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Improving Malawian teachers' mental health knowledge and attitudes: an integrated school mental health literacy approach

  • S. Kutcher (a1), H. Gilberds (a2), C. Morgan (a1), R. Greene (a1), K. Hamwaka (a3) and K. Perkins (a2)...
Abstract
Background.

Mental health literacy is foundational for mental health promotion, prevention, stigma reduction and care. Integrated school mental health literacy interventions may offer an effective and sustainable approach to enhancing mental health literacy for educators and students globally.

Methods.

Through a Grand Challenges Canada funded initiative called ‘An Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania’, we culturally adapted a previously demonstrated effective Canadian school mental health curriculum resource (the Guide) for use in Malawi, the African Guide: Malawi version (AGMv), and evaluated its impact on enhancing mental health literacy for educators (teachers and youth club leaders) in 35 schools and 15 out-of-school youth clubs in the central region of Malawi. The pre- and post-test study designs were used to assess mental health literacy – knowledge and attitudes – of 218 educators before and immediately following completion of a 3-day training programme on the use of the AGMv.

Results.

Results demonstrated a highly significant and substantial improvement in knowledge (p < 0.0001, d = 1.16) and attitudes (p < 0.0001, d = 0.79) pertaining to mental health literacy in study participants. There were no significant differences in outcomes related to sex or location.

Conclusions.

