Factors Contributing to Anxiety and Depression among Teachers Through A Systematic Literature Review

Teachers are the main pillars to give birth to an ingenious generation that can compete globally. This huge responsibility causes teachers to be easily susceptible to anxiety syndrome and depression. Although various past studies conducted varied research on anxiety and depression, there is a need to study the trend of study through these years including the contributors towards these issues. Therefore, this study aims to identify the trend research of anxiety and depression based on the year of publication, research approach, and country context. Moreover, the research would also identify the contributing factors to anxiety and depression among teachers. A total of 31 final articles have been selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model involving four phases which are identification, screening, eligibility, and finally the included stage. The Scopus, SAGE Journal, ERIC, and Google Scholar databases have been used for research based on the most recent 5-year period from 2017 to 2022. The findings show that 2021 is the year where the most articles were published as the research approach used is mainly quantitative. Malaysia is the country that produces the most articles. A total of 4 factors contributing to anxiety and depression among Mathematics teachers were reported such as job aspects (task and teaching knowledge), the Covid-19 epidemic (e-learning), environment (friends), and personal problems (gender). This study provides implications based on teachers' management development aspect whereby counseling and guidance are developed for teachers and school staff. A suggestion for further research that can be carried out by the Malaysian Ministry of Education is by designing an Educator Self-Confidence Intervention Module to strengthen the mental health of teachers at an excellent level.


Introduction
Choosing a profession as a career is a brave step.This is because the current education field is considered a challenging and stressful job.A teacher's role is not confined to planning the curriculum in the classroom only, but also performing special tasks (Klai & Bahrin, 2020).The emotional well-being of teachers affects student learning.Teachers who have emotional and psychological stability will create a fun and interesting learning atmosphere.Mental health is an aspect that is often underestimated by society, especially among teachers.Teachers are considered to be strong and able to control their behavior.Therefore, the problem of anxiety and depression is widely discussed nowadays.Mohamad & Ibrahim (2018) argue that mental illness among teachers does not occur by itself but occurs due to the surrounding conditions.
The tasks faced by teachers is a reason teachers are facing high pressure and stress in their career.This condition certainly is the main cause of anxiety and depression in a teacher.Desouky & Allam (2017) agrees that a packed routine in school and managing family affairs is the contributor to mental health issue among teachers.Their research also shows that 67.6% of teachers in Egypt have mental illness due to work pressure in school.A teacher having pressure at their workplace is prone to have mental illness (Klai & Bahrin, 2020).
Anxiety and depression mental illness issues must be discussed thoroughly to avoid a worse effect on teachers in the country.Issaha (2018) reported the death of a teacher with depression due to an excessive overload of tasks.Besides that, the Ministry of Education of the United States of America reported that 17% of teachers choose to quit teaching as they were unable to face the work pressure.Meanwhile, the Ministry of Education in Kuwait also stated that 400 to 500 teachers choose to quit every year (Almutawa, 2022).The motivation for this research is the fact that the importance of a teacher's mental health is often taken lightly by certain quartets.Anxiety and depression can be contributing factors to suicide in a country.Research by Lizhi et. al (2021) showed that 2.8% of teachers have the tendency to injure themselves and have suicidal thoughts.Through this SLR research, the pattern and contributing factors towards anxiety and depression have been well exhibited.Besides that, most studies conducted involved the public, students, and others.However, many groups failed to grasp that teachers also do have the tendency to have symptoms of anxiety and depression.Despite findings showing that teachers can manage stress and pressure, these symptoms cannot be taken lightly as it involves human resources (Ahmad & Amir, 2018).Thus, this article also has motivation to provide exposure to the public that teachers also need help and emotional support.
Nevertheless, the development of past studies conducted showed that not many discussions were conducted about anxiety and depression in a consistent manner in these few years, especially in the specific scope of the year of publication, research approach, and national context.This type of systematic discussion is important because we are able to view the development of the mental health of teachers.Besides that, efforts to identify factors affecting anxiety and depression are developing in this country.The results of the research and its analysis can be a good reference point and contribute for future studies, thus being used by the Ministry of Education as a point of reference to develop a framework model for anxiety and depression among teachers.Besides that, this article can also contribute to the body of knowledge, especially for future researchers to obtain information and data about anxiety and depression among teachers.Through this systematic literature review, future researchers can expand their research in detail to ensure the spread of anxiety and depression among teachers does not increase drastically.

Research Objectives
Two research objectives have been underlined for this research which are to: a) Identify the trend of research on anxiety and depression among teachers according to the year of publication approach and national context.b) Identify the contributing factors towards anxiety and depression among teachers.

Research Methodology
This research uses the method of Protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) (Page et al, 2021) to conduct this research.The use of PRISMA is aimed to facilitate the synthesis made related to the study.The selected articles are related to anxiety and depression among teachers.The systematic literature highlighting process has four stages of selecting relevant articles: identification, screening, eligibility, and included.

