results from the National Survey of 4583 individuals
| ||Saadiyah Rao,Nadia Shah,Nida Jawed,Sumera Inam,Kashif Shafique |
| ||BMC Public Health. 2015; 15(1) |
|[Pubmed] | [DOI]|
||Evolution of adolescent mental health in a rapidly changing socioeconomic environment: A review of mental health studies in adolescents in India over last 10 years
| ||Shilpa Aggarwal,Michael Berk |
| ||Asian Journal of Psychiatry. 2014; |
|[Pubmed] | [DOI]|