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Elyamani R, Nour O, Singh R, Saeed K, Musa A, Alkubaisi N, Bougmiza MI. The effectiveness of the WHO school mental health package in promoting mental health literacy among secondary school teachers in Qatar: a randomized controlled trial. BMC Public Health 2024; 24:1883. [PMID: 39010010 PMCID: PMC11247775 DOI: 10.1186/s12889-024-19263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
Teachers' mental health literacy (MHL) is fundamental for recognizing and assisting students with mental disorders. The aim of this study was to assess the effectiveness of the World Health Organization School Mental Health Program (WHO-SMHP) in promoting MHL among secondary schools' teachers in Qatar. We conducted a two-arm randomized control trial. Teachers working in governmental secondary schools were eligible for selection. A total of 16 schools (8 intervention, 8 control) randomly selected and stratified by gender then randomly assigned (1:1). Participants and study team were aware of group assignment. Assessment of teachers' MHL was at day 0, 3 then 3 months afterward. Bivariat analysis and Generalized Estimating Equations were used in analysis. The primary outcome was teachers MHL. Secondary outcome was the influence of sociodemographic characteristics on the level of MHL. Between October 30, 2018 and March 21, 2019, we randomly assigned 195 teachers from 16 schools to attend training workshop on WHO-SMHP (n = 95) or usual practice (n = 100). Compared with controls, teachers from intervention group demonstrated a significant improvement in the level of MHL at day three (mean difference = 19.1, 95% CI = 17.0-21.2, Cohen's d = 2.63; p < 0.001).) and after three months (mean difference 16.61, 95% CI = 13.96-19.26, Cohen's d = 1.86; p < 001). There were no significant differences related to influence of other variables on MHL. To our knowledge, this is the first trial to prove the effectiveness of the (WHO-SMHP) in promoting teachers MHL, which can be successfully implemented in a wider scale.
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Affiliation(s)
- Rowaida Elyamani
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, 3050, Qatar.
| | - Omer Nour
- Department of Operations, Primary Health Care Corporation, Doha, Qatar
| | - Rajvir Singh
- Medical Academic & Research, ACS, Hamad Medical Corporation, Doha, 3050, Qatar
| | - Khalid Saeed
- Regional Advisor - Mental Health and Substance Abuse Unit, Department of Non- Communicable Diseases and Mental Health, World Health Organization, Regional Office for the Eastern Mediterranean, Abdul Razzak Al -Sanhouri street, Nasr City, Cairo, 11371, Egypt
| | - Afrah Musa
- Nursing Department, Primary Health Corporation, Doha, Qatar
| | - Noora Alkubaisi
- Clinical Affairs Department, Primary Health Care Corporation, Doha, Qatar
| | - Mohammed Iheb Bougmiza
- Community Medicine Residency Program - Director, Primary Health Care Corporation, Doha, Qatar
- College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
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Yamaguchi S, Foo JC, Sasaki T. A survey of suicide literacy in Japanese school teachers. Sci Rep 2023; 13:23047. [PMID: 38155213 PMCID: PMC10754903 DOI: 10.1038/s41598-023-50339-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
School teachers are in a unique position to recognize suicide-related problems in their students and to appropriately support them; teachers may need high levels of suicide literacy. However, few studies have examined current levels of suicide literacy in teachers. This study aimed to investigate suicide literacy in school teachers. Teachers (n = 857) from 48 Japanese schools (primary and junior-/senior-high) answered a self-administered questionnaire assessing (a) knowledge about suicide, (b) intention to ask about students' suicidal thoughts/plans, and (c) attitudes towards talking to students with mental health problems. The average proportion of correct answers to the knowledge questions (10 items) was 55.2%. Over half of the teachers knew that suicide is a leading cause of death in adolescents (55.0%), and that asking about suicidality is needed (56.2%). Half of the teachers intended to ask students about their suicidal thoughts (50.2%) and fewer intended to ask about experiences of planning suicide (38.8%). Most of the teachers (90.4%) agreed with the idea that talking to students with mental health problems was a teacher's responsibility. Intention to ask about students' suicidal thoughts/plans were higher in teachers in their 20s (vs. 40s-60s) and working at junior-/senior-high schools (vs. primary schools). Suicide literacy in Japanese school teachers was observed to be limited. However, teachers felt responsibility for helping students with mental health problems. The development and implementation of education programs may help improve teachers' suicide literacy, which, in turn, could encourage effective helping behaviors of teachers for students struggling with suicidality.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Jerome Clifford Foo
- Institute for Psychopharmacology, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry, College of Health Sciences, University of Alberta, Edmonton, Canada
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan.
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Bichoualne A, Oubibi M, Rong Y. The impact of mental health literacy intervention on in-service teachers' knowledge attitude and self-efficacy. Glob Ment Health (Camb) 2023; 10:e88. [PMID: 38161751 PMCID: PMC10755373 DOI: 10.1017/gmh.2023.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024] Open
Abstract
Mental health literacy (MHL) is an essential component in the process of de-stigmatization, promoting mental health, and supporting people struggling with mental illness. Today, as the number of people suffering from mental illnesses is nearly 450 million people worldwide, the importance of having a teacher-training program that incorporates MHL in its curriculum has become paramount. This study is a quasi-experimental pre-post research that uses the MHL program as an intervention. The sample included 36 (n = 36) high school in-service teachers from 11 schools. The participants took an online training program for 6 weeks. The evaluations were used before and after the training to assess their mental health knowledge, attitude, and self-efficacy. The data were analyzed using the paired sample t-test. The findings revealed a significant level of improvement in relation to the teachers' MHL knowledge, attitude, and self-efficacy after the training. The study findings reveal the effectiveness of MHL training in improving in-service teachers' knowledge, attitude, and self-efficacy in relation to mental health. The study's limitations and future study recommendations are discussed.
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Affiliation(s)
| | - Mohamed Oubibi
- Smart Learning Institute of Beijing Normal University, College of Education, Beijing, China
| | - Yu Rong
- College of Education. Zhejiang Normal University, Jinhua, China
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Costardi CG, D'agostini ACC, Pan PM, Bressan RA. Digital mental health interventions for school teachers - A narrative review. Early Interv Psychiatry 2023; 17:749-758. [PMID: 37041728 DOI: 10.1111/eip.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 12/31/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
AIM School teachers face the paradox of being in a privileged position to act in youth mental health prevention, but in a vulnerable position for not receiving adequate training and personal support. Digital interventions can provide unexpensive tools and narrow this gap in a large scale without major structural changes. We aimed to synthesize the evidence for digital mental health interventions for school teachers. METHODS Studies published from any date until August 2022 were identified through a literature search of the MEDLINE, Embase, ScIELO, and Cochrane Central databases. The studies included evaluated digital interventions targeting school teachers to deal with their own mental health or to assist them in the management of students' mental health. Studies that addressed school-based digital mental health interventions, but directly targeted students, parents, or specifically other professionals were not included. RESULTS The literature search retrieved 5626 hits and several interventions were described, but only 11 studies fulfilled the inclusion criteria, none of which focused on teachers' mental health. There was some evidence that these interventions improved knowledge about general or specific topics in mental health, and most studies also reported gains in preparedness, confidence, and attitudes towards mental health. CONCLUSIONS The studies identified in this review provide initial support for teacher-focused mental health digital interventions. However, we discuss limitations regarding study designs and data quality. We also discuss barriers, challenges, and the need for effective evidence-based interventions.
