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

青少年的心理健康问题可能对健康和发展产生破坏性和持久的影响，但获得治疗的机会有限，特别是在世界上90%的青少年生活的低收入和中等收入国家（LMIC）。世界卫生组织（卫生组织）和儿童基金会支持的一个办法是将精神保健设在学校，在那里青少年容易获得精神保健，并可由受过训练的学校工作人员提供。然而，个别学校在其规范，政策和价值观（统称为学校氛围）方面存在显着差异，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、被重视和能够表达自己，与提高学习成绩、减少暴力、药物使用和问题行为有关，了解学校氛围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。在低收入和中等收入国家，尽管青少年在这些环境中的心理健康和学校经历多种多样，但跨文化工作有限。博士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。与跨文化心理社会组织（TPO）尼泊尔，一个经验丰富的心理健康研究组织合作，博士生将：（i）通过审查来自LMIC的定性和定量研究，建立学校气候对青少年心理健康影响的概念模型（ii）审查现有干预措施的特点和机制，旨在通过针对学校气候改善青少年心理健康（iii）探索学校气候如何影响青少年心理健康，以及如何通过与青少年，教师，家长和卫生工作者协商来优化尼泊尔。(iv)通过分析尼泊尔一项基于学校的心理健康干预措施的调查数据，探索学校气氛与青少年心理健康之间的关联。(v)整合与目标1-4相关的调查结果，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LMIC环境提供学习机会。TPO将支持博士生通过导师制和实地访问，在尼泊尔设计和实施文化上适当和可行的研究。TPO还将让学生参与尼泊尔心理健康利益相关者的研究培训和活动。通过博士学位，学生将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，并在国际合作伙伴关系和国外学术网络中拥有丰富的经验。博士将对学校环境产生影响，为LMICs的校本精神保健提供本地和全球政策和研究信息。它还将有助于通过相互能力建设和加强英国和尼泊尔早期职业研究人员的不断增长的社区，加强KCL和TPO之间的伙伴关系。

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.