Columbia Worldwide Mental Health Awareness
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Columbia Worldwide Mental Health Awareness Columbia Worldwide Mental Health Awareness Presentation Transcript

  • Child Mental Health Awareness: A Nine-Country Pilot Study, 2004-2005 Presented by: Christina W. Hoven For: WPA-WHO Awareness Taskforce Chairperson: Sam Tyano, Israel Members: Theresa Ange Agossou, WHO/AFRO Myron Belfer, Switzerland K. Michael Hong, Korea Christina W. Hoven, USA Du, Yasong, China Danuta Wasserman, Sweden WPA WHO IACAPAP WPA Meetings; Cairo, Egypt September 15, 2005 Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • WPA Child Mental Health Steering Committee • Chairperson: Ahmed Okasha, Egypt • Vice Chairperson: Norman Sartorius, Switzerland • Scientific Director: Helmut Remschmidt, Germany • Scientific Vice Director: Sam Tyano, Israel • Secretary: Tarek Okasha, Egypt • Members: John H. Heiligenstein, USA Peter Jensen, USA Barry Nurcombe, Australia • WHO Representative: Myron Belfer, Switzerland Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Participating Countries Armenia Site Project Director: Maruke Yeghiyan Project Coordinator: Anna Velitsyan Other Contributors: ACPP members Area: One school in the Yerevan district Azerbaijan (Funded by GIP) Site Project Director: Fuad Ismayilov Project Coordinator: Nadir Ismayilov Co-Investigator: Hadji Agabek Sultanov Project Director: Polad Azizov Other Contributors: Indira Hadjiyeva, Viktoria Magerramova, Nazim Babayev, Tamerlan Radjabov, Vugar Mehtiyev, Sevda Katibli, Zemfira Ismayilova, Shaik Sultanov Area: Four schools: two urban schools in Baku; and, two rural schools in Mardakan and Shuvelan Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Participating Countries (continued) Brazil Project Coordinator: Co-Principal Investigator: Co-Investigator: Other Contributors: Area: Luis Augusto Rohde Júlia Obst Comassetto Rosane Brusius de Moraes Maycoln L. M. Teodoro, and Clarissa Paim One public school in Porto Alegre, the capital of Brazil’s southernmost state. China Project Director: Project Manager: Data Coordinator: Other Contributors: Area: Du, Yasong Zhao, Zhimin Liu, Yi Wu, Zengquiang Six schools in Shanghai Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Participating Countries (continued) Egypt Project Director: Amira Seif El Dine Other Contributors: Mohamed Ramadan, Nagla Fathi, Mohamed Osman, Dalia El Said, Wafaa Saad Area: Four schools in Alexandria Georgia (Funded by GIP) Project Director: Co-Investigator: Tea Jaliashvili Marine Gegelashvili Project Manager: Campaign: Jan Vorisek Four schools: three in Tbilisi and one in Rustavi Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Participating Countries (continued) Israel Principal Investigator: Alan Apter Site Project Manager: Gitit Peer candidate Area: Two high schools and one elementary school in a small town in Northern Israel. Russia Principal Investigator: Tatjana Dmitrieva Other Contributors: Andrey Zanozin, Andreyuk, Alexandra Drozdova Area: One school in Nizhny Novgorod. Uganda Principal Investigator: Project Manager: Other Contributors: Area: Emilio Ovuga Juliet Nakku Alexander Bombom Four primary schools and five secondary schools in Kampala City Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • International Coordinating Center at Columbia University International Study Director: Christina W. Hoven International Project Coordinator: Thao Doan International Project Data Managers: Fan Bin, George J. Musa Awareness Manual Writing Team: David Wilkin (Team Leader), Thao Doan, Carol Herbig, Mohammad Karim, Chakravarthy Koonapareddy, Donald J. Mandell, Katie Merrill, Awali Samara, Karen Sautter, Cynthia Weinstein Procedure Manual Writing Team: Fan Bin, Donald J. Mandell, George J. Musa, Karen Sautter, Min Tang, Judith Wicks, Data Entry Programming Team: Alex Resto, Bensheng Ouyang Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Study Rationale • Psychiatric disorders/symptoms are frequently undetected/untreated. • Awareness is a precondition for symptoms/disorders to be recognized. • To raise awareness while avoiding unrealistic expectations about available services. • Assumption that sound information will contribute to advocacy, thus shorten the time when services become available. