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Teaching and Teacher Education 23 (2007) 1177–1192

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Teachers’ mental health and teaching levels

Viviane Kovess-Masféty, Carmen Rios-Seidel, Christine Sevilla-Dedieu
The MGEN Foundation for Public Health, 3 square Max Hymans, 75748 Paris Cedex 15, France
Received 11 July 2006; accepted 18 July 2006

Abstract

The purpose of this study was to determine the prevalence and to identify the occupational risk factors of both
psychiatric disorders and psychological distress for public school teachers in France depending on their teaching level.
A survey was carried out on teachers aged 20–60 (N ¼ 3586). Some teaching levels, depending on the teacher’s gender,
were found to be at a higher risk of mental health problems. The main occupational risk factors identified were lack of
support from colleagues, and to a lesser extent, depending on the mental health problem, the fear of physical or verbal
abuse and the reasons the teaching profession was chosen.
r 2006 Elsevier Ltd. All rights reserved.

Keywords: Teachers; Teaching levels; Mental disorders; Psychological distress; Risk; Public schools

1. Introduction prevention measures, stress and depression manage-

The studies and reports issued by the World
Health Organization (WHO) and the International
Labor Organization (ILO) on the promotion of
mental health in the workplace demonstrate the
growing awareness of this problem as a public
health issue (Gabriel & Liimatainen, 2000; Lavikai-
nen, Lahtinen, & Lehtinen, 2000; World Health
Organization, 2002). In Europe, 28% of workers
report they have health problems related to on-the-
job stress (European Agency for Safety and Health
at Work, 2000). The economic consequences are
directly related to absenteeism (Stansfeld et al.,
1995), impaired work performance (Dewa & Lin,
2000) and the ensuing high cost of mental health
care (Gabriel & Liimatainen, 2000). Among other
Corresponding author. Tel.: +33 1 40 47 24 20;
fax: +33 1 40 47 21 91.
E-mail address: vkovess@mgen.fr (V. Kovess-Masféty).
ment programs dispensed in the workplace are now
available to employers in the United States, Europe
and Japan (Dunnagan, Peterson, & Haynes, 2001;
Health Education Authority, 1997, 1999; Jones,
Tanigawa, & Weiss, 2003; Putnam & McKibbin,
2004). Setting up these types of programs requires
in-depth studies on mental health risk factors found
in different work environments.
Among ‘‘high-risk professions’’, teachers have
always been considered to be subject to a particu-
larly high level of stress on the job (Beer, 1992;
Borg, 1990; Borg, Riding, & Falzon, 1991; Boyle,
Borg, Falzon, & Baglioni, 1995; Kyriacou, 1987;
Kyriacou & Sutcliffe, 1979; Russell, Altmaier, &
Van Velzen, 1987; Schonfeld, 1990; Smith &
Bourke, 1992). This being the case, studies designed
to compare teachers’ mental health to that of other
occupational groups often describe a higher level of
mental fatigue among teachers, i.e., psychological
distress and burnout (De Heus & Diekstra, 1999;