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Affiliation(s)
- Carlos Gustavo Costardi
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Instituto Ame Sua Mente (IASM), São Paulo, Brazil
| | | | - Pedro Mario Pan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Instituto Ame Sua Mente (IASM), São Paulo, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, Brazil
| | - Rodrigo Affonseca Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Instituto Ame Sua Mente (IASM), São Paulo, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento (INPD), São Paulo, Brazil
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Manjula M, Roopesh BN, Bhaskarapillai B, Mendon GB. Mental health literacy on youth depression and suicides for teachers and its impact on knowledge, attitudes and help facilitation: A preliminary study. Ind Psychiatry J 2023; 32:302-308. [PMID: 38161444 PMCID: PMC10756612 DOI: 10.4103/ipj.ipj_135_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/13/2023] [Indexed: 01/03/2024] Open
Abstract
Background Depression and suicide are among the most prevalent mental health problems among the adolescents in India. However, help seeking is very poor due to lack of knowledge on mental health among youth and significant individuals in their life. Imparting knowledge to teachers becomes important as youth spend most of their time in the educational set up. The present study aimed at examining the effect of mental health literacy on depression and suicidal behaviours on knowledge, attitudes and help facilitation of teachers. Materials and Methods The study adopted a stratified sampling method and a sample (N = 102) of high school teachers (8th-12th standard) from both private and government institutions in Bangalore were included in the study. A pre- and post-assessment, single group design with a follow-up after 3 months was adopted. Data were collected using the socio-demographic data sheet and questionnaire prepared to assess the knowledge, attitudes and help facilitation. Results The mean age of the teachers was 41.74 years, with 80% female respondents and 58.8% of the sample with master's degrees and diplomas in teaching. There was a significant increase in knowledge about the symptoms, consequences of depression and attitude toward depression and suicide. About 16% of the sample had taken steps to help students with distress and facilitated help seeking at 3-month follow-up. Conclusion Mental health literacy programme has positive impact on the knowledge and helps in improving support and help facilitation behaviours among teachers.
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Affiliation(s)
- Munivenkatappa Manjula
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka State, India
| | - Bangalore N. Roopesh
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka State, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka State, India
| | - Gurucharan B. Mendon
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka State, India
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Granada-López JM, Ramón-Arbués E, Echániz-Serrano E, Juárez-Vela R, Cobos-Rincón A, Satústegui-Dordá PJ, Navas-Echazarreta N, Santolalla-Arnedo I, Nash M. Mental health knowledge and classroom experiences of school teachers in Aragon, Spain. Front Public Health 2023; 11:1171994. [PMID: 37441655 PMCID: PMC10335789 DOI: 10.3389/fpubh.2023.1171994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Background Research shows that many mental disorders begin in childhood but are sometimes not diagnosed until later years. School-age children spend much of their time in schools and have daily interactions with school teachers. Aim Examine school teachers' experiences of mental disorders in school going children and adolescents and their associated mental health training needs. Method and sample A descriptive cross-sectional study was carried out with teachers in Infant-Primary and Secondary Education-Baccalaureate schools. Results A convenience sample of 685 teachers responded to the online survey. Participants worked in both urban and rural areas and in Infant-Primary and Secondary Education-Baccalaureate schools. Over half of participants reported classroom experiences of learner mental disorders such as ADHD, anxiety, conduct disorders or autism. Most participants acknowledged a training need, both in recognition of symptoms of mental disorders and in care resources and processes. However, 80% of respondents reported having not received any training in this regard. Participant preferences for training included face-to-face or hybrid - combined online learning. Participants also considered the management of their own mental health to be deficient, therefore any training should incorporate personal mental health awareness and self-help strategies. Conclusion In Aragón (Spain), teachers of children and adolescents with mental disorders, recognize a need for training in the identification of symptoms and other aspects of mental healthcare, such as availability and access to services. Protocols for early identification and referral would promote mentally healthy school environments and reduce stigma which could be a barrier to timely intervention. In addition, any training should include mental health self-care for teachers.
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Affiliation(s)
- José Manuel Granada-López
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Research Group GIISA021, University of Zaragoza, Zaragoza, Spain
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
| | - Enrique Ramón-Arbués
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
- Faculty of Health Sciences, University San Jorge, Zaragoza, Spain
| | - Emmanuel Echániz-Serrano
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Pedro José Satústegui-Dordá
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
| | - Noelia Navas-Echazarreta
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Iván Santolalla-Arnedo
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Michael Nash
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
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Wingenbach G, Koswatta TJ, Engels J, Freeny J, Haddad S. Outcomes of professional development activities for selected Texas school personnel helping students cope with behavioral and mental health issues. Sci Rep 2023; 13:10346. [PMID: 37365213 DOI: 10.1038/s41598-023-37298-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
School personnel help youth cope with life and school stressors. However, help may depend on each person's confidence or knowledge of such issues. In 2019 and 2020, more than 13,800 Texas educators participated in Emotional Backpack Project (EBP) training to support youth coping with behavioral and mental health issues. Post-intervention results revealed significant gains in self-perceived understanding of students' behavioral and mental health issues, improved confidence in approaching students, parents, or other school staff to discuss students' harmful behaviors, understanding of mindfulness activities, and increased knowledge of trauma informed schools and trauma informed educators. Teachers and other school personnel were less confident in approaching parents or guardians to discuss youth mental health issues than in approaching students, counselors, and other staff. School personnel's knowledge, perceptions, and confidence to help students cope with behavioral and mental health issues was significantly better after EBP interventions. EBP training should be adopted widely and occur more than once annually.
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Affiliation(s)
- Gary Wingenbach
- Texas A&M University, 2116 TAMU, College Station, TX, 77843-2116, USA.
| | - Taniya J Koswatta
- Texas A&M University, 2116 TAMU, College Station, TX, 77843-2116, USA
| | - Josephine Engels
- Center for School, Behavioral Health at Mental Health America of Greater Houston, Houston, USA
| | - Jamie Freeny
- Center for School, Behavioral Health at Mental Health America of Greater Houston, Houston, USA
| | - Sana Haddad
- Center for School, Behavioral Health at Mental Health America of Greater Houston, Houston, USA
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Robin D, Albermann K, Dratva J. Schulprogramme zur Förderung der psychischen Gesundheit. Die psychische Gesundheitskompetenz von Lehrpersonen als wichtiger Umsetzungsfaktor. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2023. [DOI: 10.1007/s11553-022-01008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Zusammenfassung
Hintergrund
Weltweit sind bis zu einem Fünftel der Kinder und Jugendlichen von psychischen Störungen betroffen. Auffälligkeiten, die bereits im Schulalter auftreten, sind insbesondere für die Betroffenen, aber auch die Lehrpersonen belastend. Schulische Präventionsprogramme zur psychischen Gesundheit haben das Potenzial, die Belastungen beidseitig zu reduzieren. Die psychische Gesundheitskompetenz von Lehrpersonen, die nicht nur das Wissen und das Verständnis, sondern auch die Handlungen untersucht, gilt dabei als wichtiger Umsetzungsfaktor. Die Studienlage ist mager.
Ziele
Die Studie untersucht die psychische Gesundheitskompetenz von Lehrpersonen im Kontext von Belastungssituation der Schülerinnen und Schüler sowie das Vorhandensein entsprechender Schulprogramme.
Methoden
Im Schuljahr 2019/2020 wurden alle Lehrpersonen in einer Deutschschweizer Stadt zu einem Online-Survey eingeladen (n = 1514; Rücklauf: 38 %). Die Daten wurden quantitativ mittels bivariater und multivariater Methoden ausgewertet. Eine offene Frage zum Verständnis psychischer Störungen wurde qualitativ mittels einer Inhaltsanalyse ausgewertet.
Resultate und Diskussion
Die Befragten betreuten oder unterrichteten im letzten Jahr durchschnittlich 4,7 psychisch belastete Schülerinnen und Schülern. Die Anzahl Betroffener unterschied sich nach Schulstufe und Schulfunktion. Die Lehrpersonen schätzten ihre Fähigkeit, Informationen zum Thema zu finden und zu verstehen als (sehr) gut ein, es fiel ihnen jedoch schwerer, zu beurteilen, ob die gefundenen Informationen korrekt sind. Die Handlungskompetenz der Lehrkräfte war partiell gering, beispielsweise beim Wissen über Störungsbilder und stellt ein Hindernis in der Umsetzung von Schulprogrammen dar. Lehrkräfte relativierten auffälliges Verhalten, was die Triage für weitere Abklärungen erschwert. Den Schulen wird zum einen empfohlen in die Eigeninitiative der Lehrpersonen zu investieren, zum anderen sollte die Steigerung der psychischen Gesundheitskompetenz nicht nur Aufgabe der Lehrpersonen sein, sondern durch eine entsprechende Schulkultur und gesellschaftlich gefördert werden.
