School Mental Health Training of TeachersNCT02937714
Effectiveness of School Based Intervention for Promoting Mental Health Literacy Among Teachers
A study testing School Mental Health training in people with School Mental Health Training of Teachers, run by King Edward Medical University at 1 site in Pakistan.
Trial summary
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… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- School Mental Health Training of Teachers
- What is being tested?
- School Mental Health training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 231 participants
- Where
- 1 sitePakistan
- Study dates
- 10 Sep 2017to 30 Nov 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- All the teachers in the participating schools.
- Teachers of Grade 1-10 will be approached.
- Both Genders.
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: 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.
Read more
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.
Read the 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
- To assess whether school mental health Manual based intervention leads to better self- efficacy among school teachers.
- 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.
- Being tested
- School Mental Health training
- Keywords
- Teachers, mental health literacy, school mental health promotion
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
School Mental Health trainingOther
Also called WHO-EMRO School Mental Health Manual Based 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
| Study group | Role | What they receive |
|---|---|---|
| School mental health training | Experimental | 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. Receives: Other: School Mental Health training |
| Wait list control group | No intervention | 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 being measured
The primary outcome is the main question the study is designed to answer.
Teachers' knowledge
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.
Measured: At the end of 3 days workshop
Secondary outcomes (2)
Teachers' Sense of Self Efficacy
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.
Measured: At the end of 3 days workshop
Students behavioural and emotional Problems
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.
Measured: 3 months after the teachers training
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Oct 2016 (estimated)
- Study start10 Sep 2017
- Primary completion30 Nov 2018
- Study completion30 Nov 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for School Mental Health Training of TeachersStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 231 participants (actual)
Sponsor and investigators
- Lead sponsor
- King Edward Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Nazish Imran, MRCPsych, Principal investigator, King Edward Medical University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02937714
- Sponsor's protocol ID
- KingEdwardMU
- Status last verified
- Mar 2020
- First submitted
- 13 Oct 2016
- Last updated
- 26 Mar 2020
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Syed EU, Hussein SA, Mahmud S. Screening for emotional and behavioural problems amongst 5-11-year-old school children in Karachi, Pakistan. Soc Psychiatry Psychiatr Epidemiol. 2007 May;42(5):421-7. doi: 10.1007/s00127-007-0188-x. Epub 2007 Apr 21.
PubMed 17450455Weist, MD & Murray M. Advancing school mental health promotion globally. Advances in School Mental Health Promotion 2007; 1(1): 2-12.
Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011 Jan-Feb;82(1):405-32. doi: 10.1111/j.1467-8624.2010.01564.x.
PubMed 21291449Skre I, Friborg O, Breivik C, Johnsen LI, Arnesen Y, Wang CE. A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial. BMC Public Health. 2013 Sep 23;13:873. doi: 10.1186/1471-2458-13-873.
PubMed 24053381Kutcher S, Wei Y, McLuckie A, Bullock L. Educator mental health literacy: a programme evaluation of the teacher training education on the mental health & high school curriculum guide. Advances in School Mental Health Promotion 2013;6(2):83-93 DOI: 10.1080/1754730X.2013.784615
Rahman A, Mubbashar MH, Gater R, Goldberg D. Randomised trial of impact of school mental-health programme in rural Rawalpindi, Pakistan. Lancet. 1998 Sep 26;352(9133):1022-5. doi: 10.1016/s0140-6736(98)02381-2.
PubMed 9759745Syed EU, Hussein SA. Increase in teachers' knowledge about ADHD after a week-long training program: a pilot study. J Atten Disord. 2010 Jan;13(4):420-3. doi: 10.1177/1087054708329972.
PubMed 19474460Imran N, Rahman A, Chaudhry N, Asif A. Effectiveness of a school-based mental health intervention for school teachers in urban Pakistan: a randomized controlled trial. Child Adolesc Psychiatry Ment Health. 2022 May 3;16(1):33. doi: 10.1186/s13034-022-00470-1.
PubMed 35505362Imran N, Rahman A, Chaudhry N, Asif A. World Health Organization "School Mental Health Manual"-based training for school teachers in Urban Lahore, Pakistan: study protocol for a randomized controlled trial. Trials. 2018 May 24;19(1):290. doi: 10.1186/s13063-018-2679-3.