0742-051X/$ - see front matter r 2006 Elsevier Ltd. All rights reserved.
doi:10.1016/j.tate.2006.07.015
 ARTICLE IN PRESS
1178 V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192
Finlay-Jones, 1986), however none of these studies
(Eaton, Anthony, Mandel, & Garrison, 1990;
Kovess-Masféty, Sevilla-Dedieu, Rios-Seidel,
Nerrière, & Chan Chee, 2006) have shown a higher
rate for teachers in terms of psychiatric disorders
(depression or anxiety disorders for example) as
defined in manuals of mental health diagnoses such
as the Diagnostic and Statistical Manual of Mental
Disorders (DSM) (American Psychiatric Associa-
tion, 1994). However, the fact that all teachers are
placed in the same occupational category even
though teaching is a profession carried out in a
wide variety of different environments and settings,
may hide an exceptional fragility of certain cate-
gories of teachers or those working in difficult work
environments.
This paper reports on the findings of a cross-
sectional survey we carried out in France to assess
the mental health of different categories of public
school teachers. It also presents the potential risk
factors specific to each of these categories we
identified, for both psychological distress and
psychiatric disorders, to support better targeted
interventions in these diverse settings.
2. Background
A certain number of studies done on teachers
have compared teachers’ mental health and risk
factors according to the teaching level. These studies
have mainly dealt with three different approaches of
mental health problems as distinct issues, although
these dimensions overlap to a certain extent:
psychiatric disorders, psychological distress, and
burnout. Psychiatric or mental health disorders
refer to precise diagnoses of mental health problems
(i.e., for example depression, agoraphobia or panic
disorder) as defined by diagnostic tools such as the
DSM for example. Psychological distress constitutes
an entire series of symptoms of poor mental health
that do not necessarily correspond to a diagnosis of
a psychiatric disorder. Finally, burnout is a job-
related psychological syndrome of emotional ex-
haustion, depersonalization, and reduced personal
accomplishment that can affect human service
professionals such as teachers (Maslach & Jackson,
1981).
2.1. Prevalence estimates
Not many studies using a diagnostic approach
have been conducted (Eaton et al., 1990; Kovess-
Masféty et al., 2006), and moreover, only one has
reported on comparisons of prevalence between
teaching levels (Eaton et al., 1990). This study was
carried out in the United States by Eaton et al who
estimated the prevalence of depression over 1 year
(DSM-III diagnostic definition (Helzer & Robins,
1988)) according to occupation, using a sample of
11,789 persons aged 18–64 who were working full
time, taken from the ECA (Epidemiologic Catch-
ment Area Program) population survey. The
authors used a very detailed list of codes for
occupations corresponding to the 502 categories
used for the 1980 US population census. Teachers
(N ¼ 520) were put into different categories depend-
ing on whether they worked at the elementary
(N ¼ 161), secondary (N ¼ 93), post-secondary
(N ¼ 109) or ‘‘other’’ (N ¼ 98) level (for special
education teachers and vocational counselors) and
finally, teachers who were ‘‘not elsewhere classified’’
(N ¼ 59). The overall prevalence of depression over
the last year ranged from 3% to 5%. As for
teachers, it was 1% at the secondary level, 4% at
post-secondary level, 5% at the elementary level and
10% for special education teachers. However, after
adjusting for age, gender, educational level and
race, only special education teachers and vocational
counselors had a relative risk of 2.8 compared to the
average.
On the other hand, the majority of studies done
on the teaching profession have concentrated on the
burnout rate according to teaching level and the
three dimensions of burnout (emotional exhaustion,
depersonalization and reduced personal accom-
plishment). To some extent, they consistently
showed that symptoms of burnout were higher
among teachers at the secondary level than among
teachers in elementary schools (Anderson & Iwa-
nicki, 1984; Beer, 1992; Burke & Greenglass, 1989;
Feitler & Tokar, 1982; Schwab & Iwanicki, 1982;
Schwab, Jackson, & Schuler, 1986). Secondary-level
teachers showed in particular a greater level of
distance from their students (depersonalization) and
less feelings of personal accomplishment in their
work than their colleagues in elementary schools.
Moreover, studies involving special education tea-
chers (for children with learning disabilities, for
example) showed contradictory results. Indeed,
although it could be expected that these teachers
would have higher levels of stress, studies conducted
by Beck and Gargiulo in 1983 (Beck & Gargiulo,
1983) and those done by Bensky et al. (Bensky et al.,
1980) showed that teachers working with students in
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V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192
regular schools experience higher levels of burnout
than teachers dealing with students with learning
disabilities. However, Olson and Metuskey (Olson
& Matuskey, 1982) on their side, did not find any
difference between these two groups.
2.2. Risk factors identified
The risk factors associated with the experience of
teaching and related teaching conditions and
methods have been widely studied, for psychologi-
cal distress, burnout and stress. Finley and Jones
(Finlay & Jones, 1986), using a sample of Australian
teachers, reported that factors associated with acute
psychological distress were different depending on
the teaching level. For example, for both elementary
and secondary level teachers, discipline problems
with students constituted a factor linked to psycho-
logical stress. On the other hand, lack of support
from colleagues was a risk factor for elementary
teachers only, whereas the lack of sufficient supplies
and equipment at school was identified as a risk
factor for secondary level teachers.
Potential mental health risk factors facing tea-
chers were identified and categorized by Byrne
(Byrne, 1999) for a study she did in Canada on
burnout among teachers using a sample of 3138
teachers (elementary, N ¼ 1242; intermediate,
N ¼ 417; secondary, N ¼ 1479). This author sug-
gested categorizing risks by basic variables (i.e.,
gender, age, family status, years of experience,
grade(s) taught and type of students), organiza-
tional-related variables (i.e., role conflicts and
ambiguity, work load, classroom climate, social
support and decision-making power) and person-
ality type (i.e., self-esteem and internal/external
locus of control). The influence of personal and
organizational factors on burnout and their inter-
action were studied taking into account teaching
levels. This highly complex study made it possible to
establish causal paths. Six factors appeared to have
a significant correlation to the three burnout
dimensions for each of the three teaching levels
studied (elementary, intermediate and secondary):
role conflicts, work overload, classroom climate,
decision making, self-esteem and internal/external
locus of control and their degree of correlation
varied among teaching levels.
Considering that sociodemographic features of
teachers are different depending on teaching level,
and in particular the gender ratio, certain studies
have delved into the interaction between gender,
1179
age, risk factors and teaching level. Laughlin
(Laughlin, 1984), for example, using a sample of
Australian teachers, reported that students’ beha-
vioral problems were more often identified as a
source of stress among female secondary school
teachers and young teachers (less than 26 years old)
than for elementary school teachers. These results
were confirmed by Payne and Furnham (Payne &
Furnham, 1987) in a study on secondary schools in
the French West Indies. A study involving elemen-
tary school teachers by Borg et al. (Borg et al., 1991)
in Malta showed similar results. Female teachers
reported more stress related to students’ behavior
and conversely, less stress generated by lack of
recognition of their profession and salary level, than
their male counterparts did.
3. Methods
3.1. Participants
Between June 1999 and March 2000, we con-
ducted an epidemiological survey among the popu-
lation of policyholders of French health care
insurance provided by the MGEN (Mutuelle Gén-
érale de l’Education Nationale), which notably
covers everyone working in France within the
public education system.
Due to the large number of items to be completed
in the questionnaire, we opted for a postal survey. A
self-rated questionnaire was sent out by mail to a
random sample of 10,000 policyholders aged 20–60,
taken from the national health plan records living in
continental France. Three reminder notices were
sent to those who had not responded. The response
rate obtained was respectively 39.4% on the first
run, 23% on the second run and 26% on the third
run for an overall rate of 66.5% (N ¼ 6518).
The sample was weighted for all issues related to
sample design in order to ensure a truly representa-
tive sampling of the population of MGEN policy-
holders (N weighted ¼ 6724).
For the purposes of this paper, persons qualified
as teachers had to be effectively giving classes to
students. Only teachers who were actually employed
were taken into account. Retirees and teachers
working outside of schools (on assignment) were
not included in the analyses. In order to avoid
selection bias, we did include teachers on sick leave,
long-term leave, those receiving disability pensions,
as well as teachers in rehabilitation programs (who
in most cases progressively start working again
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1180 V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192
through a ‘‘part-time therapeutic’’ work program):
2.8% of the population were in one of these
situations. The analyses were finally conducted on
a total of 3586 teachers.
3.2. Questionnaire
The questionnaire contained sociodemographic
variables such as gender, age, family status, educa-
tional level and place of residence. Questions
specially adapted to teachers were designed so as
to allow a description of employment and occupa-
tional status: teaching level, location in an Educa-
tional Priority Zone (corresponding to underpri-
vileged areas) and job seniority. Other questions
covered on-the-job experience, in particular, the
reasons the job was chosen, such as due to interest
in the profession or a real calling in life (vocation),
the drawbacks of the profession they feared, such
as for example, physical or verbal abuse, and
finally, the possibility of getting support from
colleagues to deal with job-related difficulties. Part
of the questionnaire was devoted to assessing
respondents’ mental health status using validated
instruments.
3.3. Measuring instruments
Psychiatric disorders. Questions were based on
the CIDIS (Composite International Diagnostic
Interview Simplified) (Kovess, Fournier, Lesage,
Amiel-Lebigre, & Caria, 2001; Robins et al., 1988)
self-administered format (CIDI-SA), which allows
for several psychiatric diagnoses by means of
computerized algorithms using standardized diag-
nostic criteria. The DSM-IV criteria sets (American
Psychiatric Association, 1994) were used here to
make the different psychiatric diagnoses: mood
disorders (i.e., Major Depressive Episode (MDE)),
anxiety disorders (i.e., social phobia, specific pho-
bia, agoraphobia or panic disorder), alcohol abuse
or dependency disorders, anorexia nervosa, bulimia,
somatization disorders and undifferentiated soma-
toform disorders. In addition to the DSM-IV
assessment, the risk of alcohol abuse was evaluated
using the widely applied CAGE detection system
(Bush, Shaw, Cleary, Delbanco, & Aronson, 1987).
Prevalence rates of psychiatric disorders were
determined here for two periods: lifetime and the
twelve previous months.
Psychological distress. The Hopkins Symptom
Checklist (HSC), using Ilfeld’s version (Psychiatric
Symptom Index (PSI)) (Ilfeld, 1976a, b, 1977), was
used to measure psychological distress. This scale,
widely validated in the international literature, is
composed of 29 questions that measure symptoms
of anxiety, distress and depression occurring over
the last week.
4. Results
The sociodemographic and career cycle features
of the sample surveyed by teaching level were
examined first. Table 1 presents the ratios as well
as the results of the w2-tests, which were used for
comparisons. Teaching levels differed in all vari-
ables except long-term sick leave. In particular, as
expected, the gender ratio was significantly different
depending on the teaching level: teachers working in
nursery schools and to a lesser extent in elementary
schools, clearly represented a more female popula-
tion contrary to teachers at post-secondary and
vocational secondary levels.
4.1. Psychiatric disorders and teaching levels
Tables 2 and 3 show the lifetime and 1-year
prevalence of psychiatric disorders by gender
among the different teaching levels. The w2-test
was used to compare prevalence rates. For male
teachers, a significant difference was found in
lifetime prevalence of both any psychiatric disorder
and mood disorders, which was significantly higher
among special education and nursery school tea-
chers and lower among teachers at post-secondary
level and in regular secondary schools. For female
teachers, the only significant difference concerned 1-
year prevalence of any disorder, which was higher
for teachers in regular secondary schools, followed
by those working at post-secondary level, whereas
female teachers working in vocational secondary
classes and those at the elementary level had the
lowest rates.
To measure the impact of teaching level on the
presence of a psychiatric disorder on a lifelong and
1-year basis, taking into account the differences in
sociodemographic and career cycle variables shown
in Table 1, a series of multiple logistic regression
analyses were conducted for both men and women.
The results of these analyses are summarized in
Tables 4 and 5. First, males working in special
education, nursery and intermediate schools ap-
peared to run a higher risk of having a psychiatric
disorder of any type over their lifetime. Moreover,
Table 1
Sociodemographic and career cycle features of the sample by teaching level

