Project SUMS (scaling up of mental health in schools): design and methods for a pragmatic, cluster randomised waitlist-controlled trial on integrated school mental health intervention for adolescents

Abstract Background There is an increasing need for Mental Health Promotion (MHP) among adolescents, especially in developing countries with limited resources and rapid socio-demographic transition. With the growing burden of mental health problems among adolescents (suicide, depression) and their preferences to seek help from their peers, improving Mental Health Literacy (MHL) and behaviours for First Aid in Mental Health (MH-FA) becomes crucial to promote their mental health. Methods Schools are ideal settings for reaching the vulnerable adolescents. The proposed study evaluates the effectiveness of a classroom-based teacher-led integrated school mental health intervention called SUMS (MHP + MHL + MH-FA). The study will involve a pragmatic, cluster-randomised waitlist-controlled design to evaluate the effectiveness of SUMS intervention using schools as unit-of-randomisation. The study will be conducted in Srinivaspura taluka (Sub-district) of Kolar district (administrative unit of health) of Karnataka in collaboration with a multi-disciplinary expert team from NIMHANS (National Institute of Mental Health And Neuro Sciences), Bangalore-India and Department of Education, Government of Karnataka, India. A total of 8 schools (400 students studying in 6–8 grade) from Srinivaspura taluka will be randomised into intervention and waitlist control group. The intervention group will receive SUMS intervention through 10–15 h of classroom sessions. The primary outcome is the improvement in positive mental health literacy, as measured by the Mental Health-Promoting Knowledge (MHPK-10) scale. Changes in MH-FA knowledge and intentions, Mental health stigma, help-seeking and resilience are assessed as secondary outcomes. Data will be collected at baseline, 6-weeks, 6-months and 12-months post-intervention. The waitlist-control schools will receive the interventions at the end of the 12-month follow-up assessment in intervention-schools. Discussion This is the first study to integrate Mental Health Literacy with Mental Health Promotion and behaviours for First Aid in Mental Health to promote mental health well-being among adolescent school children in India. With a need to build a more substantial evidence base on School Mental Health Promotion approaches in developing countries, the study findings will have implications for implementing and operationalising Health and Wellness Ambassador initiative in India. Trial registration Clinical Trials Registry - India, CTRI/2019/07/020394. Registered prospectively on 29 July 2019. (ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=35724&EncHid=&userName=sums).

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Teacher Mental Health Literacy: Results from a State-wide Survey in Schools

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.275 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

U Bauer ◽

O Okan ◽

F Faulbaum

Keyword(s):

Mental Health ◽

Health Promotion ◽

Health Literacy ◽

Mental Health Literacy ◽

Mental Health Problems ◽

School Mental Health ◽

Health Problems ◽

Mental Health Promotion ◽

Parental Mental Health ◽

Whole School

Abstract Background Teachers have an important role to play in context of mental health literacy (MHL) promotion of school-aged children. Their MHL is seen as the counterpart of student`s health literacy. Especially vulnerable schoolchildren such as those affected by adverse life events (e.g. parental mental health problems) can benefit from programs. In addition, the whole school environment has impact on school mental health promotion. Yet, only little evidence is available on teachers MHL in Europe. The aim is to provide evidence from a state-wide survey on the state of MHL of teachers in Germany. Methods Based on semi-structured interviews with school teachers from all school types in one federal state, including primary and secondary schools, a MHL online questionnaire was developed. The survey was conducted in in 2017 in N = 2500 teachers in Germany. Descriptive and regression analyse have been performed. Results Teachers feel considerable uncertainties when working with children affected by adversities related to parental mental health problems. Dealing with the social family background seems hard. Teachers state that they don`t feel comfortable when aiming at mental health promotion of affected children or children in general. Data also show that they may tend to make misjudgements, and that they are not sufficiently trained to address mental health issues in the classrooms. Regression models show that the degree and quality of teaching mental health is affected by differences across school forms, satisfaction with and engagement of school principals in mental health action, learned strategies to respond to parents, and experienced stress, burden and exposure during their work. Conclusions Increasing teacher MHL and the environmental capacities and responsiveness towards school mental health promotion should be an important capacity building strategy. Policy support for school mental health promotion is a critical means to sustain effective whole-school approaches.

