School communities in Addis Ababa exhibit significant lack of awareness, misconceptions, and notable stigma against schoolchildren with mental disorders, contributing to delays in seeking care and poor coping strategies, with existing school-based mental health programmes being inadequate to address these challenges.
Key Findings
Results
There is a significant lack of awareness and misconceptions about mental health issues within the school community in Addis Ababa.
Finding derived from key informant interviews with nine school-based professionals across four high schools in Addis Ababa, Ethiopia.
Participants included three school counsellors, two clinical nurses, two special needs teachers, one counselling psychologist, and one class principal teacher.
Schools represented varied contexts: two private schools, one church-affiliated school, and two public schools, one of which had a special needs programme.
Lack of awareness was identified as a key challenge as perceived and reported by school-based professionals.
Results
Students with mental disorders frequently face discrimination and stigma within school communities in Addis Ababa.
Stigma was identified as a notable challenge against schoolchildren with mental disorders across the study sites.
The study was conducted across four high schools with participants having years of experience ranging between 2 and 35 years.
Stigma was observed to be a barrier experienced by students with mental disorders in the school environment.
Five male and four female participants reported these observations from their professional proximity to students' academic journeys and health-related issues.
Results
Stigma and lack of awareness contribute to delays in seeking mental health care and may result in poor coping strategies among affected students.
Delays in seeking care were identified as a consequence of the combined factors of stigma and lack of awareness.
Poor coping strategies were reported as a potential outcome of these delays.
This finding was reported by school-based professionals who work in proximity to students' academic and health-related issues.
The qualitative methodology involved in-depth and key informant interview guides to surface these professional observations.
Results
School-based mental health programmes at the study sites are inadequate for addressing mental well-being promotion and stigma reduction.
Existing programmes aimed at promoting mental well-being and reducing stigma were described as inadequate for effectively addressing identified challenges.
The inadequacy was observed across four high schools in Addis Ababa, representing both private and public school contexts.
The study identified a need for comprehensive mental health literacy and promotion, stigma reduction, and service delivery and/or referral programmes.
The study called for a 'well-coordinated school mental health system' to address these gaps.
Conclusions
The authors identified three governance priorities needed to establish a well-coordinated school mental health system in Addis Ababa.
The three priorities identified are: (1) establishing comprehensive mental health literacy and promotion, (2) reducing stigma, and (3) implementing service delivery and/or referral programmes within schools.
These recommendations were based on qualitative data from nine school-based professionals across four Addis Ababa high schools.
The authors noted that future studies should directly engage students and their parents to triangulate these professional observations.
The study emphasized the need for a 'holistic and inclusive mental health support in Ethiopian schools.'
Methods
The study used a purposive qualitative sampling strategy recruiting participants based on their proximity to students' academic and health-related issues.
Nine participants were purposefully recruited: five men and four women with experience ranging from 2 to 35 years.
Professional roles included school counsellors, clinical nurses, special needs teachers, a counselling psychologist, and a class principal teacher.
Key Informant Interviews were conducted using in-depth and key informant interview guides.
The study was conducted at four high schools in Addis Ababa, covering private, church-affiliated, and public school types.
The qualitative design was chosen to explore mental health literacy and stigma in Ethiopia's specific context.
What This Means
This research suggests that students with mental health conditions in Addis Ababa's high schools face a difficult environment shaped by widespread misunderstanding and stigma. School staff — including counsellors, nurses, and teachers — reported that their school communities have limited knowledge about mental health, hold misconceptions about mental disorders, and often treat affected students in discriminatory ways. These barriers appear to discourage students from seeking help in a timely manner and may push them toward harmful ways of coping with their difficulties.
The study also found that the mental health support programmes currently in place at these schools are not sufficient to tackle these problems. The researchers gathered this information through in-depth interviews with nine professionals working across four different types of schools (public, private, and church-affiliated) in Addis Ababa, Ethiopia. The diversity of school settings suggests these challenges may be widespread rather than isolated to one type of institution.
This research suggests that school systems in Addis Ababa — and potentially across Ethiopia — need to invest in three areas: improving mental health knowledge and awareness among school communities, actively working to reduce stigma, and creating clearer pathways for students to access mental health services or be referred to appropriate care. The authors note that future research should also hear directly from students and parents to get a fuller picture of the situation, since this study relied solely on the perspectives of school professionals.
Megersa S, Ware F, Dehning S, Jobst A, Girma E. (2026). Breaking barriers: mental health literacy and stigma in Addis Ababa's schools - a qualitative study in Ethiopia.. BMJ open. https://doi.org/10.1136/bmjopen-2025-112423