(2019) 13:28
Estrada et al. Int J Ment Health Syst
https://doi.org/10.1186/s13033-019-0286-7

International Journal of
Mental Health Systems
Open Access

DEBATE

Religious education can contributeto adolescent mental health in school settings
Crystal Amiel M. Estrada1*, Marian Fe Theresa C. Lomboy2, Ernesto R. Gregorio Jr.3, Emmy Amalia4,
Cynthia R. Leynes5, Romeo R. Quizon2 and Jun Kobayashi1,6*

Abstract
Background: Mental disorders contribute substantial burden to the society due to their widespread occurrence anddebilitating effects. A quarter of the world’s population are children and adolescents, a significant number of whom
experience mental disorders as early as the age of 14. Some interventions have been found to effectively reduce therisk factors and reinforce protective or preventive factors. However, there is still a need to put emphasis on mental
health promotion strategies such as religious education. This paper aims to discuss the importance of religious education in promoting mental health.
Discussion: Religious education can be instrumental to improving adolescent mental health. Specifically, it can:(1) help develop healthier reaction to stimuli through the internalization of religious morality; (2) reinforce religious
coping mechanisms which reduce the impact of stresses, enhance coping skills, and promote a less risky lifestyle;(3) increase awareness regarding religious beliefs and practices and their influence on the individual, the family, andthe community; and finally, (4) promote connectedness which can enhance self-esteem and well-being. However,negative health outcomes such as discrimination and social isolation can also develop, especially among religious orgender minority groups.
Conclusion: It is important to reflect on the crucial role of religious education on adolescent mental health. Schoolbased mental health education and promotion strategies can maximize the benefits of religious education by puttingemphasis on effective implementation of religious education to positively influence adolescent mental health.
Keywords: Religious education, Adolescent mental health, Schools
Background
Mental disorders are global public health concerns dueto their widespread occurrences and debilitating effects.
In 2010, mental, neurological, and substance abuse disorders accounted for 258 million disability-adjusted life
years (DALYs), equivalent to 10.4% of global DALYs, 2.3%of global years of life lost (YLLs), and 28.5% of global
years lived with disability (YLDs) [1]. The most recent
estimates from the World Health Organization identified
depressive disorders as the largest contributor to global
YLD, accounting for 50 million or 7.5% of all YLDs [2].

*Correspondence: cmestrada@up.edu.ph; junkobalao@gmail.com
1
Department of Global Health, School of Health Sciences, Universityof the Ryukyus, Okinawa, Japan
Full list of author information is available at the end of the article

Adolescence is a critical period of cognitive and behavioral human development. According to Erik Erikson’s
Social-Emotional Development Theory, it is during thisstage when an individual urgently needs to search for aproper role model to answer the big question of who he/she is and his/her moral and spiritual aspects. This formation of identity is a major event in the development of
personality and is associated with positive life outcomes[3]. Moreover, it is during this period when an individual
develops the capacity to understand and internalize religion—its beliefs, values, and practices [4], which can leadto changes in the pattern of religious participation [5].
Furthermore, the emergence of mental disorders coincides with this developmental period, with an estimatedhalf of mental disorders manifesting as early as 14 years
old [6]. On a global scale, 10–20% of this population© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License(http://creat​iveco​mmons​.org/licen​ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creat​iveco​mmons​.org/
publi​cdoma​in/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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experience mental disorders, with depression contributing the largest burden of disease [3]. Poor mental healthhas been shown to affect the overall health and wellbeing of adolescents and is associated with adverse healthand social outcomes like substance abuse, adolescentpregnancy, school drop-out, and delinquent behaviors,
among others.
Mental disorders contribute substantial burden to
the society. Given the magnitude of this public healthproblem, it is necessary to employ strategies which caneffectively reduce its occurrence. Strategies which putemphasis on improving social determinants of healthsuch as nutrition, housing, access to education, reductions in economic insecurity and harm from addictive
substances, and strengthening of community networks
have been found to reduce risks, reinforce protective factors, and decrease psychiatric symptoms and disability
and the onset of some mental disorders [7]. School-based
interventions are especially advantageous in addressing
mental disorders, since children and adolescents spend
more time in this setting than in any other formal institutions. Interventions implemented in schools which
aim to improve adolescent mental health using strategies
such as gatekeeper training and improving knowledge
or mental health literacy among others are found to beeffective in increasing knowledge, self-esteem, and social
support thus reducing risk factors [8–10]; however, there
is limited information on the integration of religious education in these interventions, which can be an effective
approach in promoting mental health. This paper discusses religious education and how it can influence adolescent mental health.

