Experimental Evaluation of a School-Based Mental Health Literacy Program in two Southeast Asian Nations

Nguyen, Amanda J.; Dang, Hoang-Minh; Bui, Dieu; Phoeun, Bunna; Weiss, Bahr

doi:10.1007/s12310-020-09379-6

Cited by 19 publications

(25 citation statements)

References 54 publications

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“…Six studies found statistically significant increases in knowledge and awareness of mental disorders ( p ‐values ranging from <.001 to <.05; Ahmad et al., 2020; Aseltine & DeMartino, 2004; Chisholm et al., 2016; Klingman & Hochdorf, 1993; Milin et al., 2016; Nguyen et al., 2020). Four studies included follow‐up measurements and found statistically significant improvements at post‐intervention, and also at 1‐month ( n = 1; Chan et al., 2009), 2‐months ( n = 1; Yamaguchi et al., 2020), 1‐ and 2‐months ( n = 1; DeLuca, 2020b; DeLuca et al., 2020) and 6‐months ( n = 1; Perry et al., 2014) follow‐up.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies reported statistically significant reductions in MH stigma over time (Aseltine & DeMartino, 2004; Economou et al., 2012, 2014; Hart et al., 2018; Milin et al., 2016; Nguyen et al., 2020). Six studies found statistically significant reductions in stigmatising attitudes and beliefs ( p ‐values ranging from <.0001 to .034; Aseltine & DeMartino, 2004; Economou et al., 2014; Hart et al., 2018; Milin et al., 2016; Nguyen et al., 2020). Only one study, Economou et al.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies included process evaluation by considering the implementation fidelity of the interventions (Chisholm et al., 2016; Link et al., 2020; Nguyen, Dang, Bui, Phoeun, & Weiss, 2020; O’Mara et al., 2013; Painter et al., 2017; Pinto‐Foltz, 2009; Pinto‐Foltz, Logsdon, & Myers, 2011). Implementation fidelity was assessed by checklists specifically developed for the purpose for the specific interventions in all studies.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies reported statistically significant reductions in MH stigma over time (Aseltine & DeMartino, 2004;Economou et al, 2012Economou et al, , 2014Hart et al, 2018;Milin et al, 2016;Nguyen et al, 2020). Six studies found statistically significant reductions in stigmatising attitudes and beliefs (p-values ranging from <.0001 to .034; Aseltine & DeMartino, 2004;Economou et al, 2014;Hart et al, 2018;Milin et al, 2016;Nguyen et al, 2020). Only one study, Economou et al (2012), included follow-up measurements and found statistically significant improvements in attitudes and beliefs at post-intervention and also at 12-months follow-up (all p-values < .01).…”

Section: Mental Health Stigmamentioning

confidence: 97%

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Review: School‐based interventions to improve mental health literacy and reduce mental health stigma – a systematic review

