research title about mental health of teachers

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Open Access

Peer-reviewed

Research Article

Teacher mental health and workplace well-being in a global crisis: Learning from the challenges and supports identified by teachers one year into the COVID-19 pandemic in British Columbia, Canada

Roles Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

Roles Formal analysis, Funding acquisition, Methodology, Writing – original draft, Writing – review & editing

Roles Formal analysis, Investigation, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing

Roles Conceptualization, Formal analysis, Methodology, Project administration, Writing – original draft, Writing – review & editing

Affiliation Department of Psychology, Western Washington University, WA, United States of America

Roles Conceptualization, Formal analysis, Funding acquisition, Methodology, Project administration, Writing – original draft, Writing – review & editing

Roles Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Writing – review & editing

Affiliations Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, Department of Psychology, University of Illinois Chicago, Chicago, IL, United States of America

Roles Conceptualization, Funding acquisition, Investigation, Methodology, Writing – review & editing

Roles Conceptualization, Funding acquisition, Investigation, Methodology, Writing – original draft, Writing – review & editing

• Anne M. Gadermann, 
• Monique Gagné Petteni, 
• Tonje M. Molyneux, 
• Michael T. Warren, 
• Kimberly C. Thomson, 
• Kimberly A. Schonert-Reichl, 
• Martin Guhn, 

• Published: August 31, 2023
• https://doi.org/10.1371/journal.pone.0290230
• Reader Comments

The COVID-19 pandemic and related school disruptions have led to increased concerns for the mental health of teachers. This study investigated how the challenges and systemic supports perceived by teachers during the COVID-19 pandemic were associated with their mental health and workplace well-being. This cross-sectional, survey-based study was conducted in February 2021, just prior to the third wave of the pandemic in British Columbia (BC), Canada (N = 1,276). Four multivariable linear regression models examined the associations between teachers’ pandemic-related challenges (pandemic-related personal stressors, teacher workload, difficulty implementing safety measures, meeting students’ needs), systemic supports (education system mental health and well-being support), and four mental health (psychological distress, and quality of life) and workplace well-being outcomes (job-related positive affect, turnover intentions), adjusting for sociodemographic and school characteristics. The Pratt index ( d ) was used to assess the relative importance of each predictor. A thematic qualitative analysis was conducted on teachers’ open-ended responses. Teachers’ workplace well-being (job-related positive affect and turnover intentions) was predominantly associated with their perceptions of education system support for their mental health and well-being ( d = 46%, d = 41%, respectively). The most important predictor of general mental health (psychological distress and quality of life) was the number of COVID-19 related personal stressors teachers reported ( d = 64%, d = 43%, respectively). The qualitative analyses corroborated and expanded upon the quantitative findings. Understanding pandemic-related challenges and supports impacting teacher mental health and workplace well-being equips us to make evidence-informed policy decisions to support teachers now and in future school disruptions.

Citation: Gadermann AM, Gagné Petteni M, Molyneux TM, Warren MT, Thomson KC, Schonert-Reichl KA, et al. (2023) Teacher mental health and workplace well-being in a global crisis: Learning from the challenges and supports identified by teachers one year into the COVID-19 pandemic in British Columbia, Canada. PLoS ONE 18(8): e0290230. https://doi.org/10.1371/journal.pone.0290230

Editor: Humayun Kabir, McMaster University, CANADA

Received: February 8, 2023; Accepted: July 16, 2023; Published: August 31, 2023

Copyright: © 2023 Gadermann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The underlying dataset utilized for this study is available upon researcher request for the purpose of replicating the study findings by contacting Michele Wiens, Senior Manager and Privacy Officer at the Human Early Learning Partnership, University of British Columbia ( [email protected] ). In order to uphold ethical obligations to consenting study participants, the data cannot be made publicly available. At the time of recruitment, the consent form and process were not designed with the intention of making the data publicly available (this study and associated data collection was in rapid response to the COVID-19 pandemic). Given this, there are a number of restrictions that do not allow for the data to be made publicly available: First, participants have consented to the data being stored in a password protected database on Canadian-hosted servers only. Second, university policy requires that the data be stored at UBC under the responsibility of the PI for a minimum of 5 years after publication. Third, there are a number of consent form inclusions outlined by the university ethics board for making data open access that have not been included in the consent form: (1) A description of what open access means, i.e. who will have access, and where/how data will be stored. (b) A description of the data that will be made available, e.g. that identifiers will be removed. (c) Acknowledgement (if applicable) that opening access to data has the potential for increasing participant risk. (d) An explanation that once the data is made available, the participant will not be able to withdraw their data.

Funding: This study was funded by a grant titled, ‘The impact of the COVID-19 pandemic on student and teacher well-being: Examining inequity, supports, and adaptation strategies for an intersectoral response’ from the Social Sciences and Humanities Research Council (SSHRC) – a national funding agency in Canada. We have added the grant number AWD-016198.

Competing interests: The authors have declared that no competing interests exist.

Introduction

There is a long-standing recognition that teaching is a stressful profession [ 1 , 2 ], with high levels of burnout [ 3 ] and attrition rates of up to 30% [ 4 ]. The sudden and dramatic changes introduced during the pandemic created many challenges for teachers and exacerbated already-stressful job conditions [ 5 ]. The existing research on teacher mental health during the first year of the pandemic has confirmed heightened levels of stress and emotional exhaustion among teachers in Canada [ 6 – 8 ] and in other countries [ 9 – 12 ]. A systematic review of studies conducted in 2020/2021 in China, Brazil, the United States, India, and Spain found anxiety, depression, and stress to be highly prevalent among teachers during the pandemic [ 13 ]. Although the long-term effects of the pandemic on teachers’ mental health are currently unknown, preliminary research suggests that mental health challenges persisted over the course of the pandemic. For example, a longitudinal qualitative trajectory analysis exploring teachers’ mental health at three time points in 2020 found consistent declines in teachers’ mental health [ 14 ]. In the Spring of 2021 (over 1 year into the pandemic), an empirical study measuring the mental health of Canadian school staff found significantly higher rates of anxiety symptoms compared to a representative sample of Canadian adults [ 15 ]. Similarly, teachers in the United States surveyed between the Fall of 2020 and the Spring of 2021 reported significantly higher rates of anxiety and depressive symptoms compared to respondents in other professions [ 16 ].

Over and above the general stressors experienced by individuals during the pandemic, teachers have reported a number of work-related stressors related to health and safety. As some have noted, with daily exposure to unvaccinated children and youth, teachers’ work placed them on the front lines of the pandemic but without the protections afforded other essential workers, such as earlier access to vaccines [ 17 ]. About half of teachers surveyed in the fall of 2021 in BC, Canada (where schools remained open although other social gathering restrictions were in place at this time), reported that they did not feel safe at work, and over half felt school sanitation efforts were not adequate for reducing the spread of the coronavirus [ 6 ]. The persistent uncertainty due to rapid changes in public health orders and teaching conditions (i.e., online, hybrid, and in-person) further contributed to increased stress [ 18 ]. Related to the pandemic and the associated school disruptions, teachers also reported other stressors, such as a greater need for communication and learning support from families, the need to learn new technologies, and overworking to meet the needs of vulnerable students [ 7 , 19 ].

Alongside the multiple challenges and stressors, it is important from a strength-based perspective to consider the supports experienced by teachers during the pandemic. Research early in the pandemic identified relationships as especially important for teachers in the United Kingdom [ 20 ]. This finding echoes previous research identifying social supports as central to the reduction of acute teacher stress [ 12 ]. Other studies conducted during the first 6 months of the pandemic suggested that school- and district-based leadership may be essential for promoting teacher well-being and preventing burnout [ 7 , 21 , 22 ]. Research conducted in this space during the COVID-19 pandemic is limited but points to the importance of support and suggests that systemic structures and supports within education systems may play a critical role in promoting positive mental health and workplace well-being during stressful periods such as the COVID-19 pandemic.

Overall, research conducted since the onset of the COVID-19 pandemic has indicated that the mental health of teachers has been compromised. However, this research predominantly focused on a limited set of mental health factors (namely, stress and anxiety), which represent only an aspect of mental health as it is generally conceptualized today. The WHO has defined mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community”[ 23 ]. To date, few studies examining the impact of the pandemic on teacher mental health have captured a broader definition of mental health. There is a need for more research that examines teacher mental health from a strength-based perspective (i.e., considering positive as well as negative outcomes) and that accounts for a critical, context-specific component of the overall mental health of teachers: workplace well-being (“working well”, as described in the WHO definition of mental health; [ 23 ]). Additionally, there has been limited research that has captured teachers’ own voices and focused on how challenges (i.e., any factor that caused stressed or worry in the context of the COVID-19 pandemic) and supports (i.e., perceptions of education system support related to mental health and well-being) were associated with teacher mental health and workplace well-being during the pandemic. Understanding the factors that promoted positive mental health outcomes for teachers and protected against the negative outcomes during the COVID-19 pandemic is critical from a future-facing standpoint: It provides important information on how teachers can be supported in the recovery from the pandemic and provides an opportunity to take early action to support the mental health and workplace well-being of teachers in future global crises that lead to school-related disruptions, such as a pandemic or another serious global problem impacting the world.

The current study

The current study took a strength-based, contextualized perspective and investigated the specific challenges and supports reported by teachers during the COVID-19 pandemic and how they were associated with teachers’ mental health and workplace well-being in BC, Canada. The objective of the study was to investigate how pandemic-related challenges (e.g., workload changes, stressors, difficulty in implementing safety measures at school) and systemic supports (from colleagues, school-based administrators, school board, the BC Ministry of Education and Child Care, and union) were associated with teachers’ mental health (quality of life, psychological distress) and workplace well-being (job-related positive affect, turnover intentions) during the COVID-19 pandemic.

The cross-sectional, survey-based study was conducted in partnership with the BC Ministry of Education and Child Care (MOECC), and in collaboration with the BC Teachers’ Federation (BCTF). The survey was conducted online from February 3–14, 2021, at the end of the first year of the COVID-19 pandemic and just prior to the third wave when nearly 3000 cases per week (cumulative incidence of approx. 58 per 100K) were reported in BC [ 24 ]. Email survey invitations were distributed by the BCTF to a random sample of 7,000 BCTF actively employed members who work in public schools across the province. BCTF members include classroom teachers, teachers teaching on call (TTOC), adult/continuing education teachers, distributed-learning (DL) teachers, district coordinators or district helping teachers, local officers or local executive officers, special education teachers, learning assistance teachers, teacher librarians, counsellors, English language learning teachers, and Aboriginal/Indigenous Culture teachers. Prior to the survey launch, an information letter on the survey and project was sent out to all members through the BCTF newsletter. The letter and the survey explained the principles of informed consent and teachers were asked to provide their written consent on the survey at the time of survey completion. Ethics approval for this project was obtained from the University of British Columbia Behavioural Research Ethics Board.

At the time of data collection, BC schools were operating under the guidelines of the Provincial Health Officer [ 25 ] that mandated several infection prevention and exposure control measures to stop or limit transmission of COVID-19 within schools. These included avoiding activities with close face-to-face contact, assigning staff to a specific student cohort, limiting school gatherings including school assemblies and extracurricular activities, cancelling inter-school events, and mandating mask wearing indoors for all K-12 staff and middle/secondary school students (by personal or family/caregiver’s choice for elementary school students). School districts could also offer flexible in-person and remote learning options for students and families [ 26 ] and BC was one of the few contexts where in-person teaching continued uninterrupted for the 2020/2021 school year. At the time of data collection, a number of province-wide public health measures had been in place for several months, including mask mandates for indoor public settings and a restriction on social gatherings beyond household bubbles [ 27 ].

Participants

The sample included 1,276 teacher survey respondents from across BC (a response rate of 17%). The majority of respondents identified as women (83%) and between the ages of 35 and 54 (58%). On average, respondents reported just over 15 years of teaching experience. Most of the respondents were classroom teachers (64%); the remainder were in other roles, such as special education teachers and counsellors. Most respondents reported holding a full-time teaching position (83%). Just over half of the respondents (56%) were elementary school teachers, with secondary school teachers comprising the second largest proportion (30%). Respondents were mainly from large school districts (68%). A full overview of the sample demographics is provided in Table 1 .

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https://doi.org/10.1371/journal.pone.0290230.t001

Mental health and workplace well-being.

We measured four outcomes of teachers’ mental health and workplace well-being: Two general indicators of mental health (quality of life, psychological distress) and two indicators of workplace well-being (job-related positive affect, turnover intentions).

Quality of life was assessed using a previously validated item from the PROMIS Global 10 Generic Health Questionnaire. Participants were asked, “In general, would you say your quality of life is…” with response options ranging from 1 (Poor) to 5 (Excellent) [ 28 ].

Psychological distress was measured using the Kessler-6 item Psychological Distress Scale (K6) [ 29 , 30 ]. The K6 asks respondents to indicate how often they have felt six different emotional states during the past 30 days on a scale from 0 (none of the time), 1 (a little of the time), 2 (some of the time), 3 (most of the time) to 4 (all the time). Emotional states included “…so sad nothing could cheer you up,” “nervous,” “restless or fidgety,” “hopeless,” “that everything was an effort,” and “worthless.” Previous validation research has suggested summed scores ≥ 13 indicate serious mental distress and scores ≥ 5 indicate moderate mental distress [ 29 , 31 ]. The scale demonstrated good internal consistency (α = 0.85).

Job-related positive affect was measured using two items from the Job-related Affective Well-being Scale (JAWS) [ 32 ] plus a third item developed for the purpose of this study by the research team. Participants were asked, “How frequently did you experience each feeling or emotion over the past 30 days?” using response options ranging from 1 (never) to 5 (extremely often or always). The following three affective states were selected based on their relevance and representation of positive job-related affective well-being for teachers in the context of the pandemic, “My job made me feel… (1) inspired; (2) satisfied; (3) a sense of purpose.” The job-related positive affect items demonstrated good internal consistency (α = 0.88).

Turnover intentions were measured using one item adapted from the University College London COVID-19 teacher well-being survey [ 33 ]. Participants were asked, “Has the experience of the COVID-19 pandemic made it more or less likely that you will seek to leave the profession altogether in the next few years? (please select one).” Response options were, “Yes I’m now less likely to seek to leave the profession” (scored as 1), “No I’m no more or less likely to seek to leave the profession due to COVID-19” (scored as 2), and “Yes I’m now more likely to seek to leave the profession,” (scored as 3).

Pandemic-related challenges and supports.

