RANDOMIZED TRIAL OF IMPACT OF SCHOOL MENTAL-HEALTH PROGRAM IN RURAL RAWALPINDI, PAKISTAN

Background A school mental-health programme has been developed as a co mponent of the community mental-health programme in Rawalpindi, Pakist an. It has the objective of improving the understanding of disorders o f 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 . Methods We chose two secondary schools for boys and two for girls th at were similar in terms of size, staff-pupil ratio, and dropout rates . 100 children aged 12-16 years (25 girls and 25 boys in each of the s tudy and control groups), 100 parents tone for each child), 100 friend s who did not attend school tone for each child), and 100 neighbours t one for each child) were given a 19-item questionnaire before and afte r the study group had had a 4-month programme of mental-health educati on. The maximum score for the questionnaire was 16 points.Findings Bef ore the school mental-health programme the awareness of mental-health issues was poor (mean score 5.7-7.6) in the four groups of participant s. In the study group there was a significant improvement iri the mean scores after the school programme in the schoolchildren (mean improve ment 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 significa nt only in schoolchildren (1.5 [0.5-2.3], p=0.01) and their friends (0 .8 [0.3-1.3], p<0.01). Interpretation The school programme succeeded i n improving awareness of mental health in schoolchildren and the commu nity. The schoolchildren were receptive to the programme, and shared t heir new understanding with family, friends, and neighbours. Mental-he alth planners who wish to improve community awareness of mental health , particularly in areas with low literacy rates, should consider setti ng up school mental-health programmes.