• Chandra Díaz University of Nebraska Kearney, USA
  • Po Hu University of Nebraska Kearney, USA
  • Douglas Roger Tillman University of Nebraska Kearney, USA
  • David Hof University of Nebraska Kearney, USA


Mental health issues, comfort, resistance, environment, pre-service teacher


There is an expectation for in-service teachers, current teachers in the field, in primary and secondary schools to be skilled in teaching strategies and behavior management. There is a growing need for teachers also to be skilled in recognizing mental health concerns in their students. Schools are becoming acutely aware that in-service teachers are not adequately prepared in this area, and therein lies a dual responsibility to also prepare college students enrolled in teacher education programs, who will be referred to as pre-service teachers, with skills that will equip them to be supportive of students with mental health needs. This study sought to find out if there were common concepts or factors that would describe how willing a pre-service teacher would be to seek or recommend mental health services for a peer. There were 151 students enrolled in teacher education programs from one Midwestern university in the United States who volunteered to participate in this study. The research design was organized in multiple stages. The data collected were processed through an exploratory factor analysis and once the factors were found, a hierarchical multiple regression analysis was further completed to explore the relationship between such factors and the decision whether to seek or recommend mental health services. The results indicated that comfort, resistance, and environment were significant factors. The comfort factor has dominant influence over the participants’ decision whether to seek or recommend mental health services. The task ahead for primary and secondary schools, and higher education institutions, is to create programs where comfort with students with mental health needs is increased, to increase awareness of the mental health resources available in the community, as well as to decrease the resistance factors.


Adelman, H. S., & Taylor, L. (2000). Promoting mental health in schools in the midst of school reform. Journal of School Health, 70(5), 171–178.

Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice Hall.

Allen-Meares, P. (2013). School social work. In C. Franklin & L.E. Davis (Eds.-in-Chief), Encyclopedia of social work (20th ed., Vol. 4, pp 3-7). Washington, DC,and New York: NASW Press and Oxford University Press.

Askell-Williams, H., and Lawson, M.J. (2013). Teachers’ knowledge and confidence for promoting positive mental health in primary school communities. Asia-Pacific Journal of Teacher Education, 41(2), 126-143.

Atkins, M., & Rodger, S. (2016) Pre-service Teacher Education for Mental Health and Inclusion in Schools. Exceptionality Education International, 26, 93-118.

Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S.-M., & Olfson, M. (2008). Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry, 65, 1429–1437.

Cooper, A. E., Corrigan, P. W., & Watson, A. C. (2003). Mental illness stigma and careseeking. Journal of Nervous and Mental Disease, 191, 339-341.

Deng, L., & Chan, W. (2017). Testing the difference between reliability coefficients alpha and omega. Educational and psychological measurement, 77(2), 185-203.

Doll, B., Cummings, J. A., & Chapla, B. A. (2014). Best practices in population-based school mental health services, In P. Harrison & A. Thomas (Eds.), Best practices in school psychology: Systems level services (pp. 149–163). Bethesda, MD: National Association of School Psychologists.

Dunn, T. J., Baguley, T., & Brunsden, V. (2014). From alpha to omega: A practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology, 105(3), 399-412.

Eisenberg, D., Downs, M., Golberstein, E., & Zivin, K. (2009). Stigma and help seeking for mental health among college students. Medical Care Research and Review, 66(5), 5220541.

Ellis, M., & Riel, R. (2014). Work-life balance: Teachers identify four key areas. Perspectives, 15. Retrieved December, 2018 from

Franklin, C. G., Kim, J. S., Ryan, T. N., Kelly, M. S., & Montgomery, K. L. (2012). Teacher involvement in school mental health interventions: A systematic review. Children and Youth Services Review, 34(5), 973–982.

Frauenholtz, S., Mendenhall, A.N., & Moon, J. (2017). Role of school employees’ in mental health knowledge in interdisciplinary collaborations to support the academic success of students experiencing mental health distress. Children & Schools, 39(2), 71–79.

Furnham, A., Cook, R., Martin, N., & Batey, M. (2011). Mental health literacy among university students. Journal of Public Mental Health, 10(4), 198–210.

Griffiths, K.M., Christensen, H., Jorm, A.F., Evans, K., & Groves, C. (2004). Effect of Webbased depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial. British Journal of Psychiatry, 185, 342–349.

Hof, K., Bishop, M., Hof, D., Dinsmore, J., Chasek, C., & Tillman, D. (2013). Mental Health Stigma: Impact and Interventions, In G. R. Walz, J. C. Bleuer, R. K. Yep (Eds.), VISTAS 2013.

