Parikh R, Michelson D, Sapru M, Sahu R, Singh A, Cuijpers P, Patel V
Sangath, C-1/52, 1st Floor, Safdarjung Development Area, New Delhi, Delhi, India.
Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, van der Boechorstraat 1, Amsterdam, The Netherlands.
Glob Ment Health (Camb). 2019 Aug 19;6:e18. doi: 10.1017/gmh.2019.16. eCollection 2019.
Schools are important settings for increasing reach and uptake of adolescent mental health interventions. There is limited consensus on the focus and content of school-based mental health services (SBMHSs), particularly in low-resource settings. This study elicited the views of diverse stakeholders in two urban settings in India about their priorities and preferences for SBMHSs.
We completed semi-structured interviews and focus group discussions with adolescents ( = 191), parents ( = 9), teachers ( = 78), school counsellors ( = 15), clinical psychologists/psychiatrists ( = 7) in two urban sites in India (Delhi and Goa). Qualitative data were obtained on prioritized outcomes, preferred content and delivery methods, and indicated barriers.
All stakeholders indicated the need for and acceptability of SBMHSs. Adolescents prioritized resolution of life problems and exhibited a preference for practical guidance. Parents and teachers emphasized functional outcomes and preferred to be involved in interventions. In contrast, adolescents' favored limited involvement from parents and teachers, was related to widespread concerns about confidentiality. Face-to-face counselling was deemed to be the most acceptable delivery format; self-help was less frequently endorsed but was relatively more acceptable if blended with guidance or delivered using digital technology. Structured sensitization was recommended to promote adolescent's engagement. Providers endorsed a stepped care approach to address different levels of mental health need among adolescents.
SBMHSs are desired by adolescents and adult stakeholders in this setting where few such services exist. Sensitization activities are required to support implementation. School counsellors have an important role in identifying and treating adolescents with different levels of mental health needs, and a suite of interventions is needed to target these needs effectively and efficiently.
学校是扩大青少年心理健康干预措施覆盖面和使用率的重要场所。对于以学校为基础的心理健康服务（SBMHSs）的重点和内容，人们的共识有限，尤其是在资源匮乏的环境中。本研究征集了印度两个城市地区不同利益相关者对SBMHSs的优先事项和偏好的看法。
我们在印度的两个城市地区（德里和果阿），对青少年（n = 191）、家长（n = 9）、教师（n = 78）、学校辅导员（n = 15）、临床心理学家/精神科医生（n = 7）进行了半结构化访谈和焦点小组讨论。获得了关于优先结果、偏好内容和提供方式以及指出的障碍的定性数据。
所有利益相关者都表明了对SBMHSs的需求和可接受性。青少年将解决生活问题列为优先事项，并表现出对实用指导的偏好。家长和教师强调功能性结果，并倾向于参与干预。相比之下，青少年赞成家长和教师有限的参与，这与对保密性的广泛担忧有关。面对面咨询被认为是最可接受的提供形式；自助较少被认可，但如果与指导相结合或使用数字技术提供，则相对更可接受。建议进行结构化的宣传活动以促进青少年的参与。提供者赞同采用阶梯式护理方法来满足青少年不同程度的心理健康需求。
在这种几乎没有此类服务的环境中，青少年和成年利益相关者都希望有SBMHSs。需要开展宣传活动以支持实施。学校辅导员在识别和治疗有不同心理健康需求水平的青少年方面具有重要作用，并且需要一系列干预措施来有效且高效地满足这些需求。
