Date of Award

11-21-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Rozina Karamali

Second Advisor

Dr. Mohammad Asim

Third Advisor

Dr. Saleema Gulzar

Department

Community Health Sciences

Abstract

Introduction: “Mental health is a dimension of health and well-being, not merely the absence of disease.” It is inter-connected with physical and behaviour health. Mental health has been an oversight for decades, but at present, the United Nations (UN) has acknowledged mental health as a priority for the Sustainable Developmental Goals (SDGs). School health promotional programs include health literacy related to the human mind and body, life skill-building and healthy coping skills, which play a vital role in adolescents' health and well-being. School health promotion programs are essential for the overall well-being of students and the future health and productivity of the population. Examing relevant stakeholders' involvement, understanding and perceptions ofschoolbased mental health programs is essential. To the best of our knowledge, the exploration of inhouse college stakeholders identified a gap in designing and planning for school-based mental health programs in colleges. Thus, this study aims to explore and describe stakeholders' perspectives on school-based mental health programs in colleges in Karachi, Pakistan.
Method: A qualitative exploratory-descriptive study design was used to explore stakeholders' views towards college school-based mental health programs. The study was conducted in public and private colleges in Karachi (urban), Pakistan. Stakeholders were categories into three groups 1. Managerial and leadership level (Principals), 2.Educator level (Teachers), and 3.Student level (Adolescents). The purposive sampling technique was utilized. Key informants’ interviews and focus group discussion has been conducted with the principal and Teacher/Students, respectively. Data were analyzed using thematic analysis. Trustworthiness and rigour of the study were obtained.
Finding(s): A total of (n=43) representatives from three stakeholder groups participated in this research (Table 1.), five FGDs and three KIs conducted, KIs with principals (n=3), FGDs with Students (n=23) including male and female ratio of 9:14 and Teachers (n=17) include the male and female ratio of 7:10 of public and private colleges. The highest education level among principals was a master’s in education, whereas the highest level of education among teachers was a PhD scholar, primarily graduates of master in science degree. The average Teaching experience among principals and teachers was 27 and 13, respectively. Theoretical Framework on student and teacher's mental health has utilized all framework elements, including the development of the guide's questions, prompts, or discussion topics. It also explored the designing and planning lens as an informed strategy to develop mental health programs in colleges. The findings of the study include two themes from the theoretical framework, namely prevention and promotion of mental health; on the other hand, three new emerging themes followed by explored perceived barriers/threads, potential enablers/opportunities and suggestions for designing school-based mental health programs from responses of selected stakeholders in public and private colleges. Using thematic analysis, the theme has sub-theme and codes extracted from the study participant's verbatims. The theoretical framework in this research consists of the core component of student's and teacher's mental health to the overarching policy level. The school-based mental health program promotes mental health, which will further be divided into social and emotional learning and resilience sub-themes. On the other hand, the prevention of mental health problems sub-theme includes social, emotional and behavioural problems. Students, Teachers and Principals have highlighted the perceived barriers/threads as the stigma associated with mental health and illness, fear of being judged, lack of confidentiality for students, lack of mental health professionals, and financial and budget constraints regarding school-based mental health programs. Potential Enablers/opportunities include supportive school leadership and educators, enabling environment, and partnership between professionals and organizations. The overall suggestions on school-based mental health programs include art-based methodologies and interventions, time and space allocation for mental health activities and creating mental health society in educational institutes.
Conclusion: This study is one of a kind, as all three stakeholders' views regarding school-based mental health programs have been captured and described. They have highlighted the importance and need for School-based mental health programs in colleges. Besides imposing western or high-income countries' modules and curricula on mental health for adolescents, this study captures the contextual and ground-level knowledge, need and demand related to school-based mental health programs in colleges. The study's findings will benefit future school-based programs as an informed-based, feasible, adaptable and sustainable model in schools and colleges to promote adolescents' health and mental well-being.

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