Mental health status of school students in India: The role of school-based family counselling

Abstract

Holistic education that promotes children’s well-being is the core objective of schools. Despite all the sincere efforts by the authorities of most schools across society, with some variations, many school children experience a range of adversities which mostly go unnoticed. This article attempts to highlight some of the major adversities faced by school children up to higher secondary levels in India. A summary of the available secondary literature indicates that school children experience adversities like academic stress, caused by parental pressure, abuse and neglect, including corporal punishment, family violence, social discrimination, anxiety, depression, suicidal ideation and suicide. Evidence also suggests a supportive family environment and positive parent-child relationship minimise adversities and mental health challenges. Mental health support facilities are missing in most of the schools in India. In the given situation, school-based family counselling is recommended, which would benefit school children in addressing the issues they face. Further research that addresses the effectiveness and scalability of school-based mental health programs is needed as well as prioritising child protection as a national agenda.

Introduction

Every child is equally vulnerable to mental health challenges, like physical health problems, during their formative years (Schulte-Körne, 2016). Parents and teachers sometimes fail to understand children’s challenges due to factors like lack of knowledge, insensitivity, illiteracy, behavioural or psychological issues, family violence or poor communication with children. This leads to poor academic performance and worsens the problem. Evidence highlights that mental health challenges adversely impact the career of the child (McLean et al., 2020). This secondary evidence-based article attempts to highlight some of the major adversities faced by school children up to higher secondary levels in India.

The paper’s first section describes India’s demographic features, including the number and types of schools, for an international audience. This is followed by a discussion of the different areas that impact school students’ mental health in India. Finally, School-Based Family Counselling is suggested as a way forward to support the mental health of school children in India.

Demographic characteristics of India

India is the world’s second-most populous country, following China, with a population of 1.206 billion according to the 2011 Census (2011). The latest data indicates that India overtook China and is in the first position in terms of population. As of October 7, 2024, the total population of India is 1,454,392,001 (Worldometer, 2024). Its uniqueness lies in its rich cultural diversity. Geographically, India comprises 28 states and 8 union territories, each with distinct cultural beliefs and practices, dress code, food habits and a unique social and linguistic identity. The population predominantly follows Hinduism (80.5%). The birth rate surpasses the death rate, and the life expectancy at birth is 66.8 years. The population is distributed across three main age groups: 29.7% are aged 0 to 14, 64.9% are between 15 and 64, and 5.5% are over 65 years (Census, 2011).

Number of schools in India

The total number of schools in India from primary to higher secondary is 1,509,136 as per 2020–2021 data. Out of them, the number of primary, upper primary, secondary and higher secondary schools is 774,742, 442,928, 151,946 and 139,520 respectively (Ministry of Education Government of India, 2024). Schools in India are categorised into four broad groups: government, government aided, private unaided recognised and others. The Government Schools constitute the majority (n = 1,032,049), followed by Government Aided (n = 84,295), Private Unaided Recognised (n = 340,753) and Others (n = 52,039). Pupil-teacher ratio at the primary, upper primary, secondary and higher secondary levels in India is 26, 19, 18 and 26, respectively (Ministry of Education Government of India, 2024).

Mental health status of Indian school children

The types and mediums of schools vary across India, giving emphasis on the medium of instruction for teaching. In every state, especially in government schools, emphasis is given to teaching in the local language up to the 12th Standard and even at the undergraduate levels. As a result, when the students from those academic institutes go for higher studies, they experience significant difficulty with the medium of instruction which is English. This results in students experiencing anxiety, an inferiority complex, poor performance and sometimes dropping out (Deb et al., 2010). Some even develop suicidal ideation and suicide (K. S. Kumar & Akoijam, 2017).

Academic stress

Academic stress has emerged as a significant concern for secondary and higher secondary school students, particularly in Asia, where it is closely linked to various mental health issues like anxiety, depression, suicidal ideation and suicide (Mahapatra & Sharma, 2020; Nandagaon & Raddi, 2020). Various factors are responsible for increased academic stress in Asian countries’ children, including demographic differences, socio-economic variables, education systems and cultural values (Nandagaon & Raddi, 2020).