Pandemic-related personal stressors were assessed using the item, “In the context of the COVID-19 pandemic, to what extent have you been stressed or worried about any of the following in the past 2 weeks?” Example stressors included “Being exposed to the virus at school” and “Feeling isolated or alone” (see Fig 1 for all items). Responses ranged from 1 (Not at all) to 5 (Completely). Binary (0/1) variables were created for each of the 15 stressors, whereby individuals who reported being ‘Moderately’, ‘Very Much’, or ‘Completely’ stressed or worried were considered to have experienced the stressor (scored as 1; lower values were scored 0). For the analysis, a composite pandemic-related personal stressor variable was created that was the sum of all 15 aforementioned binary stressor scores (with higher scores indicating exposure to more stressors; scores ranged from 0–15). This variable was adapted from a pandemic impact survey developed by members of the study team in collaboration with the Canadian Mental Health Association and UK Mental Health Foundation [ 34 ].

Teachers who indicated feeling moderately, very much, or completely stressed or worried in the past two weeks about a given personal stressor were included as reporting stress or worry in that area. *Note. Only valid cases (i.e., teachers with children) were included to calculate the percentage of teachers stressed or worried about ‘looking after my children while continuing to work’.

https://doi.org/10.1371/journal.pone.0290230.g001

Pandemic-related changes to teacher workload was assessed using the item, “Compared to before the COVID-19 pandemic, my workload is…” Responses could range from 1 (A lot less than before) to 5 (A lot more than before). This item was adapted from a pandemic impact survey developed by the BCTF.

Difficulty implementing safety measures was assessed by the item, “How easy or hard is it to implement the following safety measures at your school?” Teachers were asked to respond in relation to five specific school safety measures: Wearing a mask, practicing physical distancing, washing hands (or using hand sanitizer) more often, staying home when sick, and avoiding large gatherings. Responses ranged from 1 (Very easy) to 5 (Very hard). For the analysis, a composite variable was created that represented the mean score for all five safety measures. This item was adapted from a pandemic impact survey developed by the BC Centre for Disease Control [ 25 ].

Meeting students’ needs was assessed using three items, “In general, during this school year, to what extent do you feel that students’ academic needs/social and emotional needs/special needs] are being met?” Responses ranged from 1 (Not at all met) to 5 (Completely met). For the analyses, a mean score of all three items was created. These items were developed by the study team in collaboration with the MOECC and BCTF.

Education system mental health and well-being support during the pandemic was assessed by asking teachers about the extent to which they felt supported by principals and school-based administrators, their school board, the MOECC, their union, and their colleagues. Teachers responded to the following item for each of the five potential sources of support, “In supporting your mental health and well-being during the pandemic this school year, to what extent are the following true for you?” (e.g., “I feel supported by my school board”). Responses ranged from 1 (Not at all true) to 5 (Completely true). For the analysis, a composite education system support score was calculated which represented the mean score across all five sources of support. This item was adapted from a pandemic impact survey developed by and in consultation with the BCTF.

School and teacher characteristics.

Teachers reported the gender they most identified with (women coded as 1, men as 0 for inclusion in analyses given the small sample size for other gender identification) and their age (see age groupings in Table 1 ). Teachers were asked about their living situations, resulting in a ‘lives alone’ binary variable (1 = lives alone, 0 = does not live alone) and a ‘lives with children’ binary variable (1 = lives with children < 18 years old, 0 = does not). Teacher experience was assessed as the number of years of teaching experience. Respondents were asked to include experience teaching in all jurisdictions, including outside of Canada.

Teachers were asked to specify the type of teaching position(s) they held (e.g., classroom teacher or learning assistance teacher). They also indicated whether their teaching assignment was a full-time or part-time position. School type was assessed by the question, “Where do you currently teach?” Teachers could select all that apply. In BC, elementary school typically covers the years from Kindergarten to Grade 7 (ages 5–12). Secondary school covers the years from Grade 8 to 12 (ages 13–17). Some school districts have Middle school, which covers Grades 6–8. District sizes were calculated based upon the number of Grade 4 students in a given district (school districts with greater than or equal to 1000 Grade 4 students were considered large; see Table 1 for details).

Open-ended responses.

Teachers were asked two open-ended questions: “During the pandemic this school year, if there were any structures, supports, or resources within the education system that had a positive impact on your mental health and well-being, please describe them below,” and, “If there is anything else you would like us to know about your experiences during the COVID-19 pandemic this school year, please share below.”

Quantitative analyses.

Analyses were conducted using IBM SPSS software (Version 28.0). Descriptive statistics were calculated for all variables. Four multivariable linear regression models were conducted to examine the associations between teachers’ pandemic-related challenges (pandemic-related personal stressors, teacher workload, difficulty implementing safety measures, meeting students’ needs) and supports (education system mental health and well-being support) and the four mental health and workplace well-being outcomes of interest (quality of life, psychological distress, job-related positive affect, turnover intentions). All four models were adjusted for school and teacher characteristics (gender, living alone, living with children, years of teaching experience, and school type). The PRATT-index [ 35 ] characterized the relative importance of each predictor in relation to the total variance explained in each model, with values ranging from 0 (predictor accounts for none of the model’s explained variance) to 1 (predictor accounts for all of the model’s explained variance). Values below .04 were considered unimportant based upon the number of predictors included in the models in the current study [ 36 ]. We conducted complete case analyses whereby missing data were excluded listwise.

Open-ended survey item qualitative analysis.

Utilizing NVivo 12 software (QSR International Pty Ltd, Melbourne, Australia), a six-phase thematic analysis was undertaken [ 37 ] for each open-ended survey item. For the first item (teachers were asked to describe any structures, supports, or resources within the education system that had a positive impact on their mental health and well-being), content that mapped onto the prompt to describe supports, structures, and resources were entered as free nodes and used to code the responses wherever references to them occurred. Through further discussion and analysis, these codes were developed into themes along with sub-codes that reflected our interpretation of the data. For the second item (teachers were asked to share anything else they wanted us to know about their experiences during the COVID-19 pandemic that school year), a similar process was used; however, since this item had no categories in the prompt, a fully inductive approach was utilized to generate codes and construct themes.

Teachers’ mental health and workplace well-being

Teachers reported that their quality of life was on average ‘good’ (a midpoint scale score of 3.01, SD = 1.05). Of the sample, 7% reported that their quality of life was poor and 9% indicated that their quality of life was excellent. Teachers’ average summed score on the Kessler-6 item Psychological Distress Scale was 8.80 ( SD = 4.85), indicating moderate levels of mental distress. The majority of scores were in the moderate mental distress stress range (56%), 23% of respondents’ scores were in the ‘serious mental distress’ range and another 21% indicated typical levels of mental distress. On the Job-related Affective Well-being Scale, the average teacher score was 3.05 ( SD = .80) which corresponds to ‘sometimes’ their job made them feel positive affect (e.g., inspired, satisfied) during the past 30 days, with 24% of the sample indicating never or rarely and 29% indicating quite often, extremely often or always feeling job-related positive affect. On average, teachers reported that they were between ‘no more or less likely’ to ‘more likely’ to seek to leave their profession in the next few years due to the experience with the COVID-19 pandemic (representing a score of 2.39 ( SD = .52) on the scale). Broken down, 41% reported that they were now more likely to seek to leave the profession and 2% indicated that they were now less likely to leave the profession due to the experience of the COVID-19 pandemic.

Teachers’ challenges and supports

Table 2 provides a descriptive summary of teachers’ reported school experiences during the COVID-19 pandemic. On average, teachers reported that their workload had increased compared to before the pandemic. When asked about personal stressors related to the pandemic, they reported feeling moderately to completely stressed or worried on about 9 of the 15 (SD = 3.47) potential stressors. Fig 1 lists all 15 personal stressors and the percentage of teachers who indicated being moderately to completely stressed for each. The three most commonly reported stressors were ‘being separated from friends and family’, ‘passing COVID-19 onto someone else if I became infected’, ‘being exposed to the virus at school’ (90.0%, 86.4%, and 77.7% of teachers reported this stressor, respectively). Teachers generally reported that implementing safety measures during the COVID-19 pandemic was ‘somewhat easy’ to ‘neither hard nor easy’, with the exception of ‘practicing physical distancing’, which respondents generally reported was ‘somewhat hard’ to ‘very hard’ (see Table 2 ). Mean scores presented in Table 2 indicate that, on average, teachers reported feeling that students’ academic needs were ‘somewhat met’ during the school year but that students’ social and emotional needs and the needs of students with diverse abilities were only ‘slightly met’ to ‘moderately met’ (see Fig 2 for response breakdowns in percentages). When asked about sources of mental health and well-being support in the education system during the pandemic, teachers reported feeling the most support from colleagues, followed by principals and school-based administrators, and the least support from the Ministry of Education and Child Care (see Table 2 ).

https://doi.org/10.1371/journal.pone.0290230.g002

https://doi.org/10.1371/journal.pone.0290230.t002

Predictors of general mental health for teachers

Table 3 presents unstandardized regression model coefficients, confidence intervals and PRATT-index values for models predicting quality of life and psychological distress. Statistically significant predictors that met the PRATT-index cut-off criterion of relative importance (i.e., 0.04) are presented here. The relatively most important predictor of both quality of life (negatively predictive) and psychological distress (positively predictive) was the number of personal stressors related to the COVID-19 pandemic ( d = 43% and 64%, respectively). This was followed in importance by COVID-19-related increased workload, which was negatively predictive of quality of life ( d = 16%) and positively predictive of psychological distress ( d = 18%). Perceptions of education system supports for mental health and well-being were positively predictive of quality of life ( d = 16%) and negatively predictive of psychological distress ( d = 7%). Perceptions that students’ needs were being met during the school year were positively related to quality of life ( d = 9%) and negatively related to psychological distress ( d = 6%).

https://doi.org/10.1371/journal.pone.0290230.t003

Predictors of workplace well-being for teachers

Table 4 presents regression model coefficients, confidence intervals and PRATT-index values for models predicting both job-related positive affect and turnover intentions. Statistically significant predictors that met the PRATT-index cut-off criterion of relative importance (i.e., 0.04) are presented here. Teachers’ perceptions of support for their mental health and well-being was the relatively most important predictor of workplace well-being. Perceptions of support was positively associated with job-related positive affect ( d = 46%) and negatively associated with turnover intentions ( d = 41%). Perceptions that students’ needs were being met during the school year was a relatively important positive predictor of job-related positive affect ( d = 23%) and to a lesser degree, a negative predictor of turnover intentions ( d = 6%). Teachers’ reported number of personal stressors related to the COVID-19 pandemic was also a relatively important predictor of job-related positive affect (negatively predictive; d = 20%) and turnover intentions (positively predictive; d = 22%). Difficulty with safety measures was a negative predictor of job-related positive affect ( d = 9%) and a positive predictor of turnover intentions ( d = 8%). Years of teaching experience was positively associated with turnover intentions ( d = 14%), such that those who had been teaching longer had higher turnover intentions.

https://doi.org/10.1371/journal.pone.0290230.t004

Teachers’ open-ended responses on education system structures, supports, and resources

When invited to comment on whether any structures, supports, or resources within the education system had a positive impact on mental health and well-being, approximately one-third of respondents commented (33%; of these, 86% identified as women, with an average teaching experience of 18 years; 60% were elementary, 9% middle, and 29% secondary school teachers). Themes related to the structures, supports, and resources were identified through our qualitative analysis (see S1 Table ): With respect to supports, colleagues were most frequently cited by teachers as being a key source of support that had a positive impact on mental health. As one teacher describes:

The only thing that helps me to get through the day is by talking and collaborating with the teachers that are in the classrooms beside me. Together we have formed a small group of support for each other. We look out for each other and debrief daily. If it weren’t for them, I would feel totally alone and isolated (Elementary teacher, identified as a woman, 17 years of teaching experience).

Another theme to emerge was with respect to supports from administration and the role they played by acknowledging and supporting well-being and encouraging work-life balance. One teacher wrote, “I appreciate my bosses checking in with my health and well-being often and making suggestions to help support my workload” (elementary/middle school teacher, identified as a woman, 1 year of teaching experience). Teachers also cited (although less frequently) the positive role that school board/districts, unions, and recognition within school and the community played in their mental health. In terms of structural supports, a prominent theme emerged around safety protocols. Teachers frequently expressed that the implementation of school safety protocols had a positive impact on mental health. In the words of one teacher, “offering masks and hand sanitizer make it easier for students and staff to access this bit of PPE (personal protective equipment) and this makes me feel a bit more safe” (Secondary teacher, identified as a woman, 11 years of teaching experience).

Teachers also referred to resources that had a positive impact on mental health and well-being. Three sub-themes related to resources emerged with respect to wellness initiatives, online learning, and social-emotional learning (SEL). The most prominent resource sub-theme was related to the positive role that wellness initiatives played in supporting teacher mental health. As one respondent describes, “school-based wellness and spirit committees have been very helpful in promoting feelings of staff well-being and connection” (elementary teacher, identified as a woman, 7 years of teaching experience). In contrast, some teachers did not perceive any education system supports, structures, or resources as supporting their mental health and well-being. For example, as one teacher put it, “the admin sent out emails telling us to ‘take care of yourselves’ but did nothing to take care of us” (Secondary teacher, identified as a woman, 20 years of teaching experience).

Teachers’ open-ended responses about their experiences during the COVID-19 pandemic

When invited to share more generally about their experiences during the COVID-19 pandemic, nearly half of the sample responded (46%; 83% women, average years of teaching experience was 17 years, 60% elementary, 10% middle, 30% secondary school teachers). Four overarching themes emerged around changes in mental health, changes in professional life, concerns regarding the pandemic response, and student-related feedback (see S2 Table ). With respect to changes in mental health, we identified four sub-themes related to teachers’ worries about exposure to the virus, experiencing increased stress, feeling burnt out and exhausted, and feeling frustrated. One teachers’ statement illustrates the worry about exposure experienced by many teachers:

I purchased my own plexiglass screens for my classroom and desk at my own expense approximately $460. I read the news at lunch and when it was announced that there would be no essential workers included in phase 2 of the vaccination program I sat behind my (plexiglass) screen at my desk with my students in my class eating their lunch and cried (Secondary teacher, identified as a woman, 24 years of teaching experience).

Nine different sub-themes related to changes in professional life were identified (see S2 Table for a full list). The most frequent sub-theme was related to the challenge of enforcing safety protocols. One teacher describes the challenges of maintaining physical distancing in the classroom:

It is very challenging to keep students apart. If social distancing and no touching within a cohort was truly meant to be implemented, we should have had smaller class sizes or extra staff to keep students apart. It’s very unrealistic. Young children are impulsive and need the touch. They wrestle, hug, jump on each other (Elementary teacher, identified as a woman, 1 year of teaching experience).

