Effectiveness of School Based Intervention for Promoting Mental Health Literacy Among Teachers

NCT ID: NCT02937714

Last Updated: 2020-03-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 231 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-09-10
• Study Completion Date: 2018-11-30

Brief Summary

Significantly higher prevalence of emotional and behavioural problems have been reported from Pakistan.This higher prevalence along with stigma of psychiatric problems and limited child & adolescent mental health services in Pakistan means that it is important to consider alternate methods for promoting psychological and emotional well-being of our youth. Schools can thus act as a natural platform for mental health promotion as schools context has almost as much impact on students' emotional health as the family context.

Teachers' role in the school mental health initiatives cannot be overemphasized. Teachers own knowledge and beliefs regarding mental health influence the way they respond to students mental health crisis. Recognizing the need for wider implementation of evidence based school mental health interventions in the region and to help in addressing the mental health literacy of educators in resource constrained settings, World Health Organization, Eastern Mediterranean Region (WHO-EMRO) has developed a concise and practical manual of school mental health in December 2014. In the absence of any "whole school approach" study from Pakistan focusing on teachers training and addressing all the various evidence based components of promotion of positive mental health, Investigators aim to conduct a pilot randomized controlled trial to assess effectiveness of training based on WHO-EMRO manual, in addition to its feasibility & acceptability in improving teachers' mental health literacy and self-efficacy in dealing with students mental health issues.

HYPOTHESIS:

For teachers:

• School mental health training intervention will significantly improve teacher's mental health literacy & self-efficacy compared to wait list control group.
• At 3 months follow-up, control group teachers' mental health literacy will also improve compared to baseline due to contamination of information provided, across groups within the same school.

All hypothesis pertains to individual level.

For students:

Mental health training of teachers would lead to an overall improvement in student's outcome measure (student's emotional and behavioural difficulties) at 3 months follow-up.

Detailed Description

Pakistan is the 6th most populous country of the world with population over 188 million; Almost 35% of population is under the age of 14. Country cannot afford to ignore mental health of this large group. School experiences are important for children emotional, psychological and social development World Health Organization (WHO) also identifies promotion of emotional health and well- being as a core feature of their Health promoting school initiative. Schools can play an important role in promoting positive mental health, reducing stigma, raising awareness among teachers, parents and children about mental health issues as well as identifying and supporting youth experiencing mental health difficulties. Furthermore, mental health initiatives in schools help teachers to feel less stressed and be more satisfied with their role and save costs. Educational interventions involving teachers have shown significant improvement in teachers knowledge and attitudes regarding mental health & better accuracy of teacher identification of children and adolescents with mental health problems. Although importance of schools for mental health promotion and early identification for mental health problems has been evident for quite some time, it is almost nonexistent in developing countries including Pakistan with only a handful of studies focusing one aspect of health promoting school or on one disorder. World Health Organization, Eastern Mediterranean Region (WHO-EMRO) has developed a concise and practical manual of school mental health in December 2014.This manual is primarily intended for all stakeholders involved in the educational process including teachers. It aims for helping educators to take practical steps that can be implemented at low costs in school settings.

OBJECTIVE:

To assess the effectiveness of locally adapted WHO school mental health Manual based intervention in improving mental health literacy among school teachers through a randomized controlled trial.

Secondary objectives include

1. To assess whether school mental health Manual based intervention leads to better self- efficacy among school teachers.

2. To determine if mental health training of teachers would lead to an indirect improvement in students outcome measure (emotional and behavioural difficulties) and school psychosocial environment.

STUDY PHASE 1: Interaction with key stakeholders to do a current situational analysis / identify priority problems.by using WHO Questionnaires & in depth Interviews.

STUDY PHASE 2: Randomized controlled trial to assess effectiveness, feasibility & acceptability of the adapted manual delivery in school settings.

STUDY PHASE 3: Process Evaluation by feedback from Teachers.

Conditions

School Mental Health Training of Teachers

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

School mental health training

Teachers Training workshop Workshop based on local adaptation of WHO-EMRO school mental health manual will be conducted in school. The duration of the workshop will be 3 days. Teachers can decline to participate or withdraw at any stage.

Group Type: EXPERIMENTAL

School Mental Health training

Intervention Type: OTHER

School based intervention (Teacher training intervention) is the teachers training program based on World Health Organization, Eastern Mediterranean Region (WHO-EMRO) School mental health manual draft (December 2014). Topics to be covered in training workshop include normal childhood development, behaviour management strategies for schools, life skills training, essential components for healthy schools, recognizing warning signs for common psychiatric and developmental disorders common to children and adolescents \& school based interventions for various psychiatric problems

Wait list control group

Wait list control group of teachers in same schools. Half of teachers in the same school will be the wait list control group.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

School Mental Health training

School based intervention (Teacher training intervention) is the teachers training program based on World Health Organization, Eastern Mediterranean Region (WHO-EMRO) School mental health manual draft (December 2014). Topics to be covered in training workshop include normal childhood development, behaviour management strategies for schools, life skills training, essential components for healthy schools, recognizing warning signs for common psychiatric and developmental disorders common to children and adolescents \& school based interventions for various psychiatric problems

Intervention Type: OTHER

Other Intervention Names

WHO-EMRO School Mental Health Manual Based Training

Eligibility Criteria

Inclusion Criteria

• All the teachers in the participating schools.
• Teachers of Grade 1-10 will be approached.
• Both Genders.

Exclusion Criteria

• Lack of informed consent.
• Teachers who are leaving/ not planning to be in the school in 3 months' time.
• Teachers who have not been involved in active teaching in last 6 months.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

King Edward Medical University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Nazish Imran, MRCPsych

Role: PRINCIPAL_INVESTIGATOR

King Edward Medical University

Locations

King Edward Medical University

Lahore, Punjab Province, Pakistan

Countries

Pakistan

References

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

PMID: 24053381 (View on PubMed)

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

PMID: 9759745 (View on PubMed)

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Reference Type: BACKGROUND

PMID: 19474460 (View on PubMed)

Imran N, Rahman A, Chaudhry N, Asif A. Effectiveness of a school-based mental health intervention for school teachers in urban Pakistan: a randomized controlled trial. Child Adolesc Psychiatry Ment Health. 2022 May 3;16(1):33. doi: 10.1186/s13034-022-00470-1.

Reference Type: DERIVED

PMID: 35505362 (View on PubMed)

Imran N, Rahman A, Chaudhry N, Asif A. World Health Organization "School Mental Health Manual"-based training for school teachers in Urban Lahore, Pakistan: study protocol for a randomized controlled trial. Trials. 2018 May 24;19(1):290. doi: 10.1186/s13063-018-2679-3.

Reference Type: DERIVED

PMID: 29793553 (View on PubMed)

Other Identifiers

KingEdwardMU

Identifier Type: -

Identifier Source: org_study_id