The 3 integrative project components and their related activities are as follows:
Culturally adapt and deliver a proven mental health literacy program (MHLP): i) to teachers, and ii) through teachers to students
The MHLP, developed and widely implemented in Canada, and several other countries (Brazil, Portugal, Africa and China),4 will be adapted for use in Nicaragua with the help of local advisory groups. This will be accomplished by:
a) Implementing a structured teacher training program to deliver the MHLP curriculum (an intensive 3-day training), with a train-the-trainer component to support sustainability. A total of 50 teachers will be trained; the first 25 trainees will teach another 25 teachers half-way through the project, allowing for supervised train-the-trainer experience. Teachers will also receive 2-day training on supporting students with mental health questions or concerns, and making appropriate health system referrals. The project team will provide the training, mentoring and supervision. An advisory group involving local community agencies, primary care, and hospitals, will help to develop a local resource and referral guide.
b) Integrating the 8-12 hour MHLP curriculum into specific final year secondary school courses and university 1st year orientation courses, targeting 500 students. Topics will include: Mental disorders and addictions among youth; stigma; stress coping/problem-solving; and help-seeking. To compare outcomes between intervention/non-intervention groups, and help identify the educational stage at which the MHLP will have greatest impact, one secondary school and one UNAN-Leon faculty will receive the MHLP, and the other secondary school and a second university faculty will be controls.
Develop and implement an innovative technological platform (Mind Cloud) to support youth self-education on mental health
To enhance and support the curriculum, an innovative, culturally-adapted e-platform (termed “Mind Cloud”) will be developed to support the project. The team hopes to partner with local advisory groups and tech companies (e.g. the Instituto Nicaragüense de Telecomunicaciones y Correos -TELCOR), to develop this multi-modal e-platform.
The platform will include:
a) Mind Web: This website of user-friendly mental health information will be modeled on Canadian mental health literacy project websites that similarly provide information on mental health, mental illness, treatment and wellness in a lay-friendly manner (e.g. www.teenmentalhealth.org, www.tigweb.org, www.camh.ca). Access will be restricted initially to MHLP intervention participants, but free public access will be granted at project end.
b) Mind Games: Short, interactive online games will promote experiential learning and skills building, by allowing students to apply their new knowledge in realistic scenarios, thus consolidating their learning. The games will link to information on Mind Web via pop-ups on interesting facts and tips and tricks for game mastery.
c) Mind Talk: A portal to online forums for MHLP intervention participants to discuss mental health issues, share knowledge and collaborate on curriculum related assignments. Forums will be available for students only, teachers only, and mixed groups. Mind Cloud will be hosted by UNAN-Leon’s website, and maintained collaboratively by local tech experts, thus becoming a long-term local resource.
Evaluate the cost-effectiveness of this model of intervention
A cost-effectiveness analyses to quantify the value for investment in the intervention will be conducted (more information in the cost-effectiveness section)
The three components are integrative. Mind Cloud will support the MHLP by being a source of supplementary information that can be accessed in-class to enhance lessons, or accessed by students and teachers independently for self-driven learning. It also offers a common platform for discussion by teachers and students across schools. At every step of the project, costs (e.g. time, money) will be tracked to assess the value added by each component and efficiencies gained.