Discussion
Defining religious education

Religious education aims to provide students with knowledge and understanding of, as well as to develop sensitivity to different religions [11]. Religious education
has been traditionally categorized into: (a) confessionalreligious education, which seeks to promote obligation
towards a specific religion, such as Islam [12], or Catholicism [13]; and (b) non-confessional religious education,
which focuses on providing information about religion/
religions for students to expand their understandingon the different worldviews and eventually result in thedevelopment of tolerance for other religions [14]. Confessional religious education is implemented in countries
such Austria and Croatia, while non-confessional religious education is present in Slovenia [15]. Education is
crucial to the development of a tolerant society. The education system in many countries have evolved from being
secular to one that promotes pluralism, an understandingthat people will have different conceptions of the good

Page 2 of 6

and understanding of the best way to live life morally[16]. In the United States, for example, public education
was designed to teach Protestant values. However, theincrease in the Catholic population has led to the instruction of religion as a subject matter without any intentionof indoctrination. Religious education remains a topic for
debate because of the inviolable separation of the Church
and State in some countries [17]. Nevertheless, teaching
religion in secular schools can provide a student withdeeper understanding of different cultures around theworld, enrich a student’s understanding of human experiences, and allow the student to acquire values that they
can integrate into their own lives [18].
Adolescence and religion

Adolescence is the stage of human development which
Erik Erikson states as a transition period from childhood
to adulthood. An integral component of this developmental stage is identity development, wherein an individual develops the ability to think about abstract concepts
and the capacity to think about the consequences of decisions that they make. This developmental stage is alsocharacterized by an increase in their sense of autonomy,
leading to more interaction with peers and other individuals [3]. These changes that occur in adolescents affecttheir view about religion and its accompanying beliefs
and practices. In their quest to develop their identity,
they start searching for life’s meaning and become critical of ideologies being taught in religion. Consequently,
adolescents question or reject some religious ideas
which were taught to them by adults during early age[19]. Experiences and interaction with others during thisdevelopmental period are also critical in the developmentof religiosity. For example, family structure and attachment influence how religious behaviors and attitudes aretransmitted from parents to their children; adolescents
who were raised by both parents and grew up in families with close relationships are more likely to adopt theirparents’ religious beliefs and practices [20]. Similarly,
peers influence adolescent religiosity in the sense that
religiosity fosters greater peer attachment; that is, religious adolescents tend to have more friends who foster
the same religious belief and they are less likely to engage
in delinquent behavior [21].
The role of religious education in adolescent mental health

Religion and its effect on health and well-being has been
the subject of many previous studies [22]. Although thedefinitions for both religiosity and spirituality remains apoint of debate among researchers, the two concepts are
considered as related [23] and include several dimensions such as beliefs, attitudes, and behaviors, to name afew [24]. A recent systematic review and meta-analysis

