Teachers with mental health problems: A burden to society, the economy?

There has been a lot of concern recently about teachers with mental health problems (in the north). It is quite natural that we are concerned about teachers who hold the future of our children in their hands for a big part of their growing years.

Since students spend quite a good amount of time with their teachers and tend to listen to their teachers, more than their parents, the teachers can change the lives of their students for better or for worse. Every one of us has stories and remembrances about our teachers who have helped us to see the world, change our view points and had a great influence on our life. Like the God and Goddesses teachers can create their students, make them grow, guide them and even destroy them. It is no wonder that since these 'gurus' play a major role in our society, they are under constant observation.

Majority of the teachers are good and capable of carrying out their responsibilities. Their passion, commitment and enthusiasm are indeed commendable. Compared to what they draw as salaries, they work very hard and spend a huge amount of their time, energy and life dedicated to their services. Teachers always impress their students and become role models and mentors. However, like in all the professions, there are teachers, who are not performing their roles up to the expected values. There are many reasons for their incompetency. Mental health problems could be considered as one of the many factors which contribute to the incompetency in some of this respected profession.

There is growing evidence that mental health problems are on the increase and play a key role in determining people's performances and functional abilities. As we know anyone can be affected by mental health problems and teachers are no exception. Both serious (major) and mild (minor) mental health problems can occur in teachers, as they can also be seen equally in other professions dealing with children and adults: doctors, nurses, administrators, politicians, security forces, government officials, etc. In general, we can expect that around 2 % of any population can have serious mental illness, while another 10 % can have other forms of (minor) mental health problems. This applies to teachers as well as to other professions.

Appropriate treatment

People, including teachers, with serious mental health problems may show characteristics like lack of concentration, motivation and enthusiasm; problems in socialization and deficiencies in communication skills; improper expressions and emotional reactions; impulsive and disinhibited behaviours; lack of proper self-care; abnormal experiences and beliefs; not having insight about their psychological problems and rarely experience side effects of medication. However, it should be remembered that medical science has improved a lot and with appropriate treatment those, including teachers, with serious mental health problems can recover from their illness, overcome their difficulties and regain their potential. There are many who had sought or have been seeking proper treatment, magnificently managing their illness, and are functioning well, doing their jobs properly and attending to their family responsibilities.

Similarly those with minor mental health problems may show characteristics like persistent anxiety and tension; continuous worrying, moody and gloomy feelings; irritability, anger outbursts and poor impulse control behaviours; quarrelling with fellow staff and punishing the students; difficulties in forming and maintaining relationships; unpredictable performances and unexplained leaves; rigid and non-negotiable viewpoints and continuous suffering from their problems. They may also have problems in their sleep, appetite and other biological functions in addition to having problems in their home environment. These teachers may not show any overt manifestations and as such are capable of concealing their mental health problems. However, in close observation we could realize that they are having 'some' problems or issues. When these teachers with minor mental health problems seek appropriate help; not necessarily in the form of medication or treatment but in the form of non-medical ways like sharing their problems, seeking help from counseling services, learning and practicing relaxation exercises, understanding their issues, identifying their problems and solving them and receiving support from appropriate people and organizations; they can help themselves and go back to their previous state of wellbeing and functioning well.

If we take the education system, there are a sizable number of people including teachers who create problems to the students, fellow teachers, principals, and the system. It is not necessary that all of them are having mental illness. Some do have mental illness but others do not have a diagnosable mental illness, but they do create problems and damage to the system. It appears that there is a delay in early recognition of behavioural changes and managing their mental health problems. When it comes to mental illness, poor drug compliance and as such poor symptom control play a major role in creating problematic behaviours and functioning at substandard levels. It is important to remember that their disturbing behaviours can be related to symptoms of the illness as well as reactions to provocation and stigma from other 'normal' people. If someone who is known to have a diagnosed mental illness shows a problematic behaviour and/or does not satis- fy the expectation of educational system, then that person will become the scapegoat of the system. Recently we have heard some extreme viewpoints in northern Sri Lanka that those teachers should be sent home immediately since they are not fit to perform their duties and not to be seen as good role models for the students. They are said to be blocking 'normal' people's chance to become teachers. These sort of extreme viewpoints are often impulsive and premature in nature and fail to analyze the contexts and causes of problems.