Features Nursery Elementary Intermediate Regular Vocational Special Post-secondary Total p

(N ¼ 449) (N ¼ 930) (N ¼ 862) secondary secondary education (N ¼ 349) (N ¼ 3586)
(N ¼ 419) (N ¼ 461) (N ¼ 116)

n (%) n (%) N (%) n (%) n (%) n (%) n (%) n (%)

Sociodemographic
Gender 0.000***
Male 52 11.6 323 34.7 352 40.8 170 40.6 259 56.2 56 48.3 246 70.5 1458 40.7
Female 397 88.4 607 65.3 510 59.2 249 59.4 202 43.8 60 51.7 103 29.5 2128 59.3

Age 0.000***
20–39 years 141 31.5 332 35.8 244 28.4 131 31.5 157 34.2 32 27.6 121 34.7 1158 32.4
40–49 years 200 44.7 346 37.3 238 27.7 114 27.4 157 34.2 49 42.2 85 24.4 1189 33.3
X50 years 106 23.7 249 26.9 377 43.9 171 41.1 145 31.6 35 30.2 143 41.0 1226 34.3

Marital status 0.000***

Married or living with someone 360 80.2 766 82.5 638 74.6 300 72.3 375 81.9 92 80.0 266 76.4 2797 78.4
Single 42 9.4 92 9.9 133 15.6 68 16.4 54 11.8 8 7.0 54 15.5 451 12.6
Separated, divorced or widowed 47 10.5 71 7.6 84 9.8 47 11.3 29 6.3 15 13.0 28 8.0 321 9.0

Career cycle
Number of years in the profession 0.000***
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p10 years 103 22.9 258 28.0 229 26.7 121 29.0 143 31.2 30 26.1 100 28.7 984 27.6
11–20 years 97 21.6 176 19.1 136 15.9 79 18.9 119 25.9 14 12.2 77 22.1 698 19.6
21–30 years 178 39.7 300 32.5 313 36.5 158 37.9 141 30.7 48 41.7 128 36.7 1266 35.5
430 years 71 15.8 188 20.4 180 21.0 59 14.1 56 12.2 23 20.0 44 12.6 621 17.4

Long-term sick leave 0.062

At least one in the past 5 years 10 2.2 31 3.3 21 2.4 11 2.6 12 2.6 3 2.6 0 0.0 88 2.5
None 439 97.8 899 96.7 841 97.6 408 97.4 449 97.4 112 97.4 349 100.0 3497 97.5
V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192

Currently working in an Ed. 0.000***

Priority Zone
Yes 84 19.0 175 19.6 155 18.6 33 8.1 43 9.5 26 23.6 1 0.3 517 14.9
No 357 81.0 717 80.4 680 81.4 372 91.9 408 90.5 84 76.4 333 99.7 2951 85.1

*po0.05; **po0.01; ***po0.001.

1181
 1182

Table 2
Prevalence of mental health disorders (DSM-IV) among males according to teaching levela

Males Nursery Elementary Intermediate Regular Vocational Special education Post-secondary Total (N ¼ 1458)
(N ¼ 52) (N ¼ 323) (N ¼ 352) secondary secondary (N ¼ 56) (N ¼ 246)
(N ¼ 170) (N ¼ 259)

N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%)

Any disorderb lifetime** 49 24 49.0 285 93 32.6 316 122 38.6 149 42 28.2 224 80 35.7 48 25 52.1 210 59 28.1 1281 445 34.7
Any disorderb 1 year 48 8 16.7 279 36 12.9 305 38 12.5 143 11 7.7 209 22 10.5 45 7 15.6 209 21 10.0 1238 143 11.6
Any mood disorderc lifetime* 52 21 40.4 322 77 23.9 341 98 28.7 164 37 22.6 252 60 23.8 54 17 31.5 233 49 21.0 1418 359 25.3
Any mood disorderc 1 year 52 7 13.5 322 27 8.4 341 21 6.2 164 8 4.9 252 17 6.7 54 3 5.6 233 19 8.2 1418 102 7.2
MDE lifetime 52 21 40.4 322 72 22.4 341 86 25.2 164 34 20.7 252 52 20.6 54 13 24.1 233 46 19.7 1418 324 22.8
Any anxiety disorderd lifetime 51 5 9.8 307 25 8.1 332 29 8.7 158 6 3.8 244 20 8.2 55 8 14.5 234 11 4.7 1381 104 7.5
Phobic disorder lifetime 51 4 7.8 316 26 8.2 345 21 6.1 166 5 3.0 251 15 6.0 54 7 13.0 236 13 5.5 1419 91 6.4
Alcohol disorder (CAGE) lifetime 51 5 9.8 315 31 9.8 332 33 9.9 162 20 12.3 244 37 15.2 49 8 16.3 238 30 12.6 1391 164 11.8
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*po0.05; **po0.01; ***po0.001.