Two sub-themes emerged related to inconsistency in public health orders and implementation as well as feeling unsupported by the government. One teacher stated:

The lack of transparency and inconsistent implementation and interpretation of PHO (Public Health Orders) is a source of constant stress. Especially when the public and school orders do not match. I’m really upset when the statement is said that there is no data that supports school transmission when the data is not being collected or accurately collected (Middle school teacher, identified as a woman, 16 years of teaching experience).

With relation to student-related feedback, sub-themes emerged around being unable to meet students’ needs, missing connection with students and families, reduced learning time, and being glad students are in school. Of the four sub-themes, teachers most frequently raised concern about not being able to meet students’ needs. As described by one teacher:

There are far more students struggling with anxiety and mental health and we’re struggling to provide enough support which creates even more stress and anxiety for teachers because we feel we are not supporting our students to the best of our ability (Elementary teacher, identified as a woman, 10 years of teaching experience).

The impacts of the COVID-19 pandemic have exacerbated stressors that already existed within the teaching profession and introduced new ones [ 38 ]. The current study sought to investigate associations between pandemic-related challenges (e.g., workload changes, stressors, difficulty implementing safety measures at school) and supports (e.g., from colleagues, school-based administrators, school board, the MOECC, and union) and indicators of teacher mental health and workplace well-being (job-related positive affect, turnover intentions, psychological distress, and quality of life). Data collection occurred in the 2020–2021 school year during which in-person teaching continued uninterrupted in BC. The majority of teachers in this study met the range for ‘moderate mental distress’ (56%) and ‘serious mental distress’ (23%) using the K6 screening scale for psychological distress [ 29 ]. This is a substantially higher proportion in comparison to previous studies using this measure with teachers (moderate mental distress: 50%; serious mental distress: 13%) [ 39 ] and with the general population (moderate mental distress: 28%; serious mental distress: 9%) [ 31 ].

Chief among our findings was that teachers’ job-related positive affect and turnover intentions were primarily associated with their perceptions of support for mental health and well-being from the education system, over and above the relative importance of COVID-19 stressors and workload–a finding that was emphasized and further illustrated through the open-ended responses. This finding suggests that supports offered by educational systems can be a powerful lever for change regarding teachers’ mental health and workplace well-being. Recent research has explored the relation between supports within the educational system and teachers’ professional or occupational well-being both during and prior to the COVID-19 pandemic. For example, Alves and colleagues [2020] conducted a cross-sectional study of Portuguese teachers’ satisfaction with the education system in relation to their well-being before and during the pandemic[ 40 ]. In line with our findings, teachers reported reduced professional well-being during the pandemic, and increased turnover intentions. van Horn and colleagues [2010] identified four dimensions of teachers’ occupational well-being: cognitive, subjective, physical and mental, and social well-being[ 41 ]. The latter dimension, social well-being, emphasizes the importance of a supportive school culture in which teachers enjoy positive interactions and working relationships with administrators, colleagues, families, and students. A recent systematic review of the literature on teacher well-being found positive relationships with colleagues, students, and parents; a supportive work environment; community recognition; and support by principals/leadership to be significant and positive predictors of teacher well-being in dozens of studies [ 42 ]. Notably, the authors concluded that three groups in particular complement each other in supporting teacher well-being: “Principals can provide positive and supportive working environments; teachers can support each other, work together, moderate stress and the demands of professional life, and help with emotion regulation; and students can give meaning to the teaching profession and reward teachers’ work,” [p. 13] [ 42 ]. This is corroborated in both our quantitative and qualitative data in which supportive relationships with colleagues and feeling supported by the school community surfaced as important factors associated with teachers’ workplace well-being. Thus, whether situated in the context of a pandemic, other global crisis (i.e., one or more serious problems impacting the world), or in more “normal” times, education systems can promote teachers’ well-being by fostering strong, supportive school cultures and positive relationships amongst all stakeholders.

Teachers’ occupational well-being has been associated with the quality of their relationships with their students and, during the pandemic, these relationships were significantly challenged. Prominent among our findings was that teachers’ perceptions of their ability to meet the needs of students was an important predictor of job-related positive affect. That teachers have struggled to meet the needs of students during the pandemic has been reported elsewhere [ 43 ]. Recent research has identified relations between teachers’ self-efficacy and well-being during the pandemic [ 44 , 45 ]. For example, Herman and colleagues [2021] surveyed over 600 US teachers before and during the pandemic and found teachers’ perceived efficacy to be a strong predictor of well-being outcomes during the pandemic [ 45 ]. Further, Beard and colleagues [2021] noted a relation between teachers’ sense of efficacy and their ability to support students’ social and emotional needs during the pandemic [ 46 ]. Describing teachers as “first responders for students’ well-being” [p. 3], the researchers sought to understand if and how teachers’ responses to students’ social and emotional needs during the pandemic also supported their own social and emotional needs, including the feeling of efficacy. They noted that innovative approaches such as online learning communities that connected teachers in communities of practice, and social media groups that buoyed their spirits, helped teachers both learn how to better support their students’ needs in the pandemic while also promoting their own well-being. This pandemic example of how bolstering supports for teachers can simultaneously help meet students’ needs and support teachers’ well-being is instructive for current and future policy-decisions around systemic supports for teachers. Identifying support factors that buffer teacher mental health and well-being during the pandemic (e.g., social and emotional learning (SEL) training for educators and for students [ 46 , 47 ]) can help inform systemic changes that build on these supports to promote teachers’ well-being now and in the future.

Limitations

There are certain study limitations to highlight. First, the study does not claim a representative sample and as such, the findings should be interpreted with caution. The survey was voluntary and the sample of participants may be biased in certain ways. For example, it is possible that teachers who chose to participate in the survey were those that had more capacity to respond and were more likely to report positive mental health and workplace well-being. Alternatively, it is possible that teachers who were particularly unhappy with their workplace circumstances were more likely to respond and more likely to report lower mental health and workplace well-being and fewer education system supports. Second, the study was not able to account for baseline mental health and workplace well-being prior to the COVID-19 pandemic. A lack of baseline hindered our ability to measure and account for differences in teachers’ mental health and workplace well-being and compare to pre-pandemic levels.

This study makes important contributions to our understanding of teacher mental health and workplace well-being in the face of the COVID-19 pandemic as well as future global crises and related school disruptions and identifies key challenges and supports impacting the mental health and workplace well-being of teachers. Understanding the key challenges and supports are essential to inform much-needed mental health and workplace well-being recovery efforts for teachers now, and as part of the pandemic recovery. Beyond this, our research and other research focused on the impact of the COVID-19 pandemic on the mental health and workplace well-being of teachers is critical for future planning so that we can (1) identify the most effective ways to build up a strong system of mental health and workplace well-being support for teachers moving forward and (2) to ensure that appropriate supports are in place in the event of future pandemics or other crises that disrupt education systems around the world.

Supporting information

S1 table. teachers’ qualitative comments and resulting themes related to education system structures, supports, and resources that had a positive impact on mental health and well-being..

https://doi.org/10.1371/journal.pone.0290230.s001

S2 Table. Teachers’ qualitative comments and resulting themes related to their experiences during the COVID-19 pandemic.

https://doi.org/10.1371/journal.pone.0290230.s002

Acknowledgments

We gratefully acknowledge the individuals who generously gave their time, expertise, and feedback for this project:

• Jeremy Higgs and Nicole Gardner, Governance and Analytics Division, BC Ministry of Education and Child Care

• Research Division, British Columbia Teachers’ Federation

• The BC teachers who took the time to complete the survey and those who offered their guidance on the original survey content. We would also like to acknowledge and sincerely thank all the teachers and those working with children and youth in schools and the community throughout the COVID-19 pandemic.

The research outlined was approved by the University of British Columbia Behavioural Research Ethics Board. All inferences, opinions, and conclusions drawn in this study are those of the authors, and do not reflect the opinions or policies of the BC Ministry of Education and Child Care or BC Teachers’ Federation.

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Mental Health Experiences of Teachers: A Scoping Review

• Kristen Ferguson Nipissing University
• Melissa Corrente University of Ottawa
• Ivy Bourgeault University of Ottawa

Teacher mental health continues to be of concern in elementary and secondary schools; however, supporting teacher wellbeing is understudied (Parker et al., 2012; Roffey, 2012), particularly from a gender perspective (Bourgeault et al., 2021). Among professionals, teachers exhibit one of the highest levels of job stress and burnout on the job. (Hakanen et al., 2006; Stoeber & Rennert, 2008). This scoping review investigates and consolidates the existing research on teacher mental health, leaves of absences, and return-to-work. Work context and personal factors/family context contribute to teacher stress and attrition and by extension may impact temporary leaves of absence (Pressley, 2021). Several articles report on interventions with moderate success to reduce teacher stress, but no studies evaluated return-to-work interventions (Ebert, 2014; Kwak et al., 2019). The amount of stress teachers are experiencing and the pressure that is causing them to burn out is the most common narrative present in the literature. The review highlights gaps in the literature surrounding teacher mental health, leaves of absence, and return-to-work and a notable gap regarding the role of gender.

Author Biographies

Kristen ferguson, nipissing university.

Kristen Ferguson is a Professor of Education with Schulich School of Education at Nipissing University in North Bay. Her research interests include stress and coping in teaching, literacy education, literacy coaching, and professional development.

Melissa Corrente, University of Ottawa

Melissa Corrente is a Research Associate at the University of Ottawa. She teaches courses on health and physical education, and her research interests include teacher mental health and food literacy for children. Melissa has published articles in The Toronto Star, SAGE Research Methods, and the Physical and Health Education Journal.

Ivy Bourgeault, University of Ottawa

Ivy Lynn Bourgeault is a Professor in the School of Sociological and Anthropological Studies at the University of Ottawa and the uOttawa Research Chair in Gender, Diversity, and the Professions.

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Teachers as School Mental Health Professionals and their Daily Practices

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• Published: 27 April 2024
• Volume 16 , pages 566–576, ( 2024 )

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• Rodrigo Rojas-Andrade   ORCID: orcid.org/0000-0002-6459-6902 1 ,
• Samuel Aranguren Zurita   ORCID: orcid.org/0000-0001-6623-0114 2 &
• Gabriel Prosser Bravo   ORCID: orcid.org/0000-0003-1255-5890 1  

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Despite the fundamental role of teachers in School Mental Health Systems, their work has been under-recognized and under-supported. Moreover, few studies on this role have been conducted in low- and middle-income countries. This study explores and describes the mental health actions undertaken by teachers in schools and categorizes them using latent class analysis. The study collected data from 726 teachers in Chile using snowball sampling. Three self-reported questionnaires were administered: Mental Health Actions and Teaching Role Questionnaire; Interprofessional Competence in Mental Health Questionnaire and Checklist of Mental Health Issues Addressed in School. The results showed that teachers play a significant role in identifying and addressing mental health issues among students, with 90% of respondents reporting that they had provided support to students with mental health concerns. The results also suggest that teachers face several challenges in this role, including a lack of training and resources, time constraints, and the need for better communication and collaboration with mental health professionals. Six latent class of teachers was founded: ow activity Class, Classroom-Centered Class, Individual Emotional Support-Centered Class, Self-Care and Professional Development Class, Mental Health Curriculum-Centered Class, and High activity Class. Based on the results provides applied recommendations for teachers to support their students' mental health, such as creating a safe and supportive classroom environment, promoting social-emotional learning, and collaborating with specialised school mental health professionals. Overall, this study highlights the need for a comprehensive and integrated approach to school mental health that involves teachers, mental health professionals, and other stakeholders.

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Data availability statement.

The data that support the findings of this study are available from the corresponding author, R.R.A., upon reasonable request.

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This work was supported by the Ministry of Education of Chile under Grant FONDECYT N°11220112.

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Rojas-Andrade, R., Aranguren Zurita, S. & Prosser Bravo, G. Teachers as School Mental Health Professionals and their Daily Practices. School Mental Health 16 , 566–576 (2024). https://doi.org/10.1007/s12310-024-09664-8

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Prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic

A prisma-compliant systematic review.

Editor(s): Hussain., Abrar

a Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-UFRN, Natal, Brazil

b Graduate Program in Biotechnology and Medical School, Potiguar University-UnP, Natal, Brazil

c Department of Nutrition, Federal University of Rio Grande do Norte-UFRN, Natal, Brazil.

∗Correspondence: David Franciole Oliveira Silva, Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-UFRN, Natal 59056-000, Brazil (e-mail: [email protected] ).

Abbreviation: PRISMA = Preferred Reporting Items for Systematic reviews and Meta-Analyzes.

How to cite this article: Silva DF, Cobucci RN, Lima SC, Andrade FB. Prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic: a PRISMA-compliant systematic review. Medicine . 2021;100:44(e27684).

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) – Finance Code 001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors have no conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

Background: 

Identifying the prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic.

Methods: 

Systematic review of original studies published in any language. Protocol published in PROSPERO under number CRD42021240543. The search was carried out in the Web of Science, PsycINFO, Pubmed, Embase, LILACS, and SciELO databases, using the descriptors: anxiety, depression, stress, teacher, faculty, COVID-19, and their synonyms. Narrative synthesis was carried out in line with the synthesis without meta-analysis in systematic reviews.

Results: 

Of the 1372 records identified, 6 studies, all cross-sectional, were included in the review. The studies were carried out in China, Brazil, the United States of America, India, and Spain. Five studies included more women than men. The participants were aged from 24 to 60 years. Three studies included only school teachers, 2 included schools and universities teachers, and 1 only university teachers. Of the 5 studies, all dealt with remote activities and only 1 included teachers who returned to face-to-face classes 1 to 2 weeks ago. The prevalence of anxiety ranged from 10% to 49.4%, and depression from 15.9% to 28.9%, being considerably higher in studies with teachers who worked in schools. The prevalence of stress ranged from 12.6% to 50.6%.

Conclusion: 

The prevalence of anxiety, depression, and stress was high among teachers during the pandemic, with great variation between studies. Anxiety and stress were more prevalent in the Spanish study. The results show the need for measures for the care of teachers’ mental health, especially when returning to face-to-face classes.

1 Introduction

During the COVID-19 pandemic, countries have implemented measures of social distancing as a strategy to reduce the speed of spread of the contagion and to organize health services for the care of infected patients. [1] In this context, face-to-face classes have been suspended in most countries, with remote classes taking their place. [2,3] Data from the United Nations Educational, Scientific and Cultural Organization, [4] reveal that more than 190 countries have closed schools nationwide during the COVID-19 pandemic.

