Abstract:
BACKGROUND: Sri Lanka recorded an extraordinary high suicide rate for adolescents
aged 15 - 19 in the early 1990s (46.5/100,000). With this in perspective, the
Ministry of Health in Sri Lanka recommends school programmes for adolescents by
mental health units of local hospitals.
METHODS: We conducted cross sectional surveys to screen for symptoms of anxiety
and depression among students aged 14 - 18 during school mental health
programmes. Two schools were randomly selected within the Ratnapura municipality
(urban population of approx. 50,000), Sri Lanka and all students aged 14-18 were
assessed with self administered (pre tested, Sinhalese translations)
questionnaires [Center for epidemiologic studies depression scale, Anxiety
screening test of suicide and mental health association international].
RESULTS: A total of 445 students were assessed (male-54.4%, female 45.6%). Thirty
six percent screened positive for depression (mild depression-17%, severe
depression-19%) and 28% screened positive for severe anxiety. Females screened
positive for depression and anxiety significantly more than the males (p =
0.0001, 0.005 respectively). Students in classes facing barrier examinations at
the end of the year had the highest positivity rates. Examination related issues
(36%) were the most commonly cited problem.
RECOMMENDATIONS: It is recommended that: 1. School mental health development
programmes in Sri Lanka concentrate more on reducing examination related stress,
and in particular focus on the female students. 2. Policy decisions are made to
reduce competition for higher education. 3. A nationally coordinated survey on
mental health of adolescent students is carried out utilizing the island-wide
network of medical officers of mental health.
