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

March 24, 2020 updated by: King Edward Medical University

Effectiveness of School Based Intervention for Promoting Mental Health Literacy Among Teachers: A Randomized Controlled Trial

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Actual)

231

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54000
        • King Edward Medical University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: HEALTH_SERVICES_RESEARCH
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: 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.
Other: 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
Other Names:
  • WHO-EMRO School Mental Health Manual Based Training
NO_INTERVENTION: 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Teachers' knowledge
Time Frame: At the end of 3 days workshop
Mental health literacy refers to a person's knowledge and beliefs about mental disorders, which in turn increases their ability to recognize, manage, or prevent the development or exacerbation of mental health problems. It has various elements including: 1) enhancing capacity to obtain and maintain good mental health; 2) enhancing understanding of mental disorders and their treatments; 3) decreasing stigma related to mental illness; 4) enhancing help-seeking efficacy. It will be assessed in the study using a self-administered questionnaire based on literature review and addressing various mental health literacy elements. Although main outcome time frame is post workshop but it will be reevaluated at 3 months time to see if change from baseline is seen.
At the end of 3 days workshop

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Teachers' Sense of Self Efficacy
Time Frame: At the end of 3 days workshop
Teachers sense of efficacy scale(TSES) measures teachers assessment of their self-efficacy for teaching tasks as well as their other responsibilities. Efficacy in Student Engagement & Efficacy in Classroom Management subscales will be used to assess self efficacy of teachers. There are 8 statements & each statement is rated on 9 point Likert scale. It will also be reassessed at 3 months after the training workshop to assess if change from baseline is seen.
At the end of 3 days workshop
Students behavioural and emotional Problems
Time Frame: 3 months after the teachers training
Self- reported Strengths and Difficulties questionnaire{SDQ} (11-16 years) will be used to assess students behavioural and emotional problems. SDQ measures 25 attributes, which are grouped in subscales of five items each, generating scores for conduct, hyperactivity, emotional, peer problems and prosocial behaviour. Statements are rated on a three point likert scale:0(not tue), 1(somewhat true) and 2(certainly true). All scales excluding the last are added to generate a total difficulties score (0-40). Total difficulties and categories scores can be coded in normal, borderline and abnormal categories.
3 months after the teachers training

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
The School psycho-Social Profile
Time Frame: 3 months after the teachers training
The School psycho-Social Profile Questionnaire (PSE ; WHO tools)will be completed by principals before and 3 months after the teacher training.
3 months after the teachers training

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

King Edward Medical University

Investigators

  • Principal Investigator: Nazish Imran, MRCPsych, King Edward Medical University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 10, 2017

Primary Completion (ACTUAL)

November 30, 2018

Study Completion (ACTUAL)

November 30, 2018

Study Registration Dates

First Submitted

October 13, 2016

First Submitted That Met QC Criteria

October 18, 2016

First Posted (ESTIMATE)

October 19, 2016

Study Record Updates

Last Update Posted (ACTUAL)

March 26, 2020

Last Update Submitted That Met QC Criteria

March 24, 2020

Last Verified

March 1, 2020

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • KingEdwardMU

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on School Mental Health Training of Teachers

Clinical Trials on School Mental Health training

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Madagascar

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe