The increasing prevalence of mental disorders impacts negatively on human health and societal welfare.¹ Globally, mental disorders rank among the top 10 leading causes of morbidity, and predictions from the World Health Organization indicate that mental health disorders will become the foremost cause of disability globally by 2030.^2,3

Depressive and anxiety disorders are the two most common mental disorders, which contribute significantly to the burden of mental illness. Together, they directly affect an estimated half a billion people, with a notable over-representation among women.⁴ Various factors play a role in influencing the onset of depression. These factors encompass anxiety, early adversity,⁵ as well as socio-economic status and demographic characteristics.⁶

Compared to other African nations, South Africa exhibits a higher prevalence of mental disorders,^7,8 which makes mental health a focus area in South African health services, although it has not received the necessary prioritisation.⁸ Addressing mental health challenges requires enhancing policies related to the detection, management and monitoring of mental disorders. The availability of easy-to-use mental health screening tools enables the integration of mental health assessment in primary health care services.^9,10 Routine screening for mental disorders could significantly contribute to detection and consequent treatment and other supporting interventions.¹¹

The workplace has been identified as a source of depression among many people,¹¹ which includes the school environment as a workplace for teachers.^12,13 Although the teaching profession can be extremely rewarding, it is also recognised as highly stressful and demanding.¹² Teachers encounter a range of work-related pressures, such as work overload, which occurs when teachers are assigned more tasks than they can realistically manage within the available time and resources, as well as teachers being expected to manage multiple demands or teach large or many classes. Emotional labour occurs when teachers are required to display cheerfulness or compassion regardless of their true emotions. Emotional labour contributes to a lack of psychological safety, which means that the teachers lack the safety of freely discussing ideas or asking questions without fear of adverse consequences, which raises concerns about the mental health of teachers in both elementary and secondary schools.¹⁴ A recent South African study identified unfavourable conditions and risk factors associated with depression among teachers to be mostly workplace-related, such as the socio-economic setting of the school, the learner-to-teacher ratio and the subjects taught by the teacher.¹⁵ Associated personal factors such as gender, marital status and race have been reported.^15,16

The many challenges in the education system in South Africa include the high rate of teacher absenteeism,^17,18 which contributes to poor teaching and learning outcomes.¹⁸ Absenteeism exists across the education sector regardless of teaching experience, workplace conditions or student population,¹⁹ which suggests that absenteeism is related to the teaching profession itself or related conditions.

Absenteeism has an inverse relationship with job satisfaction,^19,20 which implies that high absenteeism among teachers may be an indication of experienced poor working conditions. On the other hand, absenteeism among teachers has been identified as a manifestation of various mental health challenges which may not have been identified yet.²¹ Other studies have reported mental health challenges as a significant contributing factor to teacher absenteeism.^22,23 This suggests that problematic absenteeism among teachers can be reduced by attending to the mental health of teachers, with resultant improvement in health and resultant positive changes to teaching and learning outcomes. Moreover, the absenteeism of some teachers increases pressure on the remaining teachers, as they take on extra responsibilities to attend to all learners.²³ This leads to burnout and depression, and thus mental pressure on others, and more cases of absenteeism.²⁴

Presenteeism, which is the phenomenon of reporting for duty despite being unwell, also compromises the quality of teaching and interrupts teacher–student relationships, which further worsens presenteeism among teachers.²⁵ There is an association between the quality of the teacher–student relationship and the well-being of students,²⁶ which places the well-being and functionality of teachers at a level worthy of attention for the influence on the well-being of the children they interact with. Poor mental health of teachers is therefore much more consequential, and thus a priority in the considerations for teaching and learning outcomes. The purpose of this study was to screen for depression among teachers in three school districts of the Tshwane Municipality, South Africa.