Article Search Strategy
The search for this research article begins by considering the criteria and characteristics required in the study.Among them are: i. Selected articles within the last 5 years (2017)(2018)(2019)(2020)(2021)(2022).
ii. Articles related to anxiety and depression among teachers.
iii.The selected articles are in Malay and English.
Based on the criteria above, four stages in the systematic literature review process were applied with the necessary steps of identification, screening, eligibility, and included.A few researches applied the SLR PRISMA method to help analyze data needed such as the researches conducted by (Kwon et al., 2020;Batista et al., 2021;Rethlefsen et al., 2021).

Identification
Four databases were used for article searches which are Scopus, Institute of Education Sciences (ERIC), SAGE Journals and Google Scholar.Scopus is used as an article search because it is listed as a database that has highly indexed articles by publishing articles in various fields (Burnham, 2006).In addition, Scopus is used as it can be considered as the world's most extensive coverage of scientific journals, assurance in search and focused context.(Baas et al, 2020).Meanwhile, ERIC was chosen because it is one of the largest journals in the field of education (Marín-Marín et al, 2019) while SAGE Journal was chosen because its search field includes psychology and counselling (University of The West of Scotland, 2022).Next, Google Scholar is used as a database in article searches because it has the advantage of a large number of words and characters, which can be up to 256 characters.(Gusenbauer & Haddaway, 2020).
The keywords used during the search are "teachers", "anxiety" and "depression".There were 1140 articles displayed when those keywords were used.A total of 524 articles from Scopus, 415 from SAGE Journal, 92 from ERIC, and 109 from Google Scholar.Table 1 shows the keywords used for each database.

Screening
As a result of the search, a few articles passed the initial screening based on the criteria that had been set.Acceptance and rejection criteria for an article depends on the type of article, year of publication, language, and research context.The selected article type is an article with full access.Articles in the form of books, proceedings, or conferences are rejected from this study.In addition, the year of publication of the article must be within the most recent 5-year period.Articles published before 2018 have been excluded.
In addition, this study takes into account the language factor, whereby only articles using Malay and English will be selected.Meanwhile, articles that use other foreign languages will not be selected.Finally, the context of previous studies is also a factor in the selection of articles.The context of the study that discusses anxiety, depression, and teachers will be evaluated.A total of 634 articles that did not meet the criteria and 392 articles that had the same record were excluded from the study.As a result of this screening, a total of 114 qualified for the next stage.

Eligibility
After the screening stage, 114 full-text articles went through through the third stage, which is the qualification process.Based on all the articles that were screened at the screening stage, a total of 83 articles were rejected and excluded from this study.This is because the articles discussed the context other than the focus of the study.After going through stringent process of exclusion and screening, a total of 31 articles were eligible to be evaluated for this study.

Included
Included stage is the process by which articles are selected to be studied in this study.The selected articles are related to anxiety and depression factors among teachers.As a result, only 40 articles met the study criteria.Figure 1 shows the article selection process through the four stages that have been outlined.

Findings Findings based on First Research Objective
Identify the trend of research on anxiety and depression among teachers according to the year of publication approach and national context.

Number of articles
Year Ratanasiripong et al., 2021;Santamaría et al., 2021;Wong et al., 2021;Wakui et al., 2021;Yoo et al., 2021;Bete et al., 2022;Gawrych et al., 2022;Lizana et al., 2022;Spadafora et al., 2022).4 shows 5 sub-factors from work that lead to anxiety and depression of a teacher.Time management contributed to 5 studies, classroom management (1 study), overload of tasks (15 studies), teaching knowledge (15 studies) and workplace (13 studies).An overload of tasks and teaching knowledge recorded the highest frequency (Alvites & Cleofé 2019;Ganley et 2019;Ng et  Apart from the work factor, the Covid-19 factor also contributes to the anxiety and depression of a teacher.Table 5 shows that there are 11 articles discussing death case due to Covid-19 died cases and e-learning (13 articles).There are two aspects seen from this factor, which are family and friends.The friends subfactor contributed to 11 studies and 7 studies were from the family subfactor.Table 6 shows the environmental factors based on the selected articles.(2019) x Total 7 9 d) Independent factor Independent factors consist of 7 aspects namely known as personality, health, motivation, education, gender, finances, and lifestyle.The aspect of gender contributes to anxiety and depression with the highest frequency of 17 studies, followed by personality (6 studies) and health (6 studies), finance (5 studies), and 4 studies for each sub-factor of motivation, education, and lifestyle.Table 7 shows the independent factors based on the selected articles.

Discussion of First Objective
As a result of the literature review, it can be seen that many anxiety and depression articles were published in 2021.This may be due to the spread of the Covid-19 epidemic in 2020, which provides an opportunity for many researchers to conduct surveys on mental health.
From the aspect of the research approach, 90% of the articles, equivalent to 28 out of 31 articles, used the quantitative method in their studies.This may be due to the fact that the implementation of the research process is deemed to be easier and can involve a large sample.This analysis also found that the country that has conducted the most research on anxiety and depression is Malaysia.This shows that teachers in Malaysia are most likely to have anxiety and depression in their daily lives.Although other countries contributed to the writing of few studies, it does not prove that the rate of anxiety and depression in the following countries are low.It is hoped that more studies will be conducted to look at mental health issues in education.