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Olashore AA, Paruk S, Akanni OO, Chiliza B. Psychiatric disorders in adolescents living with HIV in Botswana. AIDS Res Ther 2023; 20:2. [PMID: 36600270 DOI: 10.1186/s12981-022-00490-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/08/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND As children living with HIV transition from adolescence into adulthood, they face a considerable burden of psychiatric disorders (PDs) which may vary between the perinatally and behaviorally infected. The knowledge of the pattern of these PDs in relation to the varying needs of the adolescents living with HIV (ALWHIV) is unclear but necessary for maximizing their linkage to care and improving their quality of life in Botswana. AIM: To determine the pattern of PDs in ALWHIV in Botswana; to compare and explore the differences in the pattern and their associated factors between congenitally infected adolescents (CIAs) and behaviorally infected adolescents (BIAs). METHODS A cross-sectional survey of 622 ALWHIV (399 CIA and 223 BIA) with the Mini International Neuropsychiatric Interview-Kid Screen. RESULTS The participants' mean age (SD) was 17.71 (1.60) years, with more males (54%), of whom 52.9% had at least one PD, with depression (23.6%) and generalised anxiety disorder (18.0%) being the most prevalent. The externalising disorders were associated with being CIA (OR = 3.99; 95% CI:1.87-8.54), male gender (OR = 3.93; 95% CI:2.02-7.64), and a viral load of 400 and above copies (OR = 3.53; 95%CI:1.92-6.48). Internalising disorders were associated with being BIA (OR = 3.64; 95%; CI: 2.39-5.56), females (OR = 2.59; 95% CI:1.75-3.83), poor counselling (OR = 2.23; 95% CI: 1.42-3.51) and struggling to accept HIV status (OR = 1.73; 95% CI:1.14-2.62). CONCLUSIONS Depression and anxiety disorders were the most prevalent PDs in ALWHIV, who differed in psychiatric presentations, the BIAs being more likely to present with internalizing disorders, while the CIAs had more externalizing disorders. Due to the varying needs of ALWHIV, individualized management plans that consider gender, mode of infection, and other psycho-social needs, should be further studied and encouraged.
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Affiliation(s)
- Anthony A Olashore
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. .,Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
| | - Saeeda Paruk
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Oluyemi O Akanni
- Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
| | - Bonginkosi Chiliza
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Atilola O, Ayinde O, Obialo FK, Adeyemo SO, Adegbaju D, Anthony R. Towards school-based mental health programs in Nigeria: the immediate impact of a depression-literacy program among school-going adolescents and their teachers. Child Adolesc Psychiatry Ment Health 2022; 16:70. [PMID: 35999596 PMCID: PMC9400212 DOI: 10.1186/s13034-022-00503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Depression-literacy, which is the foundational requirement for symptom recognition, positive attitude and help-seeking, is poor among adolescents in Nigeria. This study, therefore, aims to determine the impact of a school-based training program on depression-literacy among a cohort of high-school students and their teachers in South-West Nigeria. METHODS An adapted version of the Break Free from Depression, a 4-module depression awareness curriculum for staff and students, was implemented among students and their teachers. Paired-sample T-test was used to assess the domain-specific (knowledge, attitude, and confidence) impact of the training by comparing the baseline and immediate (within the week of the training) post-scores. RESULTS A total of 3098 students and 294 teachers from 21 schools across three states in South-West Nigeria successfully completed the training. There was a significant positive difference (p < 0.05), at post-test, in the knowledge, attitude, and confidence among the students. The same was observed among teachers except for attitude where positive change did not reach significant level (p = 0.06). When statistically significant, the calculated effect size (eta squared) was highest for knowledge (students: 0.07, p = 0.001; teachers: 0.08, p < 0.000) and least for attitude (students: 0.003, p = 0.002 teachers: 0.085, p = 0.06). Multiple regression analyses result showed that the level of pre-scores predicted the magnitude of change in all domains of depression-literacy (p < 0.05) after controlling for age, gender, and type of school among the students, but not for teachers. CONCLUSIONS School-based depression-literacy programs can lead to significant positive change in knowledge, attitude, and confidence of students and teachers.
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Affiliation(s)
- Olayinka Atilola
- Department of Behavioral Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria.
| | - Olatunde Ayinde
- grid.9582.60000 0004 1794 5983Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Felix-Kingsley Obialo
- grid.9582.60000 0004 1794 5983Center for Creativity and Entrepreneurial Studies, Dominican University Ibadan, Ibadan, Nigeria
| | - Sunday Oladotun Adeyemo
- grid.412320.60000 0001 2291 4792Department of Psychology, Olabisi Onabanjo University Ago-Iwoye, Ago-Iwoye, Nigeria
| | - Dapo Adegbaju
- grid.490120.e0000 0004 9338 1163Federal Neuro-Psychiatric Hospital Yaba, Lagos, Nigeria
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Al Omari O, Khalaf A, Al Hashmi I, Al Qadire M, Abu Shindi Y, Al Sabei S, Matani N, Jesudoss D. A comparison of knowledge and attitude toward mental illness among secondary school students and teachers. BMC Psychol 2022; 10:109. [PMID: 35488319 PMCID: PMC9052537 DOI: 10.1186/s40359-022-00820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/21/2022] [Indexed: 11/10/2022] Open
Abstract
Aim The current study aimed to assess and compare the level of knowledge and attitude towards mental illness between secondary school students and their teachers in Oman. Methods An online survey was carried out to collect data from 400 students and 411 teachers about their knowledge and attitudes toward people with mental illness. Two independent case studies about depression and schizophrenia were also tested. Results Students have a poor knowledge of mental illness compared with their teachers, as more than half scored less than 60% compared with 16.5% of the teachers. More than two-thirds of the students (80%) and teachers (76.4%) have a low or minor positive attitude toward people with mental illness. The study identified significant differences in knowledge in favour of teachers, although the opposite was found regarding attitudes. Conclusions Since students spend a significant amount of time in school, bridging the gap between teachers' and students’ knowledge and attitudes toward mental illness is an essential part in enhancing the knowledge and attitudes of the students. In addition, knowledgeable teachers with positive attitude can assist in early identification of mental illnesses and help students when needed. In turn, students who possess knowledge and positive attitude toward mental illness can share their concerns with their teachers. In the presence of such accepting and cooperative environment, the stigma can be decreased and early detection of mental illness and help-seeking behaviour can be promoted.