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Mental Health Literacy: A Strategy for Global Adolescent Mental Health Promotion

Adolescent Psychiatry ◽

10.2174/2210676610666200204104429 ◽

2020 ◽

Vol 10 (2) ◽

pp. 73-83

Author(s):

Caroline S. Clauss-Ehlers ◽

Maria Guevara Carpio ◽

Mark D. Weist

Keyword(s):

Mental Health ◽

Health Promotion ◽

Health Literacy ◽

Mental Health Literacy ◽

Global Mental Health ◽

Public Awareness ◽

Adolescent Mental Health ◽

Mental Health Promotion ◽

Research Practice ◽

Structural Components

Background: Adolescence is defined by key transitional elements which are considered within a cross-cultural context. The importance of building mental health capacity for adolescents in low- and middle-income countries (LMICs) as well as high-income countries (HICs) is reviewed. Objectives: To review the developmental period of adolescence, global needs for mental health promotion, the needs of LMICs while emphasizing building adolescent mental health capacity, and the importance of efforts to promote mental health literacy. Methods: Mental health literacy (MHL) is presented as a strategy that can increase public awareness regarding mental health issues among adolescents. Increased awareness through an MHL framework is discussed as a way to build adolescent mental health capacity; with this work ideally occurring through global communities of practice (COP), dialogue, collaboration, and mutual support that aim to build innovation in systems of mental health promotion. Results: The authors review structural components in research, practice, and policy that seek to build global adolescent mental health capacity, nested within COPs involving HICs and LMICs working together to advance mental health promotion for children, adolescents, and young people. Conclusion: The article concludes with a discussion of how the three structural components (i.e., research, practice, and policy) can address gaps in the provision of global mental health services for adolescents to meet adolescent mental health needs in LMICs and HICs. A multi-sectoral approach emphasizing a global COP is presented as a way to scale up capacity and maximize outcomes.

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Comparing the mental health literacy of Chinese people in Australia, China, Hong Kong and Taiwan: Implications for mental health promotion

Psychiatry Research ◽

10.1016/j.psychres.2017.06.032 ◽

2017 ◽

Vol 256 ◽

pp. 258-266 ◽

Cited By ~ 11

Author(s):

Daniel Fu Keung Wong ◽

Chi-Wei Cheng ◽

Xiao Yu Zhuang ◽

Ting Kin Ng ◽

Shu-Man Pan ◽

...

Keyword(s):

Mental Health ◽

Health Promotion ◽

Hong Kong ◽

Health Literacy ◽

Mental Health Literacy ◽

Mental Health Promotion ◽

Chinese People

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GoodYarn: building mental health literacy in New Zealand’s rural workforce

Journal of Public Mental Health ◽

10.1108/jpmh-07-2017-0027 ◽

2017 ◽

Vol 16 (4) ◽

pp. 180-190 ◽

Cited By ~ 3

Author(s):

Kate Morgaine ◽

Louise Thompson ◽

Katie Jahnke ◽

Rebecca Llewellyn

Keyword(s):

Mental Health ◽

Health Promotion ◽

Health Literacy ◽

Mental Health Literacy ◽

Positive Impact ◽

National Level ◽

Mental Health Promotion ◽

Content Type ◽

Rural Workforce ◽

The Impact

Purpose “GoodYarn” is a skills-based workshop that focusses on building mental health literacy in rural communities, members of which are known to experience geographic, attitudinal and service configuration barriers to accessing mental health services. The purpose of this paper is to evaluate the impact of the GoodYarn project on raising mental health literacy in the rural community. Design/methodology/approach GoodYarn is primarily for farmers, their families and farm workers, as well as the “farmer facing” workforce. The focus on mental health literacy aligns with the mental health promotion approach of using methods that foster supportive environments. By raising the mental health literacy of those not directly needing help, but in positions to help those that do – such as employers, rural professionals and rural support industries who are well placed to perceive stressors in farmers – GoodYarn builds a community with the knowledge and skills to identify and approach those experiencing mental distress or illness, and direct them to appropriate support and services. All participants in the GoodYarn workshops (n=430) were invited to complete a questionnaire at the end of the workshop. All participants answered the questionnaire, with over 80 per cent answering all questions. Findings Participant feedback affirmed the utility of GoodYarn as an effective vehicle to facilitate the discussion of mental illness in rural farming communities of New Zealand. GoodYarn had a significant positive impact on the three immediate workshop indicators of awareness, confidence and knowledge (p<0.001 for all three indicators). Further, the high level of concordance in workshop outcomes across various organisations’ delivery indicates programme consistency and quality has been maintained throughout the upscaling of the programme. Originality/value The uptake of the GoodYarn programme by rural organisations and communities at a national level, and the positive evaluation results, provide encouragement that building mental health literacy in the rural workforce is a promising mental health promotion strategy.