Although the use of online learning resources is already common, especially in the university community, the new reality of 100% remote classes may have had an impact on teachers’ mental health. [5] This is because the change took place in an abruptly short period of time, without adequate training for the use of digital resources, as well as, in most cases, without the provision of adequate equipment for remote classes. [6] In distance education courses, for example, classes are usually prepared by a team of professionals that includes content teachers and specialists in educational technologies, who are responsible for producing materials in a format accessible to various equipment, as well as being visually attractive. [7]

In this context, teachers highlight several challenges related to remote classes, but mainly related to didactic organization, in order to improve their online educational experience. [8,9] In addition, another potential risk factor for anxiety, stress, and depression stems from the unequal access to computer equipment among students, which can compromise their participation in school activities. Worldwide, half of the students do not have access to a computer, and approximately 40% do not have access to the internet. [10] Thus, depending on the context, it may be necessary to adopt several strategies to assist students who do not have regular access to the internet, by providing them with printed materials and engaging them in activities. This could in turn overload teachers and increase the risk of mental illness. [11]

In the context of major changes in the professional practice of teachers, monitoring of mental health is important. Studies carried out during the COVID-19 pandemic have recorded different levels of anxiety and depression among teachers. [12,13] However, to the best of our knowledge, there is still no systematic review on this topic in the literature. The objective of this review is to identify the prevalence of anxiety, depression, and stress among teachers at schools and universities during the COVID-19 pandemic.

A systematic review of observational studies elaborated according to the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA) was conducted. [14] The protocol was registered at PROSPERO under number CRD42021240543.

2.1 Research question

What is the prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic?

2.2 Inclusion criteria

Original studies, published between 2020 and 2021 in any language, which met the following criteria, according to the acronym PICoS, were considered eligible:

• (1) Population (P): Nursery, pre-school, elementary, high school, or higher education teachers;
• (2) Interest (I): Anxiety, depression, and stress;
• (3) Context (Co): COVID-19 pandemic;
• (4) Study type (S): Observational studies (cross-sectional, case control, and cohort).

Exclusion criteria: Report and case series, randomized clinical trials, literature reviews, books, and conference abstracts were excluded.

2.3 Database search

The virtual search was carried out in the databases Pubmed, Embase, PsycINFO, Web of Science, LILACS, and SciELO, using the descriptors teacher, faculty, professor, anxiety, depression, stress, insomnia, COVID-19, and their synonyms. Chart 1 shows the descriptors used in the search strategy for each database.

2.4 Screening and selecting records

The screening of the records identified in the databases was carried out independently by 2 researchers (DS and RC) by reading the title and abstract. Then, the full text was independently analyzed by 2 researchers (DS and RC) to verify whether the studies met the inclusion criteria.

2.5 Data extraction

Data extraction was performed by 2 authors (DS and RC) in an electronic spreadsheet containing the following fields: authorship, year of publication, country of study, sample characteristics, including number, age and gender, criteria for assessing anxiety, depression and stress, prevalence anxiety, depression and stress, and the prevalence by sex and place of work (schools or university).

2.6 Evaluation of the methodological quality of the studies

The Newcastle-Ottawa Scale modified for cross-sectional studies was used to assess the methodological quality of the studies included in the review. [15] Although this scale has 7 items distributed in the domains of selection (4 items), comparison (1 item), and outcome (2 items), in this systematic review, only the following were analyzed: sample representativeness, sample size, response rate, evaluation outcome, and statistical analysis, since the items exposure and comparability were not applicable to the type of study included. The total score for each study can vary from 0 to 6 because for each item a star can be assigned and for the outcome item up to 2 stars can be assigned. Thus, the classification of the methodological quality of the studies was carried out considering the total number of points received: ≥4 – good quality and <4 – low quality.

2.7 Data analysis and results synthesis

Considering the small number of studies and the heterogeneity in the evaluation criteria and/or cutoff points used, a narrative synthesis was carried out on the prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic. The recommendations of the synthesis without meta-analysis in systematic reviews were also considered. [16] With this, the number of studies that found a higher prevalence of anxiety in women was counted and compared with the number of studies that identified a higher prevalence in men. For the place of professional practice (school vs university), the same strategy was used for the synthesis of the data.

2.8 Ethical approval

This systematic review does not require ethical approval because the data come from published articles.

The search in the databases retrieved 1370 records and 2 were identified through manual search and analysis of article references, totaling 1372 records. With the initial analysis of eligibility by reading the title and abstract, 42 articles were selected, of which 20 were duplicates, resulting in 22 articles for reading text-complete. Six studies, with 91,508 teachers, met the eligibility criteria and were included in the review. [12,13,17–20] Figure 1 shows the flowchart of the study selection process for inclusion in the systematic review.

3.1 Characteristics of the studies

All studies presented a cross-sectional design. [12,13,17–20] Regarding the country of performance, 2 were in China, [17,18] 1 in Brazil, [12] 1 in the United States of America, [19] 1 in India, [20] and 1 in Spain. [13] Four studies presented good methodological quality, [12,17–19] and 2 low quality. [13,20] In 5 studies, more women than men were included. [12,13,17–19] In the studies, the ages ranged from 24 [12,20] to 60 years. [20] However, there were studies that reported only the average age, which ranged from 36 [17] to 42 years. [13]

Three studies included only school teachers, [12,18,20] 2 included school and university teachers, [13,17] and 1 only university teachers. [19] Only 1 study referred to the academic training of teachers. The majority (64.95%) held a bachelor's degree, 23.10% had a high school degree, 6.65% held a master's degree, and the rest had other levels of education. [17] Regarding the form of professional performance, in 4 studies [12,17,18,20] all dealt with remote activities. One study [19] reported that 60.6% of teachers were engaged in remote activities and 1 study included teachers who returned 1 to 2 weeks before (this study date) for face-to-face classes. [13] Table 1 presents the characteristics of the studies included in the review.

Regarding exposure to COVID-19, the study by Cruz et al, [12] with Brazilian teachers, recorded that 15.5% of the participants reported contact with a COVID-19 positive person. Evanoff et al [19] found that 16.3% of teachers reported having experienced some exposure to COVID-19. No study reported diagnosis of teachers with COVID-19. Only the study by Ozamiz-Etxebarria et al [13] presented data on chronic diseases in the participants, recording that 16.7% had at least 1.

3.2 Criteria for assessing anxiety, depression, and stress

Three studies included in the review used the Depression, Anxiety and Stress Scale-21 Items for the diagnosis of anxiety, depression, and stress. [12,13,19] In 2, the standard cutoff points of the instrument were used: 5 for mild, 10 for moderate, and 15 for severe, [13,19] and 1 study did not mention the cutoff point. [12]

Three studies used criteria other than Depression, Anxiety and Stress Scale-21 Items to assess anxiety. The Generalized Anxiety Disorder tool was used in the study by Li et al, [17] with a cutoff point of 10, referring to moderate or severe anxiety. Zhao et al [18] used the Self-rating Anxiety Scale, using 50 as the cutoff point. Godbole et al [20] used the Hamilton Anxiety Rating Scale, with a cutoff point of 18 to 24 for moderate anxiety and 25 to 30 for severe anxiety.

3.3 General prevalence of anxiety, depression, and stress

The prevalence of anxiety among teachers during the COVID-19 pandemic ranged from 10% [19,20] to 49.4%. [13] In the 2 studies where the assessment was on the bases of sex, [13,17] a higher prevalence of anxiety was recorded in females. Ozamiz-Etxebarria et al [13] reported a higher prevalence of anxiety in teachers with chronic diseases (61.9% vs 47.0%). Two studies found that teachers with older chronological age had a lower prevalence of anxiety [13,19] and Li et al [17] found no difference in the average age between teachers with anxiety and without anxiety. In the only study that showed the prevalence of anxiety by degree of academic education, a similar prevalence was found, with 14.7% among high school teachers, 12.7% among those with bachelor's degrees, and 13.4% for those with master's degrees. [17]

Regarding the prevalence of anxiety by place of professional activity, among teachers who work in schools it ranged from 10% [20] to 21.7%, [12] while for teachers employed at a university it ranged from 10% [19] to 12.9%. [17] Reviewing the data by continent, in studies carried out in Asia the prevalence of anxiety ranged from 10% [20] to 17.2%, [18] in the Americas from 10% [19] to 21.7% and in Europe 49.4%. [13]

The prevalence of depression ranged from 15.9% [19] to 28.9% [12] in studies conducted in the Americas and the study conducted in Europe identified a prevalence of 32.2%. [13] In the study that showed prevalence by sex, no significant difference was identified. [13] The prevalence of depression was similar between age groups in 1 study. [13] Another study found that teachers aged over 40 years had a lower prevalence rate for depression. [19] Ozamiz-Etxebarria et al [13] reported a higher prevalence of depression in teachers with chronic diseases (41.0% vs 30.4%). The study carried out with university professors [19] identified a considerably lower prevalence than that carried out with school teachers. [12]

The prevalence of stress ranged from 12.6% [19] to 12.7% [12] in studies in the American countries. The European study registered a prevalence of 50.6%. [13] Ozamiz-Etxebarria et al [13] identified a prevalence of stress in females of 52.1% and 43.9% in males. In the study by Ozamiz-Etxebarria et al [13] teachers aged over 46 years had a lower prevalence of anxiety. Similar results were presented by Evanoff et al. [19] A higher prevalence of stress was found in teachers with chronic diseases (71.4% vs 64.1%). [13] No study reported the prevalence of anxiety, depression, and stress among teachers, in the context of exposure to COVID-19. Table 2 shows the prevalence of anxiety, depression, and stress reported in each study.

4 Discussion

To the best of our knowledge, this is the first systematic review to assess the prevalence of anxiety, depression, and stress in school and university teachers during the COVID-19 pandemic. The prevalence of anxiety ranged from 10% to 49.4% and was considerably higher in the study conducted in Europe. The prevalence of depression ranged from 15.9% to 28.9%, being considerably higher in the study with teachers who worked in schools. For stress, a considerably higher prevalence was found in Europe (50.6%) than in studies conducted in the Americas (12.7%).

The study conducted in Spain (Europe) [13] recorded a considerably higher prevalence of anxiety and stress compared to the other studies and was the only one where, during data collection, teachers had returned to face-to-face classes, after a period of remote classes. The higher prevalence of anxiety and stress can be explained, in part, by the uncertainty of the impact of face-to-face classes on the risk of contagion, due to the greater need for commuting, as well as by the possibility of greater contact with other professionals from schools or universities, as well as with students. [21] In addition, the return to face-to-face classes with strict bio-safety protocols and the teachers’ “enhanced responsibility to monitor the students” may be related to a higher prevalence of anxiety and stress. [2,22]

Another factor that could contribute to increased levels of anxiety and stress when returning to in-person classes is the health status of teachers; there was a higher prevalence of anxiety in teachers with chronic diseases. [13] Several studies have recorded a high prevalence of obesity, hypertension, diabetes, respiratory disorders, and other chronic non-communicable diseases in teachers. [23–25] Considering that obesity, diabetes and hypertension are associated with higher mortality due to COVID-19, when resuming classes, teachers with chronic diseases may be more afraid that, if infected, they could see more harmful effects. This could justify the greater anxiety among this group. [26]

In this context, it is important that prior to the reopening of schools, education professionals receive training in the measures to be taken to minimize the risk of infection due to COVID-19. This, in addition to helping reduce the incidence of cases among the school or university community, can contribute to reducing the degree of anxiety and stress when returning to face-to-face classes. Li et al, [27] in a study with 67,357 teachers in China, found that the lack of knowledge about the proper type of mask and the correct way to use it, as well as the non-adherence to the use of a mask, were factors associated with a higher risk of anxiety. In addition, it is important to provide good quality personal protective equipment and in sufficient quantity. A study conducted with 2665 teachers in Denmark found that the shortage of personal protective equipment, as well as greater contact with parents of students and other education professionals, were factors associated with more frequent changes in emotional state. [28]

Regarding the prevalence of anxiety according to the place of professional activity, a higher prevalence of anxiety was found among school teachers [12,18] as shown in 2 studies, than among university professors. One possible explanation is that school teachers may have less experience in remote education than those at university. [29] In this sense, a study carried out during the COVID-19 pandemic with 260 school teachers in the United States of America, a developed country, registered that 52% referred to the challenge of scarcity or little knowledge about strategies for remote/online education and 44% were unaware of the communication tools required for remote/online classes. [30]

Another hypothesis for this difference in relation to the place of work may be that university professors engage with young adults who may find it easier to adapt to remote education than children and adolescents, who represent the majority of the students of school teachers. [31,32] In addition, studies conducted during the pandemic have found that parents have devoted considerable time (more than 1 hour a day) to assisting their children in remote classes. [32,33] With regard to school teachers, in addition to online teaching strategies, there is a need for strategies to facilitate communication with the children's parents. This is an additional task and could be 1 more factor that adds to anxiety and stress. [30]

Regarding depression, teachers working at schools also had a higher prevalence than those working in universities. As university professors are generally more accustomed to remote education, this may have favored the lower prevalence of depression in this group. [29] In addition, as the study with school teachers was carried out in Brazil and with university teachers in the United States of America, a possible explanation for this result is the lower remuneration among Brazilians, which forces teachers to do more than a single job. This has been associated with a higher risk of depression. [34,35] In this sense, Patel et al, [36] in a meta-analysis of 12 studies, found that there is a greater risk of depression in countries with higher income inequality than in countries with lower income inequality.

Another probable explanation for depression being less prevalent among university professors is the fact that these professionals generally have a higher degree of academic training. In Brazil, for example, 4.6% of basic education teachers (schools) had a master's degree or doctorate in 2017, [37] while 64.3% of university professors had completed a doctorate. [38] Data from the United States Department of Education revealed that in 2018, just over 50% of primary and secondary school teachers completed a master's degree or doctorate, [39] while for university professors this percentage was 68%. [40] In this context, studies have found that a higher degree of academic training is associated with a lower risk of depression, possibly mediated by greater financial stability, which may represent better access to health services, as well as may influence the adoption of behaviors beneficial to mental health. [41,42]

Regarding sex, there was a considerably higher prevalence of anxiety and stress among females than males. [13,17] The first explanation for this may simply be the greater female participation in the studies included in the review. However, studies have found that women are at higher risk for anxiety and stress, which may be related to high levels of estrogen and greater sensitivity to increased catecholamine in the consolidation of emotional memory. [43,44]

In addition, the greater participation in housework by women, as well as the greater investment of time to help their children with schoolwork, are factors that can contribute to a higher prevalence of anxiety and stress in women. [45] These factors can also contribute to gender inequality in the academic production of female teachers, including during the COVID-19 pandemic, as many university teachers are also researchers. [46] In this sense, Gabster et al, [46] in an analysis of 1179 articles on COVID-19, found that in 28% and 22% of the studies, the first author and the last author were women, respectively. In comparison with articles published in the same journals in 2019, a reduction of 23% and 16% of women as first author and last author (respectively) was seen.

