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Resiliency and mental health of Resiliency and

mental health
school teachers in Okinawa of teachers
Paul Ratanasiripong
College of Education, California State University, Long Beach, California, USA
Takashi China
Okinawa International University, Ginowan, Japan Received 8 November 2019
Nop T Ratanasiripong Revised 11 February 2020
Accepted 25 March 2020
School of Nursing, California State University–Dominguez Hills, Carson,
California, USA, and
Shiho Toyama
California State University, Long Beach, California, USA

Abstract
Purpose – The purpose of this paper is to describe the mental health issues among teachers globally and to
investigate the significant factors that specifically impact the mental health of school teachers in
Okinawa, Japan.
Design/methodology/approach – This cross-sectional study examined depression, anxiety, stress, self-
esteem and resiliency among 174 teachers from seven schools in Okinawa, Japan. The study questionnaire
consisted of four parts, including demographic data, Depression, Anxiety, and Stress scale (DASS-42),
Rosenberg Self-Esteem Scale (RSE), and Connor-Davidson Resiliency Scale (CD-RISC). Multiple regression
analyses were performed to identify predictors of mental health variables.
Findings – Of the 174 teachers, 111 were females (64%) and 60 were males (35%). Average age of participants
was 41.65 (SD 5 10.07). Average number of years being a teacher was 15.50 (SD 5 9.88). There was a significant
gender difference in the level of self-esteem. Significant differences in anxiety were found among varying grade
levels taught. Regression analyses indicated that resiliency and self-esteem significantly predicted depression,
anxiety and stress among school teachers in Okinawa.
Originality/value – This is the first study among school teachers in Okinawa that examined the impact of
resiliency and self-esteem on their mental health. To reduce psychological distress common within the teaching
profession, social and environmental support should be provided within the school to better foster the
successful promotion of teacher resiliency and self-esteem.
Keywords Resilience, Depression, Anxiety, Stress, Teachers, Japan
Paper type Research paper

Introduction
Teachers worldwide demonstrate susceptibility to mental health issues such as depression,
anxiety and stress based on the multitude of primary stressors they encounter, including a
lack of resources, a pressure to fulfill multiple roles, interpersonal troubles, demanding
working conditions, low student achievement and excessive workload [1–5]. Further,
numerous studies have demonstrated that these primary stressors threaten the psychological
wellbeing of teachers internationally [6–10]. Poor psychological wellbeing may contribute to
problems such as low teacher performance and teacher burnout, which in turn may lead to

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JHR costly social and economic consequences, such as poor academic outcomes for students and
low retention rates of quality teachers [8,11–14]. An improved understanding of factors
contributing to teacher wellbeing is therefore necessary for increasing the longevity and
quality of teachers across the globe.
In the general population, resilience has consistently demonstrated a negative correlation
with mental health issues [15–18]. However, limited research has examined teacher resilience
and its impact on teachers’ psychological wellbeing. This study examines mental health and
resilience among Okinawan teachers. Understanding the relationship between resilience and
mental health issues in this subgroup of teachers may offer valuable insights into the mental
health of teachers in the international context.

Resilience and self-esteem

Resilience is defined as an individuals’ ability to positively adapt to stressful situations [19].
Resilient individuals tend to successfully adapt to the exposures of stressors, thus decreasing
maladaptive responses and negative consequences [20]. In turn, high levels of resilience
correspond to positive psychological wellbeing [16,17,19,21–23]. A study in the United States
found that resilient coping was negatively correlated with depression and neuroticism [17].
Further, resilient coping was identified as a moderator between depression and trauma
exposure; among individuals who experienced trauma, depression levels were roughly twice
as high for those with lower resilient coping skills, illustrating the positive effect of resilience
on depression [17]. More importantly, resilience was found to be a predictor of depression,
work stress and burnout among diverse sample populations, exhibiting a strong influence on
mental health issues [24–26]. Adding to this notion, a study in Australia found that resilience
was the only variable that decreased the probability of clinical depression [23].
The impact resilience has on multiple mental health issues may be explained by elevated
levels of self-esteem among resilient individuals; resilience was positively correlated with self-
esteem in Turkey [15]. Self-esteem, defined as the attitude an individual has regarding one’s
self-concept, determines the individual’s beliefs in their abilities. Individuals with high self-
esteem demonstrate their ability to utilize coping strategies to mitigate or eliminate
experienced stressors, increasing resilience among individuals with high self-esteem [27].
Thus, resilience and self-esteem play a vital role in psychological wellbeing among
individuals.

