Psycho-social Support on Mental Health and Hope of Adolescents Affected by Earthquake in Nepal

Not Applicable

Completed

• Conditions: Mental Health Issue (E.G., Depression, Psychosis, Personality Disorder, Substance Abuse)
• Interventions: Behavioral: Psychosocial support training for school teachers

• Registration Number: NCT03387007
• Lead Sponsor: Tokyo University

Brief Summary

Adolescents are prone to mental health problems such as post-traumatic stress disorder (PTSD) and depression which could become worse in the aftermath of disasters. However, hope can help adolescents cope with the challenges better. For resource poor disaster prone settings, school teachers can provide timely psycho-social support that could improve mental health and hope among adolescents.

Nepal is a disaster prone country that faced a devastating earthquake in 2015 that claimed thousands of lives and left many homeless which could have affected the mental health of adolescents.This study was conducted in schools of Dhading, a severely earthquake affected district and schools of Myagdi, a least affected district by earthquake in Nepal. The intervention focused on training school teachers on psycho-social support for adolescents.

Detailed Description

Adolescents are prone to mental health problems such as post-traumatic stress disorder (PTSD) and depression which could become worse in the aftermath of disasters. However, some adolescents can have better hope that helps them to cope with the challenges following adverse events such as earthquake.

Nepal is a low income and disaster prone country that ranks 11th for earthquake risks globally. In April 2015, the country faced a devastating earthquake of 7.8 Magnitude that killed thousands of people. Fourteen out of seventy five districts in Nepal were declared as severely affected districts.

However, the adolescents may not have received enough psychosocial support after the earthquake. The damage caused by earthquake was further worsened by the political instability in the country leading to delay in reconstruction work in earthquake-affected areas. Difficult circumstances following the earthquake could have affected the mental of adolescents negatively. However, the evidence on mental health status of adolescents following massive disaster such as earthquake remains inadequate.

For resource poor and disaster prone settings such as Nepal, school teachers can provide timely psychosocial support that could improve mental health and hope among adolescents. School based teacher mediated interventions could be more sustainable and feasible in the complex scenario of post-disaster settings. However, evidence on teacher mediated interventions in low resource disaster settings remain inadequate.

The objectives of this study were to assess mental health and level of hope among the adolescents in selected districts and examine the effect of school teachers' training on psychosocial support on mental health and hope among the adolescents.

The intervention for this study was schoolteachers' training on psycho-social support. A clinical psychologist provided 2-day training on psycho-social support for 22 schoolteachers (2 teachers from each intervention school). The training guidelines were adapted from the United Nations Relief and Works Agency (UNRWA) on psycho-social support for education in emergencies. The training provided basic skills to the schoolteachers so that they will be able to provide psycho-social support for children affected. The lesson learned from the training was intended to be applied by the school teachers in their everyday regular school activities. A follow up study was conducted at 6 months follow up among the adolescents to assess the change in their mental health status and hope.

Study Timeline

• Study Start: 2016-06
• Primary Completion: 2017-03
• Status Verified: 2017-12
• Study Completion: 2017-12
• Study First Submitted: 2017-12-21
• Study First Submitted QC: 2017-12-28
• Last Update Submitted: 2017-12-28
• Study First Posted: 2017-12-29
• Last Update Posted: 2017-12-29

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1912

Inclusion Criteria

• Adolescents studying in grade 6, 7 and 8 of the selected schools at the time of data collection
• Adolescents with written consent from themselves and their guardian

Exclusion Criteria

• Adolescent who refused to participate

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention	Psychosocial support training for school teachers	Two teachers from each of the schools included in this arm received training on providing psycho-social support to their students to be implemented in their regular routine school activities

Primary Outcome Measures

Name	Time	Method
Change from baseline hope at 6 months	baseline and 6 month follow up	Hope as an antecedent of resilience and positive aspect of mental health using Children's Hope scale which is a 6 item scale. The minimum score is 0 and maximum score is 1 and maximum score is 36. The higher score indicate higher hope.
Change from baseline post traumatic stress symptoms at 6 months	baseline and 6 month follow up	Post traumatic stress disorder symptoms among adolescents using Child post traumatic symptom scale symptom scale which is a 17 item scale. The minimum score is 0 and maximum score is 52. Higher score indicates higher symptoms for PTSD.
Change from baseline depression symptoms at 6 months	baseline and 6 month follow up	Depression symptoms among adolescents using depression self rating scale which is an 18 item scale. The minimum score is 0 and maximum score is 36. Higher scores indicate higher symptoms for depression.