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Institutional Review Board Approval • Baseline and follow-up surveys to be anonymous. • Institutional Review Board (IRB) approval obtained at each site. • International Coordinating Center IRB approval obtained before data was submitted. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Study Design • Pre and Post assessment of students, parents and teachers. • Assessment of awareness of signs and symptoms of childhood psychopathology. • Assessment of child psychopathology/ impairment (SDQ), child only. • Assessment of stigma and attribution of symptoms. • Assessment of knowledge and desire for more information about mental illness. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Study Methodology • Countries selected to represent different regions, cultures and languages. • To systematically disseminate accurate information, an Awareness Manual was developed. • Awareness Manual describes signs and symptoms and serves as a resource for educating healthcare professionals, parents, teachers and students. • To insure comparability in implementation and execution, a Procedures Manual was developed, describing all aspects of study, including sampling methods • Data Procedures Manual: Data collection, data entry, etc. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Samples • School children, their parents and their teachers. • Schools were to be randomly selected. • Student ages: 10-11 and 16-17. • Target at least 400 students (200 in each age group) at each site. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Study Procedures • Following Procedures Manual participants completed a baseline questionnaire. • Each site waged an Awareness Campaign, based on the Awareness Manual. • Approximately two weeks after the Awareness Campaign, a follow-up questionnaire was administered. • Data Entry Manual to guide data collect, data entry and data transmission procedures. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Manuals Developed for Study Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Overview of Study Design Approval (Highest, Local, and Individual School Authorities) Parent Support Organizations Start Planning Awareness Campaign Randomly Select Schools and Classrooms Obtain Parent Consent Pilot Test Procedures Pre-Campaign Survey Conduct Awareness Campaign Post-Campaign Survey Double Data Entry and Data Submission Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Study Website • Dissemination of information and materials (e.g., the Awareness Manual, the Procedures Manual, Site Activity Logs, Survey Questionnaires, Data Entry Programs and Data Entry Manual). • Email link for asking questions about procedures, which were responded to by the International Coordinating Center. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Pre-Campaign Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Questionnaires Administered Pre-Campaign Site Post-Campaign Students Parents Teachers Students Parents Teachers Armenia 100 100 100 0 0 0 Azerbaijan 400 51 50 381 49 45 Brazil 119 0 7 106 0 5 China 541 0 114 541 0 115 Egypt 174 94 39 0 0 0 Georgia 432 53 43 364 42 34 Israel 143 31 60 0 0 0 Russia 159 129 26 144 96 15 Uganda 403 149 56 418 73 22 2,472 607 495 1,954 260 236 Total Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Pre-Campaign Student Demographics N Age (Mean + SD) Female (%) Armenia 100 13.3 + 3.14 53.0 Azerbaijan 400 13.5 + 2.86 51.5 Brazil 119 14.0 + 2.81 53.8 China 541 15.8 + 1.99 48.6 Egypt 174 13.6 + 1.62 54.6 Georgia 432 13.9 + 2.35 55.0 Israel 143 15.1 + 2.60 60.6 Russia 159 13.9 + 2.88 57.6 Uganda 403 13.4 + 3.06 53.6 2,472 14.2 + 2.73 53.1 SITE TOTAL Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Pre-Campaign Parent Demographics N Female (%) Has at least 1 child w/ MH problem (%) Armenia 100 65.0 11.0 Azerbaijan 47 76.5 6.4 Brazil NA China NA Egypt 88 51.1 12.6 Georgia 51 100.0 12.0 Israel 27 63.0 NA Russia 86 83.7 17.1 Uganda 119 63.9 37.5 518 69.9 17.4 SITE TOTAL Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Pre-Campaign Teacher Demographics N Female (%) Has at least 1 student w/ MH problem (%) Armenia 100 65.0 11.0 Azerbaijan 50 76.0 68.0 Brazil 7 100.0 100.0 China 114 64.4 57.0 Egypt 33 72.7 74.3 Georgia 42 97.6 41.0 Israel 54 75.9 94.0 Russia 21 100.0 90.9 Uganda 56 53.6 60.8 477 70.6 54.8 SITE TOTAL Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Pre-Campaign Student Report: SDQ (N = 2,281) Unlikely Possible Probable 88.8% 70.0% 73.9% 80.0% 83.2% 90.0% 93.1% 100.0% 60.0% 50.0% 9.0% 17.1% 3.3% 7.8% 3.7% 10.0% 4.9% 20.0% 3.3% 30.0% 13.6% 40.0% 0.0% Hyperactivity Conduct Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Emotional www.childepi.org/awareness Any awareness@childpsych.columbia.edu