Discussion of Second Objective
Based on this research, it was reported that there are four main factors that form the basis of a teacher's anxiety and depression.Those main factors include work factors, the Covid-19 epidemic, the environment and self.In addition, this study also looked at research trends for past studies such as the number of articles for each year, country and research approach.

Occupational Factor
Based on this literature review, occupational factor is a confirmed contributor towards the anxiety and depression faced by a teacher.This can be seen for the abudance of task subfactor that is the cause for this issue.The public is well aware of the overload of tasks faced by teachers on a daily basis.Teachers role no longer revolves around teaching only, but also carrying out other duties.Therefore, an abundance is tasks accumulated by teachers leads them to be constant under pressure from many parties ( Furthermore, the subfactor of teaching knowledge is also closely related to the teacher's tendency to anxiety and depression.This is because teachers who are incompetent in pedagogy and content knowledge will have low self-esteem making them to be living in fear that causes anxiety and depression in themselves (Desouky & Allam, 2017;Ramirez et al., 2018;Alvites et al., 2019;Dizon-Ross et al., 2019;Ganley et al., 2019;Oguzhan et al., 2019;Thomas & Sari, 2019;Othman & Sivasubramaniam, 2019;Li et al., 2020;Syuhada & Retnawati 2020;Bete et al., 2020;Genoud & Waroux, 2021;Pressley et al., 2021;Wakui et al., 2021;Gawrych et al., 2022;Spadafora et al., 2022).
Other than that, workplace subfactor also affects anxiety and depression of a teacher.Teachers teaching in primary schools and secondary schools are more prone to stress, anxiety and depression.This is because the syllabus are tougher for teachers to comprehend.Therefore, teachers had to work harder to ensure the students understand what is being taught.The fatigue faced by teachers made them to be susceptible to emotional and psychology disturbance.

Environmental Factor
Besides that, environmental factors is also a cause for depression and anxiety among teachers.This is because there is lack social support from family and friends.Family subfactor is where teachers have family crisis that causes them to develop this mental problem.There are teachers who had to face divorce issues and the burden of taking care of their family members (Atabek et al., 2019;Othman & Sivasubramaniam, 2019;Aperribai et al., 2020;Klai & Bahrin, 2020;Ratanasiripong et al., 2020;Lizana & Lera, 2022;Spadafora et al., 2022).
Relationship with friends can also be a reason for anxiety and depression in a teacher.Friends who are inconsiderate and always pressure each other are the main cause of this mental illness (Alvites & Cleofé, 2019;Atabek et alm., 2019;Ng et al., 2019;Aperribai et al., 2020;Bete et al., 2020;Klai & Bahrin, 2020;Talidong & Toquero, 2020;Santamaría et al., 2021;Gawrych et al., 2022) This research shows that from the environment aspect, friends can impact the emotion and mental of a person.A positive environment does not only provides a good emotion but also helps teachers to work productively.

Independent Factor
Based on the independent factor, the gender subfactor leads to syndrome of anxiety and depression among teachers.Most articles describe women to be more prone to have mental problems compared to men.This can be associated with the routine factors of women who had to manage their household affairs and also school affairs.Female teachers face twice as much anxiety compared to their male counterparts (Lizana & Lera, 2022).This is because they had to balance between their family affairs and work affairs (Desouky & Allam, 2017;Atabek et al., 2019;Budyawati & Utami, 2019;Dizon-Ross et al., 2019;Ng et al., 2019;Othman & Sivasubramaniam, 2019;Bete et al., 2020;Li et al., 2020;Ratanasiripong et al., 2020;Ozamiz et al., 2021;Santamaría et al., 2021;Lizana et al., 2021;Wakui et al., 2021;Yoo et al., 2021;Gawrych et al., 2022;Spadafora et al., 2022).Jakubowski & Sitko (2021) in their study found that female teachers in Poland are more likely to have anxiety and depression as the culture of the country still associates managing household to be a full responsibility of a female.Other subfactors such as personality, health, motivation, education, finance and lifestyle does not impact as much towards anxiety and depression.This can be observed through the frequency of each subfactors, whereby it does not have vast difference.

Conclusion
The findings showed that most articles are produced in 2021, the most famous approach is the quantitative approach and the country with the most publication about anxiety and depression is Malaysia.Other than that, an overload of tasks and teaching activities, changes of learning towards e-learning, peers' influence and gender are the dominant factors that leads to mental health issues that are anxiety and depression.This research has a few implications from the aspect of teachers' management development whereby the guidance and counseling unit in school are not focused for students only, but also for teachers and school staff.
This study can be improved with collaboration between Ministry of Education (MOE) with the Ministry of Health (MOH) to conduct mental health screening among teachers.This study has its limitations which is the selection of articles are more generally focused to primary school teachers, secondary school teachers and university.It is suggested that in the next study, anxiety and depression pattern can be observed among Mathematics teachers

Figure
Figure 1: Research article search process

Figure 2 :
Figure 2: Number of articles published from 2017 to 2022

Table 2
Article acceptance and exclusion criteria

Table 6
Environmental factors based on selected articles

Table 7
Independent factors based on selected articles