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of randomized controlled trials which investigated theeffects of religious and spiritual interventions showed
positive effects on mental health outcomes such as significant decrease in stress, alcoholism, and depression[25]. However, the importance of religious educationin the promotion of both physical and mental health in
the school has not been given emphasis despite several
religions teaching about overall health and well-being.
For example, Islam teaches the importance of personal
hygiene, stress management, and eating healthy [26];Buddhism teaches avoidance of any drink or drug which
can cloud the mind [27]; the Catholic Christian spiritual
perspective puts emphasis on confession of sins for forgiveness by God to provide relief to a troubled mind;
and Jewish beliefs emphasize that their bodies belong to
God and should therefore take care of it by maintaining
a proper diet, getting adequate exercise and sleep, maintaining good hygiene, and having a healthy mind [28].
One of the basic aims of religious education is to promote awareness about religious beliefs and practices andhow these affect the individual, the family, and the community [29]. Previous studies have presented evidence ofthe positive effects of religious education against risky
health behaviors such as alcohol use, drug use, violence[30], and suicidal ideation [31]. Religious education canbe instrumental to improving adolescent mental healthby developing religious morality, reinforcing religious
coping, developing respect for religious diversity, andpromoting connectedness.
Religious beliefs and practices contribute substantiallyto the development of personal morality and sound judgment, which influence decisions that shape one’s life.
Religious education strengthens the formation of moral
consciousness through the internalization of religious
morality [32]. Internalization, the process wherein an
individual adopts the values or regulations prescribed bya religion as their own [33], can affect mental health [34].
Religious moral beliefs such as objections to suicide canalso influence suicide rates and attitudes towards suicide[35].
Religious beliefs also affect how individuals deal withstressful situations, suffering, and life problems [36] as itenhances acceptance and one’s ability to function competently in the face of stress and adversity [37]. Religious
education reinforces religious coping, which is the use ofcognitive behavioral techniques to manage stressful situations in light of one’s spirituality or religious beliefs [38].
Previous studies have shown that people frequently counton religion to cope with stressful situations [35, 36, 39,40]. Furthermore, meta-analyses have already indicatedthe positive impacts of religious coping on health wellbeing [41–43]. Positive religious coping involves engaging in religious practices, seeking social support throughPage 3 of 6

religious leaders and congregations, and reframing stressful events in reference to their relationship with God[43–45]. Some of these practices and religious involvement have been proven to help in dealing with stressful
situations, anxiety, and isolation, displacement after natural disasters, among others [46]. For example, meditation and yoga have been demonstrated to relieve tension
and anxiety and stabilize emotions. Traditionally, studies
have examined religious coping among Christian populations. However, ethnic minorities living as long-term
residents in Western countries have begun to receive
attention. These findings suggest that disempowered anddeprived groups, including women and ethnic minorities, resort to the use of religious coping and found great
efficacy in it [43]. In addition, religious coping has beenshown to be extensively used when situations are deemeduncontrollable [41, 47], thus providing an outlet for thoseat a social disadvantage and with limited access to external resources [48]. Based on these findings, it is apparent
that religious coping serves as a resilience mechanism as
it enhances a more stable and positive measures of wellbeing. The use of religious coping can enhance contentment with one’s life, thus, potentially protecting against
the long-term effects of distress [49].
Religious education can likewise serve as a vehicle toemphasize respect for diversity, by providing a venue foradolescents to understand the differences in religions
and world views. Social skills are needed to live and work
together harmoniously and to function effectively in adiverse society [50]. It is likewise vital to developing good
relationships and values and respecting differences at apersonal level [51]. By talking about other’s beliefs andtraditions, students are equipped with social skills andthe ability to prevent prejudice and hatred towards others[52]. Exploring issues within and across faiths can teachchildren and adolescents how to understand and respectdifferent religions, beliefs, values and traditions (including ethical life stances), and their influence on individuals, societies, communities and cultures [53]. Puttingemphasis on religious diversity can eventually reduce, if
not eliminate, cases of bullying, offensive behavior, andviolence [54].
Schools exist not only to provide academic knowledge
to students, but also to promote connectedness amongits students and teachers. Through religious education,
the learning atmosphere can be improved by connecting
students regardless of their faith [50]. It has been foundthat receiving religious education provided students witha higher purpose in life and more social support frompeers [55]. It can also be a means for teaching religious
beliefs and practices which promote support and carefor one another. The social support one receives frombeing part of religious communities and participating inEstrada et al. Int J Ment Health Syst