India’s unique cultural, social and economic context profoundly influences students’ mental health, particularly through societal norms and expectations (Deb et al., 2015). Academic achievement is often seen as a marker of self-worth and a means of upward social mobility, placing immense pressure on students to perform well (K. Singh et al., 2015). Parental expectations can be overwhelming, as parents frequently prioritise grades over holistic development, leading to anxiety and depression among children (K. Singh et al., 2015). The stigma attached to academic failure amplifies this stress, with many students fearing judgement from their families and communities (Ninan et al., 2019)

Prevalence of academic stress in India

In India, academic stress is alarmingly high. Research highlights various dimensions of this issue. A study by Arun and Chavan (2009) involving 2,402 students found that 45.8% of the subjects experienced psychological problems. Notably, 8.82% reported feeling that life was a burden, and 6% experienced suicidal ideation. Another south Indian study observed higher academic stress among private schools as compared to government school students (Subramani & Kadhiravan, 2017).

Academic stress in India is significantly influenced by parental expectations regarding academic performance. Research indicates that this pressure often compels students to engage in extended study hours, to achieve high grades or percentages in examinations, as highlighted by (Deb et al., 2014).

The Grade X Board Examination is particularly impactful as it largely dictates a student’s ability to specialise in their preferred academic stream (Deb et al., 2015). This decision has lasting implications for their future educational and employment opportunities, as the Indian educational and job markets offer limited flexibility for changing academic paths. Similarly, the results of the Grade XII Board Examination directly influence students’ admissions into colleges and universities. On and above, academic performance in India is closely tied to social status (Deb et al., 2015).

To enhance academic performance, many parents and guardians in Kolkata, as well as throughout India, often seek private tutors for their children. This trend is prevalent across various socio-economic groups (Deb et al., 2015). One Indian study revealed that 96.3% of students in Grades X and XII (specifically in science streams) engaged the services of private tutors, and a significant 42% of these students had four or more tutors. The study also indicated that approximately 32.6% of the student’s exhibited symptoms of psychiatric issues, while 81.6% reported experiencing examination-related anxiety (Deb et al., 2015). These findings suggest that while private tutoring may provide additional academic support, it can also contribute to heightened stress and anxiety levels among students. Having four or more tutors is significantly linked to higher levels of academic stress and examination anxiety (Deb et al., 2015). The effective implementation of the National Education Policy 2020 will bring some positive change in the school education system in future.

Child abuse and neglect including corporal punishment

Child abuse and neglect instigates a pervasive social and cultural issue in India, reflecting the deep-rooted societal norms that often normalise harmful practices (Deb & Ray, 2022). Recent day-to-day media reports concerning sexual abuse of minor school students in the school premises or outside the school while returning home by private vehicle are raising serious concerns about the safety measures in the school, the role of law enforcement agencies and government in protecting children from harm. For example, one media report indicates that two minor girls aged 6 years were sexually abused by a van driver (The Indian Express, 2024).

This incident indicates that school children are at risk of not being safe in school. In a number of similar cases in the past justice was not only delayed, but it was also denied for want of witnesses as the cases were continued for a longer period.

There have been studies conducted in India investigating child abuse and neglect. A study carried out in Kolkata disclosed that 52.4% of adolescents reported psychological abuse, 25.1% physical abuse, and 12.7% sexual abuse (Deb, Ray, Bhattacharyya, & Sun, 2016). In a 1-year prevalence study in Kerala, M. T. Kumar et al. (2019) reported that child physical and emotional abuse, including sexual abuse was very common. In particular, 1-year prevalence of any form of abuse was 89.9%. Boys reported experiencing more abuse as compared to girls. These findings are troubling and reflect a broader trend in which children, particularly in educational settings, face corporal punishment. Importantly, children who have experienced any form of violence, regardless of its nature, exhibited significantly lower social adjustment scores, compared to those who had not encountered violence (Deb & Walsh, 2012).

Corporal punishment (CP) in India

In India, children experience corporal punishment (CP) at home as well as in schools. It is considered to be a normal cultural practice and is perceived to be good for disciplining children (Deb, 2018). It is defined as ‘any punishment involving physical force intended to cause some degree of pain or discomfort’ (Human Rights Watch, 2008, p. 23). A study carried out among school children in Puducherry, India found ‘that 62% of schools experienced CP in the past 12 months. Students who experienced CP reported higher levels of anxiety and depression, with this relationship being particularly strong among those reporting family tension’ (Deb et al., 2017, p. 65). Evidence indicates that children who experience CP at home face a higher risk of developing various mental health issues and suffer from compromised relationships with their parents (Maguire-Jack et al., 2012). One secondary-based study found a positive association between corporal punishment and gender, age, power hierarchies and conflict in the family, migration and modernisation (Lokot et al., 2020). In order to prevent corporal punishment, the Government of India introduced a legislative measure in 2009 titled ‘The Right of Children to Free and Compulsory Education Act’. The main challenge lies in the proper implementation of the law.

