RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,BANGALORE

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 NAME OF THE CANDIDATE

AND ADDRESS

Ms. R.SINDHUIst 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

MASTER OF SCIENCE IN NURSING ( PSYCHIATRIC NURSING )

4 DATE OF ADMISSION TO THE

COURSE

21-04-2012

5.1 TITLE OF THE TOPIC ADOLESCENTS MENTAL ILLNESS

5.2 STATEMENT OF THE

PROBLEM

A PRE EXPERIMENTAL STUDY TO EVALUATE

THE EFFECTIVENESS OF SELF

INSTRUCTIONAL MODULE ON KNOWLEGDE

REGARDING ADOLESCENTS MENTAL ILLNESS

AMONG THE HIGH SCHOOL TEACHERS IN THE

SELECTED HIGH SCHOOLS AT BANGALORE

6. BRIEF RESUME OF INTENTED WORK

INTRODUCTION

“On earth there is nothing great but man; in Adolescents there is nothing great but mind.”

-Hamilton, Sir William

Adolescence, the transitional stage of development between

childhood and adulthood, represents the period of time during which a person

experiences a variety of biological changes and encounters a number of

emotions issues. adolescence covers the period of life between 13 to 19 years of

age. Adolescence is often divided by psychologists into three distinct phases:

early, mid, and late adolescence. They are free from the responsibilities in

general. However, they have the right to get appropriate education. For that

students has to choose their area of interest and they have to study themselves.

During this period they may which is natural encounter some sort of mental

illness.1

Egger and Angold (2006) suggested that to understand early onset of psychiatric

disorders. we can start no later than preschool period . Some problems common to adults

may start in childhood or be influenced by events that occurred early in life. Some

problem may resolve with neurological development or emotional maturity or with a

stable, supportive environment. With effective interventions and early identification of

risk of common childhood mental disorders and reducing the risk of development of

psychological disorders at a later stage is recognized as a major public health goal. The

rates of childhood mental problems continue to increase and interventions carried out

later on in childhood appear limited in effectiveness in many conditions. 2

In India there is a lack of mental health services, more so for this age group.

There is also a lack of qualified personnel to cater to these needs. Under these

circumstances, the role of the school teacher in early detection and prevention of mental

problem is essential. The school teacher spend most of their time with children and

adolescent age group. Therefore they are the ideal personnel who will be in the position

to identify the adolescence mental disabilities early and reduce the risk for psychiatric

disorders reaching into their adult life. There is very limited knowledge in the area of

effectiveness of training the school teachers in identifying those puples at risk and

promoting mental health among adolescent students. 3

Mental disorder can arise from a combination of sources. In many cases there is

no single or consistent cause .Mental illness is not result of personal weakness or

character defect. Mental disorders are complex phenomenon which may caused by a

variety of factors. It may caused by hereditary or biological causes, psychological trauma

or environmental stressors. It affects one third of humans at least once during their

lifetime. A common belief even to this day is that disorders result from genetic

vulnerabilities exposed by environmental stressors. However it is clear enough from a

simple statistical analysis across the whole spectrum of mental health disorders that there

is a strong relationship between various forms of severe and complex mental disorders in

adulthood and the abuse (physical, sexual, emotional).Or neglect of children during the

developmental years especially during the stressful adolescent period.4

Adolescence is a stage before entering into adulthood. There may be many

challenges in this period and it demands adjustment of many fronts. It is a period of

transition between childhood and adulthood. It is a period where rapid physiological

changes and demands for new social roles. Due to these changes often face a number of

crises and delemmas. These may lead to mental or emotional disturbances. In this period

they have many psychological problems. The more serious problems include drug

addiction, alcoholism, smoking, truancy, sexual obsession etc.5

There is stigma that is still attached to mental illness in the developed countries

also. Public health experts who have studied the stigmatization of mental illness in recent

years have noted that the general public's perception of mental illness varies, depending

on the nature of the disorder. It is significant that researchers in the field of social

psychology have moved in recent years to analyzing stigma in terms of stress. Newer

studies in this field now refer to membership in a stigmatized group as a stressor that