Yan

Anderson

Burn

2022

Child Adoles Ment Health

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Background: The steadily increasing prevalence of mental disorders in children and adolescents presents itself as a public health challenge, especially given the health, social and economic burden of mental disorders. School-based interventions aimed at improving mental health literacy and reducing mental health stigma have the potential to prevent mental disorders and promote mental well-being, thus reducing the burden of mental disorders. This review identified and synthesised evidence on the effectiveness of school-based interventions designed to improve mental health literacy and reduce mental health stigma. Methods: Electronic bibliographic databases including MEDLINE, Embase, PsycINFO, Education Resources Information Center (ERIC), Child Development and Adolescent Studies, British Education Index and Applied Social Sciences Index and Abstracts (ASSIA) were searched. Randomised controlled trials (RCTs) were included if they assessed the effectiveness or cost-effectiveness of school-based intervention aimed at improving mental health literacy and reducing mental health stigma for children and young people aged 4-18 years. Quality of studies was appraised using the EPHPP tool. A numerical summary and a narrative description of the findings in relation to the research questions were synthesised. This systematic review was registered with PROSPERO (CRD42020191265). Results: We identified 21 studies describing 20 unique school-based mental health interventions. Overall, there is moderate evidence suggesting that school-based mental health interventions can be effective in improving mental health literacy and reducing mental health stigma defined as attitudes and beliefs regarding mental disorders. However, there is less evidence for their long-term effectiveness, as most studies did not include follow-ups. Conclusions: Despite exclusively including studies with randomised designs, intervention and methodological heterogeneity poses uncertainties to any conclusions made. Future research should focus on resolving methodological issues concerning how outcomes are assessed and include process evaluations to better inform the design of an intervention in term of its delivery and implementation. Key Practitioner Message• One in eight children and young people aged 5 to 19 years have at least one mental disorder. Research shows that low perceived need and attitudinal barriers are the main barriers to mental health treatment. Improving mental health literacy and reducing stigma may facilitate help-seeking and use of mental health services by young people. • School-based interventions can improve mental health literacy and reduce stigma in the short term; however, refresher interventions may be required to sustain the positive outcomes in the long term. • Interventions comprising mental health education followed by contact with a person with lived experience of mental disorders may be most effective. Live contact and filmed contact are equally effective.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Mental Health Stigmamentioning

confidence: 97%

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Review: School‐based interventions to improve mental health literacy and reduce mental health stigma – a systematic review

Yan

Anderson

Burn

2022

Child Adoles Ment Health

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“…Mental health literacy training can increase individuals' effective mental health help-seeking, including in LMIC such as Vietnam. For instance, a recent study [10] conducted in 20 secondary schools in Danang, Vietnam involved 80 teachers who participated in a three-day mental health literacy teacher training, and 2,538 of their students who received a 5-week classroombased student mental health literacy curriculum. Both teachers and students showed significant increases in mental health help-seeking skills, including the ability to identify appropriate mental health services [10].…”

Section: Mental Health Literacy At the Public Health Levelmentioning

confidence: 99%

Mental health literacy at the public health level in low and middle income countries: An exploratory mixed methods study in Vietnam

et al. 2020

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Purpose Mental health literacy (MHL) is key for mental health development, particularly in low-and-middle-income countries (LMIC) where mental health resources are limited. MHL development can be thought of as occurring at two levels: the individual person level (via direct contact, with specifically-targeted individuals), and the public health level (via indirect contact through public media, targeting the general public). Each approach has advantages and disadvantages. Methods The present mixed methods study assessed the status of and best approaches for development of mental health literacy in the Southeast Asian LMIC Vietnam. Because there has been relatively little discussion of MHL development at the public health level, this assessment focused on the public health level, although not exclusively. Because mental health professionals generally have the most in-depth understanding of their mental health system, study participants were 82 Vietnamese mental health professionals who completed a quantitative survey, with 48 participating in focus groups. Results Most of the professionals viewed MHL in Vietnam as low or very low, and that it was difficult or very difficult for the general public to find effective mental health services. Main barriers underlying these problems and more generally for developing MHL in Vietnam identified in the focus groups were: (a) misinformation in the media regarding mental health and mental illness; (b) lack of licensure for non-medical mental health professionals (e.g., psychologists; social workers); (c) lack of interest in mental health from upper-level leadership. Conclusions To the best of our knowledge, this is the first study assessing professionals’ perceptions regarding mental health literacy at both the public health and individual-person levels. Although sampling was restricted to Vietnamese professionals, results may provide initial preliminary guidance for other LMIC considering mental health literacy development at multiple levels.

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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Experimental Evaluation of a School-Based Mental Health Literacy Program in two Southeast Asian Nations

Cited by 19 publications

References 54 publications

Review: School‐based interventions to improve mental health literacy and reduce mental health stigma – a systematic review

Review: School‐based interventions to improve mental health literacy and reduce mental health stigma – a systematic review

Mental health literacy at the public health level in low and middle income countries: An exploratory mixed methods study in Vietnam

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

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