Mental health of teachers globally

Multiple studies have demonstrated the ubiquity of mental health issues experienced by
teachers internationally. A study involving secondary school teachers in Malaysia indicated
severe depression and stress among 3% and severe anxiety among 13% of the sample
population [28]. A study on Italian teachers reported 11% anxiety and 49% depression,
distinguishing work stress as the major factor for depression and anxiety among teachers [6].
In addition to the stressors faced by teachers during school hours, teachers are required to
generate lesson plans prior to class lectures and spend additional post-class hours grading
paperwork, resulting in roughly 50 work hours per week and two-thirds of total work time per
month spent on overtime [5,29]. This contributes to teachers’ global vulnerability to mental
health issues. A study of female elementary school teachers in Brazil concluded that teachers
who worked the longest hours had the highest prevalence of depression [7].
Although depression, anxiety and stress are established issues among the global teaching
population, specific factors impact teachers’ mental health to varying degrees. Teachers in
rural areas have higher odds of depression than teachers in urban schools [30]. In addition,
elementary school teachers in the United States reported the highest level of major depressive
disorder at 47% in comparison to high school and middle school teachers with 27 and 22%,
respectively [31]. Similarly, a study of Chinese teachers indicated that primary school, middle Resiliency and
school and special education teachers reported worse levels of mental health than mental health
kindergarten teachers and college instructors [32].
of teachers