There was a considerably lower prevalence of anxiety and stress among older teachers compared to younger teachers in the 2 studies. [13,19] Among the general population, a higher prevalence of anxiety was seen among younger people during the COVID-19 pandemic. [47] Older people may have a lower risk of anxiety and stress due to possible greater resilience gained from exposure to various stressful situations over time, which may favor better emotional control. [47,48]

This study, to the best of our knowledge, is the first systematic review to assess the prevalence of anxiety, depression, and stress among teachers during the COVID-19 pandemic. In addition, the search for studies was carried out on 6 databases, in order to seek comprehensive coverage of the literature on the topic and the narrative synthesis following the pattern recommended by synthesis without meta-analysis. [16] However, this review has some possible limitations, such as the limited number of studies and the high heterogeneity among them, which limited us to carry out the meta-analysis. Furthermore, considering the cross-sectional nature of the included studies, it is not possible to infer causality in factors related to anxiety, depression, and stress. Regarding the prevalence of anxiety, the different diagnostic criteria and cutoff points used in the studies may have influenced the different prevalence levels. Finally, it was not possible to separate the analysis of prevalence among teachers from public and private schools where differences in structure, remuneration, and teaching resources could influence the prevalence of anxiety, depression, and stress. The results cannot be extrapolated to countries with different cultures, economies, and educational systems that were not included in the studies considered in this review.

In addition, the review has practical implications, as it indicates the need for better training of teachers to work in the remote education model, with pedagogical and psychological support that prevents work overload and mental problems. Likewise, the return of face-to-face classes can increase the prevalence of stress and anxiety, indicating that these professionals are involved in biosafety protocols for safe return to face-to-face activities. This can contribute to teachers being less anxious and stressed about the risk of contracting the COVID-19 virus.

5 Conclusion

The prevalence of anxiety among teachers was high during the COVID-19 pandemic, varying from 10% to 49.4%, with the highest prevalence among participants in the study carried out in Spain (where face-to-face classes were witnessing a return). The rampancy of stress was also higher in the participants of the European study compared to those in the studies carried out in the Americas. Depression was more prevalent among teachers who worked in schools.

The results show a high prevalence of anxiety, depression, and stress among teachers and alerts us to the need for greater care of mental health issues. However, due to discrepant data in the different studies included in the review, studies with more rigorous methodology and standardization of diagnostic instruments are necessary to know the real impact of the pandemic on the mental health of these professionals.

Author contributions

Conceptualization: David Franciole Oliveira Silva, Ricardo Ney Oliveira Cobucci, Severina Carla Vieira Cunha Lima, Fábia Barbosa de Andrade.

Data curation: David Franciole Oliveira Silva, Ricardo Ney Oliveira Cobucci.

Formal analysis: David Franciole Oliveira Silva, Ricardo Ney Oliveira Cobucci.

Methodology: David Franciole Oliveira Silva, Ricardo Ney Oliveira Cobucci, Severina Carla Vieira Cunha Lima, Fábia Barbosa de Andrade.

Visualization: David Franciole Oliveira Silva, Ricardo Ney Oliveira Cobucci.

Writing – original draft: David Franciole Oliveira Silva, Ricardo Ney Oliveira Cobucci, Fábia Barbosa de Andrade.

Writing – review & editing: Severina Carla Vieira Cunha Lima.

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Safeguarding the Mental Health of Teachers

• Posted December 3, 2019
• By Emily Boudreau

Teachers tell their students that mindset matters. Yet teachers do not always allow themselves space to receive those same messages of reflection and self-care.

Henry Seton , a longtime high school teacher and department head, learned that firsthand. In a courageous and insightful essay in Educational Leadership , Seton explored the hurdles that teachers face — especially those who work in schools in high-poverty settings — in safeguarding their mental health. He also revealed the challenges he’d faced in his own life.

“Teachers are attuned to the social-emotional wellbeing of our students and trained to monitor for signs such as trauma, anxiety, bullying, or microaggressions,” he wrote. “Yet we are still just learning how to discuss a huge, lurking threat to our work: our own mental health.”

Usable Knowledge sat down with Seton, who earned his master's degree at the Harvard Graduate School of Education last May, to talk about the ways in which school communities can both hinder and support the wellbeing of their members.

Where do you think the silence around teacher mental health originates from?

I think so many educators, especially in high-poverty settings, are barely holding on as is. To acknowledge, head on, where we are in terms of our mental health might not be something we feel like we can bear. High-poverty schools also often attract a certain type of intensity junkie who loves the intensity of that work — a person who, previously, has always been able to get through it. Talking about issues of mental health can be seen as a weakness and there’s this mentality of “I just need to be tougher. I just need to work harder and work smarter.”

How have you seen that mindset translate into a school culture? Did you feel equipped, at an early stage in your career, to handle it?

I worked for a decade at a young charter school that, like many young start-up organizations, had a blurring of work-life boundaries. It was predominately young people in their twenties, and we were all super mission-oriented, very energetic, very committed. I think we came into the work with a lot of unprocessed insecurities, whether it was our desire to be a savior or issues of our own guilt, that we were never doing enough. Just like open offices today, you see who gets there earliest, you see who stays there latest.

And there’s always this feeling that you could be doing more. Instead of the neighbor’s grass being greener, it’s the classroom next door that’s always operating at a higher level than yours. We all loved each other and worked hard to support each other but intimidated each other to death. It drove us to wonderful growth and phenomenal outcomes for students. Also, at times, it burnt through our emotional resilience and destabilized our emotional constancy with one another and with students. It affected our mental health. As the school transitioned, it did learn how to support teachers over time, but that transition is difficult for all sorts of schools and organizations.

"It’s not uncommon to have school leaders who sometimes sleep in their offices because they’re so busy, who don’t take a single break during the day. ... They often model, I think unintentionally, that we can’t take breaks, we can’t ease up, we need to always be going full throttle." 

How do schools perpetuate the silence around teacher wellbeing — and how might schools break that silence?

It’s not uncommon to have school leaders who sometimes sleep in their offices because they’re so busy, who don’t take a single break during the day. I want to name school leaders, in particular, as people who can steer the conversation. They often model, I think unintentionally, that we can’t take breaks, we can’t ease up, we need to always be going full throttle. That trickles down in organizations to the point where we feel we can’t attend to ourselves.

What do you see as the first step toward making teaching more sustainable?

Technology makes it so easy to stay connected with the work, but this can also make it hard to find balance. If we could double the amount of time teachers stay in high-poverty settings, we would change the education sector so much. In order to stay in this game — which is something I want to do for my whole life — teachers need to have boundaries. Veteran teachers, in order to survive, inevitably learn how to erect boundaries. But young teachers in younger schools don’t always have the model of boundary setting. There are not as many older teacher colleagues with children who, by necessity, set stricter boundaries.

You mentioned school leaders as being a group that had a lot of influence over how issues around teacher mental health and wellbeing are talked about in a school community. What else might leaders do?

I believe the number one step is leaders talking about these issues more vulnerably. I was really impressed by Eva Moskowitz of Success Academy Charter Schools. She has a reputation for being very hard-driving in terms of how she leads her organization, but she spoke in her memoir about the importance of therapists for teachers to be able to process this work, which I thought was phenomenal. It’s just so rare in the high-performing charter space and high-poverty settings that school leaders talk about seeing therapists or the importance of mindfulness practices, let alone practice vulnerability in front of their staff. And I think that’s so critical because it gives everybody else that permission to discuss this…. Leaders need to regularly gather input around the stress points for teachers and respond to it. Healthcare plans for teachers should allow access to free or minimal copay mental health services. And there needs to be a space for teachers to process the intensity of their work.

"The most important thing we can do for each other is just to listen. If we have the bandwidth and time to just stop and listen to a colleague, that’s just such an important first step towards healing and wholeness."

How could that space be created?

The most important thing we can do for each other is just to listen. If we have the bandwidth and time to just stop and listen to a colleague, that’s just such an important first step towards healing and wholeness. Listening dyads are connected to the Buddhist tradition. You just listen and you don’t need to say anything or even respond. Then, if colleagues are open to it, you can talk towards some action steps.

Where might people begin to find resources, supports, and answers to questions?

I see more colleagues starting to talk about issues related to mental health. I feel like terms like mindfulness, vulnerability, and self-compassion are coming up more in teacher spaces. The number one place I’d start is Elena Aguilar’s work on cultivating resilience in educators. It is the best introduction to a myriad of practices that support teacher mental health — everything from mindfulness, to compassion, gratitude. Authors like Brene Brown have appeared in TED Talks that have helped bring attention to it. But I think there’s still more we can do — we’re still not discussing it enough.

Additional Resources:

• A recent Harvard EdCast explores why teachers leave the profession and how leaders can better provide support
• Harvard Ed. Magazine offers tips for early childhood educators to practice mindfulness and destress
• A guide to helping first-year teachers cultivate resilience

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Connecting education research to practice — with timely insights for educators, families, and communities

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Mental Health in Schools

Mental health in schools, where we stand.

NAMI believes that public policies and practices should promote greater awareness and early identification of mental health conditions. NAMI supports public policies and laws that enable all schools, public and private, to increase access to appropriate mental health services.

Why We Care

One in six  U.S. youth aged 6-17 experience a mental health disorder each year, and  half  of all mental health conditions begin by age 14. Attention-deficit/hyperactivity disorder (ADHD), behavior problems, anxiety, and depression are the  most commonly  diagnosed mental disorders in children. Yet,  about half  of youth with mental health conditions received any kind of treatment in the past year.

Undiagnosed, untreated or inadequately treated mental illnesses can significantly interfere with a student’s ability to learn, grow and develop. Since children spend much of their productive time in educational settings, schools offer a unique opportunity for early identification, prevention, and interventions that serve students where they already are. Youth are almost as likely to receive mental health services in an education setting as they are to receive treatment from a specialty mental health provider — in 2019,  15% of adolescents aged 12-17  reported receiving mental health services at school, compared to 17% who saw a specialty provider.

School-based mental health services are delivered by trained mental health professionals who are employed by schools, such as school psychologists, school counselors, school social workers, and school nurses. By removing barriers such as transportation, scheduling conflicts and stigma, school-based mental health services can help students access needed services during the school-day. Children and youth with more serious mental health needs may require school-linked mental health services that connect youth and families to more intensive resources in the community.

Early identification and effective treatment for children and their families can make a difference in the lives of children with mental health conditions. We must take steps that enable all schools to increase access to appropriate mental health services. Policies should also consider reducing barriers to delivering mental health services in schools including difficulty with reimbursement, scaling effective treatments, and equitable access.

How We Talk About It

• Many mental health conditions first appear in youth and young adults, with  50%  of all conditions beginning by age 14 and 75% by age 24.
• One in six  youth have a mental health condition, like anxiety or depression, but only  half  receive any mental health services.
• Early treatment is effective and can help young people stay in school and on track to achieving their life goals. In fact, the earlier the treatment, the better the outcomes and lower the costs.
• Unfortunately, far too often, there are long delays before children and youth get the help they need.
• Delays in treatment lead to worsened conditions that are harder — and costlier — to treat.
• For people between the ages of 15-40 years experiencing symptoms of psychosis, there is an average delay of  74 weeks  (nearly 1.5 years) before getting treatment.
• Untreated or inadequately treated mental illness can lead to high rates of school dropout, unemployment, substance use, arrest, incarceration and early death.
• In fact, suicide is the  second  leading cause of death for youth ages 10-34.
• Schools can play an important role in helping children and youth get help early. School staff — and students — can learn to identify the warning signs of an emerging mental health condition and how to connect someone to care.
• Schools also play a vital role in providing or connecting children, youth, and families to services. School-based mental health services bring trained mental health professionals into schools and school-linked mental health services connect youth and families to more intensive resources in the community.
• School-based and school-linked mental health services reduce barriers to youth and families getting needed treatment and supports, especially for communities of color and other underserved communities.
• When we invest in children’s mental health to make sure they can get the right care at the right time, we improve the lives of children, youth and families — and our communities.

What We’ve Done

• NAMI  letter  of support for the Mental Health Services for Students Act (H.R. 1109), introduced by Reps. Napolitano and Katko
• NAMI  letter  of support for Mental Health Services for Students Act of 2019 (S. 1122) introduced by Senator Tina Smith
• NAMI  Ending the Silence  Presentation Program

Know the warning signs of mental illness

Learn more about common mental health conditions

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264 , text “helpline” to 62640 , or chat online. In a crisis, call or text 988 (24/7).

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Supporting K–12 Student Mental Health in 2024–25

• May 31, 2024
• Topic: Culture, Climate, & Family Engagement , K–12 Education , Program Evaluation , Student Success
• Resource type: Insights Blog

K – 12 s tudent mental health needs are growing. Here’s how school districts can measurably improve student well-being outcomes to ensure student success .  

Mental Health Awareness month is observed each May. Awareness plays an important role in reducing stigma and normalizing discussions of invisible disabilities . However, when it comes to K–12 student well-being, awareness alone won’t be enough to provide relief. The National Center for Education Statistics still reports a significant decline in K – 12 student mental health since the COVID-19 pandemic.   

Increased support and services in schools has already shown promising results in reducing the number of youth mental-health-related hospitalizations. However, many districts are facing budget shortfalls and the loss of ESSER funding that put them at a crossroads for how to do more to address student well-being — with fewer funds.  

Luckily, district leaders can take steps to measure and strengthen mental health support for students by focusing on improving school climate, implementing multi-tiered systems of support, and rethinking funding strategies, even in resource-scarce environments.  

How to Excel Beyond K–12 Mental Health Awareness    

Mental health awareness remains an important first step to boosting the well-being of a student population. However, districts must also implement actionable methods to repair school climate .   

Consider the following tips when seeking to elevate your student well-being strategy at the district level:

• Work with school leaders to identify short, medium, and long-term goals for school climate revitalization.   
• Promote accountability by continually evaluating the progress of these goals and metrics over time.   
• Prioritize policies, practices, and initiatives that focus on preventing unhealthy conflict and bullying and modeling healthy social connections.   
• Emphasize shared values and intercultural understanding.   
• Regularly collect and analyze surveys, interviews, and feedback forms from students, families, and staff to provide accessible avenues for them to voice their ideas and concerns.  