a
Due to the low number of subjects at certain teaching levels, no tests were performed for: MDE 1 year, anxiety disorder 1 year, phobic disorder 1 year or alcohol disorder (CAGE
test) 1 year.
b
‘‘Any disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder, anxiety disorders, alcohol abuse or dependence disorder,
anorexia nervosa, bulimia, somatoform disorder, undifferentiated somatoform disorder.
c
‘‘Any mood disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder.
d
‘‘Any anxiety disorder’’ refers to phobia disorders (social, specific or agoraphobia), panic disorders, agoraphobia with panic disorder, obsessive-compulsive disorder.
V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192
Table 3
Prevalence of mental health disorders (DSM-IV) among females according to teaching levela

Females Nursery Elementary Intermediate Regular Vocational Special education Post-secondary Total (N ¼ 2128)
(N ¼ 397) (N ¼ 607) (N ¼ 510) secondary secondary (N ¼ 60) (N ¼ 103)
(N ¼ 249) (N ¼ 202)

N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%)

Any disorderb lifetime 328 203 61.9 539 316 58.6 449 245 54.6 215 128 59.5 188 119 63.3 55 29 52.7 89 54 60.7 1863 1094 58.7
Any disorderb 1 year* 298 76 25.5 494 108 21.9 410 94 22.9 192 67 34.9 180 38 21.1 52 12 23.1 89 24 27.0 1715 419 24.4
Any mood disorderc lifetime 379 172 45.4 592 276 46.6 488 202 41.4 243 102 42.0 200 89 44.5 60 27 45.0 99 46 46.5 2061 914 44.3
Any mood disorderc 1 year 379 51 13.5 592 71 12.0 488 66 13.5 243 45 18.5 200 20 10.0 60 8 13.3 99 17 17.3 2061 278 13.5
MDE lifetime 379 150 39.6 592 256 43.2 488 186 38.1 243 96 39.5 200 85 42.5 60 20 33.3 99 40 40.4 2061 833 40.4
Any anxiety disorderd lifetime 354 50 14.1 559 94 16.8 469 73 15.6 233 43 18.5 197 41 20.8 56 7 12.5 99 15 15.2 1967 323 16.4
Phobic disorder lifetime 370 43 11.6 579 91 15.7 483 64 13.3 235 36 15.3 201 39 19.4 57 7 12.3 103 18 17.5 2028 298 14.7
Alcohol disorder (CAGE) lifetime 349 19 5.4 534 19 3.6 456 21 4.6 228 11 4.8 187 9 4.8 54 1 1.9 93 6 6.5 1901 86 4.5
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*po0.05; **po0.01; ***po0.001.

a
Due to the low number of subjects at certain teaching levels, no tests were performed for: MDE 1 year, anxiety disorder 1 year, phobic disorder 1 year or alcohol disorder (CAGE
test) 1 year.
b
‘‘Any disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder, anxiety disorders, alcohol abuse or dependence disorder,
anorexia nervosa, bulimia, somatoform disorder, undifferentiated somatoform disorder.
c
‘‘Any mood disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder.
d
‘‘Any anxiety disorder’’ refers to phobia disorders (social, specific or agoraphobia), panic disorders, agoraphobia with panic disorder, obsessive–compulsive disorder.
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Table 4
Factors influencing the likelihood of having a mental health disorder (DSM-IV) in males. Data expressed as odd ratios

Males Any disordera Any anxiety disorderb MDE

Lifetime 1 year Lifetime 1 year Lifetime 1 year

Age
20–39 1.0 1.0 1.0 1.0 1.0 1.0
40–49 2.6 [1.6–4.0]*** 2.5 [1.3–4.8]** 3.3 [1.6–7.0]** 1.8 [0.7–5.0] 2.1 [1.4–3.4]** 3.1 [1.4–6.6]**
X50 years 2.0 [1.1–3.6]* 1.0 [0.4–2.4] 3.7 [1.4–10.0]* 1.3 [0.3–5.4] 2.0 [1.1–3.7]* 1.2 [0.4–3.5]
Marital status
Married or living with 1.0 1.0 1.0 1.0 1.0 1.0
someone
Single 1.5 [1.0–2.2]* 1.1 [0.6–1.9] 2.6 [1.4–4.7]** 3.2 [1.5–6.7]** 1.5 [1.0–2.3]* 0.5 [0.2–1.2]
Separated, divorced or 1.7 [1.0–2.9]* 1.2 [0.6–2.6] 1.1 [0.4–2.6] 1.1 [0.3–4.4] 1.4 [0.8–2.4] 1.4 [0.6–3.2]
widowed
Teaching level
Nursery 2.3 [1.2–4.7]* 1.7 [0.7–4.4] 2.5 [0.8–7.9] 2.7 [0.4–17.3] 3.0 [1.5–6.1]** 1.5 [0.5–4.3]
Elementary 1.3 [0.9-2.0] 1.3 [0.7–2.4] 1.8 [0.8–3.9] 2.6 [0.8–9.0] 1.4 [0.9–2.3] 0.9 [0.4–1.8]
Intermediate 1.7 [1.2–2.6]** 1.3 [0.7–2.3] 1.7 [0.8–3.7] 3.1 [0.9–10.1] 1.7 [1.1–2.7]* 0.6 [0.3–1.3]
Regular secondary 1.1 [0.7–1.8] 0.8 [0.4–1.8] 0.8 [0.3–2.1] 1.8 [0.4–7.3] 1.3 [0.8–2.2] 0.7 [0.3–1.7]
Vocational secondary 1.5 [0.9–2.3] 1.0 [0.5–2.1] 1.6 [0.7–3.6] 2.2 [0.6–7.8] 1.2 [0.8–2.0] 0.8 [0.4–1.7]
Special education 3.3 [1.6–6.5]** 1.8 [0.7–4.7] 4.0 [1.4–11.1]** 7.8 [1.8-33.5]** 1.7 [0.8-3.6] 0.3 [0.0–1.6]
Post-secondary 1.0 1.0 1.0 1.0 1.0 1.0
Number of years in the
profession
p10 years 1.0 1.0 1.0 1.0 1.0 1.0
11–20 years 1.1 [0.7–1.7] 0.7 [0.4–1.4] 1.0 [0.5–2.0] 0.9 [0.3–2.5] 1.2 [0.7–1.9] 0.7 [0.3–1.5]
21–30 years 0.8 [0.5–1.3] 0.6 [0.3–1.3] 0.4 [0.2–1.1] 0.6 [0.2–2.1] 0.6 [0.4-1.1] 0.6 [0.2–1.3]
430 years 0.7 [0.4–1.4] 1.0 [0.4–2.9] 0.6 [0.2–1.7] 0.8 [0.2–4.2] 0.6 [0.3–1.2] 0.7 [0.2–2.6]

