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

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.

Mental health literacy programs for school teachers: A systematic review and narrative synthesis

“…Recruitment of participants was not random or consecutive in 2 studies (Kidger et al, 2016;Moor et al, 2000). Seven studies did not report the method of participant recruitment in detail (Coppens et al, 2014;Eustache et al, 2017;Hussein & Vostanis, 2013;Kutcher et al, 2015;Kutcher, Wei, Gilberds, et al, 2016;Martinez et al, 2015;Vieira et al, 2014). The ROB evaluation was consistent between the two reviewers for 12 out of the 16 studies.…”

“…High ROB and clinical/methodological heterogeneity also lowered the quality, within and across the studies, respectively. (Eustache et al, 2017;Hussein & Vostanis, 2013;Jorm et al, 2010;Kidger et al, 2016;Kutcher et al, 2015;Kutcher et al, 2013;Martinez et al, 2015;Powers et al, 2014;. Of these 11 studies, 1 was a cluster RCT (Jorm et al, 2010), 1 was a CBA (Kidger et al, 2016) and 9 were case series (Eustache et al, 2017;Hussein & Vostanis, 2013;Kutcher et al, 2015;Kutcher et al, 2013;Powers et al, 2014;.…”

Malawi Educators Assessment of Student Mental Health Outcomes

“…Following a teach-the teacher technique, the trainers taught teachers and youth club leaders in schools and out-of-school youth clubs involved in the program how to apply the AGMv to teach their students about mental health and mental illness. Results previously reported have demonstrated a significant and substantial positive impact of this training on teachers MHL [38] and project evaluation of the effect of this approach on the MHL of both teachers and students is ongoing. This paper examines teacher reports of the impact of the school MHL program on students who received classroom instruction from teachers trained to deliver the AGMv resource.…”

“…The life improvement metrics in this study extend beyond usual measures of MHL applied in other research [22,35,38] and provide an additional and wider ranging assessment of the impact of a school based MHL intervention. The teacher reported improvements in students' at-school behaviour and mental health care related helpseeking behaviour suggests that the mental health curriculum resource (AGMv) embedded and applied in schools may have the potential to lead to wider improvements in students' health outcomes.…”

“…Teachers attended a one week training session. Evaluation of the impact of the training showed significant improvements in teachers mental health knowledge and decreases in stigma [38]. The questionnaires were administered in person by members of the project staff in a face-to-face interview where the teacher respondents' answers were recorded on paper.…”