  • All Sites: Pre-Campaign Mental Health Awareness 91.8% 99.6% 80.9% 74.1% 93.3% Teacher 19.8% 28.4% 26.6% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 90.6% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Armenia: Pre-Campaign Mental Health Awareness 98.0% 98.0% 100.0% 100.0% 100.0% 37.0% 37.0% Teacher 6.0% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 91.0% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Azerbaijan: Pre-Campaign Mental Health Awareness 77.5% 76.7% 72.2% 91.8% 80.9% Teacher 21.7% 21.3% 30.7% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 100.0% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Brazil: Pre-Campaign Mental Health Awareness 100.0% 92.0% 100.0% Teacher Knows enough about MH N/A N/A 68.1% N/A 22.8% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 100.0% Student Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • China: Pre-Campaign Mental Health Awareness Knows enough about MH 79.4% N/A N/A 91.9% Teacher 65.0% 20.7% N/A 16.8% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 91.9% Student Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Egypt: Pre-Campaign Mental Health Awareness 94.7% 93.2% 87.0% 75.9% 100.0% Teacher 26.3% 23.1% 24.8% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 91.2% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Georgia: Pre-Campaign Mental Health Awareness 100.0% 98.0% 84.8% 80.4% 97.6% Teacher 27.9% 42.0% 26.1% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 98.0% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Israel: Pre-Campaign Mental Health Awareness 90.7% 86.2% 57.7% 76.6% 91.4% Teacher 1.8% 30.0% 26.6% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 79.3% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Russia: Pre-Campaign Mental Health Awareness 73.3% 67.3% 40.8% 67.2% 91.3% Teacher 21.7% 28.6% 27.8% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 80.4% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Uganda: Pre-Campaign Mental Health Awareness 91.8% 93.1% 89.6% 93.3% 93.2% Teacher 19.8% 25.7% 37.4% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 87.8% Student Knows enough about MH Wants to know more MH Campaign is good about MH idea Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Campaigns Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • 7 7 5 4 W PA 3 3 1 Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 1 1 th er 3 O 3 Ra di o Te lev isi on In ter ne Ce t ll ph on es O th er m ed ia 9 8 7 6 5 4 3 2 1 0 Po ste rs O th br er oc wr hu itt re Lo s en ca m lm at ee er tin ia Ne l gs ws / tr pa ai ni pe ng rs /m ag az in es Number of Sites Awareness Campaign Methods awareness@childpsych.columbia.edu
  • Post-Campaign Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Post-Campaign Mental Health Awareness 98.1% 90.1% Teacher 40.7% 46.5% 14.1% 34.3% 24.8% 50.7% 72.0% 60.2% 70.1% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 88.3% Student School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 0.0% Teachers/Counselors Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 27.9% 16.2% 10.0% 15.9% 20.0% 25.6% 30.0% 29.2% 40.0% 13.4% 50.0% 54.6% 58.5% 60.0% 58.7% 70.0% Friends awareness@childpsych.columbia.edu
  • All Sites: Post-Campaign Parent Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 45.2% 50.0% 59.6% 60.2% 60.0% 0.0% Parent Feels Talking to Child 30.8% 8.7% 10.0% 10.7% 20.0% 9.6% 30.0% 29.1% 40.0% Child Feels talking to Someone Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 46.2% 70.0% Parent Discussing Child's Problems w/ Teachers www.childepi.org/awareness awareness@childpsych.columbia.edu
