A cross-cultural, mixed methods study of school climate and adolescent mental health

青少年精神卫生问题可对健康和发展产生破坏性和长期影响，但获得治疗的机会有限，特别是在占世界90%青少年的低收入和中等收入国家。世界卫生组织（卫生组织）和儿童基金会支持的一种办法是将心理保健安排在青少年容易获得并可由训练有素的学校工作人员提供的学校。然而，各个学校在规范、政策和价值观（统称为学校氛围）方面存在巨大差异，这意味着一些学校可能比其他学校更适合进行心理健康干预。此外，研究表明，一个积极的学校氛围，让学生感到被倾听、被重视、能够表达自己，与提高学习成绩、减少暴力、药物使用和问题行为有关。了解学校气氛的哪些因素促进心理健康，哪些因素破坏心理健康，对于设计和实施有效和可行的学校干预措施至关重要。然而，大多数关于学校气氛和心理健康的研究都是在高收入国家进行的。尽管低收入中低收入国家的青少年在心理健康和学校方面的经历各不相同，但在这些国家开展的跨文化工作有限。博士学位旨在通过探索学校氛围如何概念化并与尼泊尔青少年心理健康相关来解决这一差距。与尼泊尔跨文化社会心理组织（TPO）合作，这是一个经验丰富的精神卫生研究组织，博士研究生将：(i)通过审查来自低收入和中等收入国家的定性和定量研究，建立一个关于学校气候对青少年心理健康影响的概念模型；（ii）审查旨在以学校气候为目标改善青少年心理健康的现有干预措施的特点和机制；（iii）探索学校气候如何影响青少年心理健康，以及如何通过与尼泊尔的青少年、教师、家长和卫生工作者协商，使其得到优化。㈣通过分析尼泊尔一项以学校为基础的心理健康干预措施的调查数据，探讨学校气氛与青少年心理健康之间的关系。㈤综合与目标1-4有关的调查结果，就如何优化尼泊尔心理健康干预的学校氛围提出建议，并为其他低收入和中等收入国家环境提供学习。TPO将通过指导和实地考察，支持博士生在尼泊尔设计和实施文化上合适且可行的研究。TPO还将使该学生参与尼泊尔精神卫生利益攸关方的研究培训和活动。通过博士学位，学生将在国际合作伙伴关系和国外学术网络中发展成为一名敏感和熟练的混合方法全球心理健康研究人员。博士学位将对学校氛围产生影响，为中低收入国家学校心理保健的地方和全球政策和研究提供信息。它还将帮助加强KCL和TPO之间的伙伴关系，通过相互的能力建设和通过加强英国和尼泊尔的早期职业研究人员不断增长的社区。

Mental health problems in adolescence can have devastating and long-lasting effects on health and development, but access to treatment is limited, especially in low- and middle-income countries (LMICs) where 90% of the world's adolescents live. One approach supported by the World Health Organization (WHO) and UNICEF is to locate mental health care in schools where it is easily accessible to adolescents and can be delivered by trained school staff. However, individual schools differ dramatically in terms of their norms, policies, and values(collectively termed school climate), meaning that some schools are likely to be more suitable places for mental health intervention than others. Moreover, research has shown that a positive school climate in which students feel listened to, valued, and able to express themselves, is associated with improved academic performance, an dreduced violence, substance use, and problem behaviour.Understanding which elements of the school climate promote and which elements undermine mental health is crucial for the design and implementation of effective and feasible school-based interventions. However, most research on school climate and mental health has been done in high-income countries. There has been limited cross-cultural work in LMICs despite the diversity of adolescents' experiences of mental health and school in these settings. The PhD aims to address this gap by exploring how school climate is conceptualised and related to adolescent mental health in Nepal. Working in partnership with Transcultural Psychosocial Organization(TPO) Nepal, an experienced mental health research organisation, the PhD student will:(i) Build a conceptual model of the effects of school climate on adolescent mental health by reviewing qualitative and quantitative research from LMICs(ii) Review the characteristics and mechanisms of existing interventions that seek to improve adolescent mental health by targeting the school climate(iii) Explore how school climate influences adolescent mental health and how it can be optimised by consulting with adolescents, teachers, parents, and health workers in Nepal.(iv) Explore associations between school climate and adolescent mental health by analysing survey data from atrial of a school-based mental health intervention in Nepal.(v) Integrate findings related to objectives 1-4 to make recommendations about how to optimise the school climate for mental health intervention in Nepal, with learning for other LMIC settings.TPO will support the PhD student to design and implement culturally appropriate and feasible research in Nepal through mentorship and access to field sites. TPO will also engage the student in research training and activities with mental health stakeholders in Nepal.Through the PhD, the student will develop as a sensitive and skilled mixed methods global mental health researcher with solid experience in an international partnership and abroad academic network. The PhD will have impact generating learning on school climate to inform local and global policy and research on school-based mental healthcare in LMICs. It will also help to strengthen the partnership between KCL and TPO through mutual capacity building and by strengthening a growing community of UK and Nepali early career researchers.