(This article was first published in the New Vision on November 9, 2022)
Most learners in Ugandan schools are given the option to either pass exams or repeat classes. Some are threatened with expulsion from schools if they do not attain the passmark. Experts say this is sending many children into depression and anxiety, writes Cecilia Okoth
Eighteen-year-old Judith (not her real name), a Senior Six student at a Kampala-based school, suffered repetitive bouts of headaches and strange emotions a couple of weeks into this school term.
Known by her peers and teachers to be committed to her studies, Judith suddenly became restless, dizzy and lost interest in academic work.
Her teachers delivered her to a mental health hospital in Kampala, and after a medical examination, which involved establishing her recent experiences at school, mood and thoughts, the doctors said she was distressed. They recommended a break from intense academic activity.
Judith is among 20 Senior Four and Senior Six candidates who have been admitted to this health facility, (which will not be disclosed on privacy grounds) during this school term with signs of distress.
Passing Exams
Hillary Irimaso, a psychiatrist and general secretary of the Uganda Psychiatric Association, says the students had varying symptoms which represent mental breakdowns such as dizziness, persistent headaches, fainting, anxiety and depression.
Irimaso says before and during national exams, which are periods of distress, some candidates experience mental breakdowns due to intensive academic activity in the third term to pass the exams.
“These students were delivered to the hospital from school because of mental illnesses. They exhibited excessive worry about performance, their future and career choices.
“These are children who also typically experience fast growth physically, but are under extreme stress from schools to excel,” Irimaso adds.
On top of this, he says the learners are repeatedly told they either pass the exams or face a bleak future.
“If this kind of pressure finds a person with pre-existing conditions, then it becomes easy for them to develop mental illnesses. If you are being told all you have to do is to pass, and you are not a stable performer, it increases the worry that they are doomed to failure,” Irimaso explains.
As a result, the association says the children feel the tension and start to suffer headaches, dizziness, and fainting episodes. If this level of anxiety is not managed well, it can progress to depression, loss of interest in life and sometimes suicide, says Irimaso.
Stressful Environment
Janet Kantalama Katana, a psychologist at Safe Place Uganda, a mental, neurological and addiction treatment centre, says the peer pressure to “impress and fit in” encourages some learners to take drugs.
Her comments are consistent with the World Health Organisation (WHO) reports which cite pressure to conform with peers and the disparity between lived reality and aspirations for the future as some of the factors that expose young people to mental illness.
“There is also a lot of pressure from parents and teachers to excel. The learning environment is full of fear and stress.
“Teachers are so tough that fearful children are developing anxiety at an early age,” Katana adds.
She explains that a learning environment where children deemed to be poor performers are punished without understanding the underlying causes, depresses learners.
Judith will probably need further medical attention after writing her exams slated to begin in less than a fortnight, because WHO says if mental illness is not addressed, it can extend into adulthood and limit opportunities for living fulfilling lives.
Intensive Reading
During the World Mental Health Day commemoration at Kyambogo University last month, experts said waking up students in the wee hours of the morning to read, plus limited sleep and play time expose children to mental illness. This happens as schools try to cover the syllabus before national exams.
To cope with the pressures that come with this kind of lifestyle, the experts said some students take drugs to remain awake at night – which worsens their mental health.
This, in some cases, has resulted in mass hysteria.
Seggane Musisi, a professor of psychiatry, says he and his colleagues usually treat children ‘traumatised’ by intense academic work, which involves waking up at 2:00am, corporal punishments and fear of failure.
“They suddenly break down mentally and we have seen it in our schools,” Musisi, who is the proprietor of Entebbe Lake Side Hospital, which also offers mental health services, said during the mental health day commemoration.
Dr Juliet Nakku, the executive director of Butabika National Referral Mental Hospital, says she recently treated a distressed girl who was delivered to the hospital with “all sorts of behavioral problems”.
“She came to the hospital in her school uniform. She told me she came from a school in Nsangi where the children go to bed at 11:00pm after reading and then wake up at 2:00am to read again,” Nakku said during the Mental Health Day commemoration.
Grades
But are the schools to blame in a country where they can only become famous by producing good grades?
Jimmy Turyagenda, the former secretary-general of the Association of Secondary School Headteachers of Uganda, says the problem stems from the education system which puts academic grades before everything else.
“The current system demands that if a child, for instance, puts Ntare School, Gayaza High or St Mary’s College Kisubi as their first choice, they must get aggregate four to be admitted,” he says.
Turyagenda’s comments are backed by the findings of a 2021 study published in the Educational Review Journal, which showed that the mental ill-health among students, especially girls who participated in the survey, was triggered by the pressure to get good grades and admission into the best colleges or universities.
This, the study says, is reinforced by pressure from parents and families to excel in exams.
Competitive School Culture
WHO says one in seven 10–19-year-olds experiences a mental disorder, accounting for 13% of the global disease burden in this age group. The 2021 Educational Review Journal study points to a growing body of evidence suggesting that academic pressures, the desire to succeed in school, and ‘a precarious’ job market can have damaging effects on girls’ emotional state.
Although this study focused on girls, some of its findings apply to boys, too. It cites heavy curricula, competitive examination systems and constant memorisation involved in rote learning as sources of mental illness.
It also cites ‘fears for the future’ and competitive school cultures as some of the main sources of anxiety among students.
Competence Based Curriculum
Jimmy Turyagenda, the former secretarygeneral of the Association of Secondary School Headteachers of Uganda, says the competence-based curriculum now being implemented in lower secondary presents an opportunity to change the country’s education system. Under the curriculum, the national exams constitute 80% of the final mark, while practical projects account for 20%.
In two years, the content-heavy curriculum, which is still being implemented in Senior Three and Four, will be phased out. The A’level curriculum is currently under review.
How To Turn The Tide
The education ministry recently issued guidelines directing education institutions to prioritise mental health for learners and staff.
Schools are now expected to dedicate one hour every week to mental health awareness. The ministry also encouraged schools to hire psychologists or partner with health centre IIIs to handle mental health issues.
Understanding that children grasp concepts at different levels and a change from the theoretical teaching approach, which encourages cramming to practical methods could also help address the problem, Irimaso says.
“If a student does not get aggregate four, it does not mean they are stupid or their life is useless,” he adds. Katana says learners should be given time to interact with the environment as it offers lessons which are vital to their wellbeing.
“Schools should not be focused on directing learning because it stifles the children’s growth and exploration,” she adds.
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