Currently working in an
Ed. Priority Zone
Yes 1.5 [1.0–2.2]* 1.4 [0.8–2.3] 1.0 [0.6–1.9] 0.4 [0.1–1.2] 1.2 [0.8–1.7] 2.1 [1.2–3.8]**
No 1.0 1.0 1.0 1.0 1.0 1.0

*po0.05; **po0.01; ***po0.001.

a
‘‘Any disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder, anxiety disorders,
alcohol abuse or dependence disorder, anorexia nervosa, bulimia, somatoform disorder, undifferentiated somatoform disorder.
b
‘‘Any anxiety disorder’’ refers to phobia disorders (social, specific or agoraphobia), panic disorders, agoraphobia with panic disorder,
obsessive–compulsive disorder.

whereas male teachers in special education schools
showed an increased risk for anxiety disorders
(lifetime and over 1 year), a higher risk for
depressive disorders (lifetime) was observed in male
nursery and intermediate school teachers. On the
other hand, female teachers’ teaching levels were
less clearly associated with an increased risk of
disorders. Indeed, the only level found to be at more
risk was the regular secondary level for anxiety
disorders over the previous year. Second, concern-
ing sociodemographic features, ageing in men was
clearly associated with an increased risk of anxiety
disorders over lifetime. The relation we found
between marital status and mental health disorders
for both genders corresponds to that found in the
literature and higher risks were seen in single,
separated, divorced and widowed teachers than in
married teachers. Finally, with regard to career
cycle features, the risk female teachers have of
suffering from a depression over their lifetime
appeared to go up with their seniority in the
profession. The results also showed that working
in an Educational Priority Zone could be related to
a higher risk in men of having any psychiatric
disorder over their lifetime or a depression over the
previous year.
 ARTICLE IN PRESS
V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192 1185

Table 5
Factors influencing the likelihood of having a mental health disorder (DSM-IV) in females. Data expressed as odd ratios

Females Any disordera Any anxiety disorderb MDE

Lifetime 1 year Lifetime 1 year Lifetime 1 year

Age
20–39 1.0 1.0 1.0 1.0 1.0 1.0
40–49 1.1 [0.8–1.6] 1.0 [0.7–1.5] 1.3 [0.8–2.0] 0.7 [0.4–1.3] 0.7 [0.5–1.0] 1.0 [0.6–1.7]
X50 years 1.3 [0.8–2.0] 1.1 [0.7–1.9] 1.5 [0.9–2.6] 0.7 [0.3–1.6] 0.8 [0.5–1.2] 1.1 [0.6–1.9]
Marital status
Married or living with someone 1.0 1.0 1.0 1.0 1.0 1.0
Single 1.5 [1.1–1.9]* 1.4 [1.0–2.0]* 1.5 [1.0–2.1]* 1.4 [0.8–2.3] 1.2 [0.9–1.6] 1.4 [0.9–2.0]
Separated, divorced or widowed 2.3 [1.7–3.3]*** 1.7 [1.2–2.4]** 1.4 [0.9–2.0] 2.0 [1.2–3.2]** 1.8 [1.3-2.4]*** 1.3 [0.9–1.9]
Teaching level
Nursery 1.0 [0.6–1.7] 1.0 [0.6–1.7] 1.0 [0.5–1.9] 1.8 [0.6–5.6] 0.9 [0.6–1.5] 0.7 [0.4–1.4]
Elementary 0.9 [0.6–1.5] 0.8 [0.5–1.4] 1.2 [0.6–2.2] 2.6 [0.8–7.9] 1.1 [0.7-1.7] 0.7 [0.4–1.3]
Intermediate 0.7 [0.4––1.2] 0.8 [0.5–1.4] 1.0 [0.5–1.9] 1.8 [0.6–5.5] 0.8 [0.5–1.3] 0.7 [0.4-1.3]
Regular secondary 0.9 [0.5–1.5] 1.4 [0.8–2.5] 1.3 [0.7–2.5] 3.5 [1.1–10.9]* 0.9 [0.5–1.4] 1.0 [0.5–1.9]
Vocational secondary 1.1 [0.6–1.9] 0.7 [0.4–1.3] 1.5 [0.8-3.0] 2.9 [0.9–9.2] 1.1 [0.6–1.8] 0.5 [0.2–1.0]
Special education 0.7 [0.4–1.5] 0.9 [0.4–2.0] 0.9 [0.4–2.5] 1.5 [0.3–7.5] 0.8 [0.4-1.6] 0.6 [0.2–1.6]
Post-secondary 1.0 1.0 1.0 1.0 1.0 1.0
Number of years in the profession
p10 years 1.0 1.0 1.0 1.0 1.0 1.0
11–20 years 1.5 [1.1–2.1]* 1.3 [0.9–1.9] 1.2 [0.8–1.9] 1.2 [0.7–2.2] 1.6 [1.1–2.1]** 1.5 [0.9–2.3]
21–30 years 1.7 [1.1–2.5]* 1.3 [0.8–2.0] 1.2 [0.7–2.0] 1.6 [0.8–3.4] 2.3 [1.5–3.3]*** 1.3 [0.7–2.2]
430 years 1.6 [0.9–2.7] 1.2 [0.7–2.2] 1.4 [0.7–2.6] 1.7 [0.7–4.3] 2.3 [1.4–3.8]** 1.2 [0.6–2.4]
Currently working in an Ed. Priority Zone
Yes 0.9 [0.7–1.1] 1.1 [0.8–1.5] 0.8 [0.5–1.1] 1.1 [0.7–1.7] 1.1 [0.8–1.4] 1.0 [0.7–1.4]
No 1.0 1.0 1.0 1.0 1.0 1.0

*po0.05; **po0.01; ***po0.001.

a
‘‘Any disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder, anxiety disorders,
alcohol abuse or dependence disorder, anorexia nervosa, bulimia, somatoform disorder, undifferentiated somatoform disorder.
b
‘‘Any anxiety disorder’’ refers to phobia disorders (social, specific or agoraphobia), panic disorders, agoraphobia with panic disorder,
obsessive–compulsive disorder.