Mental health in Okinawa

According to World Mental Health, Japan had lower levels of mental health issues than most
other participating countries in North and Southeast Asia [33]. However, Japanese citizens
still demonstrate concerning levels of mental health issues, reporting over 5.7 million cases of
depressive disorders and roughly 3.7 million cases of anxiety disorders in 2015, with anxiety
disorders declared the most common in a 12-month period [34]. An estimated 2.6 million
Japanese suffered from role impairment due to mental disorders, suggesting the impact of
mental health issues on life functions [33].
However, prefectural differences revealed varying discrepancies in the psychological
wellbeing of Japanese populations. More specifically, the Okinawa prefecture has exhibited
unique mental health trends uncommon among populations across the globe. Generally, low
socioeconomic status is correlated with higher levels of depression [35,36]. However, Okinawa
– ranking lowest in prefectural income – indicated a low prevalence of patients with major
depressive disorder, ranking 35th out of the 47 prefectures [37]. Additionally, gender
differences have been exhibited among the Okinawan population. Female Okinawans ranked
44th in suicide victims, illustrating a low prevalence of suicide and better mental health in
comparison to their male counterparts which ranked 16th [37]. Males may be more reluctant
to express emotional needs; accumulated experiences of mental health issues may, therefore,
increase the vulnerability to suicide among the male Okinawan population.
The distinction between prevalence and influences of mental health issues within
Okinawa may be explained by the complex history of Okinawa and its geographic location.
Okinawa began as an independent country ruled by the Ryukyu kingdom [38]. However, in
1609, the Satsuma Kingdom invaded Okinawa, forcing Okinawa to join the rest of Japan
under the Shogunate system; in 1879, the establishment of the prefecture system occurred,
turning Okinawa into one of the 47 prefectures of Japan [38]. Despite its recognition as a
prefecture of Japan, the end of the Pacific War in 1945 marked another period in history when
Okinawa was no longer part of Japan; instead, Okinawa was placed under the U.S.
administration, only to return to the Japanese administration in 1972 [38]. Throughout this
course of history, Okinawa has been exposed to various populations and rulers that influence
the overall culture established within this particular prefecture. Additionally, Okinawa is in
closer proximity to China in comparison to mainland Japan, and thus inherits Confucian
beliefs commonly practiced within Chinese cultures [39]. The variability highlighted
throughout the historical and geographic background of Okinawa may in part explain the
distinct mental health issues that the Okinawan population experience.
Limited literature is available on the mental health of Okinawan residents and even less
literature has been published on the psychological wellbeing of Okinawan teachers.
A comparison study between the general Japanese population and Japanese teachers did not
demonstrate a significant difference in depression scores, implying that Japanese teachers
may show similar trends in depression as the general population [40]. Teachers in Japan are
considered equals and salary is based strictly on accumulated service years, thus eliminating
the confusion and anxiety presented by the differences in pay rate between themselves and
their colleagues [41]. However, teachers were more stressed and possessed more negative
subjective moods than other white-collar workers. This may be a result of the additional
responsibilities teachers take on without compensation. As students in Japan become heavily
involved in extracurricular activities during middle and high school education, teachers are
required to dedicate additional hours in their career to plan and lead such activities with no
JHR additional compensation [42,43]. The negative subjective mood frequently experienced by
Japanese teachers may be detrimental to teacher’s perception of the work environment and
attitude, accounting for 88% of reported severe or very severe depressive symptoms among
teachers [40,41,44]. Supporting this notion, 63% of elementary and junior high school
teachers reported major psychiatric disorders contributed by factors such as job
dissatisfaction and reduced leisure time [45]. Although working long hours was not
considered a risk factor, reduced leisure time may be a potential consequence of longer work
hours, thus paralleling results of global studies [5,9,46,47].
Teaching is considered a prestigious job in Japan, and the wider society holds high
expectations of teachers [48]. Further, the structure of the Japanese educational system
increases the stress experienced by Japanese teachers. Only the first nine years of school,
consisting of six years in elementary school and three years in middle school, are considered
compulsory [43]. Students who wish to continue their education are required to pass an
entrance exam to be admitted into the high school of their choice [43]. The pressures to perform
within a prestigious profession and maintain the standards and academic outcomes of students
within their affiliated institution heighten teacher vulnerability to mental health issues [49].
In addition to these public standards, the dominant Eastern culture’s emphasis on outside
approval enumerates the stress distinctly experienced by Japanese teachers. Stress among
Japanese teachers is often experienced through interpersonal relationships with colleagues
[48, 50]. In other words, relationships with colleagues, supervisors and other personnel within
teachers’ academic groups are more highly associated with stress among Japanese teachers in
comparison to their relationship with their students [50,51]. In 2015, Japanese teachers
worked 1,891 hours in the year, roughly 200 more hours than the average teacher across the
globe [42]. Experienced teachers are required to provide mentorship to new teachers
undergoing an induction period, without formal training or compensation for the additional
responsibilities [42]. Both mentee and mentor are required to work together on classroom
management, subject guidance, lesson planning, and analyzing classroom teaching, resulting
in increased workload and interactions with their colleagues and potentially decreasing their
psychological wellbeing [5,42].
Gender differences were also prevalent among the Japanese teaching population. As observed
globally, male teachers in Japan have better mental health and higher self-esteem than female
teachers [52,53]. Female teachers experience supplementary stressors, such as household
responsibilities which impact their mental health and can result in less time to prepare for
teaching and fulfill other job demands. These problems contribute to the lower psychological
wellbeing of female teachers as illustrated among female teachers worldwide [45,52].
A significant gap in the literature exists on the resilience and mental health of school
teachers in Okinawa. Additionally, the Japanese educational system is divided based on
prefecture; each prefecture has different municipalities and school boards [42]. Therefore, it is
important to examine the mental health of teachers in Okinawa as a separate entity to
mainland Japan and its prefectures. Determining the relationship between resilience and
mental health issues among the Okinawa teacher population will help identify pertinent
strategies for improving teachers’ collective mental health. Based on previous research, the
conceptual framework for this study is displayed in Figure 1. Specifically, among school
teachers in Okinawa, resilience and self-esteem are hypothesized to be significant predictors
for depression, anxiety and stress.

Methods
Procedures and participants
This cross-sectional study used a convenience sample. After Human Ethics Board approval
(CSULB Ref#19-108), several public schools in Okinawa prefecture were invited to
 Resiliency and
Depression mental health
− of teachers

Resilience −
Anxiety
Self-Esteem

Figure 1.
− Conceptual framework
for depression, anxiety,
Stress and stress

participate in the study. Seven schools responded to the invitation. The paper-based surveys
were distributed to all the teachers at each school. To be eligible for the study, the participant
had to be employed as a teacher at the school. Teachers who volunteered for the study and
agreed to the informed consent completed the anonymous survey that included demographic
data and three instruments.