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A quasi-experimental and Guided Social Media Intervention to Improve Mental Health Literacy Level of Urban School Adolescents in Ethiopia: A Detailed Study Protocol

10.21203/rs.3.rs-17074/v1 ◽

2020 ◽

Author(s):

Hailemariam Mamo Hassen ◽

Manas Ranjan Behera ◽

Pratap Kumar Jena ◽

Sudhir Kumar Satpathy

Keyword(s):

Mental Health ◽

Social Media ◽

Health Promotion ◽

Health Literacy ◽

Mental Health Literacy ◽

Urban School ◽

Mental Health Promotion ◽

Health Literacy Level ◽

Quasi Experimental ◽

Literacy Level

Abstract Background: Studies showed Ethiopian adolescents have lower knowledge and awareness about resilient and risk factors and preventive methods of mental health problems that increases mental health promotion and prevention gap. Addressing this gap in school settings using technology assisted mental health promotion platforms could help improve mental health literacy level. Therefore, evaluating effectiveness outcomes of guided social media intervention to improve mental health literacy of school adolescents is convenient issue. Methods: Quantitative and quasi-experimental study will be used among urban school adolescent in Dire Dawa, Ethiopia. Following pretest measure among adolescents who have smart phones or social media access and age > 15 years old, participants will be assigned by regression discontinuity design as good as random and then mental health literacy module will be delivered through face book/telegram group to be created for about four weeks and posttest will be done after lapse of a week. Control group will receive posts on effective academic studying skills. Adapted and tested questionnaire in convenient local languages along with English version will be used. Inferential statistics will be applied with significance level of p<0.05. Informed voluntary consent will be obtained from participants, their parents/guardians and school directors. Ethical approval is already obtained.Discussion: Mental health promotion in school settings most importantly using technology assisted mental health promotion platforms supposed to be cost-effective, accessible, acceptable, adoptable, appropriate, feasible, reliable, scalable and sustainable approach helping tailor mental health literacy focused mental health first aid practices still deficient and new for Ethiopia. The study will test the hypothesis whether social media is effective channel of intervention in improving mental health literacy level of urban school adolescents.

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Mental Health Promotion and Stigma Reduction Among University Students Using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) Framework: Protocol for a Mixed Methods Study (Preprint)

10.2196/preprints.25592 ◽

2020 ◽

Author(s):

Kenneth Fung ◽

Sheng-Li Cheng ◽

Xuan Ning ◽

Alan Tai-Wai Li ◽

Jingxuan Zhang ◽

...

Keyword(s):

Mental Health ◽

Health Promotion ◽

Mixed Methods ◽

Health Literacy ◽

Health Center ◽

Mental Health Literacy ◽

Mental Health Center ◽

Mental Health Promotion ◽

Health Network ◽

Acceptance And Commitment

BACKGROUND Rapid urbanization, academic pressures, and developmental life transition stressors contribute to mental health stress for postsecondary students in China. Effective prevention, early identification, and timely intervention are challenged by stigma, a lack of mental health literacy, and inadequate mental health resources. OBJECTIVE Our implementation science (IS) research project is aimed at evaluating the use of an evidence-informed mental health promotion intervention named Acceptance and Commitment to Empowerment – Linking Youth and ‘Xin’ (hearts) (ACE-LYNX) to promote university student mental health in Jinan, China. METHODS We will engage and collaborate with Shandong Mental Health Center, the provincial mental health center, and six local universities in different regions of Jinan. The ACE-LYNX intervention aims to reduce social stigma against mental illness, enhance mental health literacy, and improve access to quality mental health care by increasing interdisciplinary collaboration and forming a mental health network. It is based on two evidence-based approaches, Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP), and it will be delivered through online learning and in-person group training. The project will train 90 interdisciplinary professionals using the model. They will in turn train 15 professionals and 20 students at each university. The project will adopt the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework, which provides a structure to examine the process and outcomes of implementation using mixed methods comprising quantitative and qualitative approaches along five dimensions: reach, efficacy, adoption, implementation, and maintenance. RESULTS Over the course of the project, 720 champions will be directly trained. They will contribute to developing a formal and informal mental health network, strengthened by student-led mental health initiatives and professional-led initiatives to promote collaborative care and facilitated care pathways. We anticipate that our project will reach out to 11,000 to 18,000 students. CONCLUSIONS This IS protocol will outline our unique intervention model and key steps to contextualize, implement, and evaluate community-based mental health intervention. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/25592

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Helping adolescents to better support their peers with a mental health problem: A cluster-randomised crossover trial of teen Mental Health First Aid

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417753552 ◽

2018 ◽

Vol 52 (7) ◽

pp. 638-651 ◽

Cited By ~ 26

Author(s):

Laura M Hart ◽

Amy J Morgan ◽

Alyssia Rossetto ◽

Claire M Kelly ◽

Andrew Mackinnon ◽

...