4.2. Psychological distress and teaching levels
Fig. 1 presents mean scores of psychological
distress by gender according to teaching level. The
F-test was used to compare mean scores. These
results paralleled those on the prevalence of
psychiatric disorders (Tables 2 and 3), although
for females, differences between teaching levels were
insignificant (p ¼ 0.235). For instance, in male
teachers, the highest scores were observed in nursery
and special education schools with a mean score
of 10.5 [CI 95% 7.7–13.2] and 9.3 [CI 95%
6.9–11.7], respectively, whereas the lowest scores
were seen in males working in regular secondary
schools, who came in with a mean score of 6.7 [CI
95% 5.6–7.8].
4.3. Occupational risk factors, mental health
problems and teaching levels
We subsequently went on to study the occupa-
tional factors that may be related to poor mental
health. Tables 6 and 7 give the prevalence of six
possible occupational risk factors by gender among
the different teaching levels. The w2-test was used to
compare prevalence rates. For both genders, the
prevalence of the six factors among the different
levels was significantly different (po0.05), with the
exception, depending on the gender, of certain
reasons the teaching profession was chosen. How-
ever, the differences in the occupational factors
between the different teaching levels were not the
same for male and female teachers. For instance,
 ARTICLE IN PRESS
1186 V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192

Males (p = 0.028) Females (p = 0.235)

16.0 15.2

14.0 13.4 13.5

13.0
12.4 12.5
Mean score of psychological distress

11.9
12.0
10.5

10.0 9.0 9.3

8.8
8.4
7.7
8.0
6.7

6.0

4.0

2.0

0.0

ry
ary

on

ary
ry

e
ry

iat

da
nta
rse

ati
nd

nd
ed

on

uc
me
Nu

co

co
erm

ec

ed
se

se
Ele

ls
Int

st-
ial
lar

na

ec

Po
gu

tio

Sp
Re

ca
Vo

Fig. 1. Comparison of mean scores on psychological distress scale according to teaching level and gender.

having the support of colleagues in case of job- and over 1 year). As regards depression in
related difficulties was more prevalent among male particular, not having a teaching vocation was
elementary school teachers and female special strongly related to the occurrence of the disease in
education teachers with 79.6% and 81.0%, respec- both genders. Finally, not having chosen to become
tively. In contrast, it was less present among male a teacher due to an interest in the profession showed
nursery school teachers (63.5%) and female inter- a different pattern depending on the gender.
mediate school teachers (70.6%). Whereas this factor tended to increase the risk of
To identify which of the six occupational factors mental health disorders in women, surprisingly
may be associated with the presence of a psychiatric enough, it appeared to make male teachers less
disorder on a lifelong and 1-year basis for both vulnerable to developing such disorders during their
genders, multiple logistic regression analyses ad- career.
justed for all confounding variables, were per- To then explore the relationship between each
formed. The results of these analyses are presented occupational factor and psychological distress, an
in Tables 8 and 9. Not being able to rely on analysis of variance (ANOVA) was used. The
colleagues for help with job-related difficulties results indicated first of all, that the lack of support
appeared to be strongly related to all diagnoses from colleagues gave way to significantly higher
for both men and women. Fear of physical abuse in scores of psychological distress in both genders. The
women was clearly associated with a higher risk of fear of physical abuse was related to higher
anxiety disorders (lifetime and over 1 year). On the psychological distress scores in female teachers
other hand, teachers—regardless of their gender— only, whereas the fear of verbal abuse had a
who reported they feared verbal abuse were more at significant impact for both genders. Although
risk of having any mental health disorder, and for choosing teaching as a calling in life appeared to
female teachers only, a depressive disorder (lifetime be related to lower levels of psychological distress in
Table 6
Prevalence of occupational factors among males according to teaching level

Males Nursery (N ¼ 52) Elementary Intermediate Regular Vocational Special education Post-secondary Total (N ¼ 1458)
(N ¼ 323) (N ¼ 352) secondary secondary (N ¼ 56) (N ¼ 246)
(N ¼ 170) (N ¼ 259)

N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%)

Support from colleagues* 52 33 63.5 319 254 79.6 344 252 73.3 163 110 67.5 258 186 72.1 55 41 74.5 240 183 76.3 1431 1059 74.0
Fear of physical abuse*** 52 6 11.5 319 47 14.7 346 71 20.5 168 33 19.6 256 87 34.0 56 8 14.3 240 5 2.1 1437 257 17.9
Fear of verbal abuse*** 52 11 21.2 319 117 36.7 347 173 49.9 168 67 39.9 255 129 50.6 56 17 30.4 240 20 8.3 1437 534 37.2
Chose teaching as a vocation** 52 12 23.1 322 101 31.4 347 120 34.6 168 73 43.5 258 85 32.9 55 18 32.7 246 105 42.7 1448 514 35.5
Chose teaching due to interest 52 35 67.3 322 190 59.0 347 219 63.1 167 112 67.1 258 167 64.7 55 32 58.2 246 174 70.7 1447 929 64.2
Currently working in an Ed. 50 11 22.0 314 57 18.2 340 63 18.5 166 13 7.8 249 21 8.4 53 12 22.6 234 1 0.4 1406 178 12.7
Priority Zone***

*po0.05; **po0.01; ***po0.001.