This study aimed to determine the prevalence of depressive symptoms among teachers in the Tshwane Municipality, South Africa. Participants were drawn from Tshwane South, North, and West, with the majority residing in Tshwane South. The sample was predominantly female and married, with a mean age of approximately 40 years. The finding that most teachers in the sample are female confirms findings from other studies, which profile the teaching profession as being dominated by females.^15,29 This trend has been explained by the Theory of Gender and Power, which divides women and men into gender-specific occupations,³⁶ and thus renders the teaching profession to be associated with caring and femininity.³⁷

The finding that female teachers have a higher prevalence than their male counterparts is aligned with established findings of higher depression prevalence among females in the general population.³⁸ Although some studies have reported marriage to be a protective factor against poor mental health outcomes,^37,38 it was interesting to find that marital status in the current study was significantly associated with elevated symptoms of depression among married teachers. The difference may be explained by the quality of the marriage, as poor marital quality, marital conflict, lack of spousal support and domestic violence may contribute towards deteriorating mental health outcomes, which may serve as a plausible explanation for the current study findings.³⁹

The prevalence of depressive symptoms was just above half, which is high but similar to other studies which reported a high global prevalence of depressive symptoms among teachers. The current study rate is approximately 25% higher than national rates among the general South African population,⁴⁰ which highlights the difficulties faced by teachers. African countries which have reported high prevalence of depression among teachers include Namibia⁴¹, Nigeria⁴², Ghana⁴³, Tanzania⁴⁴ and South Africa¹⁵. The high prevalence cuts across the education profession, from early learning practitioners¹⁶ to academics in higher education institutions.⁴⁵

This study found work-related factors significantly associated with depressive symptoms at both univariate and multivariate levels, which were reported by other studies, which reported work-related factors like difficult relationships, including teachers being bullied by learners,^46,47 as well as dealing with bullying among learners,⁴⁸ which is rife in South African schools.⁴⁹ Moreover, often teachers do not know how to deal with these problems which they are expected to resolve,^50,51 which worsens the mental health of such teachers. Other workplace-related risk factors for depressive symptoms among teachers reported in other studies were the low socio-economic status of the school, the lack of a conducive school environment and the unfavourable learner-to-teacher ratio,¹⁵ which are a reality for many teachers in South Africa.

This study found that being responsible for teaching Grade 12 was significantly associated with symptoms of depression, which confirms the importance that the education system and South Africans place on academic performance in Grade 12. This grade is not only the last year of the schooling system, but student performance in this grade is also a measure of the academic performance of a school and a critical gateway to higher education and employment prospects.⁵¹ The impact of the pressure on learners is also reflected by the symptoms of depression in teachers, which suggests consideration for support for teachers responsible for teaching this grade.

The study found that seeking professional help regarding mental health is a protective factor against depressive symptoms, while failure to seek help is a risk factor. Among teachers, barriers to seeking help for mental health challenges include a lack of training in assessment of mental health as well as a lack of knowledge, skills and confidence in the area of mental health.^52,53 The finding also suggests limited knowledge regarding where to seek help pertaining to their mental health.

Because mental health challenges are reported to be rife among teachers, employee assistance programmes should include training in both their pre- and in-service.⁵² Common undesirable behaviours relating to experiences of poor mental health include masking or ignoring the symptoms,^53,54 which results in a worsening of the symptoms, while the productivity deteriorates.⁵⁴ When the person can no longer mask the pain, he or she breaks down, and recovery takes a longer time. Absenteeism and presenteeism have also been linked to underlying mental health challenges, including depression, and can negatively affect teaching quality and teacher–learner relationships.^{20–22,24,25} While these outcomes were not directly assessed in this study, they represent potential occupational consequences of depressive symptoms among teachers, with implications for the broader school environment.

Teaching is one of the careers that requires optimum mental health, because the profession itself focuses on the mental development of children. The mental health of teachers therefore needs intentional attention to promote productivity in their profession. The scourge of mental health challenges among children has resulted in calls for non-mental health professionals who are in contact with children, such as teachers, to be trained to identify and mitigate such challenges among children.⁵⁶ However, teachers cannot play a meaningful role if they themselves are struggling with mental health challenges that they are not ready, willing and able to mitigate.

This study confirmed the high prevalence of depressive symptoms among both primary and high school teachers and across the three districts of the Tshwane Municipality. Mental illness among teachers is costly for the teachers themselves, as well as the children who are exposed to being taught by teachers who are not in optimum health. This study and others call for the promotion of mental health in the teaching profession, with the development of employee assistance programmes with significant attention to mental health promotion.⁵⁵ Moreover, the PHQ-9 scale used in the current study is merely a screening tool indicating probable depression; thus, future research should consider using diagnostic interviews to adequately quantify the prevalence of major depressive disorder.