Measurements
The Japanese version of the Depression, Anxiety, Stress Scale (DASS) was used to measure
the levels of depression, anxiety and stress [54]. The Japanese DASS had 42 statements (14
per subscale) for participants to rate, from 0 (did not apply to me at all) to 3 (applied to me most
of the time). Higher scores indicated more symptoms. For this study, Cronbach’s alpha was
0.91 for depression, 0.83 for anxiety, and 0.91 for stress.
The Japanese version of the Connor-Davidson Resilience Scale (CD-RISC) was used to
assess the level of resilience [55]. The Japanese CD-RISC had 25 statements for participants to
rate, from 0 (not true at all) to 4 (true nearly all the time). A higher score indicated a higher
level of resilience. Cronbach’s alpha of the CD-RISC was 0.94 for this study.
The Japanese version of the Rosenberg Self-Esteem Scale (RSE) was used to measure the
level of self-esteem [56]. The Japanese RSE had 10 statements for the participant to rate, from
1 (disagree) to 4 (agree). Higher scores indicated higher self-esteem. Cronbach’s alpha for the
RSE for this study was 0.86.

Statistical analyses
Statistical analyses were performed by SPSS version 24. Between-group comparisons were
done using independent sample t-tests (normality and homogeneity of variance
assumptions were checked). Pearson’s correlations were utilized to explore associations
between variables of interests (depression, anxiety, stress, self-esteem, and resilience).
Depending on the number of potential predictors, simple or multiple linear regression
analysis was used to identify predictors for each mental health issue. The statistically
significant level was set at p < 0.05. To check the minimal number of subjects required for
multiple regression analyses, the parameters of effect size 5 0.15, power 5 0.9,
alpha 5 0.05, and significantly related predictors (self-esteem, resilience, and class level,
for anxiety) 5 3 were entered in G*Power 3.1 [57]. The 0.15 effect size (f2) was calculated
from the squared multiple correlation p2 in G*Power. The minimum number of subjects
needed was 99.
JHR Results
Out of 200 teachers from seven public schools, 174 teachers participated in this study (87%
response rate). There were 111 female teachers (64%) and 60 male teachers (35%). There were 108
primary school teachers (62%) and 66 secondary school teachers (38%). Average age of
participants was 41.65 (SD 5 10.07, Range 5 22-62). The average number of years being a teacher
was 15.50 (SD 5 9.88, Range 5 1-40). Average class size was 27 (SD 5 10.42, Range 5 2-40).

Significant associations of the variables

Among school teachers in Okinawa, self-esteem in male teachers (M 5 30.97, SD 5 4.90) was
significantly higher than female teachers (M 5 28.87, SD 5 4.93), t (169) 5 2.66, p < 0.01. Self-
esteem in secondary school teachers (M 5 30.53, SD 5 5.04) was also significantly higher
than elementary school teachers (M 5 28.90, SD 5 4.92), t (172) 5 2.11, p < 0.05. In addition,
anxiety in secondary school teachers (M 5 3.37, SD 5 3.29) was significantly lower than
elementary school teachers (M 5 4.96, SD 5 4.77), t (171) 5
2.37, p < 0.05.
As shown in Table 1, higher self-esteem and resilience were significantly correlated to less
depression, anxiety, and stress (r2 5
0.38 to
0.53). In addition, resilience and self-esteem
were positively correlated with each other (r2 5 0.56). To identify predictors of the outcome
variables (depression, anxiety, and depression), the assumptions (linearity and normal
distribution) of multiple linear regression were met. However, multicollinearity was found. To
attain a reliable prediction model, resilience and self-esteem variables were then combined as
the “Strength” variable since they both might be theoretically intertwined [58]. Because of the
combination, simple linear regressions were calculated to predict depression and stress.
The results of the model were significant, F (1,170) 5 61.62, p < 0.001, R2 5 0.27, 27% of the
variation in depression can be explained by the model containing Strength only (B 5
0.15,
p < 0.001). The predictive model was: depression 5 18.08 þ (
0.15*Strength). For stress,
Strength was a significant predictor (B 5
0.16, p < 0.001). The model significantly
explained 20.0 % of the variance in stress, F (1,170) 5 41.89, p < 0.001, R2 5 0.20. The
predictive model was: stress 5 21.27 þ (
0.16*Strength).
To investigate how well Strength predicts anxiety when controlling for class level,
hierarchical multiple regression was used to control the confounding factor. When the class
level was entered alone, it significantly predicted anxiety, F (1,170) 5 5.21, p 5 0.02,
adjusted R2 5 0.02 (only 2% of the variance in anxiety could be predicted by class level).
When Strength was added, it significantly improved the prediction, R2 change 5 0.17,
F (1,169) 5 36.57, p < 0.001. The entire group of variables significantly predicted anxiety,
F (2,169) 5 21.43, p < 0.001, adjusted R2 5 0.19. However, Strength was the only
significantly contributing factor to the model (see Table 2).