Table 7
ARTICLE IN PRESS

Prevalence of occupational factors among females according to teaching level

Females Nursery Elementary Intermediate Regular Vocational Special education Post-secondary Total (N ¼ 2128)
(N ¼ 397) (N ¼ 607) (N ¼ 510) secondary secondary (N ¼ 60) (N ¼ 103)
(N ¼ 249) (N ¼ 202)

N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%) N n (%)

Support from colleagues* 391 314 80.3 587 457 77.9 489 345 70.6 247 186 75.3 200 151 75.5 58 47 81.0 102 82 80.4 2074 1582 76.3
V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192

Fear of physical abuse*** 394 78 19.8 593 120 20.2 503 151 30.0 248 40 16.1 201 58 28.9 59 15 25.4 100 2 2.0 2098 464 22.1
Fear of verbal abuse*** 395 159 40.3 594 226 38.0 503 317 63.0 248 82 33.1 201 107 53.2 59 26 44.1 100 17 17.0 2100 934 44.5
Chose teaching as a vocation 397 168 42.3 601 264 43.9 507 250 49.3 247 111 44.9 202 84 41.6 60 26 43.3 103 35 34.0 2117 938 44.3
Chose teaching due to interest* 397 284 71.5 601 403 67.1 507 331 65.3 247 159 64.4 202 132 65.3 60 46 76.7 103 80 77.7 2117 1435 67.8
Currently working in an Ed. 391 73 18.7 578 118 20.4 494 92 18.6 238 19 8.0 201 22 10.9 58 14 24.1 100 0 0.0 2060 338 16.4
Priority Zone***

*po0.05; **po0.01; ***po0.001.

1187
 ARTICLE IN PRESS
1188 V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192

Table 8
Occupational factors influencing the likelihood of having a mental health disorder (DSM-IV) in males. The results are obtained from
multiple logistic regression analyses adjusted for teaching level and all sociodemographic and career cycle variables that differed according
to teaching level. Data expressed as odd ratios

Males Any disordera Any anxiety disorderb MDE

Lifetime 1 year Lifetime 1 year Lifetime 1 year

Support from colleagues

Yes 1.0 1.0 1.0 1.0 1.0 1.0
No 1.3 [1.0–1.8]* 2.2 [1.5–3.3]*** 2.4 [1.5–3.8]*** 2.5 [1.3–4.8]** 1.4 [1.1–1.9]* 2.2 [1.3–3.5]**
Fear of physical abuse
Yes 1.1 [0.8–1.6] 1.2 [0.7–2.1] 1.6 [0.9–2.8] 1.6 [0.7–3.5] 1.1 [0.8–1.7] 1.5 [0.8–2.9]
No 1.0 1.0 1.0 1.0 1.0 1.0
Fear of verbal abuse
Yes 1.4 [1.1–1.9]* 1.4 [0.9–2.3] 1.4 [0.8–2.3] 1.5 [0.8–3.2] 1.3 [0.9–1.8] 1.1 [0.6–2.0]
No 1.0 1.0 1.0 1.0 1.0 1.0
Chose teaching as a
vocation
Yes 1.0 1.0 1.0 1.0 1.0 1.0
No 1.4 [1.1–1.8]* 1.6 [1.0–2.4]* 1.0 [0.7–1.7] 1.3 [0.7–2.6] 1.5 [1.1–2.0]** 1.6 [0.9–2.8]
Chose teaching due to
interest
Yes 1.0 1.0 1.0 1.0 1.0 1.0
No 1.0 [0.7––1.2] 0.6 [0.4–0.9]** 0.8 [0.5–1.2] 0.5 [0.3–1.1] 1.0 [0.7–1.3] 0.5 [0.3–0.9]*
Currently working in an
Ed. Priority Zone
Yes 1.4 [0.9–2.1] 1.4 [0.8–2.3] 1.0 [0.5–1.8] 0.4 [0.1–1.2] 1.1 [0.8–1.7] 2.2 [1.2–4.0]**
No 1.0 1.0 1.0 1.0 1.0 1.0

*po0.05; **po0.01; ***po0.001.

a
‘‘Any disorder’’ refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder, anxiety disorders,
alcohol abuse or dependence disorder, anorexia nervosa, bulimia, somatoform disorder, undifferentiated somatoform disorder.
b
‘‘Any anxiety disorder’’ refers to phobia disorders (social, specific or agoraphobia), panic disorders, agoraphobia with panic disorder,
obsessive–compulsive disorder.

male teachers, the interest in the profession as a
reason for having chosen this job was found to have
a significant positive impact for both men and
women. Working in an Educational Priority Zone
was not related to higher psychological distress
scores in either men or women. Finally, no
significant interaction was found between each
occupational factor and teaching level, with the
exception of support from colleagues, which
appeared to be related to lower levels of psycholo-
gical distress only for females teaching in nursery,
elementary and intermediate schools, as well as at
the post-secondary level.
5. Discussion
To date, several studies have compared teachers’
mental health and risk factors according to teaching
level. However, most of them concentrate on
psychological distress, burnout and stress, describ-
ing series of symptoms of poor mental health
without corresponding to precise psychiatric diag-
noses. The present study, in addition to examining
psychological distress in teachers, is one of the very
few attempts to use a diagnostic approach to
determine the prevalence of psychiatric disorders
among teachers, which may be more relevant to
evaluate their real professional risk of a mental
health problem.
The results of our study show that the prevalence
of mental health problems may differ depending on
the teaching level, but there were differences
between men and women. Men teaching in special
education, nursery and intermediate schools as well
as women working at the regular secondary level
were found to be at risk of psychiatric disorders and
 ARTICLE IN PRESS
V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192 1189

Table 9
Occupational factors influencing the likelihood of having a mental health disorder (DSM-IV) in females. The results are obtained from
multiple logistic regression analyses adjusted for teaching level and all sociodemographic and career cycle variables that differed according
to teaching level. Data expressed as odd ratios

Females Any disordera Any anxiety disorderb MDE

Lifetime 1 year Lifetime 1 year Lifetime 1 year

Support from colleagues

Yes 1.0 1.0 1.0 1.0 1.0 1.0
No 1.8 [1.4–2.4]*** 1.5 [1.2–2.0]** 1.5 [1.2–2.0]** 1.4 [0.9–2.0] 2.0 [1.6–2.4]*** 1.7 [1.3–2.3]***
Fear of physical abuse
Yes 0.9 [0.7–1.1] 1.0 [0.7–1.4] 1.4 [1.0–2.0]* 1.6 [1.0–2.5]* 0.8 [0.6–1.1] 0.8 [0.5–1.1]
No 1.0 1.0 1.0 1.0 1.0 1.0
Fear of verbal abuse
Yes 1.6 [1.3–2.1]*** 1.4 [1.1–1.9]** 1.1 [0.8–1.5] 1.2 [0.8–1.8] 1.7 [1.4–2.2]*** 1.5 [1.1–2.0]*
No 1.0 1.0 1.0 1.0 1.0 1.0
Chose teaching as a
vocation
Yes 1.0 1.0 1.0 1.0 1.0 1.0
No 1.0 [0.8–1.2] 1.2 [0.9–1.5] 0.8 [0.7–1.1] 1.0 [0.7–1.4] 1.2 [1.0–1.5]* 1.7 [1.3–2.2]***
Chose teaching due to
interest
Yes 1.0 1.0 1.0 1.0 1.0 1.0
No 0.9 [0.8–1.2] 1.4 [1.1–1.9]** 1.3 [0.9–1.6] 1.9 [1.4–2.8]*** 1.0 [0.8–1.3] 1.3 [0.9–1.8]
Currently working in an
Ed. Priority Zone
Yes 0.8 [0.6–1.1] 1.1 [0.8–1.5] 0.7 [0.5–1.1] 0.9 [0.6–1.5] 1.0 [0.8–1.4] 1.0 [0.7–1.5]
No 1.0 1.0 1.0 1.0 1.0 1.0