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Affiliation(s)
- Omar Al Omari
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Atika Khalaf
- College of Nursing, Sultan Qaboos University, Muscat, Oman. .,Faculty of Health Science, Kristianstad University, 291 88, Kristianstad, Sweden.
| | - Iman Al Hashmi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Mohammad Al Qadire
- College of Nursing, Sultan Qaboos University, Muscat, Oman.,Faculty of Nursing, Al Al-Bayt University, Mafraq, Jordan
| | | | | | - Nasir Matani
- College of Nursing, Sultan Qaboos University, Muscat, Oman
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Jumbe S, Nyali J, Simbeye M, Zakeyu N, Motshewa G, Pulapa SR. ‘We do not talk about it’: Engaging youth in Malawi to inform adaptation of a mental health literacy intervention. PLoS One 2022; 17:e0265530. [PMID: 35349575 PMCID: PMC8963557 DOI: 10.1371/journal.pone.0265530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/03/2022] [Indexed: 02/03/2023] Open
Abstract
Purpose There is limited knowledge on how to tackle mental health problems among youth in Africa. Literature describing community engagement (CE) approaches in low/middle-income countries (LMICs) health research is sparse. CE with youth from LMICS can help steer and shape culturally relevant interventions for stigmatised topics like mental health, resulting in better healthcare experiences. We share our experience of engaging youth in Malawi through advocacy organisations to inform cultural adaptation of a mental health literacy intervention. Methods Young people were recruited using social media from universities and community youth organisations in Malawi to participate in focus group discussions to help culturally adapt content of an existing mental health literacy intervention. Nine online focus groups with 44 individuals were conducted. Discussions involved views and experiences of mental health, including impact of the coronavirus pandemic. Discussions were recorded, transcribed verbatim and analysed using content analysis. Results Transcript analyses revealed a vicious cycle of poverty and mental health problems for youth in Malawi. Four key themes were identified, 1) poverty-related socioeconomic and health challenges, 2) no one talks about mental health, 3) lacking mental health support and 4) relationship issues. These themes fed into one another within this vicious cycle which perpetually and negatively impacted their lives. The coronavirus pandemic worsened socioeconomic issues, health challenges, mental health and substance use issues, and burden on Malawi’s already weak mental health system. Conclusion Findings suggest increasing untreated mental health burden among Malawi’s youth. It highlights great need to address mental health literacy using existing community structures like educational settings to minimise burden on a weak health system. Online focus groups are an effective way of acquiring views from various young people in Malawi on mental health. This CE approach has grown our stakeholder network, strengthening potential for future CE activities and broader research dissemination.
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Affiliation(s)
- Sandra Jumbe
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- Millennium University, Blantyre, Malawi
- * E-mail:
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13
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Mansfield R, Humphrey N, Patalay P, Moore A, Stapley E. Adaptation of a school-based mental health literacy curriculum: from Canadian to English classrooms. Glob Ment Health (Camb) 2021; 8:e39. [PMID: 34703613 PMCID: PMC8518024 DOI: 10.1017/gmh.2021.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/16/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND School-based mental health literacy (MHL) interventions are increasingly trialled outside of the country in which they were developed. However, there is a lack of published studies that qualitatively explore their cultural adaptation. This study investigated the reasons for adaptations made and suggested to a Canadian MHL curriculum (The Guide) within the English school context. METHOD Semi-structured interviews were conducted with 11 school staff responsible for the planning and/or implementation of The Guide across three schools in the South East of England, as part of the Education for Wellbeing (EfW) feasibility study. Transcripts were analysed using a hybrid, deductive-inductive thematic analysis. RESULTS Adaptations made and suggested included dropping and emphasising content, and adapting language, examples and references. Most adaptations were proactive and related to The Guide's implementation methods, including developing more interactive and student-led approaches. Staff Capacity and Expertise, Timetabling, and Accessibility of Resources were identified as logistical reasons for adaptations. Philosophical reasons included Consistency of Messages, Student Characteristics, Reducing Stigma and Empowering Students, National and Local Context, and Appropriate Pedagogic Practices. CONCLUSION Overall, recommendations were for immediately implementable lesson plans informed by teachers' knowledge about best pedagogic practices in England. Adequate training, attended by both senior leadership and those implementing, was also emphasised. While ensuring that the core components are clear, MHL interventions should be developed with a necessary level of flexibility to accommodate contextual characteristics. Future research should ensure that adaptations are captured through process and implementation evaluations conducted alongside efficacy trials.
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Affiliation(s)
- Rosie Mansfield
- Centre for Longitudinal Studies, University College London, London, UK
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies, University College London, London, UK
- MRC Unit for Lifelong Health and Aging, University College London, London, UK
| | - Anna Moore
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK
| | - Emily Stapley
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK
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14
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Brick K, Cooper JL, Mason L, Faeflen S, Monmia J, Dubinsky JM. Training-of-Trainers Neuroscience and Mental Health Teacher Education in Liberia Improves Self-Reported Support for Students. Front Hum Neurosci 2021; 15:653069. [PMID: 34220469 PMCID: PMC8249721 DOI: 10.3389/fnhum.2021.653069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/14/2021] [Indexed: 12/25/2022] Open
Abstract
Education programs have been central to reestablishing social norms, rebuilding public educational institutions, and addressing public attitudes toward mental illness in Liberia following a protracted civil war and the Ebola epidemic. The aim of this study was to determine if a program combining an understanding of neuroscience with mental health literacy content could increase teachers’ awareness of students’ mental health issues and produce changes in teacher attitudes and classroom practices. A tiered Training-of-Trainers approach was employed. The first workshop trained 24 Liberian secondary science teachers in the neurobiology of learning, memory, emotions, stress and adolescent brain development. A Leadership Team formed from eight of the Tier I participants then adapted the curriculum, added in more mental health literacy content and led four Tier II workshops and four follow-up Refresher sessions. Participants completed a neuroscience knowledge test and surveys assessing stigma, general perceptions of people with mental illness, and burnout. A subset of Tier II teachers participated in a structured interview at the Refresher time point. Teachers in both tiers acquired basic neuroscience knowledge. Tier I, but not Tier II teachers significantly improved their surveyed attitudes toward people with mental illness. No changes were found in overall teacher burnout. Despite these survey results, the interviewed Tier II teachers self-reported behavioral changes in how they approached their teaching and students in their classrooms. Interviewees described how they now understood social and emotional challenges students might be experiencing and recognized abnormal behaviors as having a biopsychosocial basis. Teachers reported reduced use of verbal and corporal punishment and increased positive rewards systems, such as social and emotional support for students through building relationships. Refresher discussions concurred with the interviewees. In contrast to previous teacher mental health literacy programs which did not bring about a change in helping behaviors, this pilot program may have been successful in changing teacher knowledge and self-reported behaviors, improving teacher–student relationships and decreasing harsh discipline. The combination of basic neuroscience concepts with training on how to recognize mental health issues and refer students should be investigated further as a strategy to promote teacher mental health literacy.
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Affiliation(s)
- Kara Brick
- Carter Center Mental Health Program, Monrovia, Liberia.,Peace Corps Liberia, Monrovia, Liberia
| | | | - Leona Mason
- Carter Center Mental Health Program, Monrovia, Liberia
| | | | - Josiah Monmia
- Carter Center Mental Health Program, Monrovia, Liberia
| | - Janet M Dubinsky
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
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15
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Arthur YA, Boardman GH, McCann TV. Qualitative process evaluation of a problem-solving and Story-bridge based mental health literacy program with community leaders in Ghana. Int J Ment Health Nurs 2021; 30:683-693. [PMID: 33368929 DOI: 10.1111/inm.12832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/15/2020] [Accepted: 12/01/2020] [Indexed: 01/31/2023]
Abstract
Improved knowledge about, and positive attitudes towards, people with mental illness could lead to improved support and decreased stigma for people with mental illness, including their families and carers. The aims of our study were to evaluate the perspectives of community leaders about the usefulness of a cluster randomized trial of a problem-solving and Story-bridge based mental health literacy (MHL) programme and to understand whether they utilized the knowledge acquired from the programme in their usual interactions with people with mental illness and their families. Twenty-five participants were sampled randomly from the intervention cluster of the trial to participate in a qualitative process evaluation, and individual interviews were used to collect data. A thematic analysis of the data was undertaken. Three themes were abstracted from the data, reflecting participants' perspectives about the usefulness of the programme: overcoming fear of perceived dangerousness, increasing willingness to engage, and becoming empathetic and non-judgemental. This qualitative process evaluation offers insights into how a problem-solving and Story-bridge based MHL programme to a targeted group could lead to real and supportive actions/attitudes to people with mental illness. The findings have clinical relevance for a collaboration among family members and caregivers, community leaders and community psychiatric nurses, and other primary healthcare workers to develop community MHL strategies to improve the quality of care, support and life of people with mental disorders.
