Mental health training for secondary school teachers in Haiti: a mixed methods, prospective, formative research study of feasibility, acceptability, and effectiveness in knowledge acquisition

Abstract

BackgroundEngagement and training of educators in student mental health holds promise for promoting access to care as a task sharing strategy but has not been well-studied in low-income regions.MethodsWe used a prospective and convergent mixed methods design to evaluate a customized school mental health 2½ day training for teachers in rural Haiti (n = 22) as the initial component of formative research developing a school-based intervention to promote student mental health. Training prepared teachers to respond to student mental health needs by providing psychoeducational and practical support to facilitate access to care. We examined level of participation and evaluated feasibility, acceptability, and perceived effectiveness by calculating mean scores on self-report Likert-style items eliciting participant experience. We examined effectiveness of the training on improving mental health knowledge and attitudes by comparing mean scores on an assessment administered pre- and post-training. Finally, we examined self-report written open-ended responses and focus group discussion (FGD) interview data bearing on perceived feasibility, acceptability, and effectiveness to contextualize participant ratings of training and to identify recommendations for enhancing the utility of mental health training locally for educators.ResultsMean scores of knowledge and attitudes significantly improved between the pre-test and post-tests; e.g., knowledge improved from 58% correct at baseline to 68% correct on the second post-test (p = 0.039). Mean ratings of the training were favorable across all categories and FGD data demonstrated widespread participant endorsement of training acceptability and effectiveness; participants recommended extending the duration and number of training sessions.ConclusionsFindings support feasibility, acceptability, and a limited scope of effectiveness of brief mental health training for secondary school teachers in Haiti. Further development of approaches to engage teachers in promoting school mental health through training is warranted.

High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country

“…Cross-sectional study data were collected during the baseline assessment phase of the Teacher- Accompagnateur Pilot Study (TAPS), a school-based pilot mental health intervention in Haiti’s Central Plateau in October and November 2013 (Eustache et al, 2014; Eustache et al,. 2017b).…”

Teacher training in K–12 student mental health: A systematic review

“…A common component of the training included an overview of major mental health disorders that are prevalent among children and adolescents to increase mental health literacy. As outlined in Table 3, six of the included studies were an overview of several diagnosis such as ADHD, depression, anxiety, or behavioral disorders (Eustache et al, 2017; Hussein & Vostanis, 2013; Jorm, Kitchener, Sawyer, Scales, & Cvetkovski, 2010; Kutcher et al, 2016; Kutcher, Wei, McLuckie, & Bullock, 2013; Powers, Wegmann, Blackman, & Swick, 2014). Other studies were specific to one diagnosis such as depression (Kirchner, Yoder, Kramer, Lindsey, & Thrush, 2000; Moor et al, 2007, 2000), oppositional defiant disorder (ODD; Froelich, Breuer, Doepfner, & Amonn, 2012), or substance abuse (Moor et al, 2007).…”

“…Other studies were specific to one diagnosis such as depression (Kirchner, Yoder, Kramer, Lindsey, & Thrush, 2000; Moor et al, 2007, 2000), oppositional defiant disorder (ODD; Froelich, Breuer, Doepfner, & Amonn, 2012), or substance abuse (Moor et al, 2007). The goal of reviewing specific disorders, was to increase teachers' understanding of signs, symptoms (Eustache et al, 2017; Kirchner et al, 2000; Moor et al, 2007, 2000; Powers et al, 2014), diagnosis criteria, and screening tools (Vieira, Gadelha, Moriyama, Bressan, & Bordin, 2014) specific to those particular disorders. When covering the diagnosis, the developmental aspect of the behavior and diagnosis was included to identify the age‐appropriate behaviors, learning capabilities, and how to differentiate between normal and abnormal developmental characteristics.…”

“…Mental health professionals experienced an increase in referrals however, teachers were more likely to identify distressed students rather than students with mental illness (Moor et al, 2007). Studies aiming to improve teachers' knowledge of mental health showed significant increases in knowledge, attitudes, mental health literacy, and a decrease in stigma (Barbaresi & Olsen, 1998; Baum, Rotter, Reidler, & Brom, 2009; Eustache et al, 2017; Hussein & Vostanis, 2013; Jorm et al, 2010; Kutcher et al, 2016; Lasisi, Ani, Lasebikan, Sheikh, & Omigbodun, 2017; Powers et al, 2014). Furthermore, in one study, as many as 90% of teachers were more likely to share the information they gained from the training with a colleague after the training (Moor et al, 2007).…”

“…Teachers typically rely on in-service professional development to enhance their knowledge of student mental health. Teacher training programs related to student mental health tend to focus on areas such as early identification and referral processes (von der Embse, Kilgus et al, 2018;von der Embse, Rutherford, Mankin, & Jenkins, 2018), or content knowledge (Kutcher et al, 2016). Training programs may also focus on a specific type of mental health concern (e.g., attention deficit hyperactivity disorder [ADHD], depression).…”