Keyword(s):

Mental Health ◽

Health Literacy ◽

Mental Health Literacy ◽

Crossover Trial ◽

Training Programme ◽

First Aid ◽

Medium Effect ◽

Mental Health First Aid ◽

Significant Group ◽

Cluster Randomised

Background: teen Mental Health First Aid (tMHFA) is a classroom-based training programme for students aged 15–18 years to improve supportive behaviours towards peers, increase mental health literacy and reduce stigma. This research evaluated tMHFA by comparing it to a matched emergency Physical First Aid (PFA) training programme. Methods: A cluster-randomised crossover trial matched four public schools in two pairs and then randomised each to first receive tMHFA or PFA for all Year 10 students. In the subsequent calendar year, the new Year 10 cohort received the opposite intervention, giving eight cohorts. Online surveys were administered at baseline and 1 week post-training, measuring quality of first aid intentions, mental health literacy, problem recognition and stigmatising beliefs, towards fictional adolescents with depression and suicidality (John) and social anxiety (Jeanie). Results: A total of 1942 students were randomised (979 received tMHFA, 948 received PFA), 1605 (84%) analysed for the John vignette at baseline and 1116 (69% of baseline) provided post-training data. The primary outcomes, ‘helpful first aid intentions’ towards John/Jeanie, showed significant group-by-time interactions with medium effect sizes favouring tMHFA ( ds = 0.50–0.58). Compared to PFA, tMHFA students also reported significantly greater improvements in confidence supporting a peer ( ds = 0.22–0.37) and number of adults rated as helpful ( ds = 0.45–0.46) and greater reductions in stigmatising beliefs ( ds = 0.12–0.40) and ‘harmful first aid intentions’ towards John/Jeanie ( ds = 0.15–0.41). Conclusions: tMHFA is an effective and feasible programme for increasing supportive first aid intentions and mental health literacy in adolescents in the short term. tMHFA could be widely disseminated to positively impact on help seeking for adolescent mental illness.

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5.L. Workshop: Public mental health promotion: a global perspective drawing on local narratives

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.272 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Public Health ◽

Mental Health ◽

Health Promotion ◽

Health Literacy ◽

Mental Health Literacy ◽

Public Mental Health ◽

Mental Health Promotion ◽

Global Public Health ◽

Health Action ◽

Shed Light

Abstract The past decade has brought a heightened awareness of the importance of mental health and its adequate promotion. In context of global public health, the tagline is “No global public health without mental health”. The impact of mental disorders concerning increased prevalence rates, severity of mental illnesses, associated disability and mortality rates has let traces, which is why mental health promotion is high on the agenda of European public health researchers, health practitioners and health policy makers. The 2005 mental health declaration and a mental health action plan by WHO and the 2006 “Green Paper on Mental Health” by the European Commission are both proof of and drivers for the development of mental health and mental health promotion strategies in the European region. Currently, there is need to shed light on the mental health states and the mental health related capacities of different high-risk populations and professionals that work in critical fields to promote mental health. The improvement of mental health knowledge, including the biological, social, psychological and political risk factors for mental health is as important as the stimulation of the development of policies and practices to establish a basis for preventive mental health action. Key target groups are children, and especially children affected by adversities, such as parental mental health problem, and professionals in education and mental health, who are in need of guidance to address important mental health topics within programmes and interventions, such as mental health literacy, mental health awareness and mental health capacities The aim of this workshop is to: (1) present unique research projects and their findings on mental health literacy and stigma prevention in schools in different European countries, (2) shed light on the critical importance of global public mental health promotion and (3) initiate a critical discussion on methods to strengthen mental health literacy and overcome stigma. The 1st presentation will introduce the first German adaptation of the mental health literacy teacher manual (TeenMentalHealth) addressing mental health literacy learning and stigma prevention in the classroom. The 2nd presentation will present evidence from a research project on high school students' and teachers' mental health literacy in Turkey. The 3rd presentation will introduce empirical findings from a state-wide survey in Germany on the mental health literacy capacities of primary and secondary school teachers. The 4th presentation will introduce findings from an online social media study on mental health and stigma in young Russian adolescents and their perceptions and attitudes towards living with affective disorders. The 5th presentation will focus on mental health information materials to raise parents' awareness of children's mental health and provide specific suggestions for mental health promotion and screening for mental health problems in Switzerland. Key messages This workshop will shed light on public mental health promotion and various intersecting approach from different countries. Public mental health promotion and mental health literacy are important global health concerns and as such should be included as an agenda item on policies.

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