scholarly journals Perceptions, Attitudes, and Knowledge of Teachers Serving as Mental Health Lay Counselors in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study

2020 ◽  
Author(s):  
Christina M Cruz ◽  
Molly M Lamb ◽  
Priscilla Giri ◽  
Juliana Vanderburg ◽  
Peter Ferrarone ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Health Attitudes ◽  
Post Intervention ◽  
Middle Income ◽  
Mental Health Attitudes ◽  
Lay Counselors ◽  
Willingness To Serve ◽  
Attitudes And Knowledge ◽  
Low And Middle Income

Abstract Background: Low and middle-income countries (LMICs) have a dire need for trained mental health professionals, especially for children. While teachers’ child development expertise potentially positions them to serve as lay counselors, they have rarely delivered indicated child mental health care in LMICs. As part of assessing the feasibility of teachers serving as lay counselors, we explored teachers’ perceptions about serving as mental health lay counselors on top of typical professional duties and their attitudes towards and knowledge about mental health after serving as lay counselors.Methods: In 2018, 20 primary school teachers from five rural, low cost private schools in Darjeeling, India, received training and supervision to serve as lay mental health counselors in their classrooms. Using mixed methods, we measured teacher mental health attitudes and knowledge and perceptions of serving as lay counselor with study-specific assessments and through semi-structured interviews. Pre-training, post-training, and post-intervention mean scores were compared using paired t tests. Post-intervention interviews were coded for teachers’ mental health attitudes and knowledge and perceptions of serving as lay counselor. Results: Interviews revealed teachers qualitatively having more inclusive mental health attitudes, expressing a willingness to serve as lay counselor, and retaining mental health knowledge as applicable to what may be used during instructional time. By contrast, quantitatively, teachers’ attitudes appeared to become more inclusive on the study-specific survey pre versus post-training, but reverted to pre-training levels post-intervention. Teachers’ mental health counseling knowledge on the quantitative study-specific assessment did not change pre-training versus post-training versus post-intervention.Conclusions: Training, supervision, and serving as lay counselors led to teachers’ willingness to serve as lay counselors. Teachers served as lay counselors by incorporating therapeutic techniques into their student interactions during class time and as part of their typical instruction, not through delivering one-on-one office-like traditional care. Their changes in attitudes and knowledge reflected those expected within an “education as therapy” emerging system of care. Quantitative measures of knowledge and attitude changes did not capture these nuanced changes.Trial Registration: The parent feasibility trial was registered on January 01, 2018 with Clinical Trials Registry – India (CTRI), reg. no. CTRI/2018/01/011471, ref. no. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27

scholarly journals Perceptions, attitudes, and knowledge of teachers serving as mental health lay counselors in a low and middle income country: a mixed methods pragmatic pilot study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Christina M. Cruz ◽  
Molly M. Lamb ◽  
Priscilla Giri ◽  
Juliana Vanderburg ◽  
Peter Ferrarone ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Knowledge ◽  
Summative Assessment ◽  
Health Attitudes ◽  
Post Intervention ◽  
Middle Income ◽  
Mental Health Attitudes ◽  
Teachers Perceptions ◽  
Lay Counselors ◽  
Attitudes And Knowledge

Abstract Background Low and middle-income countries (LMICs) lack trained child mental health professionals. While teachers’ child development experience potentially positions them to fill the gap as lay mental health counselors, they have rarely delivered indicated child mental health care in LMICs. As part of assessing the feasibility of teachers serving as lay counselors, we explored teachers’ perceptions of serving as lay counselors and their mental health attitudes and knowledge. Methods In 2018, with training and supervision, 19 primary school teachers from five rural, low cost private schools in Darjeeling, India, served as lay counselors in their classrooms. Using mixed methods, we examined teacher perceptions of serving as lay counselor and mental health attitudes and knowledge through a survey (n = 15), a summative assessment (n = 14), and semi-structured interviews (n = 17). For the survey and summative assessment, pre-training, post-training, and post-intervention mean scores were compared using paired t tests. Post-intervention interviews were coded for teachers’ perceptions of serving as lay counselor and mental health attitudes and knowledge. Results Qualitatively, teachers expressed being willing to serve as lay counselor, having more inclusive mental health attitudes, and retaining mental health knowledge as applicable to use during instructional time or incorporation into the knowledge transfer process, their primary duty. By contrast, quantitatively, teachers’ attitudes appeared to become more inclusive on the study-specific survey pre versus post-training, but reverted to pre-training levels post-intervention. Teachers’ mental health knowledge on the summative assessment did not change pre-training versus post-training versus post-intervention. Conclusions Training, supervision, and serving as lay counselors led to teachers’ willingness to serve as lay counselors. Teachers served as lay counselors by utilizing therapeutic techniques during class time and incorporating them into their typical instruction, not through delivering traditional office-like care. Teacher practices may be pointing to the potential emergence of an “education as mental health therapy” system of care. Their changes in attitudes and knowledge reflected their emerging practices. Quantitative measures of knowledge and attitude changes did not capture these nuanced changes. Trial Registration The parent feasibility trial was registered on January 01, 2018 with Clinical Trials Registry – India (CTRI), reg. no. CTRI/2018/01/011471, ref. no. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27..