Discussion
The study aimed to distinguish significant relationships among variables impacting mental
health among Okinawan school teachers. Survey data revealed significant gender differences

M SD A 1 2 3 4 5

1. Depression 4.07 5.30 0.91 – 0.73 ***

0.77 ***

0.45 ***

0.53***
Table 1. 2. Anxiety 4.36 4.33 0.83 – 0.79***
0.38***
0.45***
Descriptive statistics 3. Stress 6.82 6.34 0.91 –
0.41***
0.40***
and correlations of 4. Resilience 62.71 14.86 0.94 – 0.56***
measured 5. Self-esteem 29.52 5.01 0.86 –
variables (N 5 174) Note(s): *p < 0.05, **p < 0.01, ***p < 0.001
and discrepancies among mental health issues experienced by teachers responsible for Resiliency and
varying grade levels. Resilience and self-esteem, considered together, were identified as mental health
significant predictors of depression, anxiety, and stress among this population.
Paralleling the results of previous studies on school teachers in other prefectures of Japan,
of teachers
the present study found that male teachers in Okinawa reported higher levels of self-esteem
and better psychological wellbeing relative to their female counterparts [45,52,53]. Further,
results indicated higher self-esteem and lower anxiety among high school teachers in
comparison to elementary school teachers. This result supports previous studies
demonstrating significant differences in the mental states of teachers appertaining to the
grade levels taught [30–32]. The requirement for students to pass an entrance exam to enter
high school may increase the pressures for elementary and middle school teachers to develop
positive academic outcomes, thus exacerbating the mental health of such teachers [43].
In terms of resilience, the present study also supports findings from earlier research.
Resilience has consistently been seen to be a predictor of mental health issues across diverse
populations internationally [24]. The results of the present study similarly indicate resilience,
alongside self-esteem, as significant predictors of stress within the current sample
population. Self-esteem has previously demonstrated a positive correlation with resilience;
thus, the corresponding relationship between resilience and self-esteem may yield a stronger
impact on stress [15]. This corresponding relationship may especially be important among
Japanese school teachers due to their additional responsibilities outside of student-teacher
interactions. Without formal training, experienced teachers are required to mentor new
teachers during their induction period, therefore, may develop Japanese teachers’ resilience in
overcoming the challenges that accompany their additional roles. Further, these roles may
help develop self-esteem among both new and experienced teachers by cultivating new skills
as a school teacher.
Similarly, the present study found that resilience and self-esteem significantly predicted
depression and anxiety as illustrated in other studies [25,26]. In past research, resilience has
demonstrated a positive correlation with reflective, proactive, preventative, and problem-
oriented coping strategies, identifying such coping strategies as beneficial components to
resilience [33,34]. Thus, school teachers who possess resilience may better adapt to
challenging occupational stressors, which help to reduce mental health issues such as
depression and anxiety [18,59,60].

Implications
As predictors of stress, anxiety, and depression, resilience and self-esteem exhibit a direct
impact on an individual’s psychological wellbeing. Thus, results indicate the importance of
identifying methods to increase resilience and self-esteem to enhance psychological wellness.
Teacher resilience is often developed through the social support provided by colleagues and

Variables B SEB β R2 Δ R2

Step 1 0.03 0.03 Table 2.

