Implementing Early Mental & Physical Health Detection & Support: Promoting a Whole-School Approach to Health & Well-being (ISOBAR)

实施早期心理

• 批准号: MR/Y013573/1
• 负责人: Swaran Singh
• 金额: $ 270.53万
• 依托单位: University of Warwick
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY013573%2F1
• 关键词: Implementing; Early; Mental; Physical; Health

Adolescence is a critical life stage where the foundations of lifelong health and wellbeing are laid. It is now well-established that most serious mental disorders that disable or kill in adult life have an onset between the ages of 12-25, with over half having an onset before the age of 16. While disorders such as anxiety, depression and psychosis have an adolescent onset their recognition is often delayed, and interventions, when offered, are often 'late'; only when the disorders have become established and disability set in. The majority of adolescents live in low- and middle-income countries (LMIC) where resources are scarce, the stigma of ill-health high, and the most vulnerable are at the greatest disadvantage. There is a frequent association between mental health problems and physical problems, especially those related to nutrition, both undernutrition and obesity. The most common non-communicable disorders (NCDs) of adolescence, and their greatest burden, is hence related to a combination of mental ill-health and nutrition-related problems. It is well-established from work in high-income countries that such disorders can be prevented and, if identified early, be treated with low-intensity interventions to prevent chronicity and continuity into adult life. The ISOBAR project aims to implement evidence-based interventions in school-settings in two LMICs, India and Nigeria. The project team has extensive experience in working with young people in school-settings in these countries. Our previous work in these countries has shown that while many adolescents suffer from such disorders and see schools as places where they would seek help, almost no state-funded school in such settings offers any health programmes that promote positive health and prevent serious disorders from emerging. We will recruit and train school-based counsellors in evidence-based interventions which have been tailored to local socio-cultural context and offer these in a staggered manner to three schools at each site (two in India, one in Nigeria). We will conduct this work in an equitable partnership with schools, young people, their carers, local community organisations, health providers and policymakers who have strong and well-established links. Using an implementation research framework, we will evaluate our programme for whether it is acceptable to the local community, useful in promoting positive health, preventing serious disorders from emerging, and ensuring that those who need specialist care receive it in a timely and effective manner. We will determine the costs and benefits of our intervention and explore factors that affect its sustainability beyond the lifetime of our project. The work will leave a lasting legacy that has the potential to transform the health and well-being of millions of adolescents in the developing world.

青春期是人生的一个关键阶段，是奠定终身健康和幸福的基础。现在已经确定，在成年生活中致残或致死的大多数严重精神障碍在12-25岁之间发病，一半以上在16岁之前发病。虽然焦虑、抑郁和精神病等疾病是在青少年时期发病的，但对这些疾病的认识往往被推迟，而且即使提供干预措施，也往往是“迟到”的;只有在这些疾病已经确立，残疾开始时才采取干预措施。大多数青少年生活在低收入和中等收入国家，那里资源稀缺，健康不良的耻辱感很高，最脆弱的人处于最不利的地位。心理健康问题与身体问题之间经常存在关联，特别是与营养有关的问题，包括营养不足和肥胖。因此，青少年最常见的非传染性疾病及其最大负担与心理健康不良和营养相关问题有关。在高收入国家开展的工作已经证明，这类疾病是可以预防的，如果及早发现，可以采用低强度干预措施进行治疗，以防止慢性化并持续到成年。ISOBAR项目旨在印度和尼日利亚这两个低收入国家的学校环境中实施循证干预措施。项目小组在这些国家的学校环境中与青年人合作方面有着丰富的经验。我们以前在这些国家的工作表明，虽然许多青少年患有这种疾病，并将学校视为他们寻求帮助的地方，但在这种情况下，几乎没有一所公立学校提供任何促进积极健康和预防严重疾病出现的健康计划。我们将招聘和培训学校辅导员，进行适合当地社会文化背景的循证干预，并以交错方式向每个地点的三所学校提供这些辅导员（印度两所，尼日利亚一所）。我们将与学校，年轻人，他们的照顾者，当地社区组织，卫生服务提供者和政策制定者建立平等的伙伴关系，并与他们建立牢固的联系。使用实施研究框架，我们将评估我们的计划是否为当地社区所接受，有助于促进积极的健康，防止出现严重的疾病，并确保那些需要专家护理的人及时有效地接受治疗。我们将确定我们干预的成本和收益，并探索影响其在项目生命周期之外的可持续性的因素。这项工作将留下持久的遗产，有可能改变发展中世界数百万青少年的健康和福祉。