increases a person's risk of developing a mental illness. The physiological and

psychological effects of stress caused by racist behavior, for example, have been

documented in African Americans. Stigma has a secondary effect on rates of mental

illness in that members of stigmatized groups have less access to educational

opportunities, well-paying jobs, and adequate health care. They are therefore exposed to

more environmental stressors in addition to the stigma itself.6

Mental illnesses are just medical conditions that disrupt person’s thinking,

feeling, mood, ability to relate to others and daily functioning. By giving awareness on

causes which may negatively affects mental health, helping adolescents in identifying the

triggers and controlling or modifying these and maintain a healthy mind.7

6.1 NEED FOR THE STUDY

Mental health is a natural and important concern for us all. There is more to good

health than just a physically healthy body; healthy person should also have a healthy

mind. A person with a healthy mind should be able to think clearly, able to solve various

problems faced in life. Mind and body as if they are separate in reality but they are like

two sides of a same coin. They share a great deal each other. Importance of maintaining a

good mental health is crucial to living a long healthy life.8

Mental illness is a disorder of mind where thought and /or behavior are normal

and cause distress. The social definition of mental illness is those non –normative

behaviors that are not in line with the expectations of society.9

The findings of a qualitative study conducted by Shikha Dixit in a village in

Kanpur reveals that social understanding causes of mental illness are less and more over

there were many misconceptions regarding this. This emphasis importance of awareness

programme on mental illness and its causes.

The world health organization reported in 2001 about 450 million people

worldwide suffer from some form of mental disorder and majority of these were in

adolescent age.10

An article “Need for a realistic mental health programme in India” from Indian

journal of psychological medicine describes 45 million people in India suffer from

psychiatric illness. Of this about 20 million comes under adolescence.11

A community based cross sectional study was conducted on prevalence and

pattern of mental disability using Indian disability evaluation assessment scale in a rural

community of Karnataka in 2008.Result of this study explains that prevalence of mental

illness was found to be 2.3% and it was higher among adolescence (0.9%) than adults and

older.12

These statistics concerning psychiatric problem among adolescents are

alarming. NIMH estimates that “only 50% of adolescents are diagnosed before

kindergarten” they also state that 44% of primary care providers report caring for at least

10 children with substance abuse 1. Early education is considered to be a significant input

to compensate for early environmental deprivation at home by providing an appropriately

stimulating environment in adolescents. Many studies in country have demonstrated a

significantly positive impact of early adolescents educational experience on retention

rates. 13

In India mental health of the adolescents under 13to 19 years is not given much

consideration. This may be due to lack of mental health promotion services, this

predisposes the adolescents to mental health problems which may in turn lead to

psychiatric disorders in later adulthood. Evidences have shown that interventions for

preventing chronic behavior problems are effective if applied early in life.1 A chance of

success in promoting mental health is more if it is carried out through the ICDS system.

Therefore there is a need for training for school teachers regarding mental health

promotion activities for adolescents belonging to the age group of 13 to 19years .14

According to Surgeon General’s report in 1999 there is emerging evidence

continue to point to an increase in the prevalence of mental health problems among

adolescence and young adults. According to Kessler etal half of all life time cases of

mental illness are now recognized to begin by 14 years. This explains the importance of

educating adolescence regarding mental illness and its causes.15

Government of India has launched the National mental health programme

in1982.One of the most important objective of this is awareness on mental illness and its

causes to the valuable section of population and eradicating stigmatization on mental

illness. The tenth five year plan also emphasis on teaching and research in the field of

adolescent psychiatric clinics and awareness programmes on mental illness. It was a

theme for the word health day 2001 “mental health stop exclusion date to care.”16

Dr.Frankinstein a psychiatrist in his study regarding adolescent mental illness

there is general lack of adolescence understanding of mental illness

From above studies it is clear that there is need for heightening the adolescent’s

knowledge on mental health issues and their impacts. Special education should be given

in the adolescence age period regarding the factors which contributes mental illness. It is

being the crucial period of life they are in need of awaring about the triggers which may

lead to mental illness.17

During psychiatric posting as a part of bachelor of nursing the researcher herself

experienced that there were many adolescents who have suffering mental illness and they

are throwing from normal life. The investigator herself felt that there is lack of awareness

on factors which may lead to mental illness. Hence the researcher helps school teachers

of adolescence to gain knowledge regarding mental illness and its causes. 18

6.2: REVIEW OF LITERATURE The review of literature is defined as a broad, comprehensive in depth, systematic

and critical review of scholarly publication, unpublished scholarly print material, audio

visual material and personal communication.

