The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study
Objective: We assessed task-shifting children's mental health care to teachers as a potential approach to improving access to child mental health care.Methods: In Darjeeling, India, we conducted a single-arm, mixed-methods feasibility study with 19 teachers and 36 children in five rural primary...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.790536/full |
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| author | Christina M. Cruz Christina M. Cruz Priscilla Giri Juliana L. Vanderburg Peter Ferrarone Surekha Bhattarai Aileen A. Giardina Bradley N. Gaynes Bradley N. Gaynes Karen Hampanda Karen Hampanda Molly M. Lamb Molly M. Lamb Michael Matergia Michael Matergia |
| author_facet | Christina M. Cruz Christina M. Cruz Priscilla Giri Juliana L. Vanderburg Peter Ferrarone Surekha Bhattarai Aileen A. Giardina Bradley N. Gaynes Bradley N. Gaynes Karen Hampanda Karen Hampanda Molly M. Lamb Molly M. Lamb Michael Matergia Michael Matergia |
| author_sort | Christina M. Cruz |
| collection | DOAJ |
| description | Objective: We assessed task-shifting children's mental health care to teachers as a potential approach to improving access to child mental health care.Methods: In Darjeeling, India, we conducted a single-arm, mixed-methods feasibility study with 19 teachers and 36 children in five rural primary schools to determine whether teachers can deliver transdiagnostic mental health care to select children-in-need with fidelity to protocol, to assess which therapeutic options teachers chose to use within the protocol, and to evaluate for a potential signal of efficacy.Results: Participation rates for intervention activities were >80%. A majority of teachers met or exceeded quality benchmarks for all intervention activities. Teachers chose to deliver teacher-centric techniques, i.e., techniques that only teachers could deliver given their role in the child's life, 80% of the time. Children improved in mental health score percentiles on the Achenbach Teacher Report Form. Key facilitators included the flexibility to adapt intervention activities to their needs, while identified barriers included limited time for care delivery.Conclusion: Findings support the feasibility of task-shifting children's mental health care to classroom teachers in resource-limited schools. Fidelity to protocol appeared feasible, though the freedom to choose and adapt therapeutic techniques may also have enhanced feasibility. Surprisingly, teachers consistently chose to deliver teacher-centric therapeutic techniques that resulted in a potential signal of efficacy. This finding supports the potential emergence of “education as mental health therapy” (Ed-MH) as a new therapy modality. Continued investigation is required to test and refine strategies for involving teachers in the delivery of transdiagnostic mental health care. |
| first_indexed | 2024-04-11T17:03:29Z |
| format | Article |
| id | doaj.art-5aa267a1a97b441ca1f42a0c396bed3e |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-11T17:03:29Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-5aa267a1a97b441ca1f42a0c396bed3e2022-12-22T04:13:06ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-12-011210.3389/fpsyt.2021.790536790536The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot StudyChristina M. Cruz0Christina M. Cruz1Priscilla Giri2Juliana L. Vanderburg3Peter Ferrarone4Surekha Bhattarai5Aileen A. Giardina6Bradley N. Gaynes7Bradley N. Gaynes8Karen Hampanda9Karen Hampanda10Molly M. Lamb11Molly M. Lamb12Michael Matergia13Michael Matergia14Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United StatesSchool Psychology Program, University of North Carolina at Chapel Hill School of Education, Chapel Hill, NC, United StatesDarjeeling Ladenla Road Prerna, Darjeeling, IndiaSchool Psychology Program, University of North Carolina at Chapel Hill School of Education, Chapel Hill, NC, United StatesDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United KingdomDarjeeling Ladenla Road Prerna, Darjeeling, IndiaBroadleaf Health & Education Alliance, Stroudsburg, PA, United StatesDepartment of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United StatesDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesCenter for Global Health, Colorado School of Public Health, Aurora, CO, United StatesDepartment of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesCenter for Global Health, Colorado School of Public Health, Aurora, CO, United StatesDepartment of Epidemiology, Colorado School of Public Health, Aurora, CO, United StatesBroadleaf Health & Education Alliance, Stroudsburg, PA, United StatesCenter for Global Health, Colorado School of Public Health, Aurora, CO, United StatesObjective: We assessed task-shifting children's mental health care to teachers as a potential approach to improving access to child mental health care.Methods: In Darjeeling, India, we conducted a single-arm, mixed-methods feasibility study with 19 teachers and 36 children in five rural primary schools to determine whether teachers can deliver transdiagnostic mental health care to select children-in-need with fidelity to protocol, to assess which therapeutic options teachers chose to use within the protocol, and to evaluate for a potential signal of efficacy.Results: Participation rates for intervention activities were >80%. A majority of teachers met or exceeded quality benchmarks for all intervention activities. Teachers chose to deliver teacher-centric techniques, i.e., techniques that only teachers could deliver given their role in the child's life, 80% of the time. Children improved in mental health score percentiles on the Achenbach Teacher Report Form. Key facilitators included the flexibility to adapt intervention activities to their needs, while identified barriers included limited time for care delivery.Conclusion: Findings support the feasibility of task-shifting children's mental health care to classroom teachers in resource-limited schools. Fidelity to protocol appeared feasible, though the freedom to choose and adapt therapeutic techniques may also have enhanced feasibility. Surprisingly, teachers consistently chose to deliver teacher-centric therapeutic techniques that resulted in a potential signal of efficacy. This finding supports the potential emergence of “education as mental health therapy” (Ed-MH) as a new therapy modality. Continued investigation is required to test and refine strategies for involving teachers in the delivery of transdiagnostic mental health care.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.790536/fullteachertask-shiftingchild mental healthfeasibilityfidelityglobal mental health |
| spellingShingle | Christina M. Cruz Christina M. Cruz Priscilla Giri Juliana L. Vanderburg Peter Ferrarone Surekha Bhattarai Aileen A. Giardina Bradley N. Gaynes Bradley N. Gaynes Karen Hampanda Karen Hampanda Molly M. Lamb Molly M. Lamb Michael Matergia Michael Matergia The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study Frontiers in Psychiatry teacher task-shifting child mental health feasibility fidelity global mental health |
| title | The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study |
| title_full | The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study |
| title_fullStr | The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study |
| title_full_unstemmed | The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study |
| title_short | The Potential Emergence of “Education as Mental Health Therapy” as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study |
| title_sort | potential emergence of education as mental health therapy as a feasible form of teacher delivered child mental health care in a low and middle income country a mixed methods pragmatic pilot study |
| topic | teacher task-shifting child mental health feasibility fidelity global mental health |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.790536/full |
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