Display options
Cite
Cruz CM, Lamb MM, Giri P, et al. Perceptions, attitudes, and knowledge of teachers serving as mental health lay counselors in a low and middle income country: a mixed methods pragmatic pilot study. Int J Ment Health Syst. 2021;15(1):40doi: 10.1186/s13033-021-00453-3.
Cruz, C. M., Lamb, M. M., Giri, P., Vanderburg, J., Ferrarone, P., Bhattarai, S., Giardina, A. A., Hampanda, K., Gaynes, B. N., & Matergia, M. (2021). Perceptions, attitudes, and knowledge of teachers serving as mental health lay counselors in a low and middle income country: a mixed methods pragmatic pilot study. International journal of mental health systems, 15(1), 40. https://doi.org/10.1186/s13033-021-00453-3
Cruz, Christina M, et al. "Perceptions, attitudes, and knowledge of teachers serving as mental health lay counselors in a low and middle income country: a mixed methods pragmatic pilot study." International journal of mental health systems vol. 15,1 (2021): 40. doi: https://doi.org/10.1186/s13033-021-00453-3
Cruz CM, Lamb MM, Giri P, Vanderburg J, Ferrarone P, Bhattarai S, Giardina AA, Hampanda K, Gaynes BN, Matergia M. Perceptions, attitudes, and knowledge of teachers serving as mental health lay counselors in a low and middle income country: a mixed methods pragmatic pilot study. Int J Ment Health Syst. 2021 Apr 29;15(1):40. doi: 10.1186/s13033-021-00453-3. PMID: 33926487; PMCID: PMC8082764.
Copy Download .nbib Format: NLM
Share it on

Int J Ment Health Syst. 2021 Apr 29;15(1):40. doi: 10.1186/s13033-021-00453-3.

Perceptions, attitudes, and knowledge of teachers serving as mental health lay counselors in a low and middle income country: a mixed methods pragmatic pilot study.

International journal of mental health systems

Christina M Cruz, Molly M Lamb, Priscilla Giri, Juliana Vanderburg, Peter Ferrarone, Surekha Bhattarai, Aileen A Giardina, Karen Hampanda, Bradley N Gaynes, Michael Matergia

Affiliations

  1. Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, CB #7160, Chapel Hill, NC, 27599, USA. [email protected].
  2. Department of Epidemiology, Colorado School of Public Health at the University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Mail Stop C245, Aurora, 80045, CO, USA.
  3. Center for Global Health, Colorado School of Public Health at the University of Colorado Anschutz Medical Campus, 131999 E. Montview Blvd., Suite 310, Mail Box A090, Aurora, CO, 80045, USA.
  4. Darjeeling Ladenla Road Prerna, 42 Ladenla Road, Darjeeling, West Bengal, 734101, India.
  5. School Psychology Program, University of North Carolina at Chapel Hill School of Education, 100 E. Cameron Ave, Chapel Hill, NC, 27514, USA.
  6. Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
  7. Broadleaf Health and Education Alliance, 919 Main Street, Stroudsburg, PA, 18360, USA.
  8. Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  9. Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, CB #7160, Chapel Hill, NC, 27599, USA.
  10. Center for Global Health, Colorado School of Public Health at the University of Colorado Anschutz Medical Campus, 131999 E. Montview Blvd., Suite 310, Mail Box A090, Aurora, CO, 80045, USA. [email protected].
  11. Broadleaf Health and Education Alliance, 919 Main Street, Stroudsburg, PA, 18360, USA. [email protected].

PMID: 33926487 PMCID: PMC8082764 DOI: 10.1186/s13033-021-00453-3

Abstract

BACKGROUND: Low and middle-income countries (LMICs) lack trained child mental health professionals. While teachers' child development experience potentially positions them to fill the gap as lay mental health counselors, they have rarely delivered indicated child mental health care in LMICs. As part of assessing the feasibility of teachers serving as lay counselors, we explored teachers' perceptions of serving as lay counselors and their mental health attitudes and knowledge.

METHODS: In 2018, with training and supervision, 19 primary school teachers from five rural, low cost private schools in Darjeeling, India, served as lay counselors in their classrooms. Using mixed methods, we examined teacher perceptions of serving as lay counselor and mental health attitudes and knowledge through a survey (n = 15), a summative assessment (n = 14), and semi-structured interviews (n = 17). For the survey and summative assessment, pre-training, post-training, and post-intervention mean scores were compared using paired t tests. Post-intervention interviews were coded for teachers' perceptions of serving as lay counselor and mental health attitudes and knowledge.

RESULTS: Qualitatively, teachers expressed being willing to serve as lay counselor, having more inclusive mental health attitudes, and retaining mental health knowledge as applicable to use during instructional time or incorporation into the knowledge transfer process, their primary duty. By contrast, quantitatively, teachers' attitudes appeared to become more inclusive on the study-specific survey pre versus post-training, but reverted to pre-training levels post-intervention. Teachers' mental health knowledge on the summative assessment did not change pre-training versus post-training versus post-intervention.

CONCLUSIONS: Training, supervision, and serving as lay counselors led to teachers' willingness to serve as lay counselors. Teachers served as lay counselors by utilizing therapeutic techniques during class time and incorporating them into their typical instruction, not through delivering traditional office-like care. Teacher practices may be pointing to the potential emergence of an "education as mental health therapy" system of care. Their changes in attitudes and knowledge reflected their emerging practices. Quantitative measures of knowledge and attitude changes did not capture these nuanced changes. Trial Registration The parent feasibility trial was registered on January 01, 2018 with Clinical Trials Registry - India (CTRI), reg. no. CTRI/2018/01/011471, ref. no. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27. .

Keywords: Attitude; Child mental health; Knowledge; LMIC; Lay counselor; Perceptions; School mental health; Task-shifting; Teacher

References

  1. J Abnorm Child Psychol. 2005 Dec;33(6):665-79 - PubMed
  2. Pediatrics. 2019 Apr;143(4): - PubMed
  3. Arch Dis Child. 2013 May;98(5):323-7 - PubMed
  4. Lancet. 2011 Nov 5;378(9803):1654-63 - PubMed
  5. Glob Ment Health (Camb). 2017 Mar 6;4:e4 - PubMed
  6. Lancet. 2010 Dec 18;376(9758):2086-95 - PubMed
  7. Dev Psychol. 2015 Mar;51(3):309-22 - PubMed
  8. Indian J Psychiatry. 1997 Apr;39(2):130-5 - PubMed
  9. Lancet Psychiatry. 2014 Oct;1(5):388-98 - PubMed
  10. Child Adolesc Ment Health. 2010 Sep;15(3):150-156 - PubMed
  11. Health Aff (Millwood). 1995 Fall;14(3):147-59 - PubMed
  12. Glob Health Action. 2021 Jan 1;14(1):1861921 - PubMed
  13. PLoS Med. 2020 Feb 11;17(2):e1003021 - PubMed
  14. Cochrane Database Syst Rev. 2013 Nov 19;(11):CD009149 - PubMed
  15. Lancet. 2018 Dec 8;392(10163):2465-2477 - PubMed
  16. Indian J Psychiatry. 2019;61(4):415-419 - PubMed
  17. Lancet. 2017 Jan 14;389(10065):176-185 - PubMed
  18. J Am Acad Child Adolesc Psychiatry. 2007 May;46(5):647-52 - PubMed

Publication Types

Grant support