1. Studies related to identify the causes of adolescent mental illness.

2. Studies related to knowledge and attitude of adolesecent 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. The importance of psychological well being in adolescent for their healthy

emotional, social, physical, cognitive & educational development is well

recognized .So steps to promote mental health should be identified and importance

needs to be given the often neglected age group, namely the adolescents.19

1. Studies related to identify the causes of adolescent mental illness.

A cross sectional study was conducted in general public of southern India to

assess the knowledge and attitude of mental illness and its causes. Data collected by a

questionnaire. 100 subjects were needed Mean knowledge score of the subjects was 5.9.

The conclusion of study was that knowledge of mental illness among general public was

quite poor and suggests the need for strong emphasis on public education to increase

mental health literacy to increase knowledge.20

A cross sectional descriptive study was conducted in a village in northern Nigeria

to examine the knowledge attitude and beliefs about causes of mental illness. Data

collected by a semi-structured questionnaire among 250 samples. Drug misuse including

alcohol, cannabis, and other street drugs was identified in 34.3% of responses as a major

cause of mental illness, followed by divine wrath/Gods will(19%),and magic/spirit

possession(18%).This study demonstrates the need for educational programs aimed at

demystifying mental illness.21

A study was conducted by Claudine Fox Eith ne Buchman on knowledge of

causes and consequences of mental illness among adolescence. The study adopted a semi

structured interview technique was adopted for data collection.150 subjects were

participated in the study. Overall the findings indicate adolescents do hold less

knowledge on causes and consequences.22

A 3 year panel study was conducted on mental disorder among adolescents in

Taiwan. This study investigated the prevalence and changing trends of mental disorder

and effects of urbanization among adolescents in Taiwan. Random sampling technique

used in selection of 1051 adolescence. A two-stage case identification was conducted by

mental health professionals with the Schedule for Affective Disorders and Schizophrenia

for School-Age Children—Epidemiologic Version, supplemented by information from

the Child Behavior Checklist. Result of the study was weighted 3-month prevalence rates

across the 3 consecutive years for overall psychiatric disorders were 20.3%, 22.7%, and

14.8%, respectively. The most prevalent psychiatric condition was attention deficit

hyperactivity disorder (ADHD) in the first 2 years and substance use disorders in the

third. During the 3 years, the rates for ADHD, specific phobia, and social phobia

decreased, and the rates for major depression and substance use disorders, conversely,

increased. Although conduct disorder, ADHD, and substance use disorders were more

prevalent among boys, the rates for major depression, social phobia, specific phobia, and

adjustment disorder were higher among girls. Rural adolescents had higher rates of

conduct disorder, oppositional defiant disorder, and substance use disorders than their

urban counterparts. Findings were similar to those of previous studies among

adolescents in prevalence rates, changing trends of most mental disorders. The

differential changing trends in various diagnostic groups may imply the importance of

specific measures for prevention during adolescence.23

2. Studies related to knowledge and attitude of adolescence mental

illness A study was conducted by Amya Watson &Emilie on changing adolescence

attitude about mental illness through education. 23 teachers from 16 states and districts of

