Behavioral and Emotional Problems among School Children in Tripoli, Libya: What Impact does it have on Community Public Health?

Abstract

Objective: to detect the prevalence of mental health problems, including behavioral and emotional difficulties among school children (6-15 years) in Tripoli, Libya as observed by their parents and teachers. Methods: The study took place in Tripoli, Libya. Data was collected over three months period between January and March 2022 from parents and teachers. The Arabic version of Strengths and Difficulties Questionnaire (SDQ. Goodman 2002) were used. The sample size was 300 children aged between 6 and 15 years who were attending compulsory education. Four schools were randomly selected and then children were randomly sampled from each class. Parents were asked to hand over the questionnaire to their child’s teacher and collect them later. Data was analyzed to describe normative scores, bandings and cut-offs for normal, borderline and abnormal scores. Only public schools were included in the study. Results: When it came to the perception of teachers and parents, it was found that the response rate for parents and teachers were almost the same only 245 questionnaires were returned (134 male and 111 female) giving a response rate of 81.6%. out of these, 208, both the parents and teacher questionnaires were returned (84.8%),26 filled in only the parents' questionnaires (10.6%), and 11 returned only the teacher’s questionnaire (4.4%). TEACHERS rated their pupils consistently as showing difficulties in all areas with (23.0 %) of the children considered to be displaying abnormal behavior (Total Difficulties Score). The highest proportion of abnormal behavior was for peer relation (17.0%) and conduct problems (18.0%). PARENTS rated their children as having fewer problems than rated by teachers, but rates were still high with (15%) of the children receiving total difficulty scores in the abnormal band. The most problematic areas as assessed by parents were peer relations (29%) followed by emotion problems (22%). Conclusion: Parent SDQs revealed high rates of children with conduct, emotional and peer problems falling above the 90th centile established in the UK sample. Teachers SDQs revealed higher rates of children with conduct problems. Comparison with UK and Egypt data showed abnormal total difficulties score of 11.9% which is a bit higher than UK (10.1%) but lower than that of Egypt (20.6%). Much greater investment in child mental health care is needed. More efforts are needed to identify those children and decide what we can usefully do to help the many-not only the few. Keywords: Tripoli, Libya, behavioral problems, school children, SDQ, mental health