(2019) 13:28

religious practices contributes to positive mental healthand well-being [56, 57]. This social support, which
accounts largely to the impact of religiosity to well-being,
can be credited to the concept of love and brotherhood
being promoted by religious teachings [58]. Research has
shown that participating in religious practices has positive effects on adolescents in terms of having higher selfesteem and lower incidence of substance abuse throughengaging in religious practices, adolescents achieved afeeling of belongingness [22]. Furthermore, social relationships formed through religious involvement are likewise found to intervene with adolescent suicide ideation[59].
Previous studies have also reported some negative
effects of religion and religious education on mental health. In some cases, religious beliefs and practices
contributed to the development of certain disorders likeobsession, anxiety, and depression [60]. In other cases,
religiosity was cited as a deterrent in seeking professional
help for mental health [61–63]. There are also conflicting findings regarding radicalism and extremism due toreligious education. In the case of Pakistan and Indonesia, religious educational institutions were reported to
be exploited by perpetrators of extremism [64, 65]. However, others argue that there is no sufficient evidence toconclude that Islamic education contributes to extremism; on the contrary it is reported to foster civic empowerment among students [66].
Additionally, students who are considered as religious
minority are also at risk to developing negative mental
health outcomes. For example, non-Christian students
attending a school where majority of the population are
Christians can experience religious discrimination or
microaggressions [67]. A previous study has also foundthat a religious “mismatch” (i.e. students attending aschool with religious education which is different fromtheir religion) increased the risk of suicide attempts andself-harm significantly [68]. Other issues identified byprevious studies include concerns about schools as being
safe spaces [69].
Aside from negative effects experienced by religious
minority, religious education can also negatively impact
adolescents who belong to sexual minority groups. As
discussed previously, adolescence is an important periodof personal development and sexual identity development figures prominently during this stage. However,previous studies have reported negative effects of religious education on lesbian, gay, bisexual, transgender, and queer (or questioning) (LGBTQ) adolescents.
Although gender discrimination is not unique to religious
schools, hostile messages promoted by religious denominations and groups can foster victimization of LGBTQ
adolescents [70–72]. These religiously-based messages

Page 4 of 6

of discrimination can contribute to social exclusion.
Furthermore, non-acceptance of LGBTQ views (i.e. notaccepted or permitted in school work) can also undermine academic achievement [72]. Despite, these unintended negative outcomes, religion remains an important
aspect of human life, and if implemented properly, religious education can positively influence adolescent mental health.

Conclusion
Schools are an effective setting for gathering large populations of adolescents for mental health promotion and
it is also important to reflect on the crucial role of religious education on mental health among this age group.
School-based mental health education and promotion
strategies can maximize the benefits of religious education by putting emphasis on effective implementation ofreligious education to influence adolescent mental health.
Abbreviations
DALY: disability-adjusted life years; LGBTQ: lesbian, gay, bisexual, transgender,and queer (or questioning); YLD: years of life lived with disability; YLL: years oflife lost.
Authors’ contributions
JK conceived the presented idea. CAME and MFTCL wrote the manuscript in
consultation with EA, ERG, CRL, and RRQ. All authors read and approved thefinal manuscript.
Author details
1
Department of Global Health, School of Health Sciences, Universityof the Ryukyus, Okinawa, Japan. 2 Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila,
Manila, Philippines. 3 Department of Health Promotion and Education, Collegeof Public Health, University of the Philippines Manila, Manila, Philippines.
4
Faculty of Medicine, Mataram University, Mataram, Indonesia. 5 Department of Psychiatry and Behavioral Medicine, College of Medicine, University of the Philippines Manila, Manila, Philippines. 6 Japanese Consortiumfor Global School Health Research, Nishihara, Japan.
Acknowledgements
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Availability of data and materials
Not applicable.
Consent for publication
Not applicable.
Ethics approval and consent to participate
Not applicable.
Funding
This paper was supported by the Research Grant for National Center for Global
Health and Medicine (30-3, 30-4).

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Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Received: 4 December 2018 Accepted: 22 April 2019

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