Columbia participated in the field of test and provided evaluation data from total of 1566

adolescent students. Findings of the study suggest 38% adolescents having below average

knowledge regarding mental illness and its causes and education improved their

knowledge scores.24

A study was conducted by A F Jorn DSC on public knowledge and beliefs of

mental disorders and importance of public health literacy in Canberra .Method of the

study was a narrative review with in a conceptual framework. Findings of the study

explain that many members of public cannot recognize s specific disorders or different

psychological distress. Attitude which hinder recognition and appropriate help-seeking

are common. However there is evidence that mental health literacy can improve public

health.25

It is not the disease to be cured first, but stigma towards the mentally ill. Study

was conducted by Lasbikon VO, Gueje O, and Olley on knowledge and attitude of 2040

community samples in Nigeria. It was found that there is widespread stigmatization of

mental illness in the Nigerian community. Negative attitude towards mental illness may

be fuelled by notion of causation that suggest that affected people are in some way

responsible for their illness, and by fear.26

A study was conducted to estimate the incidence of psychiatric disorders in school

children. A representative sample of school children was assessed through a two stage

evaluation process involving teacher's rating (N=963) and parent rating (N=873).

Children who scored below the cut-off for psychiatric disorder (N=727) on both the

screening instruments were re-contacted six years later. 186 children and their families

were personally available for reevaluation. All the children and their parents were re-

assessed on Parent Interview Schedule. The prevalence of adolescent mental disorders is

high in low and middle income countries. Reported rates are 17.7% in 1-15 yrs old in

Ethiopia;[4] 15% among 5-10 yrs olds of Bangladesh;[5] 12.7% in 7-14 yrs olds urban

Brazilian school sample[6] and 7% in 7-14 yrs rural Brazilian school[7] and 6.9% in 4-17

yrs. Puerto Rican community based sample.[8] Studies from India have revealed the

prevalence rates to be 12.5% in 0-16 yrs community based sample from Bangalore;[9]

9.4% in 8-12 yrs olds from a community sample in Kerala[10] and 6.3% in 4-11 yrs old

school children in Chandigarh.[11] Overall rates of CAMD in India and other middle and

low income countries range between 6%-15% which are on the lower side as compared to

reported rates from certain western countries such as Canada 18.1%,[12] Germany

20.7%,[13] Switzerland 22.5%,[14] USA 21%.27

A retrospective cross-sectional time trend study was conducted by Michelle M.

Garrison, MPH; Laura P. Richardson, MD, MPH; Dimitri A. Christakis, MD, MPH;

Frederick Connell, MD, MPH to determine if mental health hospitalization have

increased among adolescence. The Washington State Comprehensive Hospital Abstract

Reporting System data set was used to examine hospitalizations among youth (aged 5-19

years) from January1, 1990, through December 31, 1999. Among adolescents (aged 15-

19 years), change occurred in the rate of mental illness hospitalizations increased from

14.5% in 1990 to 21.5%in 1999 .During the past decade, mental illness has surpassed

injury as a leading cause of hospitalization for Washington youth.28

A collaborative study was conducted on severe mental health morbidity among 4

centers in India to determine prevalence of severe mental health illness in the community.

The essential core of the study was the training of and intervention by the primary health

care personnel for identification and management of severe mental illness. A field survey

was carried out by the research team at all the 4centres to estimate the prevalence of

severe mental morbidity. Trained research investigators administered a simple 15

questions screening Performa to one adult member of every household in the study after

collecting certain basic socio-demographic information about the household. This

'symptom in others' questionnaire asked them if they knew anybody who suffered from

one or more of the 15 symptoms either in their families or in their villages. . The

'symptoms in the questionnaire' is essentially an instrument which detects severe mental

morbidity. The study results show 30% of the community having symptoms.29

All above studies reveals that the incidence of mental illness is increased now

a day especially among adolescents. Hence it requires educational programes for

strengthening their knowledge regarding mental illness and its causes.30

6.3 STATEMENT OF PROBLEM

A PRE EXPERIMENTAL STUDY TO EVALUATE THE EFFECTIVENESS

OF SELF INSTRUCTIONAL MODULE ON KNOWLEGDE REGARDING

ADOLESCENTS MENTAL ILLNESS AMONG THE HIGH SCHOOL TEACHERS IN

THE SELECTED HIGH SCHOOLS AT BANGALORE.

6.4 OBJECTIVES OF THE STUDY:

1. To assess the knowledge of high school teachers regarding adolescents mental illness

through pretest before the administration of self instructional module.

2. To assess the knowledge of high school teachers regarding adolescents mental illness

through posttest after administration of self instructional module.

