A randomised controlled trial evaluating the Guide Cymru mental health literacy intervention programme in year 9 (age 13-14) school pupils in Wales.

BACKGROUND: Adolescent mental health has become a public health concern as 10-20% of adolescents have experiences with mental health problems. Improving mental health education is critical to reducing stigma and improving access to appropriate care when needed. Here we examine the impact of a mental health literacy programme (Guide Cymru) in young adolescents in the UK. A randomised controlled trial assessed the effectiveness of the Guide Cymru intervention. METHOD: A total of 1,926 pupils (860 males and 1066 females) aged 13-14 (year 9) took part in the study. The secondary schools were randomised into the active and control arms of the study. Teachers in the active arm of the study were trained on the Guide Cymru and then delivered the intervention to their pupils. Pupils in the active groups received six modules of mental health literacy (the Guide Cymru), and control schools received teaching as usual. Mental health literacy across several domains (e.g., knowledge, stigma, help-seeking intentions) were assessed both before and after the intervention. Data collection for the randomised controlled trial ran from September 2019 to March 2020. Multi-level modelling analysis was conducted to account for the clustered nature of the design. RESULTS: All aspects of mental health literacy, including mental health knowledge (g = 0.32), good mental health behaviours (g = 0.22), mental health stigmas (g = 0.16), intentions to seek help (g = 0.15), and avoidant coping (g = 0.14) improved after completing the Guide Cymru programme (ps < .001). DISCUSSION: The current study presents evidence for the Guide Cymru's effectiveness in improving secondary school pupils' mental health literacy. We demonstrate that providing teachers with appropriate resources and training to deliver the Guide Cymru programme within their classrooms can improve the mental health literacy of pupils. These findings have important implications for the beneficial impacts the secondary school system can have on reducing the burden of mental health problems at a critical point in a young person's life. TRIAL REGISTRATION: ISRCTN15462041. Registered 03/10/2019.

Development and psychometric properties of the Knowledge and Attitudes to Mental Health Scales (KAMHS): a psychometric measure of mental health literacy in children and adolescents.

BACKGROUND: Adolescence is a crucial period for the acquisition of good mental health behaviours, which are the foundation for health and wellbeing in later life. Improved knowledge about mental health and improved help-seeking behaviours have been shown to lead to better mental health outcomes. Mental health literacy (MHL) is multifaceted (e.g., knowledge about symptoms, the stigma around mental health, good mental health practices, etc.). Measures are needed that can assess these different aspects of MHL. Measurement of mental health literacy is currently limited due to a lack of reported psychometric instruments with known psychometric properties. Given that most mental health problems start in early adolescence, a scale is needed that is reliable and valid in this age group. METHODS: The development and validation of the psychometric instrument (termed the Knowledge and Attitudes to Mental Health Scales: KAMHS) entailed two phases: 1) item generation based on an evidence-based intervention programme: The Guide; and 2) item reduction through exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) for factor structure and psychometric assessment. Participants were 559 Year 9 pupils in secondary schools across Wales aged between 13 and 14 years. RESULTS: Results from the CFA indicated an acceptable fit of the model to the data. The KAMHS showed good internal constancy and moderate test-retest validity (.40-.64). CONCLUSIONS: The final version of the KAMHS contains 50 items that are appropriate for use in children and adolescents. These results suggest that the KAMHS can be used over time to assess the efficacy of interventions aimed at increasing the mental health literacy of adolescent populations.

Phosphorus nutrition of phosphorus-sensitive Australian native plants: threats to plant communities in a global biodiversity hotspot.

South-western Australia harbours a global biodiversity hotspot on the world's most phosphorus (P)-impoverished soils. The greatest biodiversity occurs on the most severely nutrient-impoverished soils, where non-mycorrhizal species are a prominent component of the flora. Mycorrhizal species dominate where soils contain slightly more phosphorus. In addition to habitat loss and dryland salinity, a major threat to plant biodiversity in this region is eutrophication due to enrichment with P. Many plant species in the south-western Australian biodiversity hotspot are extremely sensitive to P, due to a low capability to down-regulate their phosphate-uptake capacity. Species from the most P-impoverished soils are also very poor competitors at higher P availability, giving way to more competitive species when soil P concentrations are increased. Sources of increased soil P concentrations include increased fire frequency, run-off from agricultural land, and urban activities. Another P source is the P-fertilizing effect of spraying natural environments on a landscape scale with phosphite to reduce the impacts of the introduced plant pathogen Phytophthora cinnamomi, which itself is a serious threat to biodiversity. We argue that alternatives to phosphite for P. cinnamomi management are needed urgently, and propose a strategy to work towards such alternatives, based on a sound understanding of the physiological and molecular mechanisms of the action of phosphite in plants that are susceptible to P. cinnamomi. The threats we describe for the south-western Australian biodiversity hotspot are likely to be very similar for other P-impoverished environments, including the fynbos in South Africa and the cerrado in Brazil.