Mental health problems and associated factors in secondary school students from Foshan, Guangdong, China

Secondary school students are in a relatively sensitive adolescent period, which is critical for mental development. The present study aimed to examine the mental health status and associated factors in secondary school students.

Secondary school students were enrolled from all the five secondary schools in Shunde District, Guangdong. The Mental Health Inventory of Middle School Students (MMHI-60), School Refusal Behavior Evaluation Scale (SRBES), School Refusal Assessment Scale for Children (SRAS-C), Revised Chinese Internet Addiction Scale (CIAS-R), Pittsburgh Sleep Quality Index (PSQI), Adolescent Suicide Tendency Scale (ASTS), Connor-Davidson Resilience Scale (CD-RISC), and Self-esteem scale (SES) were used to assess mental health problems and determine associated factors in secondary school students.

A total of 8,013 secondary school students were included. The prevalence of abnormal mental health was 22.4% by MMHI-60, 19.7% by SRBES, 5.4% by CIAS-R and 20.3% by ASTS, respectively. The scores of CD-RISC and SES were positively correlated with each other, and negatively correlated with the scores of SRBES, CIAS, PSQI, ASTS, and MMHI-60 (p < 0.05). The scores of SRBES, CIAS, PSQI, ASTS, and MMHI-60 were positively correlated with each other (p < 0.05). There were 62 students (0.8%) who showed abnormal mental problems suggested by all four scales of SRBES, CIAS-R, MMHI-60, and ASTS. Girls had significantly higher scores of SRBES, SRAS-C, PSQI, ASTS, CIAS-R, and MMHI-60 but significantly lower scores of SES and CD-RISC than boys (p < 0.05). Additionally, economic status, father's education, mother's education and grade rank were also associated with the above eight scales (p < 0.05).

Our study demonstrated the mental health problems in secondary school students and associated factors, which are essential for developing targeted interventions and policies to support the mental well-being of this vulnerable population.