# Mental Health and Identity Formation Among Primary School Learners: Peer Perceptions of Children Living with Epilepsy Through a Social-Educational Lens

## TL;DR

This study explores how children in rural South Africa perceive epilepsy, linking stigma to mental health and identity issues, and suggests education as a way to reduce stigma.

## Contribution

The study introduces a culturally grounded approach to epilepsy education in schools to reduce stigma and support identity formation in children.

## Key findings

- Epilepsy is often misunderstood as a supernatural condition, leading to stigma and emotional distress among children.
- Most learners lack accurate knowledge about epilepsy, contributing to peer mockery and isolation.
- Integrating epilepsy education into school curricula can promote empathy and reduce stigma.

## Abstract

Children living with epilepsy face significant stigma in school settings, particularly in rural South Africa, where misconceptions linking epilepsy to witchcraft, evil spirits, or unpredictability lead to fear, shame, and exclusion. This study explored how primary school learners perceive and experience epilepsy-related stigma within the classroom context and examined how such perceptions may influence the mental health and self-conception of peers living with epilepsy. A descriptive–exploratory qualitative design was employed, involving six focus group discussions with 36 learners aged 9–14 years from Grades 4 to 7 in rural schools across Limpopo and Mpumalanga provinces. Data were analyzed thematically using ATLAS.ti software (version 22). Findings revealed that epilepsy was commonly described as a “falling disease,” associated with ancestral spirits or supernatural causes, contributing to peer mockery, isolation, and emotional distress. While some learners expressed empathy and willingness to help, most lacked accurate knowledge about the condition. This study concludes that integrating culturally grounded, age-appropriate epilepsy education into life skills curricula can promote empathy, reduce stigma, and support inclusive identity formation. Embedding such programs in school health policies and teacher training frameworks can strengthen mental health promotion and contribute to equitable health education within the goals of Universal Health Coverage.