Class level 1.54 0.68 0.17* Hierarchical multiple
Constant 1.88 1.15 regression analysis
summary for strength
Step 2 0.20 0.17 (combined resilience
Class level 1.05 0.62 0.12 and self-esteem),
Strength (resilience and self-esteem)
0.10 0.02
0.42** controlling class level
Constant 11.96 1.15 variable, predicting
Note(s): *p < 0.05, **p < 0.01 anxiety
JHR principals within schools; support from colleagues is the strongest contributor to teacher
resilience [61]. As institutional leaders, principals are responsible for organizing a positive
and effective school climate that supports teachers. Strong and supportive leadership by
principals foster a positive school climate. Cultivating a productive school environment
allows teachers the opportunity to develop healthy relationships with their students,
contributing to a better understanding of their students’ needs [61,62]. In turn, positive
student–teacher relationships reinforce self-efficacy among teachers and increase motivation
to overcome obstacles within the profession [61].
Additionally, teacher resilience increases when leaders create a supportive school
environment, take an interest in teacher professional development, and administer resources
needed for teachers to meet the demands of their occupation with integrity [62]. Proposing
objectives to construct interpersonal relationships among all professionals within schools
enhances teacher resilience and safeguards the mental state of teachers.
Several implications may be incorporated within Okinawan schools to help alleviate the
stressors experienced by teachers within this particular region. The leadership role in
extracurricular activities and mentorship roles occupied by experienced teachers are often
mandatory within the Japanese educational system with no compensation [42]. Okinawan
school teachers may benefit from creating such roles as optional, and providing
compensation for taking on additional responsibilities. The compensation associated with
the additional roles may increase motivation and likelihood of Okinawan teachers filling
multiple roles.
In addition, the mentorship training program may bolster in benefits by being led by the
principals of the institution; through this experience, principals and teachers can develop a
trusting and supportive relationship, encouraging professional and personal development
within Okinawan teachers and increasing teacher resilience [61].
Consistent with the research on social support, teachers in the United States reported
benefits from networking with other teachers within a writing project [63]. For instance, The
National Writing Project (NWP) was primarily introduced to further develop teaching
techniques; simultaneously, NWP influenced self-esteem and motivation among teachers
through increasing professional skills and engaging veteran teachers in their career [63].
More importantly, participation in the NWP provided a sense of belonging among the
teaching community [63]. As teachers in Japan have demonstrated higher burnout among
those who failed to seek help from colleagues, developing a similar project among Okinawan
teachers may contribute to an increase in teacher resilience. In particular, such a project could
be beneficial for teachers who experience higher anxiety.
Additionally, training teachers to implement a mental health promotion program for their
students has demonstrated to indirectly increase resilience and improve psychological
wellbeing among teachers [64]. Aussie Optimism, a universal mental health promotion
program, was administered by teachers in Australia; the objective of this program was to
focus on the risk factors of depression and anxiety among students [64]. The teachers were
trained to teach social life and optimistic thinking skills to their students; these skills included
problem-solving and social skills while building social support and enforcing cognitive
restructuring to promote positive self-perception and self-esteem [64]. The program was
effective in reducing depression and anxiety among students with elevated levels of
depression; female students demonstrated decreased levels of depression and increased self-
esteem [64]. More importantly, the program increased teacher resilience [64]. Initiating a
mental health promotion program by focusing objectives on developing the necessary skills
to decrease vulnerability to depression and anxiety may be more effective in countries with a
high stigma against publicly reporting mental health concerns, such as Japan.
In the collectivistic culture of Japan, individuals experience pressure to pursue success in
ways that gain the approval of their affiliates. Thus, Japanese individuals may be more self-
critical. Incorporating mindfulness-based stress reduction (MBSR) may decrease negative self- Resiliency and
perception and susceptibility to mental health issues, as demonstrated among teachers in the mental health
United States [65]. More specifically, MBSR assisted in decreasing distress associated with self-
confidence and increasing mindfulness within teachers. Additionally, MBSR interventions are
of teachers
available online, accommodating to the stigma against mental health issues in Japan.
Some limitations of this study included the use of cross-sectional design and convenience
sampling. Although the demographic and educational characteristics of the teachers in the
survey were similar to the teacher population in Okinawa, results need to be interpreted with
caution. Future research should expand on this study to several prefectures in Japan to better
understand similarities and differences of teacher wellbeing across different parts of Japan.

Conclusions
The present study aims to minimize the gap in the literature on the mental health of
Okinawan teachers. Concurrently, it seeks to identify resilience and self-esteem in local,
national, and international contexts as a means of promoting psychological wellbeing among
teachers. Given the Japanese cultural emphasis on social integration, successful promotion of
teacher resilience and self-esteem hinges upon the support of colleagues and principals,
improved student-teacher relationships, and increased mindfulness among teachers.

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