3. To associate the pre test scores of high school teachers with selected demographic

variables.

4. To associate the post test scores of high school teachers with selected demographic

variables.

6.5 OPERATIONAL DEFINITIONS:

1. EVALUATE:

The process of judging the value or quality of self instructional module regarding

adolescents mental illness among the high school teachers in a selected high schools

at Bangalore.

2. EFFECTIVENESS:

It means the extent to which self instructional module produces an intended

outcome as measured by structured knowledge questionnaire

3. SELF INSTRUCTIONAL MODULE:

Self instructional module refers to a systematically organized learning module

prepared by investigator and validated by experts on teaching strategy of information

regarding adolescents mental illness its causes and prevention.

4. KNOWLEDGE:

It refers to the understanding of information regarding adolescents mental illness.

5. MENTAL ILLNESS:

Conditions characterized by impairment of an individual’s normal cognitive,

emotional or behavioral functioning.

6. ADOLESCENTS:

Adolescent refers to students under the age group of 13-19 years in a selected high

schools.

7. SELECTED H IGH SCHOOLS TEACHERS:

The teachers who is working in the Institution which offer education for 8 th ,9th ,10th

standard students.

6.6 HYPOTHESIS:

H 1=There will be a significant difference between pretest and posttest among teachers

regarding adolescents mental illness after the administration of self instructional module.

H2=There will be significant association between posttest score of knowledge and

selected demographic variables

6.7 VARIABLE

INDEPENDENT VARIABLE

It is the condition or character manipulated by researcher. self instructional module for

high school teachers regarding the adolescents mental illness is the independent variable

in this study.

DEPENDENT VARIABLE

These are the characteristics that appear or disappear or change as the researcher

introduces removes or change independent variable. Dependent variable is the knowledge

of high school teachers regarding adolescents mental illness.

EXTRANEOUS VARIABLE

These are variables not manipulated by the researcher that may have significant effect on

dependent variables. They are gender, age, religion, marital status, education, experience

and source of previous knowledge.

6.8 ASSUMPTIONS:

1. High school teachers may have basic knowledge regarding adolescents mental

illness to and may show interest to learn further.

2. Self instructional module will improve the knowledge of teachers regarding

adolescents mental illness.

7. MATERIAL AND METHODS OF STUDY

7.1 METHOD OF DATA COLLECTION

7.1.1 RESEARCH APPROACH

Evaluative approach.

7.1.2 RESEARCH DESIGN:

A pre experimental study one group pre test post test design is planned for

research study.

7.1.3 RESEARCH SETTING

This study is conducting in a selected high schools at Bangalore, Karnataka.

7.1.4 POPULATION

A population is an aggregate of elements showing some commonest of criteria.

Population of the study includes high school teachers who are working in the high

schools at Bangalore.

7.1.5 SAMPLE

Sample is a subject of population selected to participate in research studies. it includes

high school teachers who are working in the high schools at Bangalore. who have

fulfilled the inclusion and exclusion criteria.

7.1.6 SAMPLE SIZE

50 high school teachers who are working in the high schools at Bangalore.

7.1.7 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.

7.2 CRITERIA FOR SAMPLE SELECTION

Inclusion criteria

1. Teachers who are present at the time of data collection.

2. Teachers who are willing to participate.

3. Teachers who are working at high schools.

4. Teachers who are offering education to 8th, 9th 10th classes.

Exclusion criteria

1. Teachers who are working in the primary schools.

2. Teachers who are working in the pre university college.

7.3 LIMITATIONS OF THE STUDY.

This study limited to,

1. 50 High school teachers in a selected high schools at Bangalore, Karnataka.

2. Study limited to a period of 4 weeks.

7.4 SIGNIFICANCE OF THE STUDY

This study will help the researcher to find out the high school teachers knowledge

about causes of mental illness and this will Increase the knowledge of teachers regarding

causes and prevention of adolescent mental illness. Hence this helps them to identify the

factors contributing to the onset of mental illness and preventing or modifying them.

7.5 COLLECTION OF DATA

Data will be collected by a structured questionnaire.