These positive results suggest that an approach that integrates mental health literacy into the existing school curriculum may be an effective, significant and sustainable method of enhancing mental health literacy for educators in Malawi. If these results are further found to be sustained over time, and demonstrated to be effective when extended to students, then this model may be a useful and widely applicable method for improving mental health literacy among both educators and students across Africa.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Address for correspondence: S. Kutcher, M.D., FRCPC, FCAHS, Dalhousie University and IWK Health Centre, 5850 University Avenue, PO Box 9700, Halifax, Nova Scotia B3K 6R8, Canada. (Email: stanley.kutcher@iwk.nshealth.ca)
References
Hide All
Barry M, Patel V, Jané-Llopis E, Raeburn J, Mittelmark M (2007). Strengthening the evidence base for mental health promotion. In Global Perspectives on Health Promotion (ed. McQueen D. V. and Jones C. M.), pp. 6786. Springer: New York.
Canadian Alliance on Mental Illness and Mental Health (2008). National integrated framework for enhancing mental health literacy in Canada: final report (http://www.mooddisorderscanada.ca/documents/Publications/CAMIMH%20National%20Integrated%20Framework%20for%20Mental%20Health%20Literacy.pdf). Accessed 10 October 2014.
Crabb J, Stewart RC, Kokota D, Masson N, Chabunya S, Krishnadas R (2012). Attitudes towards mental illness in Malawi: a cross-sectional survey. BMC Public Health 12, 541-2458-12-541.
Crowe F (2014). Young people and mental health in schools – the policy context (http://www.education.ox.ac.uk/wordpress/wp-content/uploads/2014/04/Young-people-and-mental-health-in-schools-%E2%80%93-the-policy-context.pdf). Accessed 9 December 2014.
Curriculum Services Canada (2014). Curriculum Services Canada: designing quality solutions for learning. (http://www.curriculum.org). Accessed 19 September 2014.
Farm Radio International (2014). Data on hand.
Fatiregun AA, Kumapayi TE (2014). Prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria. Journal of Adolescent Health 37, 197203.
Gureje O, Alem A (2000). Mental health policy development in Africa. Bulletin of the World Health Organization 78, 475482.
Hendren R, Weisen R, Birrell OJ (1994). Mental health programmes in schools (http://whqlibdoc.who.int/hq/1993/WHO_MNH_PSF_93.3_Rev.1.pdf). Accessed 4 June 2014.
Institute of Medicine (2004). Health Literacy: a Prescription to End Confusion. The National Academies Press: Washington, DC.
Jacob KS, Sharan P, Mirza I, Garrido-Cumbrera M, Seedat S, Mari JJ, Sreenivas V, Saxena S (2007). Mental health systems in countries: where are we now? Lancet 370, 10611077.
Jané-Llopis E, Barry M, Hosman C, Patel V (2005). Mental health promotion works: a review. Promotion & Education 2, 925, 61, 67.
Jorm AF (2012). Mental health literacy: empowering the community to take action for better mental health. American Psychologist 67, 231243.
Jorm AF, Kitchener BA, Sawyer MG, Scales H, Cvetkovski S (2010). Mental health first aid training for high school teachers: a cluster randomized trial. BioMed Central Psychiatry 10, 51.
Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P (1997). “Mental health literacy”: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia 166, 182186.
Journalists for Human Rights (2012). Growing mental health awareness in Malawi calls for more trained medical professionals (http://www.jhr.ca/blog/2012/02/growing-mental-health-awareness-in-malawi-calls-for-more-trained-medical-professionals/). Accessed 10 October 2014.
Kanj M, Mitic W, For the World Health Organization (2009). Promoting Health and Development: Closing the Implementation Gap (http://www.who.int/healthpromotion/conferences/7gchp/Track1_Inner.pdf). Accessed 16 July 2014.
Kauye F, Udedi M, Mafuta C (2014). Pathway to care for psychiatric patients in a developing country: Malawi. International Journal of Social Psychiatry [Epub ahead of print] PubMed PMID: 24903683.
Kavinya T (2011). Opinions on mental health care in Malawi: is Malawi getting mental health care right? Malawi Medical Journal 23, 98.
Khasakhala LI, Ndetei DM, Mathai M, Harder V (2013). Major depressive disorder in a Kenyan youth sample: relationship with parenting behavior and parental psychiatric disorders. Annals of General Psychiatry 12, 15.
Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A (2011). Child and adolescent mental health worldwide: evidence for action. Lancet 378, 15151525.
Kim MH, Mazenga AC, Devandra A, Ahmed S, Kazembe PN, Yu X, Nguyen C, Sharp C (2014). Prevalence of depression and validation of the Beck Depression Inventory-II and the Children's Depression Inventory-Short amongst HIV-positive adolescents in Malawi. Journal of the International AIDS Society 17, 1896518977.
Kutcher S (2011). Facing the challenge of care for child and youth mental health in Canada: a critical commentary, five suggestions for change and a call to action. Healthcare Quarterly 14, 1521.
Kutcher S, Wei Y (2013). Challenges and solutions in the implementation of the school-based pathway to care model: the lessons from Nova Scotia and beyond. Canadian Journal of School Psychology 28, 90102.
Kutcher S, Wei Y (2014). School mental health literacy: a national curriculum guide shows promising results. Education Canada 54, 2226.
Kutcher S, Bagnell A, Wei Y (in press). Mental health literacy in secondary schools: a Canadian approach. Psychiatric Clinics of North America.
Kutcher S, Wei Y, McLuckie A, Bullock L (2013). Educator mental health literacy: a programme evaluation of the teacher training education on the mental health and high school curriculum guide. Advances in School Mental Health Promotion 6, 8393.
MacLachlan M, Nyirenda T, Nyando C (1995). Attributions for admission to Zomba Mental Hospital: implications for the development of mental health services in Malawi. International Journal of Social Psychiatry 41, 7987.
McGorry PD, Purcell R, Goldstone S, Amminger GP (2011). Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Current Opinion in Psychiatry 24, 301306.
McLuckie A, Kutcher S, Wei Y, Weaver C (2014). Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools. BMG Psychiatry 14, 1694. [Epub ahead of print] PubMed PMID: 25551789.