Family violence and social discrimination

Family violence is on the rise in Indian society, although many incidents go unreported due to factors such as women’s financial dependence, social stigma, and a cultural tendency among some women to protect their husband’s reputation despite enduring violence. Studies have highlighted the prevalence of family violence witnessed by children. For instance, a study revealed that 31.2% of children in urban areas had observed domestic violence in their households (A. Raj et al., 2009). Another study found that in rural communities, approximately 20% of children reported exposure to family violence, highlighting its widespread nature across demographics (Donta et al., 2015). Such experiences have profound negative effects on children’s mental health, often leading to anxiety, low self-esteem and emotional adjustment challenges. Additionally, these children may struggle academically, frequently attending school without completing homework or adequate preparation (Lee et al., 2012).

Caste-based discrimination in the public schools in rural India is another challenge (M. T. Kumar et al., 2019). Nevertheless, the situation has improved substantially over a period of time, resulting in increased enrolment in the schools (Bailwal & Paul, 2021).

Anxiety, depression, suicidal ideation and suicide among School students

Anxiety disorders affect an estimated 9% of children and adolescents globally, with many cases remaining undiagnosed due to the internalised and often overlooked nature of their symptoms (World Health Organization, 2022). Anxiety significantly impacts children’s emotional well-being, social functioning and academic performance, potentially leading to long-term developmental challenges (V. Kumar & Talwar, 2014). In India, mental health issues among school children are widespread, often fuelled by the immense pressure to excel academically, as shaped by societal and parental expectations (Pinquart, 2017). Research highlights symptoms such as depression, anxiety, school avoidance, physical complaints and a loss of interest in studies as common manifestations of this stress (Mahapatra & Sharma, 2020). This mental strain has consequences, contributing to a worrying trend in student suicides (Thippaiah et al., 2019).

Suicide among students in India

The National Crime Record Bureau (NCRB, 2022), Ministry of Home Affairs, Government of India data, a total of 13,089 students died by suicide in 2021 because of academic failure, averaging 36 students per day, compared to 12,526 student suicides in 2020. The data indicates that suicide is more prevalent among males, accounting for 56.51% of cases, while females represent 43.49% (NCRB, 2022). This situation raises critical questions about the impact of the school system on the well-being of young individuals. This situation underscores the vital role of mental health professionals and school-based family counselling in addressing the challenges that school children encounter at both family and institutional levels.

Knowledge about child rights

Knowledge and attitude determine the behaviour of an individual to a great extent (Deb & Mathews, 2012). In this regard, they observed that about one quarter of participants did not think children should have the rights to freedom of expression and association. Knowledge of laws promoting children’s rights was poor. Another study covering samples from four cities in India disclosed that while participants held positive attitudes toward several specified child rights, about half had never heard of the UN Convention on the Rights of the Child (Deb, Sun, et al., 2016). The above findings justify the need for intensive awareness among community members about child rights and available legislative measures available for protection of child rights.

Legislative measures for protection of rights of children in India

Accepting The UN Convention on the Rights of the Child (1989), the Government of India reiterated its commitment to safeguarding children’s rights. Since gaining independence, the Indian government has expressed concern for protecting child rights. For instance, Articles 23 and 39 of the Constitution of India guarantee freedom from all forms of exploitation (The Constitution of India, 1949). Article 21A mandates that all Indian states provide free and compulsory education for children aged 6 to 14. In addition, the Government of India has adopted various legislations for protection of child rights. The main problem lies with the implementation and documentation of information. However, the situation is improving slowly as the personnel of law enforcement agencies are becoming more aware of child rights.

Engagement of school students in social networking sites (SNSs)

School students and young people are increasingly drawn to social networking sites, as these platforms allow them to access information and stay connected with others. While social networking has certain benefits, it also manifests significant risks for school children. Several global studies highlighted the negative consequences of engagement of school children in social networking sites (Baltaci & Ersoz, 2022; Bener et al., 2016). The scenario in India is not different. For example, one study carried out in Siliguri, West Bengal indicates that about 70.7% of adolescents were found to be addicted to SNS (M. Raj et al., 2018). The authors recommended raising awareness among students regarding the negative effects of excessive engagement with SNS.

Role of family in quality child upbringing

For holistic and healthy child development, a happy home environment is a prerequisite where a child will enjoy quality care and positive relationships with family members. A supportive family environment ensures emotional security among children and adolescents, facilitating their development and academic motivation, especially during significant developmental changes (Deb, 2018). Unfortunately, many children experience complex family environments and in turn, it adversely affects their healthy growth and development, as a good number of them experience neglect and abuse in different forms.

