Setareh Ekhteraei, fourth-year medical student at the University of Colorado, and Choden Dukpa, development professional and researcher from Darjeeling, India, deliver a video abstract on their co-authored CAMH journal Short Research Article ‘RESEED – the perceived impact of an enhanced usual care model of a novel, teacher-led, task-shifting initiative for child mental health’.
Authors: Setareh Ekhteraei, Juliana L. Vanderburg, Choden Dukpa, Priscilla Giri, Surekha Bhattarai, Arpana Thapa, Catherine Shrestha, Bradley N. Gaynes, Molly M. Lamb, Michael Matergia, Christina M. Cruz
First published: 10 August 2023
Paper: https://doi.org/10.1111/camh.12673
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Setareh Ekhteraei graduated from the University of Southern California and is currently a fourth-year medical student at the University of Colorado. She is passionate about research and innovation in women’s health and in global health. After receiving her Doctor of Medicine (MD) in May 2024, she plans to pursue specialization in obstetrics and gynecology.
Choden Dukpa is a development professional and researcher from Darjeeling, India. She is trained academically and professionally in social work and research. Currently she has been working as a Research Administrator at DLR Prerna (darjeeling based NGO) and has been involved in research based projects on child mental health and climate change and mental health.
Other resources
- Featured paper ‘Short Research Article: RESEED – the perceived impact of an enhanced usual care model of a novel, teacher-led, task-shifting initiative for child mental health’ by Setareh Ekhteraei, Juliana L. Vanderburg, Choden Dukpa, Priscilla Giri, Surekha Bhattarai, Arpana Thapa, Catherine Shrestha, Bradley N. Gaynes, Molly M. Lamb, Michael Matergia, Christina M. Cruz
- Podcast ‘Bridging the Child Mental Health Care Gap in LMICs: RESEED and Task-shifted, Teacher-led Care’ with Dr. Christina Cruz, Dr. Michael Matergia, and Priscilla Giri
Transcript
[00:00:04.280] Choden Dukpa: Hi, my name is Choden Dukpa, and I am one of the authors for this paper. I work as a Research Administrator at a Darjeeling based organisation that is DLR Prerna. Before I move into our research questions or the research objectives for this paper, I’ll just give a short background about the intervention that we’re having. So, the intervention is Tealeaf, which is a research-based study on child mental health. And the abbreviation of Tealeaf is TEAchers LEAding the Frontline, and we’ve been running this trial since 2018, where we’ve been implementing a task shifting model by training Teachers in providing mental healthcare to the students within the classroom setting.
So, the schools that we work with are all located in the rural regions of Darjeeling and Kalimpong District, which is within the West Bengal state in India. So, these schools are all low-cost private institutions and as a trial, it is a full-fledged four-year RCT, that is randomised controlled trial. So, we have the schools divided into two groups. So, one is the intervention arm, and the other is the comparator, or the enhanced usual care arm.
So, when it comes to the enhanced usual care, or EUC arm, we wanted some form of engagement with them, as well, which would be as ethical as possible and it would also be fair for them, as they are engaging with us for a very long period of time, hmmm. So, hence, what we did is that we came up with an abbreviated version of Tealeaf for the EUC arm and we named it RESEED. That is REsponding to Students’ Emotions through EDucation. So, in RESEED, what we do is we give basic training on mental health to the Teachers, where there is no direct intervention with them after the training. However, the Teachers are free to reach out to the team in case they need any kind of help.
So, talking about the training model, it is a three days’ training module that we developed, where we introduced child mental health to Teachers and it’s important. We also introduced a behavioural plan tool, which is called the Four Cs Plan, where the Teachers are taught to fill up a Four Cs Plan form to try to figure out the cause for a child’s behaviour, you know, the changes they could make to intervene and also, how they could connect more with the child and lastly, how they could cultivate good behaviour amongst the children.
So, for this paper, our major research objective was to evaluate the impact RESEED had from a Teacher’s perspective, and also, understand the process of its implementation in a real world setting. So, what we did is that at the end of the school year, after the Teachers were trained and they had implemented RESEED in their particular schools or classes, we conducted a qualitative assessment through focus group discussions, with the Teachers who were trained. And we tried to understand their perspective and experiences, while implementing whatever they had learned from the RESEED training.
So, I would now request Setareh to take this video forward. Thank you.
[00:04:02.320] Setareh Ekhteraei: Hi, my name is Setareh Ekhteraei. I’m a fourth year medical student and one of the authors on this paper. I’ll be discussing the results and implications of our study. So, from our focus group discussions, or interviews with the Teachers involved in RESEED, we were able to assess various themes that came up in regards to how RESEED was received by Teachers, by students and also, by the greater community.
We found that Teachers thought that RESEED was acceptable, overall. They felt that after the intervention, children improved not only in their academic performance in terms of grades and standardised test scores, but also in their behaviour. For example, children that were quieter before were more willing to speak up in the classroom.
Various themes that were present throughout the interviews included a need to apply an intervention to all children, to have more Teachers receive the training and that overall, the community felt positively about the intervention and grateful for the intervention.
What was particularly interesting was that there were changes in beliefs about mental health and the child thought process that Teachers demonstrated in these focus groups discussions. There was an apparent shift from corporal punishment to encouragement and engagement of children in the classroom and how this change un – affected children. There seemed to be a, sort of, mental reframing that involved basic principles of child mental health, without delving deeper into the complexities of child psychology.
RESEED was deemed feasible because despite the fact that it was rather short, kind of, three days long training, and involved minimal external support, it was positively received and Teachers felt that it impacted their own beliefs, in addition to resulting in positive behavioural and academic changes in children. Because of the need for youth mental health approaches in low and middle-income countries, RESEED could be a feasible first step in improving Teachers’ mental health literacy and beginning to address the mental health needs of youth in resource limited settings. Thank you.