PubMed 29793553
Study at a glance
From the registry record, last updated by the sponsor on 26 Mar 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of School Based Intervention for Promoting Mental Health Literacy Among Teachers: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT02937714
- Acronym / sponsor ID
- KingEdwardMU
- Keywords
- Teachers, mental health literacy, school mental health promotion
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 231 participants (actual)
- Lead sponsor
- King Edward Medical UniversityUniversity, hospital or other
- Study start
- 10 Sep 2017 (actual)
- Primary completion
- 30 Nov 2018 (actual)
- Study completion
- 30 Nov 2018 (actual)
- First posted
- 19 Oct 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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
- To assess whether school mental health Manual based intervention leads to better self- efficacy among school teachers.
- 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 design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| School mental health training | Experimental | Other: School Mental Health trainingTeachers 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. |
| Wait list control group | No intervention | –Wait list control group of teachers in same schools. Half of teachers in the same school will be the wait list control group. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- All the teachers in the participating schools.
- Teachers of Grade 1-10 will be approached.
- Both Genders.
Key exclusion criteria (3 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| School Mental Health trainingAlso: WHO-EMRO School Mental Health Manual Based TrainingSchool 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 | School mental health training |
Primary outcome
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.
2 secondary outcomes
Teachers' Sense of Self Efficacy
Time frame: At the end of 3 days workshop
Students behavioural and emotional Problems
Time frame: 3 months after the teachers training
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Mar 2020.
- Background: PubMed 17450455Syed EU, Hussein SA, Mahmud S. Screening for emotional and behavioural problems amongst 5-11-year-old school children in Karachi, Pakistan. Soc Psychiatry Psychiatr Epidemiol. 2007 May;42(5):421-7. doi: 10.1007/s00127-007-0188-x. Epub 2007 Apr 21.
- BackgroundWeist, MD & Murray M. Advancing school mental health promotion globally. Advances in School Mental Health Promotion 2007; 1(1): 2-12.
- Background: PubMed 21291449Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011 Jan-Feb;82(1):405-32. doi: 10.1111/j.1467-8624.2010.01564.x.
- Background: PubMed 24053381Skre I, Friborg O, Breivik C, Johnsen LI, Arnesen Y, Wang CE. A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial. BMC Public Health. 2013 Sep 23;13:873. doi: 10.1186/1471-2458-13-873.
- BackgroundKutcher S, Wei Y, McLuckie A, Bullock L. Educator mental health literacy: a programme evaluation of the teacher training education on the mental health & high school curriculum guide. Advances in School Mental Health Promotion 2013;6(2):83-93 DOI: 10.1080/1754730X.2013.784615
- Background: PubMed 9759745Rahman A, Mubbashar MH, Gater R, Goldberg D. Randomised trial of impact of school mental-health programme in rural Rawalpindi, Pakistan. Lancet. 1998 Sep 26;352(9133):1022-5. doi: 10.1016/s0140-6736(98)02381-2.
- Background: PubMed 19474460Syed EU, Hussein SA. Increase in teachers' knowledge about ADHD after a week-long training program: a pilot study. J Atten Disord. 2010 Jan;13(4):420-3. doi: 10.1177/1087054708329972.
- Derived from this study: PubMed 35505362Imran N, Rahman A, Chaudhry N, Asif A. Effectiveness of a school-based mental health intervention for school teachers in urban Pakistan: a randomized controlled trial. Child Adolesc Psychiatry Ment Health. 2022 May 3;16(1):33. doi: 10.1186/s13034-022-00470-1.
- Derived from this study: PubMed 29793553Imran N, Rahman A, Chaudhry N, Asif A. World Health Organization "School Mental Health Manual"-based training for school teachers in Urban Lahore, Pakistan: study protocol for a randomized controlled trial. Trials. 2018 May 24;19(1):290. doi: 10.1186/s13063-018-2679-3.
- Individual participant dataSharing planned: Undecided
Related trials for School Mental Health Training of Teachers
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Psychosocial Support Program for Public School Teachers
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Nazish Imran, MRCPsych principal investigator
King Edward Medical University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing School Mental Health training in people with School Mental Health Training of Teachers, run by King Edward Medical University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Teachers' knowledge (time frame: At the end of 3 days workshop). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02937714, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Mar 2020; AzTrials last refreshed its copy on 8 Nov 2026.