Hogan, M. F. (2003). New Freedom Commission Report: The President’s New Freedom Commission: Recommendations to transform mental health care in America. Psychiatric Services, 54, 1467.

Humensky, J., Kuwabara, S.A., Fogel, J., Wells, C., Goodwin, B., & Van Voorhees, B. W. (2010). Adolescents with depressive symptoms and their challenges with learning in school. Journal of Nursing, 26, 377–392.

Ingersoll, R., Merrill, E., Stuckey, D., & Collins, G. (2018). Seven trends: The transformation of the teaching force – Updated October 2018. CPRE Report. Philadelphia, PA: Consortium for Policy Research in Education, University of Pennsylvania. Retrieved on December, 2018 from

Johnson, S., Cooper, C., Cartwright, S., Donald, I., Taylor, P., & Millet, C. (2005). The experience of work-related stress across occupations. Journal of Managerial Psychology, 20, 178–187. doi:10.1108/02683940510579803

Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231–243.

Jorm, A. F., Korten, A. E., Jacomb, P. A., et al (1997). Mental health literacy: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166, 182–186.

Krogh, G. von. (1998). Care in Knowledge Creation. California Management Review, 40(3), 133–153.

Mattingly, J. (2018). More School Resource Officers and Mental Health Resources: Virginia School Safety Committee Signs Off on Recommendations. Retrieved December 10, 2018 from

McLeod, J.D., & Fettes, D. L. (2007). Trajectories of failure: The educational careers of children with mental health problems. American Journal of Sociology, 112, 653–661.

McLeod, J. D., Uemura, R., & Rohrman, S. (2012). Adolescent mental health, behavior problems, and academic achievement. Journal of Health and Social Behavior, 53(4), 482–497.

Meldrum, L., Venn, D., & Kutcher, S. (2009). Mental health in schools: How teachers have the power to make a difference. Health & Learning Magazine, 8, 3–5.

Merz. (2017). Who in your class needs help? Educational Leadership, 75 (4) 12–17.

Mistry, R.S., Benner, A.D., Tan, C.S., & Kim, S. (2009). Family economic stress and academic well-being among Chinese-American youth: The influence of adolescents’ perceptions of economic strain. Journal of Family Psychology, 23, 279–290.

National Alliance on Mental Illness (2014.). Mental Health Facts – Children & Teens. Retrieved September 5, 2018 from

Peters, G.-J. Y. (2014). The alpha and the omega of scale reliability and validity: Why and how to abandon Cronbach’s alpha and the route towards more comprehensive assessment of scale quality. European Health Psychologist, 16(2), 56-69. doi:10.31234/

Poulou, M., & Norwich, B. (2002). Cognitive, emotional and behavioural responses to students with emotional and behavioural difficulties: A model of decision making. British Educational Research Journal, 28(1), 111–138.

Reavley, N. J., McCann, T. V., & Jorm, A. F. (2012). Mental health literacy in higher education students. Early Intervention in Psychiatry, 6(1), 45–52.

Santor, D., Short, K. H., & Ferguson, B. (2009). Taking mental health to school: A policy-oriented paper on school-based mental health for Ontario. Ottawa, ON: Provincial Centre of Excellence for Child and Youth Mental Health, Children’s Hospital of Eastern Ontario.

Stanovich, P. J., & Jordan, A. (1998). Canadian teachers’ and principals’ beliefs about inclusive education as predictors of effective teaching in heterogeneous classrooms. The Elementary School Journal, 98, 221–238.

Starkweather, J. (2012). Step out of the past: Stop using coefficient alpha; there are better ways to calculate reliability. University of North Texas Research and statistical support. [PDF file]. Retrieved from files/omega_jds_jun2012.pdf

Volk, A., Craig, W., Boyce, W., & King, M. (2006). Perceptions of parents, mental health, and school among Canadian adolescents from the provinces and the northern territories. Canadian Journal of School Psychology, 21, 33–46.

Watkins, M. W. (2013). Omega [computer software]. & Psych Associates.

Watkins, M. W. (2017). The reliability of multidimensional neuropsychological measures: From alpha to omega. The Clinical Neuropsychologist, 31(6-7), 1113–1126.

Weist, M. D., Lever, N. A., Bradshaw, C. P., & Owens, J. S. (2013). Handbook of school mental health: Research training, practice and policy. New York, NY: Springer.






Scientific Publications