World Health Organization "School Mental Health Manual"-based training for school teachers in Urban Lahore, Pakistan: study protocol for a randomized controlled trial

Nazish Imran, Atif Rahman, Nakhshab Chaudhry, Aftab Asif, Nazish Imran, Atif Rahman, Nakhshab Chaudhry, Aftab Asif

Abstract

Background: The teacher's role in school mental health initiatives cannot be overemphasized. Despite global evidence of educational interventions in improving teachers' knowledge and attitudes regarding mental health, this area remains under researched in Pakistan. This paper presents a study protocol of a pilot randomized controlled trial to examine the effectiveness of a teacher training intervention for improving mental health literacy and self-efficacy among school teachers in urban Lahore, Pakistan.

Methods: The randomized controlled trial will follow the CONSORT guidelines. Participants will be allocated to the Intervention group (receiving the World Health Organization, Eastern Mediterranean Region (WHO-EMRO) School Mental Health Manual-based intervention in three 6-h, face-to-face sessions) or a waitlist control group (not receiving training during the study period). Participants will be teachers of private schools with similar broad demographic characteristics in an inner city area of Lahore. The primary outcome measures for the trial is teachers' mental health literacy. It will be assessed by using the previously applied (during WHO training of Master Trainers) self-administered questionnaire in both groups pre and post training and at 3 months' follow-up. Secondary outcomes include: for teachers: Teachers' self-efficacy (assessed by the Teachers' Sense of Self Efficacy Scale (TSES) short form.); for students (11-16 years): socio-emotional skills and psychological problems measured by the Strengths and Difficulties Questionnaire (assessed at baseline and 3 months post intervention); for schools: the WHO School Psychosocial Profile Questionnaire (baseline and 3 months post intervention).

Discussion: Given the high prevalence of child mental health problems, stigma and lack of services, it is important to consider alternate avenues for promoting positive mental health among youth. This pilot study should establish the effectiveness of the WHO-EMRO School Mental Health Manual-based Intervention improving teacher's mental health literacy and helping them to learn practical steps that can be implemented at low cost in school settings. It will also provide information regarding intervention implementation and sustainability.

Trial registration: ClinicalTrials.gov, ID: NCT02937714 . Registered on 18 October 2016.

Keywords: Children; Intervention; Mental health literacy; Promotion; Schools; Socio-emotional skills; Teacher.

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the study in all schools was given by the Institutional Review Board of King Edward Medical University, letter ref. no 299/RC/KEMU dated 8 June 2016. Being private schools, the school directors/ heads were directly approached with the study proposal and ethical approval requested for the study to be conducted in their schools. Teachers of the participating schools will have to sign a written consent form to participate. Schools were required to obtain consent forms signed by parents/guardians for students to participate in the study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Diagram
Fig. 2
Fig. 2
Trial schema

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