Learn how to how to balance all aspects of a positive school climate with our infographic, The Why and How of a Positive School Climate .

Exploring multi-tiered support systems for sustainable intervention  .

Student mental health persists as a multifaceted issue, influenced by factors such as income , race, and gender. Moreover, not all students require the same level of support. By identifying the risk factors and warning signs of mental health challenges, districts can scale resources for the students who need it the most.   

A multi-tiered support system (MTSS) organizes intervention strategies along a continuum, starting with prevention and graduating to more intense support to match student need. Districts with a strong MTSS in place prioritize data-based decision-making and problem-solving to more efficiently connect students with appropriate tiers of support. Implement or enhance structures and practices to build capacity for a MTSS model in your district, including:    

• Identify and engage in community and family partnerships to better understand how systemic bias, mental illness, and other disabilities inform the unique support needs of different student groups.   
• Modify school schedules to include protected time for problem-solving meetings, intervention delivery, universal screening and progress monitoring, and professional development.   
• Clearly define the gradient of support beyond generalized prevention measures by identifying intervention methods that support students with targeted needs in a group environment and methods that address individuals with the highest needs and risks profiles.   
• Refine screening tools to identify specific risk factors and warning signs.  

Strengthen your student well-being strategy with data by tuning into our prerecorded webinar, Enhancing Student Outcomes in K – 12 Districts: Strategies for Success .

Diversifying k–12 student mental health funding options    .

Funding remains a major challenge for districts that aim to improve student mental health support systems. With ESSER funding rapidly expiring, it’s a challenging environment for districts to adequately allocate resources for both academic and behavioral programs.   

To counter budget constraints, a benchmarking study by Hanover found that some districts and educational service agencies have found success with a blended or braided model of funding streams to implement comprehensive school-based mental health supports. Leverage the following tips when navigating funding options for your student mental health programs:   

• Explore options for implementing a braided funding model to support school- based mental health support and services, using a combination of federal grants , state funding, and funding from private donors/foundations to cover the expenses.   
• Form community partnerships with organizations that could support and/or directly provide mental health services in district schools or offer telehealth services.   
• For example, consider how local hospitals, universities, non-profits, and existing outpatient behavioral centers could help triangulate support.   
• Connect with Medicaid and other government agencies to learn about ways to lighten the district financial load through insurance coverage.   

ESSER funding may be expiring but you can read our 2024 Trends in K – 12 Education report to learn how other districts are overco ming funding challenges. 

Everyone needs support when overcoming mental health hurdles — and students are no different. Awareness provides a terrific opportunity to shed light on potentially overlooked issues. However, district leaders should also focus on action and accountability to support growing K–12 student mental health needs. Districts and schools can find success in promoting student well-being by using data to establish actionable goals, providing a multi-tiered system of support, and taking innovative approaches to funding and resourcing.  

K–12 Student Well-Being Program Evaluation Checklist

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{{item.title}}, my essentials, ask for help, contact edconnect, directory a to z, how to guides, eight practical tips to support children's wellbeing.

We know how important the first 5 years are for a child’s brain development. Half of all adult mental health challenges will have started before the age of 14.

26 June 2024

Mental wellbeing is as important as physical wellbeing. Children need positive mental health for their physical and emotional development. It’s important for educators to create safe and healthy environments, and to promote positive wellbeing in children.

Assessing the mental health of children can be tricky. A great way to do this is to look for positive behavioural, social and emotional development.

According to Emerging Minds , positive child mental health may look like a child who:

• plays (alone and with others)
• meets development milestones
• expresses their feelings
• makes meaning of their world
• is building their resilience
• is curious and engaged.

Signs of mental health concern

It’s important to note that signs of mental health concerns can present themselves in many ways. Signs should be considered within the context of the child’s age and developmental stage, experiences (for example, have they been or are they being exposed to trauma), cultural and spiritual beliefs, environmental factors and their personality.

Sydney Children's Hospital Network says signs may include but are not limited to:

• trouble sleeping or constantly overtired
• consistent low mood such as sadness for more than 2 weeks
• sudden mood or behavioural changes
• irritability
• weight loss or weight gain
• loss of appetite or significant change in dietary intake
• behaving in a way they have outgrown (for example, wetting the bed or sucking their thumb)
• withdrawal of regular social situations, friends or family.

For school-aged children, a drop in academic performance or experiencing self-harm or suicidal thoughts are also signs of mental health concerns.

Some events and situations that may impact children’s mental health include natural disasters, family conflict or violence, and experiences of poverty, neglect, loss and grief, and severe injury.

These events – whether they’re a one-off, part of everyday life or experienced multiple times over a prolonged period – can contribute to trauma in children.

As Be You explains on its Trauma webpage:

“It’s a child or young person’s experience of the event, rather than the event itself, that makes it traumatic or not.

Whether a child or young person feels overwhelmed and completely out of control or like they had some agency during the incident impacts on their perception of the event as traumatic.”

Children’s responses to trauma can vary – and their reactions may be immediate or occur days, weeks or even years later. They may also respond in unexpected or unpredicted ways. Research also tells us that experiencing trauma early in life can have a profound and lasting effect on a child’s cognitive, social and emotional development.

Understanding and being able to recognise signs of mental health concerns and trauma responses enable early childhood education and care (ECEC) services to provide appropriate supports and strategies to improve outcomes – immediate and long term – for children and their families.

Watch our ‘ Working with children who’ve experienced trauma ’ webinar, facilitated by the Australian Childhood Foundation, to deepen your understanding of childhood trauma and strategies for supporting children’s wellbeing.

Tips and strategies for educators

1. maintain routines and rhythms.

It’s important to acknowledge events and how children may feel, but also provide normal play opportunities and experiences. Continuing to do things in a familiar way can help children feel safe.

2. Encourage connections and conversations

Positive relationships are important to children’s wellbeing and development. Children rely on trusting and respectful relationships with the adults around them.

Being calm and encouraging can make it easier for a child to talk about what they’re feeling. It also may take a few times reaching out for them to feel comfortable. Children also process experiences through play and interactions – conversations about big situations may happen as they play.

3. Work collaboratively with families

Engage in ongoing conversations with families to find out about their child's circumstances, preferences and routines. Work with them to develop opportunities that build on each child’s experience, and promote and support their development.

4. Support children in ways that are sensitive to their experiences

Be aware of and support each child’s physical health, wellbeing and comfort. This can include nutrition, sleep, rest and relaxation, and activity and leisure. It’s important to recognise each child’s personal preferences, routines and needs, such as practices, values and beliefs of the child and their family.

5. Consider your mandatory reporting obligations

Where you have ongoing concerns about a child’s safety and wellbeing use the NSW Mandatory Reporter Guide to help you determine whether you need to report your concerns to the Child Protection Helpline and/or identify alternative supports available for vulnerable children and their families.

6. Link families to specialist services when necessary

Child who are distressed, have experienced a traumatic event, are experiencing ongoing trauma (for example, due to family violence) or simply require additional mental health support may benefit from specialised services. Establishing relationships with local support agencies and health professionals will build your service’s capabilities to support children at your service and provide advice and referrals to their families or carers.

7. Engage in professional development

There are a range of educational programs which help in understanding and supporting children’s learning, development and wellbeing.

• Access our Understanding and supporting children’s behaviour online program, delivered by Phoenix Support for Educators.
• Develop your understanding and capabilities in trauma-informed practice by engaging with Alannah & Madeline Foundation’s Trauma informed practice guide for ECEC and Early Childhood Australia’s Being the champion for children who are impacted by trauma and adversity e-learning.
• Browse Emerging Minds’ suite of online professional learning , including training on culturally responsive practice strategies , educator resources and implementation support .

8. Take care of yourself

Parent and carer mental health

Families are where children first learn about love, support and belonging. Children who are a part of a strong and supportive family are more likely to achieve their best possible mental health. It's important to understand there is no 'perfect' family. Families are diverse, each with their own challenges, circumstances and joys.

The NSW Government provides a range of mental health and emotional support for parents and carers who may need it. Head to Health and Beyond Blue also offer practical guidance and tools for families and children, too.

Educator mental health

Though rewarding, supporting children and family wellbeing can – at times – take a toll on your own mental health. It’s important to look after yourself and seek support when needed.

Download Be You’s Beyond Self-Care: An Educator Wellbeing Guide for guidance, suggested activities and actions you can take at your service to promote educator wellbeing. You can also connect with a Be You consultant for tailored guidance and to develop goals specific to your service.

Watch our ‘Mentally health workplaces’ March 2024 ECE Connect session for evidence-based insights and strategies to create and maintain a psychologically and psychosocially safe workplace.

Useful links

• NSW Department of Education’s Mental health and wellbeing webinars
• Raising Children Network’s Mental health resources
• Smiling Mind website and app
• Brighter Beginnings Parent and Carer Information Hub
• NSW/ACT Inclusion Agency’s Big situations page

Mental health services and hotlines

• Beyond Blue 1300 224 636: 24/7 mental health support service
• Kids Helpline 1800 55 1800: 24/7 crisis support and suicide prevention services for children and young people aged 5 to 25
• 1800RESPECT 1800 737 732: 24/7 support for people impacted by sexual assault, domestic violence and abuse
• Lifeline 131 114: 24/7 crisis support and suicide prevention services
• Suicide Call Back Service 1300 659 467: 24/7 crisis support and counselling service for people affected by suicide
• MensLine Australia 1300 78 99 78: 24/7 counselling service for men
• Qlife 1800 184 527: LGBTI peer support and referral. Available 3pm to midnight
• 13YARN 139 276: 24/7 crisis support for Aboriginal and Torres Strait Islander people
• Sector resources available online 28 June 2024
• Collaborative transition to school practices delivers continuity for children 28 June 2024
• Tips to meet Quality Area 4: Staffing arrangements 28 June 2024
• Compliance focus – safe sleep requirements 26 June 2024
• Eight practical tips to support children's wellbeing 26 June 2024

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Guidance for Responsible Conduct of Research (RCR) Training Requirements

NIH requires that all trainees, fellows, participants, and scholars receiving support through any NIH training, career development award (individual or institutional), research education grant, and dissertation research grant must receive instruction in responsible conduct of research. 

For complete requirements, applicants should review official policies  NOT-OD-10-019  and NOT-OD-22-055  .

NIMH-specific RCR information

NIMH requires successful completion RCR instruction during Year 01 of NIMH-supported research training and career development awards (i.e. NRSAs, mentored Ks), including the R36 and R25. Instructional details must be reported in the Research Performance Progress Report (RPPR). This requirement is fulfilled if the fellow/trainee provides documentation that acceptable instruction has been completed within the last four years and during the current career stage (e.g. if a postdoctoral fellow, during the postdoctoral period).

Instructional component recommendations

Format of Instruction : Describe the required format of instruction, i.e., face-to-face lectures, coursework, and/or real-time discussion groups (a plan with only on-line instruction is not acceptable). Discussion-based instruction should not exclusively employ video conferencing unless there are unusual or well-justified circumstances.

Subject matter : Developments in the conduct of research and a growing understanding of the impact of the broader research environment have led to a recognition that additional topics merit inclusion in discussions of the responsible conduct of research. For context, those additional subjects among the list of topics traditionally included in most acceptable plans for RCR instruction, cited in  NOT-OD-22-055  and appearing below:

• Conflict of interest– personal, professional, and financial – and conflict of commitment, in allocating time, effort, or other research resources
• Policies regarding human subjects, live vertebrate animal subjects in research, and safe laboratory practices
• Mentor/mentee responsibilities and relationships
• Safe research environments (e.g., those that promote inclusion and are free of sexual, racial, ethnic, disability and other forms of discriminatory harassment)
• Collaborative research, including collaborations with industry and investigators and institutions in other countries
• Peer review, including the responsibility for maintaining confidentiality and security in peer review
• Data acquisition and analysis; laboratory tools (e.g., tools for analyzing data and creating or working with digital images); recordkeeping practices, including methods such as electronic laboratory notebooks
• Secure and ethical data use; data confidentiality, management, sharing, and ownership
• Research misconduct and policies for handling misconduct
• Responsible authorship and publication
• The scientist as a responsible member of society, contemporary ethical issues in biomedical research, and the environmental and societal impacts of scientific research

Faculty participation: Training faculty and sponsors/mentors are highly encouraged to contribute both to formal and informal instruction in responsible conduct of research.  Informal instruction occurs during laboratory interactions and in other informal situations throughout the year.

Duration of instruction: Instruction should involve substantive contact hours between the trainees/fellows/scholars/participants and the participating faculty.  Acceptable programs generally involve at least eight contact hours. A semester-long series of seminars/programs may be more effective than a single seminar or one-day workshop because it is expected that topics will then be considered in sufficient depth, learning will be better consolidated, and the subject matter will be synthesized within a broader conceptual framework.

Frequency of Instruction: Instruction must be undertaken at least once during each career stage, and at a frequency of no less than once every four years.

Additional RCR advice for applicants

• Online training is not considered sufficient for RCR training though it can serve as a valuable supplement to face-to-face instruction. A plan that employs only online coursework for instruction in RCR will not be considered acceptable, except in special instances of short-term career development programs, or unusual and well-justified circumstances.
• Discussion-based instruction and face-to-face interaction is expected to remain a key feature of RCR training. However, it is recognized that video conferencing allows for effective “face-to-face” discussions, provided that virtual options are utilized in a way that fosters discussion, active learning, engagement, and interaction. RCR plans that that only include video conference-based training will not be considered acceptable, except in the circumstances described in NOT-OD-10-019  .
• It is helpful to use the above categories (format, subject matter, faculty participation, duration, and frequency) as a framework for describing the proposed training.
• Applicants are encouraged to tailor RCR instruction to the needs of the individual and to include instruction beyond formal institutional courses. RCR training should provide opportunities to develop the trainee’s own scholarly understanding of the ethical issues associated with their research activities and its impact on society.

For complete requirements, applicants should review official policies NOT-OD-10-019  and NOT-OD-22-055  .

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Teachers’ Mental Health and Their Involvement in Educational Inclusion

Silvia salinas-falquez.

1 Department of Psychology, University of Guayaquil, Guayaquil 090514, Ecuador; [email protected]

Carlos Roman-Lorente

2 Department of Psychology, Hum-878 Research Team, Health Research Centre, University of Almeria, 04120 Almeria, Spain; se.oohay@etnerolnamorsolrac (C.R.-L.); moc.liamg@9791anaelialerim (M.B.); se.lau@zeravlaj (J.Á.); se.lau@212agn (N.G.)