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Affiliation(s)
- Yaw Amankwa Arthur
- Disciplines of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Gayelene H Boardman
- Disciplines of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Disciplines of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,Turning Point, Eastern Health Clinical School, Melbourne, Victoria, Australia
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16
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Arthur YA, Boardman GH, Morgan AJ, McCann TV. Effectiveness of a Problem-Solving, Story-Bridge Mental Health Literacy Programme in Improving Ghanaian Community Leaders' Attitudes towards People with Mental Illness: A Cluster Randomised Controlled Trial. Issues Ment Health Nurs 2021; 42:332-345. [PMID: 32877258 DOI: 10.1080/01612840.2020.1799273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In Ghana, people with mental disorders commonly experience negative attitudes and discrimination because of deep-rooted public stigma. The aim of the study was to assess the effectiveness of a mental health literacy programme in improving community leaders' attitudes toward people with mental disorders. A cluster randomised controlled trial, comprising an intervention and control group, participated in a 3-hour problem-solving, Story-bridge mental health literacy programme. Data were collected at baseline and 12-week follow-up. The intervention group performed better in most outcome measures at follow-up compared to the control group. There were statistically significant differences between the two groups, in perceived stigma, community mental health ideology (CMHI), and benevolence outcome measures over the two time-points. Overall, the findings suggest that the programme was somewhat effective in improving community leaders' attitudes and who might, subsequently, foster supportive, non-judgemental and empathetic attitudes toward individuals with mental disorders in their communities. There is scope for community psychiatric nurses and other primary health care workers to work with community leaders to increase public awareness of, and favourable attitudes toward, people with mental health problems in the community.
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Affiliation(s)
- Yaw Amankwa Arthur
- Discipline of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Gayelene H Boardman
- Discipline of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Terence V McCann
- Discipline of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Australia.,Turning Point, Eastern Health, Melbourne, Australia
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17
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O'Connell J, Pote H, Shafran R. Child mental health literacy training programmes for professionals in contact with children: A systematic review. Early Interv Psychiatry 2021; 15:234-247. [PMID: 32342663 DOI: 10.1111/eip.12964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 02/11/2020] [Accepted: 03/15/2020] [Indexed: 12/23/2022]
Abstract
AIMS There has been a surge in child mental health literacy training programmes for non-mental health professionals. No previous review has examined the effectiveness of child mental literacy training on all professionals in contact with children. METHODS Studies were identified through a systematic literature search of the Cochrane, EMBASE, Medline, and PsycINFO databases in February 2019. The review included studies that delivered training to professionals who have regular contact with young people aged 0 to 19 in the context of their role and at least one component of mental health literacy; (a) knowledge, (b) attitudes, (c) confidence in helping, (d) intention to help and (e) actual helping behaviour. The quality of papers was reviewed using the Cochrane revised Risk of Bias Tool for randomized controlled trials (RCTs) and the Integrated Quality Criteria for the Review of Multiple Study Designs for non RCTs. RESULTS Twenty-one studies met eligibility criteria (n = 3243). There was some evidence that global and specific child mental health literacy training improved professionals' knowledge and stigma-related attitudes towards mental health. Few studies investigated the impact of training on actual helping behaviour. CONCLUSION There may be value in providing child mental health literacy training to professionals in contact with children, however there is a need for studies to evaluate the long-term impact of such training, particularly on subsequent access to appropriate support. Findings raise concerns about the quality of the studies reported in the systematic review and recommendations are made for future studies.
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Affiliation(s)
- Jennifer O'Connell
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Helen Pote
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK
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18
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Parker BL, Chakouch C, Subotic-Kerry M, Batterham PJ, Mackinnon A, Newby JM, Whitton AE, McGoldrick J, Cockayne N, O'Dea B. The Building Educators' Skills in Adolescent Mental Health Training Program for Secondary School Educators: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e25870. [PMID: 33625374 PMCID: PMC7946581 DOI: 10.2196/25870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background In Australia, secondary school educators are well positioned to recognize mental illness among students and provide support. However, many report that they lack the knowledge and confidence to do so, and few mental health training programs available for educators are evidence based. To address this gap, the Black Dog Institute (BDI) developed a web-based training program (Building Educators’ Skills in Adolescent Mental Health [BEAM]) that aims to improve mental health knowledge, confidence, and helping behaviors among secondary school educators in leadership positions. A pilot study of the training program found it to be positively associated with increased confidence and helping behaviors among educators and reduced personal psychological distress. An adequately powered randomized controlled trial (RCT) is needed. Objective The primary objective of this cluster RCT is to evaluate the effectiveness of the BEAM program for improving educators’ confidence in managing student mental health. The trial will also evaluate the effect of the BEAM program in increasing educators’ frequency of providing help to students and improving their mental health knowledge and reducing educators’ psychological distress and stigma toward students with mental health issues. Methods The target sample size is 234 educators from 47 secondary schools across New South Wales, Australia. Four waves of recruitment and enrollment into the trial are planned. Schools will participate in one wave only and will be randomized to the intervention or waitlist control conditions. Participants from the same school will be assigned to the same condition. Assessments will be conducted at baseline, posttest (10 weeks after baseline), and follow-up (22 weeks after baseline) using the BDI eHealth research platform. Intervention participants will receive access to the BEAM program for 10 weeks upon completion of baseline, and the control condition will receive access for 10 weeks upon completion of the follow-up assessment. Results Recruitment for this trial began on July 21, 2020, with the first baseline assessments occurring on August 17, 2020. To date, 295 participants from 71 schools have completed baseline. Due to the unexpected success of recruitment in the first 3 waves, the final fourth wave has been abandoned. Intervention participants are currently receiving the program, with follow-up due for completion in March 2021. Conclusions This is one of the first RCTs to examine the effectiveness of a web-based adolescent mental health training program for Australian secondary school educators in leadership positions. If found to be effective, this training program will offer a sustainable and scalable delivery method for upskilling educators in caring for students’ mental health. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620000876998; https://covid-19.cochrane.org/studies/crs-14669208 International Registered Report Identifier (IRRID) DERR1-10.2196/25870
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Affiliation(s)
- Belinda L Parker
- Black Dog Institute, Randwick, Australia.,Faculty of Medicine, University of New South Wales, Kensington, Australia
| | | | - Mirjana Subotic-Kerry
- Black Dog Institute, Randwick, Australia.,Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Philip J Batterham
- Black Dog Institute, Randwick, Australia.,College of Health and Medicine, Australian National University, Canberra, Australia
| | | | - Jill M Newby
- Black Dog Institute, Randwick, Australia.,Faculty of Science, University of New South Wales, Kensington, Australia
| | - Alexis E Whitton
- Black Dog Institute, Randwick, Australia.,Faculty of Medicine, University of New South Wales, Kensington, Australia
| | | | - Nicole Cockayne
- Black Dog Institute, Randwick, Australia.,Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Bridianne O'Dea
- Black Dog Institute, Randwick, Australia.,Faculty of Medicine, University of New South Wales, Kensington, Australia
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Clauss-Ehlers CS, Carpio MG, Weist MD. Mental Health Literacy: A Strategy for Global Adolescent Mental Health Promotion. ADOLESCENT PSYCHIATRY 2020. [DOI: 10.2174/2210676610666200204104429] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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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Core components of mental health stigma reduction interventions in low- and middle-income countries: a systematic review. Epidemiol Psychiatr Sci 2020; 29:e164. [PMID: 32883399 PMCID: PMC7503169 DOI: 10.1017/s2045796020000797] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIMS To identify and categorise core components of effective stigma reduction interventions in the field of mental health in low- and middle-income countries (LMICs) and compare these components across cultural contexts and between intervention characteristics. METHODS Seven databases were searched with a strategy including four categories of terms ('stigma', 'mental health', 'intervention' and 'low- and middle-income countries'). Additional methods included citation chaining of all papers identified for inclusion, consultation with experts and hand searching reference lists from other related reviews. Studies on interventions in LMICs aiming to reduce stigma related to mental health with a stigma-related outcome measure were included. All relevant intervention characteristics and components were extracted and a quality assessment was undertaken. A 'best fit' framework synthesis was used to organise data, followed by a narrative synthesis. RESULTS Fifty-six studies were included in this review, of which four were ineffective and analysed separately. A framework was developed which presents a new categorisation of stigma intervention components based on the included studies. Most interventions utilised multiple methods and of the 52 effective studies educational methods were used most frequently (n = 83), and both social contact (n = 8) and therapeutic methods (n = 3) were used infrequently. Most interventions (n = 42) based their intervention on medical knowledge, but a variety of other themes were addressed. All regions with LMICs were represented, but every region was dominated by studies from one country. Components varied between regions for most categories indicating variation between cultures, but only a minority of studies were developed in the local setting or culturally adapted. CONCLUSIONS Our study suggests effective mental health stigma reduction interventions in LMICs have increased in quantity and quality over the past five years, and a wide variety of components have been utilised successfully - from creative methods to emphasis on recovery and strength of people with mental illness. Yet there is minimal mention of social contact, despite existing strong evidence for it. There is also a lack of robust research designs, a high number of short-term interventions and follow-up, nominal use of local expertise and the research is limited to a small number of LMICs. More research is needed to address these issues. Some congruity exists in components between cultures, but generally they vary widely. The review gives an in-depth overview of mental health stigma reduction core components, providing researchers in varied resource-poor settings additional knowledge to help with planning mental health stigma reduction interventions.