Research by Bakker et al. (2012) remarked that instability in childhood family environments is associated with both internalising and externalising problems during late adolescence. Their findings suggest that growing up in an unpredictable family setting can have long-lasting negative effects on the mental health of children and adolescents. Lee et al. (2012) noted that chronic economic hardships within families contribute to mental and physical health issues among adolescents.

Absence of mental health support facilities in the schools in India

The importance of psychological support services for children in many Asian countries is often overlooked by policymakers, as reflected in various laws and health-related policies. There is a lack of initiative in providing adequate psychological support, not only for abused children and their families, but also for the perpetrators. In most health centres and intervention programs, psychologists are rarely appointed to address the mental health needs of both developing and abused, or traumatised children (H. M. Singh et al., 2023)

Additionally, there is a scarcity of psychologists and social workers in both government and private hospitals, where mental health care is typically handled by psychiatrists. As a result, the mental health needs of abused children often go unaddressed, leaving them to cope with lifelong trauma.

In recent years, one initiative has been introduced to address the mental health needs of school children in India. The Manodarpan initiative launched by the Ministry of Education (2020) during the COVID-19 pandemic focuses on providing psychosocial support to students, teachers and families. It offers services such as a national toll-free helpline, webinars and online resources to promote mental well-being. Despite these efforts, such programs are unevenly implemented, and rural areas lack sufficient mental health resources. In most of the schools one or two teachers are given responsibility to address the mental health needs of the school children. Very few schools appointed psychologists.

School-based family counselling (SBFC): Concept and its implications

School-based family counselling (SBFC) is an interdisciplinary and integrated approach to addressing children’s issues and challenges in terms of both personal and academic aspects. The broad objective of SBFC is to reduce the challenges faced by children in the family, school and community by creating a conducive and safe environment (Gerrard et al., 2023).

A large number of school students in India experience violence and neglect in the family which mostly remains unattended as there is no family or community intervention program in India to reach out to those families for strengthening the family dynamics for the overall welfare of the children. Adversities negatively impact the overall growth of the students (Kuo et al., 2017). In the given situation, SBFC would play an important role in addressing those challenges. In particular, SBFC can address students’ mental health challenges through specific resource-efficient interventions in the family and schools. Stress management workshops can equip students with skills like mindfulness, time management and goal setting, reducing students feeling overwhelmed and fostering resilience (Ninan et al., 2019). Regular group counselling sessions offer a safe space for students to share experiences and develop coping strategies under a counsellor’s guidance. Engaging parents through workshops on positive parenting can help reduce the impact of high academic expectations by promoting healthier communication and emotional support at home (Pinquart, 2017). Additionally, teacher-counsellor collaborations can bridge gaps in mental health resources; basic mental health training for teachers enables them to identify at-risk students early and connect them with professional support (Kuyken et al., 2013). These practical interventions create a scalable, culturally sensitive framework for mental health support in schools and the family.

Recommendations and implications

In the given situation, the school teachers can play the role of mentors, listen to students’ voices carefully, understand their issues and challenges from their perspectives, and support and guide them in the right direction. Implementing school-based family counselling in India is required to support school children who are facing challenges in the family. Mental health stigma remains pervasive in India, with many families viewing counselling as a sign of weakness or failure (Losito, 2024). To overcome this, schools can normalise mental health conversations by hosting awareness programs and involving trusted community leaders to encourage acceptance. Limited funding is another critical challenge, often preventing schools from hiring sufficient counsellors or building infrastructure. Schools can address this by forming partnerships with NGOs, applying for government grants, and leveraging Corporate Social Responsibility (CSR) initiatives (Saxena et al., 2007). The shortage of trained professionals also hampers efforts, especially in rural areas. Solutions include tele-counselling services and upskilling teachers with mental health training. Addressing these barriers ensures that school-based family counselling can be implemented sustainably and equitably. At the national level, there is an urgent need to prioritise ‘Child Protection’ as a national agenda and educating the larger society about child rights by adopting various strategies.

Conclusion

Many school students face a lot of adversities because of over competition, over expectation of parents, unsafe school and social environment as well as ineffective role of law enforcement agencies which affects their mental health. Although policy makers are aware of the ground reality and are making efforts for improving the situation, emphasis should be given to mental health support facilities by appointing professional student counsellors in the schools, so that they can address the mental health needs of the students and reach out to the families to sensitise them about their support facilities, for better career progress of their wards.