scholarly journals Evaluation of an anti-stigma campaign related to common mental disorders in rural India: a mixed methods approach

2016 ◽  
Vol 47 (3) ◽  
pp. 565-575 ◽  
Author(s):  
P. K. Maulik ◽  
S. Devarapalli ◽  
S. Kallakuri ◽  
A. Tewari ◽  
S. Chilappagari ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Qualitative Interviews ◽  
Social Contact ◽  
Future Research ◽  
Post Intervention ◽  
Middle Income ◽  
Major Barrier

BackgroundStigma related to mental health is a major barrier to help-seeking resulting in a large treatment gap in low- and middle-income countries (LMIC). This study assessed changes in knowledge, attitude and behaviour, and stigma related to help-seeking among participants exposed to an anti-stigma campaign.MethodThe campaign, using multi-media interventions, was part of the SMART Mental Health Project, conducted for 3 months, across 42 villages in rural Andhra Pradesh, in South India. Mixed-methods evaluation was conducted in two villages using a pre-post design.ResultsA total of 1576 and 2100 participants were interviewed, at pre- and post-intervention phases of the campaign. Knowledge was not increased. Attitudes and behaviours improved significantly (p < 0.01). Stigma related to help-seeking reduced significantly (p < 0.05). Social contact and drama were the most beneficial interventions identified during qualitative interviews.ConclusionThe results showed that the campaign was beneficial and led to improvement of attitude and behaviours related to mental health and reduction in stigma related to help-seeking. Social contact was the most effective intervention. The study had implications for future research in LMIC.

scholarly journals Optimizing treatment cascades for mental healthcare in Mozambique: preliminary effectiveness of the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH)

2020 ◽  
Author(s):  
Katrin E Fabian ◽  
Alberto Muanido ◽  
Vasco F J Cumbe ◽  
Nelia Manaca ◽  
Leecreesha Hicks ◽  
...  
Keyword(s):  
Mental Health ◽  
Systems Analysis ◽  
Implementation Strategy ◽  
Scale Up ◽  
Mental Healthcare ◽  
Post Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Substantial investments are being made to scale-up access to mental healthcare in low- and middle-income countries, but less attention has been paid to quality and performance of nascent public-sector mental healthcare systems. This study tested the initial effectiveness of an implementation strategy to optimize routine outpatient mental healthcare cascade performance in Mozambique [the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH)]. This study employed a pre–post design from September 2018 to August 2019 across four Ministry of Health clinics among 810 patients and 3234 outpatient mental health visits. Effectiveness outcomes evaluated progression through the care cascade, including: (1) initial diagnosis and medication selection; (2) enrolling in follow-up care; (3) returning after initial consultation within 60 days; (4) returning for follow-up visits on time; (5) returning for follow-up visits adherent to medication and (6) achieving function improvement. Clustered generalized linear models evaluated odds of completing cascade steps pre- vs post-intervention. Facilities prioritized improvements focused on the follow-up cascade, with 62.5% (10 of 16) monthly system modifications targeting medication adherence. At baseline, only 4.2% of patient visits achieved function improvement; during the 6 months of SAIA-MH implementation, this improved to 13.1% of patient visits. Multilevel logistic regression found increased odds of returning on time and adherent [aOR = 1.53, 95% CI (1.21, 1.94), P = 0.0004] and returning on time, adherent and with function improvement [aOR = 3.68, 95% CI (2.57, 5.44), P &lt; 0.0001] after SAIA-MH implementation. No significant differences were observed regarding other cascade steps. The SAIA-MH implementation strategy shows promise for rapidly and significantly improving mental healthcare cascade outcomes, including the ultimate goal of patient function improvement. Given poor baseline mental healthcare cascade performance, there is an urgent need for evidence-based implementation strategies to optimize the performance of mental healthcare cascades in low- and middle-income countries.