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Nguyen AJ, Dang HM, Bui D, Phoeun B, Weiss B. Experimental Evaluation of a School-Based Mental Health Literacy Program in two Southeast Asian Nations. SCHOOL MENTAL HEALTH 2020; 12:716-731. [DOI: 10.1007/s12310-020-09379-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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22
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Mascayano F, Toso-Salman J, Ho YCS, Dev S, Tapia T, Thornicroft G, Cabassa LJ, Khenti A, Sapag J, Bobbili SJ, Alvarado R, Yang LH, Susser E. Including culture in programs to reduce stigma toward people with mental disorders in low- and middle-income countries. Transcult Psychiatry 2020; 57:140-160. [PMID: 31856688 DOI: 10.1177/1363461519890964] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Stigma is one of the main barriers for the full implementation of mental health services in low- and middle-income countries (LMICs). Recently, many initiatives to reduce stigma have been launched in these settings. Nevertheless, the extent to which these interventions are effective and culturally sensitive remains largely unknown. The present review addresses these two issues by conducting a comprehensive evaluation of interventions to reduce stigma toward mental illness that have been implemented in LMICs. We conducted a scoping review of scientific papers in the following databases: PubMed, Google Scholar, EBSCO, OVID, Embase, and SciELO. Keywords in English, Spanish, and Portuguese were included. Articles published from January 1990 to December 2017 were incorporated into this article. Overall, the studies were of low-to-medium methodological quality-most only included evaluations after intervention or short follow-up periods (1-3 months). The majority of programs focused on improving knowledge and attitudes through the education of healthcare professionals, community members, or consumers. Only 20% (5/25) of the interventions considered cultural values, meanings, and practices. This gap is discussed in the light of evidence from cultural studies conducted in both low and high income countries. Considering the methodological shortcomings and the absence of cultural adaptation, future efforts should consider better research designs, with longer follow-up periods, and more suitable strategies to incorporate relevant cultural features of each community.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jaime Sapag
- IMHPR, Centre for Addiction and Mental Health
- Mental Health, Catholic University of Chile
- Dalla Lana School of Public Health, University of Toronto
| | | | | | | | - Ezra Susser
- Columbia University
- New York University College of Global Public Health
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Yamaguchi S, Foo JC, Nishida A, Ogawa S, Togo F, Sasaki T. Mental health literacy programs for school teachers: A systematic review and narrative synthesis. Early Interv Psychiatry 2020; 14:14-25. [PMID: 30740884 DOI: 10.1111/eip.12793] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/07/2018] [Accepted: 12/26/2018] [Indexed: 12/12/2022]
Abstract
AIM The prevalence of mental disorders increases sharply during adolescence. Therefore, school teachers are in a good position to provide initial assistance to students with mental health problems. Although effects of a number of mental health literacy programs aimed at teachers have been reported, they have not yet been reviewed in a systematic manner. This study conducted a systematic review of the effectiveness of mental health literacy programs for teachers. METHODS PubMed, PsycINFO, CINAHL, ERIC, Web of Science and reference lists of included studies were searched in September 2018. Studies that quantitatively measured at least one of the main components of mental health literacy, including (a) knowledge of mental illnesses, (b) stigma towards mental illnesses, (c) confidence in helping students, and (d) behaviour of helping students, were included regardless of study design. Risk of bias was rated for each included study according to the Cochrane tool for randomized studies and the Cochrane tool, for raondomized studies, and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS), for nonrandomized studies. RESULTS Sixteen studies met the inclusion criteria, including 1 randomized controlled trial (RCT), 2 cluster RCTs, 1 controlled before-and-after study and 12 case series. Most of the studies claimed significant improvement of knowledge, attitudes, behaviour and/or confidence. However, the overall quality for all outcomes was relatively low; 15 studies had high/unclear risk of bias due to lack of allocation concealment, not controlling for confounders, and/or inadequate analysis for attrition. CONCLUSIONS More high quality evidence is required before the effectiveness of mental health literacy programs for teachers can be established.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Physical and Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Jerome C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Asuka Nishida
- Department of Physical and Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Sayoko Ogawa
- Department of Physical and Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Fumiharu Togo
- Department of Physical and Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
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Ayano G, Yohannes K, Abraha M. Epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta-analysis. Ann Gen Psychiatry 2020; 19:21. [PMID: 32190100 PMCID: PMC7071561 DOI: 10.1186/s12991-020-00271-w] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 02/26/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence, affecting 2.2 to 17.8% of all school-aged children and adolescents. ADHD in children has been associated with a wide range of developmental deficits including limitations of learning or control of executive functions as well as global impairments of social skills. However, no review has been conducted to report the consolidated magnitude of ADHD in children and adolescents in Africa. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of ADHD in Africa. METHODS Following the PRISMA guideline, we systematically reviewed and meta-analyzed studies that investigated the prevalence of ADHD in Africa from three electronic databases (PubMed, Embase, and Scopus). We also looked at the reference lists of included studies to include other relevant studies. Subgroup and sensitivity analysis was carried out based on the study setting, tools used to measure ADHD, sex of participants, and the subtype of ADHD. Heterogeneity across the studies was evaluated using Cochran's Q- and the I 2-test. We assessed potential publication bias using Egger's test and visual inspection of the symmetry in funnel plots. RESULTS In the present meta-analysis, 7452 articles were initially identified and evaluated. Of these, 12 studies that met the inclusion criteria were included in the final analysis. The pooled prevalence of ADHD in children and adolescents in Africa was 7.47% (95% CI 60-9.26). The prevalence of ADHD was apparently greater in boys (10.60%) than in girls (5.28%) with a male:female ratio of 2.01:1. In our subgroup analysis, the predominantly inattentive type (ADHD-I) was found to be the most common subtype of ADHD, followed by hyperactive-impulsive type (ADHD-HI) and the combined type (ADHD-C) with the prevalence of 2.95%, 2.77%, and 2.44% respectively. The predominantly inattentive type (ADHD-I) was the most common type of ADHD in both boys (4.05%) and girls (2.21%). The funnel plot and Egger's regression tests provided no evidence of substantial publication bias in the prevalence of ADHD. CONCLUSION Our systematic review suggested a higher prevalence of ADHD (7.47%) in children and adolescents in Africa, indicating that ADHD is a serious public health problem in children and adolescents in Africa. The prevalence of ADHD was considerably greater in males than in females. The predominantly inattentive type (ADHD-I) was the most common type of ADHD in both males and females. Greater attention needs to be paid to the prevention and treatment of ADHD.
