Cultural adaptation and randomised evaluation of a multi-component school- based intervention for common mental disorders in Pakistani adolescents

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We are currently working with the WHO to implement school mental health in a number of countries in the Eastern Mediterranean region, including Pakistan. This large-scale programme in collaboration with Ministries of Health and Education seeks to implement evidence-based interventions for children and adolescents in school-settings. The key stakeholders, including teachers and health-care providers, have identified a large unmet need for a targeted intervention to address high levels of anxiety and depression in older adolescents. In response, the WHO after consultation with international experts, and conducting a review of available evidence, have developed a brief transdiagnostic intervention called Early Adolescence Skills for Emotions (EASE). This brief group psychological intervention is based on cognitive behavioural therapy (CBT) recognised to treat anxiety and depression in young people. The intervention is designed to be delivered by non-specialists in low resource settings. The aim of this project is to adapt and add EASE to the ongoing school mental health programme in Pakistan to address the needs of adolescents with symptoms of depression and anxiety. Following this, we will conduct a study to see if the intervention is effective in improving symptoms of anxiety and depression in school-going adolescents aged 14-16 who receive the intervention, compared to those who don't. We will also evaluate the costs, and barriers and facilitators of integrating such an intervention into the Pakistani school system.