Mirela Buzica

Joaquín Álvarez, nieves gutiérrez, rubén trigueros, associated data.

Not applicable.

Teaching is one of the most stressful work contexts, psychologically affecting professionals. The objective of this study is to analyse the effect of the frustration of NPB basic psychological needs, resilience, emotional intelligence and inclusion from the perspective of teachers in the time of the COVID-19 pandemic. The study is carried out with 542 teachers of therapeutic pedagogy and special educational needs using the Psychological Need Thwarting Scale PNTS questionnaires as a research method, the Resilience Scale (RS-14), the Trait Meta Mood Scale 24 (TMMS-24), the Maslach Burnout Inventory, and the Index for Inclusion. The results revealed positive correlations, on the one hand, between the factors of frustration among themselves and with burnout and, on the other hand, the positive correlation between emotional intelligence, resilience and the inclusion index. In conclusion, the resilience of teachers plays a protective role in the inclusion of students with SEN in the face of emotional exhaustion and the frustration of psychological needs.

1. Introduction

Teaching is one of the most stressful work contexts, with a great tendency for professionals to be psychologically affected [ 1 ]. In this sense, it is a work environment which, due to its conditions, requires teachers to face complex situations with high emotional involvement [ 2 ]. This demand is marked by workload, lack of social and institutional support, and classroom management difficulties [ 3 , 4 ]. To the stress already experienced by teachers, a new factor was added, the global COVID-19 pandemic, after which all teaching staff had to adapt quickly to provide access to online educational materials for students and to undertake measures to prevent the spread of the disease in the classroom. Given this situation, teachers have reported high levels of stress and burnout [ 5 ] leading to burnout syndrome, which is characterised by a set of symptoms and signs as a response to chronic stress [ 6 ], with high consequences on the health and psychological and physical well-being of the individual [ 7 ], and effects such as job abandonment, increased absenteeism, and deterioration of the service offered [ 6 ]. Among these symptoms we can highlight physical symptoms, such as headache, myalgia, and hypertension [ 8 ]; behavioural symptoms, such as attention deficit, aggressiveness, inflexibility, rigidity, inability to relate to others, and isolation; emotional symptoms [ 9 ], such as irritability, anxiety [ 10 ], disorientation, impatience, and hostility; and cognitive symptoms, such as low self-esteem, low performance at work, professional failure, etc. Consequently, such burnout hinders the achievement of objectives, diminishing teachers’ feelings of self-efficacy and, over time, giving rise to burnout syndrome [ 11 , 12 ]. However, despite the negative psychological consequences of the excessive workload to which teachers are subjected and the consequences that COVID-19 generates and has generated, there are a series of internal psychological mechanisms that facilitate the adaptation and overcoming of the individual to the possible vicissitudes that arise. According to Bisquerra [ 13 ], a key role in school coexistence is played by the EI level of the teacher and his or her ability to control emotions in the classroom [ 13 ]. In this sense, resilience and emotional intelligence are two of the most important mechanisms that could help teachers to cope positively with daily stressors, facilitating their work to meet the special educational needs of the students they serve. Thus, the present study aims to analyse the psychological coping mechanisms of teachers when facing burnout symptoms arising from daily challenges, and the consequences this has on their inclusive behaviours.

1.1. Frustration of Basic Psychological Needs

According to self-determination theory [ 14 ] human behaviour is motivated by three basic psychological needs (BPN): autonomy, competence and relatedness to others. Autonomy refers to the need for each person to feel that he/she is able to regulate and control his/her behaviour [ 15 ]; competence relates to the person’s involvement in different situations that challenge his/her abilities and are presented as challenging situations for him/herself [ 16 ]; finally, relatedness is linked to people’s need for interaction and a sense of belonging [ 17 ]. These three needs are essential to facilitate the optimal functioning of natural tendencies for growth and integration, as well as for social development and personal well-being. NPBs can be frustrated or satisfied. The frustration of needs predicts burnout while satisfaction is highly correlated with vitality and personal development [ 18 ]. When NPBs are hindered it implies a change in maladaptive or even maladaptive motivational functioning; however, when they are satisfied, positive effects are produced regardless of people’s goals, interests, values and preferences [ 18 ], i.e., better performances are promoted.

In terms of previous research, the study by Bartholomew et al. [ 19 ] shows that the frustration of NPB increases demotivation, emotional exhaustion and cynicism in teachers. On the other hand, they highlight that those teachers who are more frustrated with their competence are those who have less intrinsic motivation and are more demotivated at work. Likewise, Bartholomew et al. [ 20 ] found that frustration with autonomy, competence and relationships with others increases burnout. In the same vein, Van den Berghe et al. [ 21 ] state that NPB satisfaction increases the negative factors of burnout and significantly reduces professional effectiveness.

1.2. Emotional Intelligence

Emotional intelligence is defined as the ability to know and manage one’s own and others’ emotions, to feel satisfaction and to be effective in life [ 22 ]. According to Bar-On [ 23 ], social–emotional intelligence is a cross-section of interrelated emotional and social competencies, skills and enablers that determine how effectively we understand and express ourselves, understand and relate to others, and cope with daily demands. This model is based on the individual, on the ability to understand one’s own weaknesses and strengths, and the ability to express one’s feelings and thoughts in a non-destructive way. In this sense, EI influences adaptation processes, facilitating appropriate responses to the different events that a person has to face in their daily life, reducing maladaptive emotional reactions, enabling the experience of positive moods, and reducing the incidence of negative ones [ 24 ].

Goleman [ 22 ] states that emotionally intelligent people possess a series of characteristics, such as: self-awareness, self-regulation, empathy, social skills, and self-motivation. All this helps a person to know themselves and to know and understand the moods they have; they know how to control impulses and emotions, and are able to think before acting, that is, they are assertive, open to new ideas and have the capacity for flexible thinking in the face of change; they are able to put themselves in the place of others and not just listen to them; they know how to manage their social skills to relate to all kinds of people; and they are able to motivate themselves without expecting to be recognised or receive a prize for their achievements, with this strength and motivation coming from within.

Several studies have provided evidence of the positive relationship between EI and psychological adjustment [ 25 ], well-being [ 26 ], social functioning [ 27 ], and health [ 28 ]. Along these lines, a growing body of research reports that teachers’ personal competences, and more specifically, EI, are extremely important for their professional performance [ 29 , 30 ]. Teachers with high levels of EI have been found to be less vulnerable when facing stressful work situations, as they feel skilled in regulating their emotions, are better able to develop active strategies to cope with stressful situations in the academic environment, and enjoy greater personal fulfilment and less stress [ 31 , 32 ].

1.3. Resilience

Resilience comprises two levels: the first is resistance or the ability to cope with the “problem” and the second is the ability to “build” or rebuild positively in spite of difficulties [ 33 ]. Resilience is a positive attitude towards life despite difficult circumstances and represents the positive side of mental health. It also consists of knowing how to learn from defeat and transform it into an opportunity for personal development. In this sense, Vanistendael and Saavedra [ 33 ] distinguishes two components: on the one hand, resistance to destruction, i.e., the ability to protect one’s own integrity under pressure and, on the other hand, the ability to forge a positive life behaviour despite the difficult circumstances that the subject is going through, i.e., resilience can be improved and trained to deal positively with adversity.

The most resilient people maintain a greater emotional balance in stressful situations, which allows them to better withstand pressure and, consequently, experience a greater sense of control and ability to cope with difficult situations [ 12 ]. A resilient person is not an exceptional being: they can be anyone, i.e., resilience is in the person and in the variables of their immediate environment. In other words, resilience is created by the person’s temperament, culture, cultural meaning and social support. It could be said that the socio-cultural context in which the individual lives can favour or hinder the development of resilience, train them, and improve the person’s capacities, transforming him/her into a resilient person.

According to Vicente de Vera and Gabari [ 34 ], resilience in secondary school teachers could be a modulating variable of teacher distress, making it easier for teachers to adapt to or overcome stressful situations and, consequently, would lead to greater dedication and motivation to meet their objectives and therefore respond adequately to the demands of the profession [ 34 ]. Likewise, the study carried out by Mérida et al. [ 35 ] concluded that resilience and emotional intelligence have a positive influence on the behaviour of teachers, increasing their commitment to their teaching work. In addition, it has been found that the use of resilient coping strategies and teacher training in this area could reduce the deterioration of stress produced by the arduous work of teaching [ 36 ]. Along the same lines, the study by Díaz and Barra [ 37 ] concluded that the dispositional characteristics of resilience would be protective factors that would allow teachers to be satisfied with their teaching work despite the difficult scenario in which they carry out their role. According to Zadok-Gurman et al. [ 38 ], in difficult times, such as a pandemic, resilience can reduce the adverse effects of stressors on mental health and promote positive mental health [ 38 ]. Finally, the work of Garcia [ 39 ] and Vicente de Vera and Gabari [ 40 ] conclude that resilience decreases vulnerability to burnout.

1.4. Burnout

The term burnout is understood as a gradual process by which people gradually lose interest in their work and responsibilities, and can lead to deep depression. Maslach and Jackson [ 41 ] define burnout as a behavioural manifestation of work-related stress, and understand it as a three-dimensional syndrome. This three-dimensional construct is characterised by three main manifestations: emotional exhaustion, depersonalisation, and low self-fulfilment [ 42 ]. One of the characteristics of burnout syndrome is exhaustion, causing the person to feel overwhelmed and tired by the performance of their work, causing a decrease in interest and job satisfaction [ 43 ]. In the same vein, Cortez-Silva et al. [ 44 ] say that burnout syndrome is a response to chronic emotional and interpersonal stressors at work, and emotional exhaustion is one of the components of burnout syndrome.

1.5. Teachers and COVID-19 Literature Review

The COVID-19 pandemic has further challenged teachers, increasing emotional exhaustion and the deterioration of their competences, resulting in a loss of sensitivity and empathy and a high sense of failure Cortez-Silva et al. [ 44 ]. This leads to decreased job and personal performance and job dissatisfaction [ 45 ]. A study by Cevallos et al. [ 46 ] and Duan and Zhu [ 47 ] concluded that the adaptive process to which teachers were subjected during the COVID-19 pandemic has caused them high physical and psychological exhaustion, highlighting, on the one hand, that symptoms of anxiety, depression and stress were the most common reactions among teachers. On the other hand, a study by Kukreti et al. [ 48 ] showed that teachers’ perceived fear of COVID-19 led to an increase in psychological stress and post-traumatic stress, resulting in an increase in absenteeism.

A study by Eşici et al. [ 49 ] showed that teachers have a need for psychological support and continuous training due to the problems experienced in adapting to the new teaching situation, especially regarding pupils’ access to education. Similarly, a study by Sugianto and Ulfah [ 50 ] showed that the pandemic led to an increase in teacher insecurity, anxiety and stress. This increase was found to be motivated by the possible lack of attention to students’ educational needs and failure to achieve academic goals. However, a study by Pressley et al. [ 51 ] found that most teachers did not perceive any extra burden during the first period of the pandemic; however, after two months, teachers began to perceive an increase in anxiety, including stress, with teachers who were following virtual instruction experiencing the greatest increase in anxiety. Similarly, a study by Hassan, Mirza and Hussain [ 52 ] showed that although many schools are technologically adapted to vicissitudes such as COVID-19, students and teachers are not prepared for its use, either because of poor adaptability or the inability to use these technological devices effectively. This situation can create stress and anxiety for teachers, which hampers their effectiveness as teachers.

Longitudinally, the results of the study by Kareem and Tantia [ 53 ] indicated that teachers’ experience and attitudes towards change were positively correlated with resilience and negatively correlated with teacher burnout at the beginning of the pandemic. Throughout the first three months of the pandemic, teachers demonstrated increased burnout and cynicism, but also increased classroom management and a greater sense of accomplishment. In addition, teachers’ cognitive and emotional attitudes towards change became more negative. Similarly, a study by Sokal, Trudel and Babb [ 54 ] examined the relationships between teacher stress, teacher self-efficacy, and teacher well-being during the COVID-19 pandemic. The study reported that teachers experienced high levels of stress and low levels of positive feelings such as joy, positivity, happiness and job satisfaction during the COVID-19 pandemic which negatively affected their well-being and self-efficacy. On the other hand, a study by Alea et al. [ 55 ] revealed that those teachers with a high level of teaching experience showed a greater capacity to adapt to new methodologies compatible with the COVID-19 situation, showing evidence of less stress and anxiety.

In relation to gender, a study by Dosil Santamaría et al. [ 56 ] showed that female teachers show significantly more symptoms of stress and anxiety than men, those with children have more depressive symptoms than those without, and people with chronic pathology or living with others with chronic pathology have more stress, anxiety and depression.

1.6. Objective and Hypothesis

The aim of this study is to analyse the effect of the frustration of basic psychological needs, resilience, emotional intelligence and inclusion from the perspective of teachers in time of the COVID-19 pandemic. Therefore, this study aims to analyse how teachers’ emotional intelligence and resilience influence the psychological well-being and educational inclusion of students with special educational needs. To this end, the following hypotheses are proposed: (a) Teachers’ emotional intelligence positively predicts resilience, anxiety, depression and stress. (b) The frustration of basic psychological needs negatively predicts resilience. (c) Resilience will negatively affect anxiety, depression and stress. (d) Anxiety, depression and stress negatively predict educational inclusion.

2.1. Participants

The present study required the participation of 542 teachers of therapeutic pedagogy and special educational needs (258 males and 284 females). The age of the teachers ranged from 33 to 56 years, with a mean of 44.87 (SD = 6.17). The percentage of teachers working in urban areas was 80,99% compared to the 20,01% of teachers that worked in rural areas.

The teachers taught in several schools and educational guidance teams in the provinces of Almería, Granada and Jaén (Spain).

2.2. Measurements

Frustration of psychological needs . To analyse the frustration of autonomy, competence and social relation needs, the adaptation of the Psychological Need Thwarting Scale (PNTS: [ 19 ]) to the Spanish educational context [ 57 ] was used. This questionnaire consists of the opening sentence “In my work environment...”, followed by 12 items (4 per factor) aimed at analysing autonomy frustration, competence frustration and social relationship frustration. Teachers had to respond on a Likert scale ranging from 1 (not true at all) to 7 (completely true).

Resilience . The Spanish version of the Resilience Scale (RS-14) by Wagnild [ 58 ] was used. The RS-14 measures two factors: Factor I: Personal Competence (11 items, self-confidence, independence, decisiveness, resourcefulness and perseverance); Factor II: Acceptance of self and life (3 items, adaptability, balance, flexibility and a stable outlook on life). Teachers were asked to respond on a Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree).