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Affiliation(s)
- Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.,2School of Public Health, Curtin University, Perth, western australia Australia
| | | | - Mebratu Abraha
- Department of Psychiatry, Paulo's Millennium Medical College, Addis Ababa, Ethiopia
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O'Connell J, Shafran R, Pote H. A Randomized Controlled Trial Evaluating the Effectiveness of Face-to-Face and Digital Training in Improving Child Mental Health Literacy Rates in Frontline Pediatric Hospital Staff. Front Psychiatry 2020; 11:570125. [PMID: 33643077 PMCID: PMC7905032 DOI: 10.3389/fpsyt.2020.570125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Children with chronic physical health conditions are up to six times more likely to develop a mental health condition than their physically well peers. Frontline pediatric hospital staff are in a good position to identify mental health problems and facilitate appropriate support for patients. To date, no evaluation of mental health literacy training has taken place with this professional group to enable early identification of difficulties. It is also not known whether face-to-face or digital training is more effective or preferable in this setting. To improve the skills of frontline hospital staff, a face-to-face and digital mental health literacy training course was delivered using MindEd content and evaluated in a randomized controlled trial. Method: Two-hundred and three frontline staff across different professions from a tertiary pediatric hospital were randomized to a face-to-face (n = 64), digital (n = 71), or waitlist control group (n = 68). Face-to-face training was two and a half hours and digital training took ~1 h. The effects of training were evaluated pre- and post-training and at two-week follow-up. Questionnaires assessed mental health knowledge, stigma, confidence in recognizing concerns and knowing what to do, actual helping behavior, as well as training delivery preference, completion rate, and satisfaction. Results: Both face-to-face and digital training increased mental health knowledge, confidence in recognizing mental health problems and knowing what to do compared to waitlist controls. Digital training increased actual helping behavior relative to the waitlist controls and stigma decreased across all groups. Staff were satisfied with both delivery methods but preferred face-to-face training. Conclusions: The results provide promising findings that digital content is an effective way of improving mental health literacy in frontline pediatric hospital staff. Providing digital training could be a time-efficient way of upskilling non-mental health professionals to identify mental health needs in a pediatric population and facilitate access to appropriate care.
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Affiliation(s)
- Jennifer O'Connell
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Roz Shafran
- UCL Institute of Child Health, London, United Kingdom
| | - Helen Pote
- Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
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Hayes D, Moore A, Stapley E, Humphrey N, Mansfield R, Santos J, Ashworth E, Patalay P, Bonin E, Boehnke JR, Deighton J. School-based intervention study examining approaches for well-being and mental health literacy of pupils in Year 9 in England: study protocol for a multischool, parallel group cluster randomised controlled trial (AWARE). BMJ Open 2019; 9:e029044. [PMID: 31481370 PMCID: PMC6731836 DOI: 10.1136/bmjopen-2019-029044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The prevalence of emotional difficulties in young people is increasing. This upward trend is largely accounted for by escalating symptoms of anxiety and depression. As part of a public health response, there is increasing emphasis on universal prevention programmes delivered in school settings. This protocol describes a three-arm, parallel group cluster randomised controlled trial, investigating the effectiveness and cost-effectiveness of two interventions, alongside a process and implementation evaluation, to improve mental health and well-being of Year 9 pupils in English secondary schools. METHOD A three-arm, parallel group cluster randomised controlled trial comparing two different interventions, the Youth Aware of Mental Health (YAM) or the Mental Health and High School Curriculum Guide (The Guide), to Usual Provision. Overall, 144 secondary schools in England will be recruited, involving 8600 Year 9 pupils. The primary outcome for YAM is depressive symptoms, and for The Guide it is intended help-seeking. These will be measured at baseline, 3-6 months and 9-12 months after the intervention commenced. Secondary outcomes measured concurrently include changes to: positive well-being, behavioural difficulties, support from school staff, stigma-related knowledge, attitudes and behaviours, and mental health first aid. An economic evaluation will assess the cost-effectiveness of the interventions, and a process and implementation evaluation (including a qualitative research component) will explore several aspects of implementation (fidelity, quality, dosage, reach, participant responsiveness, adaptations), social validity (acceptability, feasibility, utility), and their moderating effects on the outcomes of interest, and perceived impact. ETHICS AND DISSEMINATION This trial has been approved by the University College London Research Ethics Committee. Findings will be published in a report to the Department for Education, in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER ISRCTN17631228. PROTOCOL V1 3 January 2019. Substantial changes to the protocol will be communicated to the trials manager to relevant parties (eg, ISRCTN).
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Affiliation(s)
- Daniel Hayes
- Evidence Based Practice Unit (EBPU), University College London and Anna Freud National Centre for Children and Families (AFNCCF), London, UK
| | - Anna Moore
- Evidence Based Practice Unit (EBPU), University College London and Anna Freud National Centre for Children and Families (AFNCCF), London, UK
| | - Emily Stapley
- Evidence Based Practice Unit (EBPU), University College London and Anna Freud National Centre for Children and Families (AFNCCF), London, UK
| | - Neil Humphrey
- Institute of Education, University of Manchester, Manchester, UK
| | - Rosie Mansfield
- Institute of Education, University of Manchester, Manchester, UK
| | - Joao Santos
- Institute of Education, University of Manchester, Manchester, UK
| | - Emma Ashworth
- Institute of Education, University of Manchester, Manchester, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing and the Centre for Longitudinal Studies, University College London, London, UK
| | - Eva Bonin
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | | | - Jessica Deighton
- Evidence Based Practice Unit (EBPU), University College London and Anna Freud National Centre for Children and Families (AFNCCF), London, UK
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Kutcher S, Perkins K, Gilberds H, Udedi M, Ubuguyu O, Njau T, Chapota R, Hashish M. Creating Evidence-Based Youth Mental Health Policy in Sub-Saharan Africa: A Description of the Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania. Front Psychiatry 2019; 10:542. [PMID: 31555156 PMCID: PMC6724683 DOI: 10.3389/fpsyt.2019.00542] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/12/2019] [Indexed: 11/28/2022] Open
Abstract
Addressing depression in young people is a health-care policy need in sub-Saharan Africa. There exists poor mental health literacy, high levels of stigma, and weak capacity at the community level to address this health-care need. These challenges are significant barriers to accessing mental health care for depression, soon to be the largest single contributor to the global burden of disease. We here describe an innovative approach that addresses these issues simultaneously while concurrently strengthening key mental health components in existing education and health-care systems as successfully applied in Malawi and replicated in Tanzania. Improving the pathway to care for young people with depression requires the following: improving mental health literacy (MHL) of communities, youth, and teachers; enhancing case identification and linking schools to community health clinics; improving the capacity of community health-care providers to identify, diagnose, and effectively treat depression in youth. Funded by Grand Challenges Canada, we developed and applied a program called "An Integrated Approach to Addressing the Challenge of Depression Among the Youth in Malawi and Tanzania" (IACD). This was an example of, a horizontally integrated pathway to care model designed to be applied in low-resource settings. The model is designed to 1) improve awareness/knowledge of mental health and mental disorders (especially depression) in communities; 2) enhance mental health literacy among youth and teachers within schools; 3) enhance capacity for teachers to identify students with possible depression; 4) create linkages between schools and community health clinics for improved access to mental health care for youth identified with possible depression; and 5) enhance the capacity of community-based health-care providers to identify, diagnose, and effectively treat youth with depression. With the use of interactive, youth-informed weekly radio programs, mental health curriculum training for teachers and peer educators in secondary schools, and a clinical competency training program for community-based health workers, the innovation created a "hub and spoke" model for improving mental health care for young people. Positive results obtained in Malawi and replicated in Tanzania suggest that this approach may provide an effective and potentially sustainable framework for enhancing youth mental health care, thus providing a policy ready framework that can be considered for application in sub-Saharan Africa.
