Exploring Mental Health and Academic Outcomes of Children Receiving Non-manualized, Transdiagnostic, Task-Shifted Mental Health Care From Their Teachers in a Low-and-Middle Income Country

Abstract

A majority of children worldwide who face mental health difficulties, especially in low-and-middle income countries, remain undiagnosed and untreated. This deficit roots in part from a lack of trained professionals qualified to provide care. Task-shifting the provision of treatment to teachers, individuals with consistent access to children, can reduce the care gap. The current study investigated whether the implementation of a pilot trial of Tealeaf-Mansik Swastha (Teachers Leading the Frontlines—Mental Health; “Tealeaf”) was associated with improvements in child mental health and academic outcomes. Tealeaf is a transdiagnostic, non-manualized, task-shifting intervention in which teachers identify students in need of mental health care and then provide task-shifted care for them using an emerging, novel therapy modality, “education as mental health therapy” (Ed-MH). Pre-post standardized quantitative measures focused on child mental health status and academics. The measures were completed by multiple raters and compared to determine whether changes occurred. Results indicated that primary teacher raters observed significant improvements in child mental health symptoms overall, while secondary teacher raters and caregivers noted improvement for certain diagnostic categories. Caregivers observed on average a decreased impact of their children's mental health symptoms on their children's lives. Academically, math scores significantly improved while reading trended toward significance. Preliminary evidence overall supports the viability of Tealeaf and Ed-MH for positively impacting child mental health and academics. Future directions include the implementation of a formalized, randomized-controlled trial to strengthen preliminary outcomes.

Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study

“…Many teachers centered their acceptability around a belief that Tealeaf was impactful regarding changing children’s behavior and academics, implying a change in function and symptom severity from a previously more severe state. Accordingly, children receiving care, on average, had improved mental health symptoms outcomes on the TRF, as in a separate publication from this author group [ 31 ]. Further, teachers in studies in HICs expressed similar sentiments of acceptability, citing witnessed improved mental health symptoms of students in their classroom, which also implied previously more severe states [ 16 – 18 ].…”

“…Care in Tealeaf is also non-manualized, allowing teachers to customize the care they deliver, including delivering care within classroom activities or in a more traditional one-on-one (1:1) setting. Early evidence points to teachers delivering Tealeaf care feasibly, with fidelity, and with improved mental health symptoms in children who have received Tealeaf care [ 30 , 31 ].…”

Knowledge, Misconceptions, and Myths of Master’s Degree Students about Attention Deficit Hyperactivity Disorder (ADHD)

“…We note that teachers' lack of knowledge of the diagnostic criteria in the DSM-5R can hinder the early identification of disorders. This lack of familiarity can influence early identification by teachers This will allow teachers to recognise symptoms, understand the importance of early intervention, and collaborate effectively with other professionals for the benefit of students [29].…”