7.6 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 adolescent mental illness.

7.7 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 teachers regarding mental illness by a self

instructional module, followed by administration of planned self instructional module on

adolescents mental health, then conducting a post test by the same questionnaire after 7

days.

7.8 PLAN FOR DATA ANALYSIS

The analysis of data will be based on research hypothesis and by using descriptive and

inferential statistics.

Descriptive statistics

It includes percentage; frequency, mean and standard deviation will be used to depicit

the demographic data as well as the knowledge scores of high school teachers regarding

adolescents 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.

7.9 ETHICAL CONSIDERATION

1. Does the study require any intervention to be conducted on high school teachers?

Yes, Informed consent will be taken from the respondent.

2. Has ethical care be obtained from your institution?

Yes, ethical care will be obtained from our institution.

3. 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.

8. LIST OF REFERENCES (VANCOUVER STYLE)

1. http://thinkexist.com/quotation.

2. http://media.willey.com/product.”An introduction to mental health and mental

illness.”

3. http://encyclopedia.wilkipedia.org “Mental health.”

4. Ahuja neeraj.”A short text book of psychiary.”Sixth edition. New Delhi:J.P

Brothers Medical Publishers PVT(Ltd);2004 .

5. Johnson Schoen Barbara. Child Adolescent& Family Psychiatric Nursing. First

Edition.Philadelphia:J.B.Lippincot company:1995 5-7.

6. http://brainblogger.com/2011/mental health-prevalent-among-youth-worldwide.

7. 7.http://www.loudounfriends.org.Child and Adolescent Mental Health.

8. http://neuroskeptic.blogspot.com/2011/about Mental Illness/faq.html

9. Bary.D.Patricia.Psychological Nursing. Third Edition.Philadelphia: Lippincott

Company; 1996.196-198.

10. http://nichy.org/disability/specific emotional disturbance.

11. Townsend.C.Mary.Psychiatric Mental Health Nursing. Fifth Edition. New Delhi:

J.P Brothers Medical Publishers company: 1997 13-16.

12. http://encyclopedia.wilkipedia.org.Prevalence of mental disorder.

13. Ankur Barva.Need for a realistic programme in India. Indian Nursing Journal

Psychological Medicine.2009 January: Volume31.page No.348-49.

14. 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.

16. Lalitha.K.Mental Health and Psychiatric Nursing. First Edition Bangalore:

Gajanana Book Publishers; 1999 Page No 21-22.

17. Basavanthapa.B.T.Nursing Resaerch.Second Edition. New Delhi: J.P.Brothers

Medical Publishers PVT (Ltd); 2003.page No.92.

18. www.njcmindia.org.Knowledge attitude and belief of public of northern Nigeria.

19. Kabir.M.Perceptions and Beliefs about Mental illness. International Health And

Human Rights.2004 Augest; page no.698.

20. http://epubs.surrey.ac.uk/1623/1/fulltext.pdf. Claudine Fox. Children’s

Knowledge of the Causes and Consequences of Mental Illness

21. Susan.A.Gaumd. A 3-Year Panel Study of Mental Disorders among Adolescents

in Taiwan. American Journal of Psychiatry.2005July; Volume. 162:1344-1350

22. emdr.nku.edu/emdr.Amya Wason.Changin Adolescents attitude on mental illness.

23. http://bjp.rcpsych.org/content/177/5/396.full A. F. JORM, DSC Mental health

literacy

Public knowledge and beliefs about mental disorders

24. berkeley.edu/news/media/releases/2007/01/16_stigma.shtml.Stigma toward

mentally ill.

25. www.nida.nihgov.com.Saviha Malhothra.Child And Adolescent Mental Illness

drug abuse statistics.

26. archpedi.ama-assn.org/cgi/reprint/158/8/781.pdf Michelle M. Garrison

2004.Mental sIllness&Hospialization of youth.

27. 20.icmr.nic.in/mentalhealth.Dr.Narender Kumar. Indian council of medical

research.

9. Signature of the candidate.

10. Remarks of the guide.

11. Name and designation of (in block letters )

11.1. Guide 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.