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Affiliation(s)
- Stanley Kutcher
- Department of Psychiatry, IWK Health Centre and Dalhousie University, Halifax, NS, Canada
| | | | | | | | - Omary Ubuguyu
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Tasiana Njau
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Mina Hashish
- Department of Psychiatry, IWK Health Centre and Dalhousie University, Halifax, NS, Canada
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Anderson M, Werner-Seidler A, King C, Gayed A, Harvey SB, O’Dea B. Mental Health Training Programs for Secondary School Teachers: A Systematic Review. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9291-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van der Put CE, Assink M, Gubbels J, Boekhout van Solinge NF. Identifying Effective Components of Child Maltreatment Interventions: A Meta-analysis. Clin Child Fam Psychol Rev 2018; 21:171-202. [PMID: 29204796 PMCID: PMC5899109 DOI: 10.1007/s10567-017-0250-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining potential moderators of this effect, such as intervention components and study characteristics. Identifying effective components is essential for developing or improving child maltreatment interventions. A literature search yielded 121 independent studies (N = 39,044) examining the effects of interventions for preventing or reducing child maltreatment. From these studies, 352 effect sizes were extracted. The overall effect size was significant and small in magnitude for both preventive interventions (d = 0.26, p < .001) and curative interventions (d = 0.36, p < .001). Cognitive behavioral therapy, home visitation, parent training, family-based/multisystemic, substance abuse, and combined interventions were effective in preventing and/or reducing child maltreatment. For preventive interventions, larger effect sizes were found for short-term interventions (0-6 months), interventions focusing on increasing self-confidence of parents, and interventions delivered by professionals only. Further, effect sizes of preventive interventions increased as follow-up duration increased, which may indicate a sleeper effect of preventive interventions. For curative interventions, larger effect sizes were found for interventions focusing on improving parenting skills and interventions providing social and/or emotional support. Interventions can be effective in preventing or reducing child maltreatment. Theoretical and practical implications are discussed.
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Affiliation(s)
- Claudia E van der Put
- Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands.
| | - Mark Assink
- Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands
| | - Jeanne Gubbels
- Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands
| | - Noëlle F Boekhout van Solinge
- Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands
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Evaluating the benefits of a youth mental health curriculum for students in Nicaragua: a parallel-group, controlled pilot investigation. Glob Ment Health (Camb) 2018; 5:e4. [PMID: 29435354 PMCID: PMC5797937 DOI: 10.1017/gmh.2017.27] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/14/2017] [Accepted: 10/03/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND High rates of mental illness and addictions are well documented among youth in Nicaragua. Limited mental health services, poor mental health knowledge and stigma reduce help-seeking. The Mental Health Curriculum (MHC) is a Canadian school-based program that has shown a positive impact on such contributing factors. This pilot project evaluated the impact of the MHC on mental wellness and functioning among youth in Leon, Nicaragua. METHODS High school and university students (aged 14-25 years) were assigned to intervention (12-week MHC; n = 567) and control (wait-list; n = 346) groups in a non-randomized design. Both groups completed measures of mental health knowledge, stigma and function at baseline and 12 weeks. Multivariate analyses and repeated measures analyses were used to compare group outcomes. RESULTS At baseline, intervention students showed higher substance use (mean difference [MD] = 0.24) and lower perceived stress (MD = -1.36) than controls (p < 0.05); there were no other group differences in function. At 12 weeks, controlling for baseline differences, intervention students reported significantly higher mental health knowledge (MD = 1.75), lower stigma (MD = 1.78), more adaptive coping (MD = 0.82), better lifestyle choices (MD = 0.06) and lower perceived stress (MD = -1.63) (p < 0.05) than controls. The clinical significance as measured by effect sizes was moderate for mental health knowledge, small to moderate for stigma and modest for the other variables. Substance use also decreased among intervention students to similar levels as controls (MD = 0.03) (p > 0.05). CONCLUSIONS This pilot investigation demonstrates the benefits of the MHC in a low-and-middle-income youth population. The findings replicate results found in Canadian student populations and support its cross-cultural applicability.
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Household water insecurity, missed schooling, and the mediating role of caregiver depression in rural Uganda. Glob Ment Health (Camb) 2017; 4:e15. [PMID: 29230311 PMCID: PMC5719478 DOI: 10.1017/gmh.2017.14] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/03/2017] [Accepted: 06/20/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children's water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations. METHOD We conducted a population-based, cross-sectional study of female household heads (N = 257) and their children ages 5-17 (N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression. RESULTS Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls. CONCLUSIONS Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth.
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Kutcher S, Wei Y, Gilberds H, Ubuguyu O, Njau T, Brown A, Sabuni N, Magimba A, Perkins K. A school mental health literacy curriculum resource training approach: effects on Tanzanian teachers' mental health knowledge, stigma and help-seeking efficacy. Int J Ment Health Syst 2016; 10:50. [PMID: 27493684 PMCID: PMC4973111 DOI: 10.1186/s13033-016-0082-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/19/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mental health literacy (MHL) is foundational for mental health promotion, prevention, stigma reduction, and care; School supported information pertaining to MHL in sub-Saharan Africa is extremely limited, including in Tanzania. Successful application of a school MHL curriculum resource may be an effective way to increase teacher MHL and therefore help to improve mental health outcomes for students. METHODS Secondary school teachers in Tanzania were trained on the African Guide (AG) a school MHL curriculum resource culturally adapted from a Canadian MHL resource (The Guide) for use in Africa. Teacher training workshops on the classroom application of the AG were used to evaluate its impact on mental health literacy in a sample of Tanzanian Secondary school teachers. Pre-post training assessment of participant knowledge and attitudes was conducted. Help-seeking efficacy for teachers themselves and their interventions for students, friends, family members and peers were determined. RESULTS Paired t test (n = 37) results demonstrate highly significant improvements in teacher's overall knowledge (p < 0.001; d = 1.14), including mental health knowledge, (p < 0.001; d = 1.14) and curriculum specific knowledge (p < 0.01; d = 0.63). Teachers' stigma against mental illness decreased significantly following the training (p < 0.001; d = 0.61). Independent t tests comparing the paired sample against unpaired sample also demonstrated significant differences between the groups for teacher's overall knowledge (p < 0.001). Teachers also reported high rates (greater than ¾ of the sample) of positive help-seeking efficacy for themselves as well as for their students, friends, family members and peers. As a result of the training, the number of students teachers identified for potential mental health care totaled over 200. CONCLUSIONS These positive results, when taken together with other research, suggest that the use of a classroom-based resource (the AG) that integrates MHL into existing school curriculum through training teachers may be an effective and sustainable way to increase the MHL (improved knowledge, decreased stigma and positive help-seeking efficacy) of teachers in Tanzania. As this study replicated the results of a previous intervention in Malawi, consideration could be given to scaling up this intervention in both countries and applying this resource and approach in other countries in East Africa.
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Affiliation(s)
- Stan Kutcher
- Dalhousie University and the Izaak Walton Killam (IWK) Health Centre, 5850 University Avenue, PO Box 9700, Halifax, NS B3K 6R8 Canada
| | - Yifeng Wei
- Sun Life Financial Chair in Adolescent Mental Health team, Dalhousie University and IWK Health Centre, Halifax, Canada
| | | | - Omary Ubuguyu
- Muhimbili National Hospital, Kalenga Street, PO Box 65000, Dar es Salaam, Tanzania
| | - Tasiana Njau
- Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
| | - Adena Brown
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, Halifax, Canada
| | - Norman Sabuni
- Mental Health and Substance Abuse, Ministry of Health, PO Box 9083, Dar es Salaam, Tanzania
| | - Ayoub Magimba
- Non Communicable Disease, Ministry of Health, PO Box 9083, Dar es Salaam, Tanzania
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