Mental Health Commission of Canada (2010). Evergreen: A Child and Youth Mental Health Framework for Canada. A Project of the Child and Youth Advisory Committee of the Mental Health Commission of Canada. Mental Health Commission of Canada: Calgary, AB.
Milin R, Kutcher S, Lewis S, Walker S, Ferrill N (2013). Randomized controlled trial of a school-based mental health literacy intervention for youth: impact on knowledge, attitudes and help-seeking efficacy. Poster presentation at American Academy of Child and Adolescent Psychiatry 60th Annual Meeting.
Pan American Health Organization (2012). Identification, diagnosis and treatment of adolescent depression: a package for first contact health care providers. World Health Organization, Regional Office for the Americas (http://www.paho.org/hq/index.php?option=com_content&view=article&id=7434&Itemid=40615&lang=en). Accessed 10 October 2014.
Patel V, Flisher AJ, Hetrick S, McGorry P (2007). Mental health of young people: a global public-health challenge. Lancet 369, 13021313.
Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A (2007). No health without mental health. Lancet 370, 859877.
Reavley NJ, Jorm AF (2011). National survey of mental health literacy and stigma. Department of Health and Ageing, Canberra (http://pmhg.unimelb.edu.au/research_settings/general_community/?a=636496). Accessed 10 October 2014.
Rootman I, Gordon-El-Bihbety D (2008). A vision for a health literate Canada: report of the expert panel on health literacy. Canadian Public Health Association, Ottawa, Canada (http://www.cpha.ca/uploads/portals/h-l/report_e.pdf). Accessed 15 October 2014.
Rowling L, Weist M (2004). Promoting the growth, improvement and sustainability of school mental health programs worldwide. International Journal of Mental Health Promotion 6, 311.
Saxena S, Thornicroft G, Knapp M, Whiteford H (2007). Resources for mental health: scarcity, inequity, and inefficiency. Lancet 370, 878889.
Skre I, Friborg O, Breivik C, Johnsen LI, Arnesen Y, Wang CE (2013). A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial. BioMed Central Public Health 13, 873.
Stewart RC, Umar E, Tomenson B, Creed F (2014). A cross-sectional study of antenatal depression and associated factors in Malawi. Archives of Women's Mental Health 17, 145154.
TeenMentalHealth.org (2014 a). Identification, diagnosis and treatment of adolescent depression (major depression disorder): a package for first contact health providers (http://teenmentalhealth.org/wp-content/uploads/2014/08/Identification_Diagnosis_Treatment_Adolescent_Depression_website.pdf). Accessed 10 October 2014.
TeenMentalHealth.org (2014 b). School Mental Health – The Curriculum Guide (http://teenmentalhealth.org/curriculum). Accessed 19 September 2014.
The World Bank (2014 a). Data: Malawi (http://data.worldbank.org/country/malawi). Accessed 2 June 2014.
The World Bank (2014 b). Poverty headcount ratio at $1.25 a day (PPP) (http://data.worldbank.org/indicator/SI.POV.DDAY). Accessed 2 June 2014.
Udedi M (2014). The prevalence of Depression among patients and its detection by primary health care workers at Matawale Health Centre (Zomba). Malawi Medical Journal 26, 3437.
United Kingdom Department for Education (2011). Me and my school: findings from the national evaluation of targeted mental health in schools 2008–2011. DFE-RR1772011.
United Nations Educational, Scientific and Cultural Organization (2001). Regional centre for guidance, counseling and youth development for Africa (http://www.unesco.org/education/mebam/centres.shtml). Accessed 12 October 2014.
Weare K, Nind M (2011). Mental health promotion and problem prevention in schools: what does the evidence say? Health Promotion International 26(Suppl. 1), i29i69.
Wei Y, Hayden JA, Kutcher S, Zygmunt A, McGrath P (2013). The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth. Early Intervention Psychiatry 7, 109121.
Wei Y, Kutcher S (2012). International school mental health: global approaches, global challenges, and global opportunities. Child & Adolescent Psychiatric Clinics of North America 21, 1127, vii.
Wei Y, Kutcher S, Hines H, MacKay A (in press). Successfully embedding mental health literacy into Canadian classroom curriculum by building on existing educator competencies and school structures: the mental health and high school curriculum guide for secondary schools in Nova Scotia.
Wei Y, Kutcher S, Szumilas M (2011). Comprehensive school mental health: an integrated “school-based pathway to care” model for Canadian secondary schools. McGill Journal of Education 46, 213229.
Wei Y, McLuckie A, Kutcher S (2012). Training of educators on the mental health and high school curriculum guide at Halifax Regional School Board: Full program evaluation report (http://teenmentalhealth.org/images/resources/HRSB_curriculum_training_full_program_evaluation_report_May_11_2012.pdf). Accessed 3 June 2014.
Wells J, Barlow J, Steward-Brown S (2003). A systematic review of universal approaches to mental health promotion in schools. Health Education 103, 197220.
World Health Organization (2001). Mental health: new understanding, new hope. The World Health Report.
World Health Organization (2003). Strategic directions for improving the health and development of children and adolescents (http://whqlibdoc.who.int/publications/2003/9241591064.pdf). Accessed 4 June 2014.
World Health Organization (2011). World Health Organization International Health Atlas: Malawi Mental Health Profile (http://www.who.int/mental_health/evidence/atlas/profiles/mwi_mh_profile.pdf). Accessed 11 March 2014.
World Health Organization (2013). Health Literacy: the solid facts. World Health Organization, Regional Office for Europe (http://www.euro.who.int/__data/assets/pdf_file/0008/190655/e96854.pdf). Accessed 15 October 2014.
World Health Organization (2014). Health for the world's adolescents: a second chance in the second decade (http://apps.who.int/adolescent/second-decade/). Accessed 15 October 2014.
World Health Organization Expert Committee on Comprehensive School Health Education and Promotion (1997). Promoting health through schools report of a WHO Expert Committee on Comprehensive School Health Education and Promotion. 870 (http://whqlibdoc.who.int/trs/WHO_TRS_870.pdf). Accessed 4 June 2014.
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Global Mental Health
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