Rahman A, Mubbashar M H, Gater R, Goldberg D
Institute of Psychiatry, WHO Collaborating Centre for Mental Health Research and Training, Rawalpindi Medical College, Pakistan.
Lancet. 1998 Sep 26;352(9133):1022-5. doi: 10.1016/s0140-6736(98)02381-2.
A school mental-health programme has been developed as a component of the community mental-health programme in Rawalpindi, Pakistan. It has the objective of improving the understanding of disorders of mental health in the rural community. We aimed to assess the impact of a school mental-health programme on the awareness of schoolchildren, their parents, friends who were not attending school, and neighbours.
We chose two secondary schools for boys and two for girls that were similar in terms of size, staff-pupil ratio, and drop-out rates. 100 children aged 12-16 years (25 girls and 25 boys in each of the study and control groups), 100 parents (one for each child), 100 friends who did not attend school (one for each child), and 100 neighbours (one for each child) were given a 19-item questionnaire before and after the study group had had a 4-month programme of mental-health education. The maximum score for the questionnaire was 16 points.
Before the school mental-health programme the awareness of mental-health issues was poor (mean score 5.7-7.6) in the four groups of participants. In the study group there was a significant improvement in the mean scores after the school programme in the schoolchildren (mean improvement 7.6 [95% CI 6.7-8.5], p<0.01), their parents (5.3 [4.5-6.1], p<0.01), friends (5.1 [4.1-6.1], p<0.01), and neighbours (3.4 [2.6-4.2], p<0.01). In the control group the difference in awareness was significant only in schoolchildren (1.5 [0.5-2.3], p=0.01) and their friends (0.8 [0.3-1.3], p<0.01).
The school programme succeeded in improving awareness of mental health in schoolchildren and the community. The schoolchildren were receptive to the programme, and shared their new understanding with family, friends, and neighbours. Mental-health planners who wish to improve community awareness of mental health, particularly in areas with low literacy rates, should consider setting up school mental-health programmes.
在巴基斯坦拉瓦尔品第，一项学校心理健康项目已被开发出来，作为社区心理健康项目的一个组成部分。其目标是增进农村社区对心理健康障碍的了解。我们旨在评估一项学校心理健康项目对学童、其父母、未上学的朋友以及邻居的认知的影响。
我们选择了两所男校和两所女校，这些学校在规模、师生比例和辍学率方面相似。在研究组开展为期4个月的心理健康教育项目之前和之后，分别向100名12 - 16岁的儿童（研究组和对照组各25名女孩和25名男孩）、100名家长（每个孩子一名家长）、100名未上学的朋友（每个孩子一名朋友）以及100名邻居（每个孩子一名邻居）发放一份包含19个条目的问卷。该问卷的最高分是16分。
在学校心理健康项目开展之前，四组参与者对心理健康问题的认知较差（平均得分5.7 - 7.6）。在研究组中，学校项目开展后，学童的平均得分有显著提高（平均提高7.6 [95%置信区间6.7 - 8.5]，p<0.01），其父母（5.3 [4.5 - 6.1]，p<0.01）、朋友（5.1 [4.1 - 6.1]，p<0.01）以及邻居（3.4 [2.6 - 4.2]，p<0.01）的平均得分也有显著提高。在对照组中，认知差异仅在学童（1.5 [0.5 - 2.3]，p = 0.01）及其朋友（0.8 [0.3 - 1.3]，p<0.01）中显著。
该学校项目成功提高了学童和社区对心理健康的认知。学童接受了该项目，并与家人、朋友和邻居分享了他们新的理解。希望提高社区对心理健康的认知，尤其是在识字率较低地区的心理健康规划者，应考虑设立学校心理健康项目。
