Author:
Cruz Christina M.,Dukpa Choden,Vanderburg Juliana L.,Rauniyar Abhishek K.,Giri Priscilla,Bhattarai Surekha,Thapa Arpana,Hampanda Karen,Gaynes Bradley N.,Lamb Molly M.,Matergia Michael
Abstract
Abstract
Background
The acceptability of teachers delivering task-shifted mental health care to their school-aged students is understudied. Here, we evaluate teachers’, students’, and caregivers’ acceptability of Tealeaf (Teachers Leading the Frontlines), an alternative system of care in which teachers are trained and supervised to deliver transdiagnostic, non-manualized task-shifted care to their students.
Methods
In a 2019 single-arm, mixed methods, pragmatic acceptability pilot study in Darjeeling, India, 13 teachers delivered task-shifted child mental health care to 26 students in need. Teachers delivered care through using a transdiagnostic, non-manualized therapy modality, “education as mental health therapy” (Ed-MH). Measured with validated scales, teachers’ and students’ acceptability were compared after teacher training (PRE) and at the end of intervention (POST) using paired t tests. Teachers (n = 7), students (n = 7), and caregivers (n = 7) completed semi-structured interviews POST.
Results
Teachers’ quantitative measures indicated moderate acceptability PRE and POST and did not change PRE to POST. Children’s measures showed acceptability PRE and POST but decreased PRE to POST. Teachers and caregivers universally expressed acceptability in interviews. Facilitators of acceptability included impact, trust of teachers, and teachers’ ability to make adaptations. Conditions required for acceptability included supervision and teachers emphasizing academics benefits over mental health benefits to caregivers. Barriers to acceptability included a lack of teacher time and stigma. Interviewed students universally were unaware of receiving care; teachers intentionally avoided singling them out.
Conclusion
Teachers, caregivers, and children found teacher delivering task-shifted care acceptable, a key factor in care adoption and sustainability, though interviewed children were unaware of receiving care.
Trial registration The 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
Funder
American Academy of Child and Adolescent Psychiatry
Doris Duke Charitable Foundation
Thrasher Research Fund
Publisher
Springer Science and Business Media LLC
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