Inclusion of people with psychosocial disability in low and middle income contexts: a practice review

2017 ◽  
Vol 4 (3) ◽  
pp. 72-81 ◽  
Author(s):  
Helen Lea Fernandes ◽  
Stephanie Cantrill ◽  
Raj Kamal ◽  
Ram Lal Shrestha
Keyword(s):  
Mental Health ◽  
Local Community ◽  
Global Mental Health ◽  
Economic Life ◽  
Health Programs ◽  
Middle Income ◽  
Psychosocial Disability ◽  
Practice Review ◽  
Mental Health Programs ◽  
Low And Middle Income

Much of the literature about mental illness in low and middle income countries (LMICs) focuses on prevalence rates, the treatment gap, and scaling up access to medical expertise and treatment. As a cause and consequence of this, global mental health programs have focused heavily on service delivery without due exploration of how programs fit into a broader picture of culture and community. There is a need for research which highlights approaches to broader inclusion, considering historical, cultural, social, and economic life contexts and recognises the community as a determinant of mental health — in prevention, recovery, resilience, and support of holistic wellness. The purpose of this practice review is to explore the experiences of three local organisations working with people with psychosocial disability living in LMICs: Afghanistan, India, and Nepal. All three organisations have a wealth of experience in implementing mental health programs, and the review brings together evidence of this experience from interviews, reports, and evaluations. Learnings from these organisations highlight both successful approaches to strengthening inclusion and the challenges faced by people with psychosocial disability, their families, and communities.  The findings can largely be summarised in two categories, although both are very much intertwined: first, a broad advocacy, public health, and policy approach to inclusion; and second, more local, community-based initiatives. The evidence draws attention to the need to acknowledge the complexities surrounding mental health and inclusion, such as additional stigmatisation due to multidimensional poverty, gender inequality, security issues, natural disasters, and additional stressors associated with access. Organisational experiences also highlight the need to work with communities’ strengths to increase capacity around inclusion and to apply community development approaches where space is created for communities to generate holistic solutions. Most significantly, approaches at all levels require efforts to ensure that people with psychosocial disability are given a voice and are included in shaping programs, policies, and appropriate responses.

scholarly journals Mental health of children with neurodevelopmental disorders during COVID-19: A brief report of family experiences from a low and middle income country

2021 ◽  
pp. 135910452110260
Author(s):  
Sowmyashree M Kaku
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Neurodevelopmental Disorder ◽  
Case Series ◽  
Ground Level ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Difficulties ◽  
Similar Report ◽  
Low And Middle Income

COVID-19 has grossly impacted lives of people across the globe. In particular, children have also been affected due to closure of schools, therapy, and day care centers. Families have been challenged with new circumstances, and mental health professionals are coming up with novel ways to help these families who have children with mental health issues. This article describes experiences of families who have children with a diagnosed neurodevelopmental disorder with comorbid mental health difficulties and their ways of coping with the pandemic challenges. The series will throw light on ground level experiences of families during the pandemic, give insights into their ways of adapting, and brings out problem areas which healthcare professionals must work on, to design novel ways of care. The case series is novel and a similar report has probably not been presented from India or other low and middle income countries.

Follow-up of Mental Health Attitudes of Psychiatric Aides after Training

1979 ◽  
Vol 45 (3) ◽  
pp. 801-802
Author(s):  
M. K. Distefano ◽  
Margaret W. Pryer
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Training Program ◽  
Work Experience ◽  
Health Attitudes ◽  
Mental Health Attitudes ◽  
Opinions About Mental Illness ◽  
Program Changes

The Opinions About Mental Illness Scale was administered to 28 psychiatric aides who were followed up 24 to 39 mo. after completion of a basic aide training program. Changes in attitude after training were stable at follow-up on three factors. Data suggested that the unfavorable change on one factor was associated with the post-training work experience of these aides.

Prevalence of mental health and suicide risk in prisons in low- and middle-income countries: a rapid review

2022 ◽  
pp. 1-16
Author(s):  
Kathryn Hill ◽  
Verity Wainwright ◽  
Caroline Stevenson ◽  
Jane Senior ◽  
Catherine Robinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Rapid Review ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income
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