SINCE STUDENTS SPEND QUITE A GOOD AMOUNT OF TIME WITH THEIR TEACHERS AND TEND TO LISTEN TO THEIR TEACHERS, MORE THAN THEIR PARENTS, THE TEACHERS CAN CHANGE THE LIVES OF THEIR STUDENTS FOR BETTER OR FOR WORSE.

Policies

Sri Lanka's National Disability Policy, Health Policy and Mental Health Policy emphasize the rights and equality of people with disabilities, which also includes mental illness. These policies also emphasize the need for inclusiveness of those with one or the other form of disabilities. In other words, people with disabilities, physical or mental, should be given a chance to work and enjoy the rights and privileges of normal people.

This applies very well to teachers with mental health problems. However, it creates an interesting dilemma. On one hand we would like to see a good outcome from the education system as such the need to have efficient teachers, but on the other hand there are teachers who are suffering from mental health problems and showing difficulties in fulfilling their expected roles. We would like to help those teachers with disability to achieve their potential capacity. One of the ways of preventing problems is by early detection of abnormal, unpredictable and unacceptable behaviours among the teacher population. When that happens, the education system and its managers should facilitate and ensure proper assessment of those teachers with behavioural problems. In the education system, there are now trained teacher counselors who should become involved in the assessment, referral, follow-up and support for major mental problems. For the minor problems, the teacher counsellors should be able to manage most of them and con- sult mental health professionals when needed.

If necessary, the educational administrators should make sure that teachers with mental health problems receive proper treatment and psychological support. They and the school community should support, encourage and motivate those teachers with mental health problems to continue their treatment or psychological support and not ostracize them. The managers can have frequent contacts with the treating team and families of the teachers with mental health problems. Disability means differently abled. In this context, the administrators can 'manage' the teachers who are differently abled and give them appropriate tasks at school. There are teachers who may not perform well in teaching sessions but be able to assist the principals in their administration, help out with the library or to carry out the routine outside works of the schools. In almost all the schools, some teachers are needed to carry out 'non-teaching' tasks of the education system. Problems can arise when teachers who have been diagnosed do not follow their treatment. Principles and Education Directors can ensure that they follow their treatment and function well, for example by monitoring their attendance and class room teaching. Some teachers with diagnosed mental illness are allowed, out of misguided sympathy, to just sign attendance without doing anything. Similarly there are instances where the administrators keep quiet for long periods when teachers abstain from their work.

Appropriate tasks

These approaches do not help anyone. Ideally paying their regular salaries could be based on following treatment or adequate functioning in the class room. This will also suit the other teachers! When this proves difficult, we should think creatively and use these human resources to complement the tasks of the education system, other than preparing the students for exam oriented performance. Actually if we could match the appropriate tasks to these teachers they will perform better, regain their self-confidence and improve their sense of competence. This will indeed be a good example for students who witness and learn to manage people who are differently abled.

In reality, having a job provides an opportunity to keep oneself active, develop routines, complete tasks, socialize and familiarize with their environment. Nevertheless, in some cases there has to be acceptance of some of the residual symptoms or behavioural problems instead of expecting a 100 per cent 'clean' and ideal teacher, which can't be expected even in 'normal' teachers. Everyone has their strengths and weaknesses. It is helpful to create an environment with minimal stigma in the schools and in society. The education system needs to prioritize and create a society with tolerance and acceptance of other people's viewpoints and difficulties that would be model for the students to follow.

In conclusion, anyone can get mental illness and teachers are not exceptional. Having a mental illness does not mean that they are senseless and useless.

The managers of any work stations including schools need to identify their staff's strengths and weakness and effectively use their potentials to the maximum. Early detection, facilitation of assessment and treatment, monitoring, supervision, networking and regular evaluations are important in the management of teachers with mental health problems. In those few cases that prove intractable or resistant to treatment, teachers can be assessed by mental health professionals for their fitness for work and if necessary recommended for an early pension scheme.