*po0.05; **po0.01; ***po0.001.

a
Any disorder refers to major depressive disorder, adjustment disorder with depressed mood, dysthymic disorder, anxiety disorders,
alcohol abuse or dependence disorder, anorexia nervosa, bulimia, somatoform disorder, undifferentiated somatoform disorder.
b
Any anxiety disorder refers to phobia disorders (social, specific or agoraphobia), panic disorders, agoraphobia with panic disorder,
obsessive–compulsive disorder.

these findings paralleled those on psychological
distress. For females, however, differences between
teaching levels were insignificant. In addition, some
occupational factors were found to be related to the
occurrence of mental health problems, in particular
the lack of support from colleagues, and to a lesser
extent, depending on the mental health problem, the
fear of physical abuse, especially in women, as well
as verbal attacks and the reasons the teaching
profession was chosen.
This study confirms that teachers’ mental health
depends on sociodemographic factors such as
gender, age and family status, as traditionally
reported in studies on the general population.
However, this study also clearly establishes that it
is not possible to deal with teachers’ mental health
and particularly the prevention of psychiatric
disorders, such as anxiety and depression, without
taking into account the teaching level. Results on
psychological distress are not as clear-cut since
differences between teaching levels were found in
men only. As reported previously (Eaton et al.,
1990), teaching in special education schools seems
to be hard on teachers, especially for male teachers,
who in our study were found to be particularly
vulnerable to anxiety disorders, as well as psycho-
logical distress. However, our study shows that
there are other teaching levels at risk, particularly
nursery and intermediate levels for men, especially
as regards depression and psychological distress,
and regular secondary level for women as regards
anxiety disorders only.
In addition, this study shows that occupational
factors play a key role in the occurrence of mental
health problems. The existence of such factors has
already been reported in the literature. First, as
 ARTICLE IN PRESS
1190 V. Kovess-Masféty et al. / Teaching and Teacher Education 23 (2007) 1177–1192
observed here for psychiatric disorders and psycho-
logical distress, several studies showed that there
was a strong relationship between the support from
colleagues or the school administration and a good
mental health in teachers, reflected for example in
(Dunham, 1980; Fletcher & Payne, 1982; Pierce &
Molloy, 1990; Russell et al., 1987) by low levels of
stress. In addition, as suggested by previous studies
(Borg et al., 1991; Laughlin, 1984; Payne &
Furnham, 1987), we found that female teachers
seemed to be more sensitive to misbehavior as
shown by the impact on their mental health of their
fears of being verbally or physically abused by their
students, or even by their parents, as suggested by
the relatively high prevalence of these fears even
when working with very young children. Moreover,
it is worth also noting that for psychological
distress, we observed, as Finlay-Jones did (Finlay-
Jones, 1986) that the risk factors associated with
psychological distress could be different depending
on the teaching level, and furthermore, we found in
our study that they could also depend on gender.
This study admittedly has some limitations. First,
we chose to analyze different occupational aspects
as factors that could lead to the occurrence of a
specific mental health problem, but some of them
like fears and a feeling of isolation could, however,
be perceived as signs of a pre-existing psychiatric
condition. Second, we did not take into account all
sociodemographic or career cycle factors that might
have an impact on teachers’ mental health. For
example, we did not consider the ethnic group
teachers belonged to, the size of their school, the
number of students per class, the number of
working hours or their professional status (tenured,
on contract, or substitutes). Third, only teachers
working in public schools were surveyed here. In
France, roughly one-fifth of all teachers work in the
private sector (Ministère de la Jeunesse, de l’Educa-
tion Nationale et de la Recherche, 2004) and it
might be that their health and teaching conditions
differ from those presented in this study. Finally, in
this survey, no information was collected on
burnout. However, data on this aspect are currently
being collected within the framework of another
survey we launched a few months ago.
Nevertheless, this study shows that teachers
working at certain levels, depending in certain cases
on their gender, are more vulnerable to mental
health problems. Moreover, through the identifica-
tion of risk factors, this study shows the importance
of the school environment on teachers’ mental
health. Such results are important for the potential
they have in terms of public health since they open
the door to initiatives to improve managerial
aspects in schools and set up prevention measures
that could prepare and support teachers in the
difficulties they may face especially in their relations
with students and parents.
Some ideas for action plans to improve teaching
conditions have already been reported in the
literature, although they have been essentially aimed
at reducing or preventing burnout and stress in
teachers. Evidence has been published demonstrat-
ing that first of all, changes in the way schools are
operated are likely to be more effective than action
focused on teachers only (Mechanic, 1974; Milstein
& Golaszewski, 1985; Shinn & Morch, 1984).
Moreover, authors have emphasized the importance
of preventive action, which seem to be less expensive
and more effective than programs aimed at reducing
existing symptoms, especially for young teachers
(Cherniss, 1991). Based on existing studies, and as
suggested by some of our findings, a better working
environment for teachers could be achieved by
programs that have an impact on four essential
aspects of life at school (Friedman, 1999): the
relationships between teachers and students (Fried-
man, 1995), the level of social support in schools
(Dunham, 1989; Friedman, 1991), the participation
of parents in schools, particularly to improve the
relationship they or their children may have with
teachers, and the principal’s managerial skills,
especially to strengthen his or her abilities to
support the teaching team. Initiatives of this kind,
which have already been reported in some countries
(Berkels et al., 2004; INSERM, 2003), are deeply
encouraged by organizations such as the WHO,
which promotes efforts through schools to prevent
certain social problems such as violence (World
Health Organization, 1999).
Acknowledgment
This project was funded by the Mutuelle Générale
de l’Education Nationale (MGEN), France.
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