Experimental evaluation of a school-based mental health literacy program in two Southeast Asian nations.

ABSTRACT

Background: Low mental health literacy (MHL) is a particular challenge in many low and middle-income countries (LMIC). School-based MHL programs hold promise to increase MHL but lack rigorous research assessing their effectiveness in LMIC. The present study evaluated a school-based MHL program, the "Mental Health & High School Curriculum Guide" ("The Guide"), implemented separately in two different contexts in Southeast Asia (Vietnam and Cambodia) following adaptations made by the research team. Methods: Participants were 80 teachers and 2,539 students from 20 schools in Vietnam (Study 1), and 67 teachers and 275 students in one school in Cambodia (Study 2). In Vietnam, teachers/classrooms were randomized to either The Guide MHL program or a treatment-as-usual control condition, with teachers in the intervention condition receiving a 3-day training in The Guide and implementing the 6-module curriculum in their classrooms. In Cambodia, school staff were randomized to either receive The Guide training or to the control condition; four teachers who received the training implemented the curriculum in select classrooms. In both studies, teachers' and students' mental health knowledge and attitudes were assessed at baseline and following completion of the classroom curriculum. Results: In Vietnam, 6 of 7 program effects for teachers were significant with some large effects (e.g., teacher Recognition of Mental Health Disorders, R2=.36); effects for both of the student outcomes were significant, but small. Results were similar in Cambodia, with 6 of 9 program effects significant favoring the treatment group; effect sizes in Cambodia were smaller than in Vietnam for teachers/staff but larger for students. Conclusion: Findings suggest that with limited adaptation, a teacher-delivered MHL intervention can produce measurable increases in MHL among teachers and students in two Southeast Asian countries. These results support the value of school-based MHL training provided via an inexpensive and teacher-friendly program, embedding MHL into classrooms. Some small effect sizes suggest the importance of additional development and research targeting these particular components.