Emotional Intelligence . The Trait Meta Mood Scale 24 (TMMS-24) by Fernández-Berrocal, Extremera and Ramos [ 59 ]) was used. The scale is composed of 24 items, equally distributed among 3 factors: emotional attention (e.g., I tend to worry a lot about how I feel), emotional clarity (e.g., I almost always know how I feel), and emotional repair (e.g., I try to think positive thoughts even when I feel bad). Teachers were asked to rate their agreement with each item on a 5-point Likert-type scale ranging from 1 (strongly agree) to 5 (strongly disagree).

Burnout . The Spanish version [ 60 ] of the Maslach Burnout Inventory [ 41 ] was used. The scale is composed of 21 items distributed across 3 factors: self-fulfilment, depersonalisation and emotional exhaustion. Participants in the study completed the questionnaire using a Likert scale from 0 (never) to 6 (every day).

Educational Inclusion . To measure teachers’ attitudes towards educational inclusion we used Boot and Ainscow’s [ 61 ] Index for Inclusion translated and adapted to Spanish by Booth, Simón, Sandoval, Echeita and Muñoz [ 62 ]. The questionnaire is composed of a total of 56 items (e.g., “All people who come to this school are welcome”) distributed across 6 sub-factors: A1: building community; A2: establishing inclusive values; B1: developing a school centre for all; B2: organising support for diversity; C1: building a curriculum for all; and C2: orchestrating learning, which in turn is divided into 3 factors: (A) creating inclusive cultures, (B) establishing inclusive policies and (C) developing inclusive practices. Teachers respond using a Likert scale from 0 (disagree) to 3 (agree) with the response options of the original scale.

2.3. Procedure

Initially, approval was obtained from the bioethics committee of the University of Almeria in order to begin the present study (Ref. UALBIO 2021/24). Once approval was obtained, the management teams of several educational centres were contacted; we explained in detail the objective of the present study and requested their support. Subsequently, those schools that agreed to participate in the study were contacted, explaining the aim of the study and requesting their participation. Before they could participate in the study, they had to submit a signed informed consent form.

The questionnaires were filled in at the beginning of the department coordination meeting, indicating that the answers would be anonymous and confidential. In addition, a member of the research group was present to answer any questions that might arise. The questionnaires took 25 min to complete.

2.4. Data Analysis

The statistical analyses carried out in this study were descriptive statistics: mean, standard deviation and bivariate correlations, as well as reliability analysis, using the SPSS v25 statistical package. Subsequently, a structural equation model (SEM) was carried out to analyse the predictive relationships established in the hypothesised model using the AMOS v20 statistical package.

A bootstrapping of 5000 interactions was used to carry out the SEM, together with the maximum likelihood method. To analyse the goodness of fit of the hypothesised model ( Figure 1 ) the following indices were considered [ 63 ]: χ2/df, with values between 2 and 3; the Comparative Fit Index (CFI), Incremental Fit Index (IFI), and Tucker–Lewis Index (TLI), with values above 0.95; the Root Mean Square Error of Approximation (RMSEA) plus its 90% confidence interval with values below 0.06; and the Standardized Root Mean Square Residual (SRMR) with values below 0.08. Nevertheless, these indices should be interpreted with caution as they can be restrictive when the model is very complex [ 63 ].

Structural equation model showing the relationships between variables. Note: ** p < 0.01; *** p < 0.001.

3.1. Preliminary Analysis

Table 1 shows the mean, standard deviation, and bivariate correlations. The correlations reflected a positive relationship between the factors of frustration with each other and with burnout. Similarly, positive correlations were also reflected between emotional intelligence, resilience and the inclusion index. In addition, Table 1 shows the reliability analyses with all scores being above 0.80 [ 64 ].

Mean, standard deviation, internal consistency analysis and bivariate correlations.

** p < 0.01; *** p < 0.001. Note: α= Cronbach’s alpha.

3.2. Structural Equation Modelling

Testing the hypothesised predictive relationship model on teachers ( Figure 1 ) revealed the following fit indices: χ2 (105. N = 542) = 301.63, p < 0.001; χ2/df = 2.87; CFI = 0.96; IFI = 0.96; TLI = 0.96 RMSEA = 0.054 (90% CI = 0.050–0.061); and SRMR = 0.039.

The relationships obtained between the different factors that made up the model were as follows:

(a) The correlations between each of the basic psychological need frustrations were positive: β = 0.49 ( p < 0.01) between competence and autonomy frustration; β = 0.26 ( p < 0.01) between autonomy and relatedness frustration with others; and β = 0.18 ( p < 0.01) between competence and relatedness frustration;

(b) The relationship between competence frustration, resilience (β = −0.53, p < 0.01) and emotional intelligence (β = −0.42, p < 0.01) was negative;

(c) The relationship between autonomy frustration, resilience (β = −0.61, p < 0.01) and emotional intelligence (β = −0.32, p < 0.001) was negative;

(d) The relationship between relatedness frustration, resilience (β = −0.52, p < 0.001) and emotional intelligence (β = −0.24, p < 0.01) was negative;

(e) The relationship between resilience and burnout (β = −0.38, p < 0.001) was negative, whereas with the inclusion index (β = 0.43, p < 0.01) was positive;

(f) The relationship between emotional intelligence and burnout (β = −0.44, p < 0.001) was negative, whereas with the inclusion index (β = 0.57, p < 0.001) was positive;

(g) The relationship between burnout and the inclusion index (β = −0.59, p < 0.01) was negative.

4. Discussion

Teaching is one of the most stressful work activities, as the workload inherent to the activity has an effect on teachers’ relationships with colleagues and students. This involves a great deal of psychological and emotional stress that is sometimes difficult to cope with without a series of internal mechanisms that allow the teacher to adapt to these difficulties. In addition to this situation, in recent years, COVID-19 has led to an excessive workload and an increase in fear, stress and anxiety given the hygienic measures to be implemented and the modifications in teaching methodologies. Therefore, the study aimed to analyse the psychological coping mechanisms of teachers when facing burnout symptoms arising from daily challenges, and the consequences this has on their inclusive behaviours. For this purpose, a SEM was performed in order to analyse the predictive relationships between the study variables whose values were in accordance with the pre-military analyses with bivariate correlations. In addition, reliability analyses showed a score above 0.70, implying that the variables were related to the unobservable magnitude of interest.

In relation to the main analysis used in this study through SEM, the results obtained show that BPN frustration was negatively related to resilience and emotional intelligence. These results are difficult to compare with previous studies involving teachers, especially if all variables are taken into account at the same time. However, these results are similar to previous studies involving students and athletes. In this regard, a study by Trigueros et al. [ 65 ] showed that NPB frustration negatively predicted athletes’ ability to adapt to the demands and challenges faced during competitions or training. Similarly, a study by Waterschoot et al. [ 66 ] with university students showed that BPN frustration reduced students’ attention during lectures due to a decrease in students’ sense of adaptation to difficulties. On the other hand, a study by Lera and Tawahina [ 67 ] with 300 adolescents from conflict zones showed that the traumatic experiences of these young people were negatively related to contextual resilience. On the other hand, a study by van der Kaap-Deeder et al. [ 68 ] with university students showed that BPN frustration negatively influenced emotion management and regulation, factors linked to emotional intelligence. On the other hand, a study by Abidin et al. [ 69 ] with parents showed that BPN satisfaction was positively related to emotional well-being, while BPN frustration was negatively related. On the other hand, a study by Trigueros-Ramos et al. [ 70 ] with secondary school students showed that teacher autonomy support increases students’ enjoyment, motivation and confidence in sport, i.e., if the teacher had EI, he/she could satisfy his/her NPBs and thus students’ educational inclusion.

On the other hand, resilience and EI have been negatively related to burnout. However, these results cannot be contrasted with studies where each of the variables are grouped together, although they can be contrasted separately. In this sense, a study by Howard and Johnson [ 71 ] with primary school teachers showed that high levels of high resilience were associated with low levels of burnout and job stress. Similarly, a study by Richards et al. [ 72 ] analysed the impact of resilience on stress and burnout in primary and secondary school teachers. This study showed that those teachers who were highly adaptive and fluent in the use of adaptive strategies had low levels of job stress and burnout. A study by Polat and İskender [ 73 ] analysed the relationship between resilience and teachers’ job satisfaction through burnout. The results showed that high resilience was related to low levels of burnout. Regarding EI and burnout, a study by Lee and Chelladurai [ 74 ] with university teachers showed that high levels of emotional intelligence were related to low levels of burnout. Similarly, a study by Zysberg et al. [ 75 ] showed that high levels of emotional intelligence were related to low levels of stress and burnout, especially in the workplace. In this line, it can be affirmed that teachers who have a high level of EI and resilience are less affected by the effects of burnout, which implies less chronic fatigue, demotivation and a decrease in job dissatisfaction, acting as a protective barrier against the physical and emotional exhaustion that burnout produces. In this sense, resilience can be an empowering instrument to work on in formal education [ 76 ] as a tool to resolve difficult situations that teachers face in the professional and personal spheres. As for EI, this intelligence plays an important role in self-esteem and self-confidence [ 77 ], helping to overcome life’s difficulties, as well as to develop greater resilience. In other words, the positive correlation between EI and resilience is also associated with greater life satisfaction and in this case, this is corroborated by the study in older adults by Meléndez et al. [ 78 ] who found in their research that the dimensions of emotional clarity and emotional regulation were significant and positive predictors of resilience.

Finally, the results showed that emotional intelligence and resilience were positively related to educational inclusion, while burnout was negatively related. These results have been found to be partially similar with previous studies, although not with all variables. In this regard, a study by Fabio and Palazzeschi [ 79 ] showed that teacher effectiveness and teacher engagement during lessons was influenced by high levels of resilience and emotional intelligence. Therefore, emotional intelligence could increase teachers’ self-efficacy beliefs and resilience. Moreover, this effect could be inverse, i.e., teachers’ self-efficacy and resilience could increase their emotional intelligence by improving the ability to recognise and manage one’s own emotions in stressful situations [ 80 ].

As limitations of the study, it could be highlighted that there is a lot of research on BPN satisfaction and very little on BPN frustration, considering that the frustration of autonomy, competence and relationships with others usually leads to more problems for teachers in the performance of their work, raising the risk of suffering burnout implicitly. Moreover, this is a relational study that does not allow the establishment of causal relationships; thus, the results obtained can be interpreted in many ways, given that the study was carried out by means of a self-administered questionnaire. Future research should investigate the reasons for the frustration of NPBs and subsequent burnout, as well as identify what motivates teachers to develop resilience and thus inclusive educational practices. In addition, future studies could investigate the differences between teachers in urban and rural schools.

5. Conclusions

The present study has shown the protective factor of resilience and emotional intelligence against burnout, leading to more inclusive behaviour in the classroom. However, the high stress of the teaching job and unforeseen situations such as the COVID-19 pandemic make teachers vulnerable to stress, depression, anxiety and high physical and emotional demands. This leads to a decline in the quality of teaching and care for students with SEN. Therefore, education authorities should allocate reasonable resources to identify and support school teachers by providing them with the necessary tools and resources [ 81 ]. In addition, public administrations should provide teachers with educational practices on ICT tools to help them cope with future and present situations that make physical teaching difficult so that confidence is strengthened, choice is maximised, and teacher empowerment is prioritized [ 82 ].

Funding Statement

This research received no external funding.

Author Contributions

Conceptualization, R.T. and J.Á.; methodology, N.G.; formal analysis, R.T.; investigation, M.B.; resources, C.R.-L.; data curation, S.S.-F. and S.S.-F.; writing— original draft preparation, S.S.-F.; writing—review and editing, R.T. and N.G.; visualization, J.Á.; supervision, R.T.; project administration, R.T.; funding acquisition, J.Á. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by bioethics committee of the University of Almeria in order to begin the present study (Ref. UALBIO 2021/24).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

• DermWire News
• Atopic Dermatitis

NEA Study Illuminates Gaps in Mental Health Help for Eczema Patients

Forty-two percent of patients with atopic dermatitis (eczema) and caregivers of children/teens with the condition never spoke about mental health with primary eczema care providers, according to National Eczema Association (NEA) research published this month in Skin and Health Disease .

This was the second publication from the NEA’s real-world research on eczema and its impacts on mental health; the first examined eczema patients' perceptions of how mental health relates to eczema symptoms, and was published in  Dermatitis  in March.

Research has already shown that eczema is strongly associated with symptoms of psychological distress, including anxiety, depression and social isolation. However, there had not been an understanding of what type of mental health support eczema patients receive or don't receive from their primary eczema provider.

"This is the first study to explore this important topic for the eczema patient community," said Jessica Johnson, lead author of the study and director of community engagement and research at NEA. 

As part of the study, adult eczema patients and primary caregivers of eczema patients ages 8 to 17 completed a survey that included questions about eczema symptoms, mental health symptoms, perceptions of the connection between eczema and mental health, and experiences accessing mental health services. Mental health services in the survey were defined as, but not limited to: counseling with a mental health provider; cognitive behavioral therapy; social support groups; alternative mental health therapy (such as music or art therapy); and/or mental health medications. 

Other important findings from the study include: 

• 50% of patients were never asked about mental health by their primary eczema care provider during any visits
• 64% of adult patients and caregivers of young patients with eczema were not referred to mental health resources
• The patients more likely to be referred to mental health services included children, men, those with limited education, and people seeing non-specialists
• If patients were referred to mental health resources, the most common referrals were to counseling services (23% of referrals), alternative mental health therapy (15%), cognitive behavioral therapy (13%), and peer/social support groups (12%) 
• Among those who received a referral for mental healthcare, 57% utilized the recommended services 
• The patients more likely to have never spoken with their primary eczema care providers about mental health included women, people of low income, and people seeing specialists (such as dermatologists or allergists) for their primary eczema care
• Young adults 18–34 years old frequently reported not being asked about their mental health but wanted to be

"We know about the emotional and psychological toll that eczema can take on patients of all ages," said Wendy Smith Begolka, study senior author and chief strategy officer at NEA. "Ideally, patients and healthcare providers would feel comfortable discussing mental health during their visits. Our study highlights the opportunity to help this discussion occur more consistently." 

The NEA said in a press release that more research is needed to identify the most effective mental health interventions for eczema patients, as well as current barriers to referring patients to mental healthcare. Additional findings and insights from this study are expected to be published in the coming months.

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S. 3060 — A bill to establish a Youth Mental Health Research Initiative in the National Institutes of Health for purposes of encouraging collaborative research to improve youth mental health; to the Committee on Health, Education, Labor, and Pensions.

Cosponsors added, S2516 [21MR]