  • All Sites: Post-Campaign Teacher Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 60.0% 68.2% 70.0% 75.2% 75.2% 80.0% 50.0% 0.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 1.3% 20.9% 3.9% 10.0% 22.3% 20.0% 2.5% 30.0% 30.5% 40.0% Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • All Sites: Post-Campaign Parent Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 64.8% 70.0% 28.6% 6.7% 10.0% 34.1% 20.0% 8.8% 30.0% 11.0% 42.9% 40.0% 48.4% 50.0% 54.9% 60.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness Parents awareness@childpsych.columbia.edu
  • All Sites: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 60.0% 59.9% 70.0% 70.0% 79.2% 80.0% 50.0% 40.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 27.6% 12.5% 8.7% 0.0% 13.6% 10.0% 7.1% 20.0% 21.3% 30.0% Parents awareness@childpsych.columbia.edu
  • Azerbaijan: Post-Campaign Mental Health Awareness 100.0% 82.5% 53.3% 62.8% 17.1% 30.4% 31.9% 96.3% Teacher 89.3% Parent 100.0% 100.0% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 96.3% Student School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Azerbaijan: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfortable 90.0% 80.0% 70.0% Teachers/Counselors Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 60.2% 10.0% 0.0% 13.1% 10.0% 13.3% 20.0% 30.0% 30.0% 28.8% 40.0% 29.7% 50.0% 56.9% 57.9% 60.0% Friends awareness@childpsych.columbia.edu
  • Azerbaijan: Post-Campaign Parent Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 50.0% 66.7% 60.0% 60.0% 70.4% 70.0% Parent Feels Talking to Child Child Feels talking to Someone Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 33.3% 0.0% 0.0% 22.2% 10.0% 12.0% 20.0% 7.4% 30.0% 28.0% 40.0% Parent Discussing Child's Problems w/ Teachers www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Azerbaijan: Post-Campaign Teacher Report: “Campaign Changed How …” 80.0% 97.1% 90.0% Feels MORE comfrotable 100.0% Feels about the SAME 94.4% Feels LESS comfortable 100.0% 70.0% 60.0% 50.0% 40.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 2.9% 0.0% 0.0% 0.0% 0.0% 10.0% 2.8% 20.0% 2.8% 30.0% Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • Azerbaijan: Post-Campaign Parent Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 44.0% 50.0% 40.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 0.0% 10.0% 0.0% 20.0% 8.0% 29.2% 30.0% Students www.childepi.org/awareness 20.0% 60.0% 48.0% 70.8% 70.0% 80.0% 80.0% Parents awareness@childpsych.columbia.edu
  • Azerbaijan: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 80.0% 70.0% 75.7% 86.5% 89.2% 90.0% 60.0% 50.0% 40.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 0.0% 10.8% 0.0% 0.0% 13.5% 10.0% 0.0% 20.0% 24.3% 30.0% Parents awareness@childpsych.columbia.edu
  • Brazil: Post-Campaign Mental Health Awareness School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH N/A 20.0% N/A N/A N/A 18.8% 51.0% 91.9% 100.0% Teacher 100.0% Parent 100.0% N/A 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 100.0% Student Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Brazil: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 70.0% 10.0% 0.0% 9.0% 20.0% Teachers/Counselors Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 53.5% 38.4% 8.1% 30.0% 11.0% 34.0% 40.0% 49.0% 50.0% 40.0% 57.0% 60.0% www.childepi.org/awareness Friends awareness@childpsych.columbia.edu
  • Brazil: Post-Campaign Teacher Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 80.0% 70.0% 60.0% 60.0% 50.0% 0.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 40.0% 33.3% 33.3% 0.0% 10.0% 0.0% 20.0% 20.0% 30.0% 33.3% 40.0% www.childepi.org/awareness Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • Brazil: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 80.0% 70.0% 50.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 20.0% 20.0% 10.0% 0.0% 20.0% 20.0% 30.0% 20.0% 40.0% 40.0% 40.0% 60.0% 60.0% Students www.childepi.org/awareness Parents awareness@childpsych.columbia.edu
  • China: Post-Campaign Mental Health Awareness 95.5% Teacher School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH N/A 24.3% N/A 32.4% 12.2% N/A 18.3% 57.4% N/A 44.0% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 83.6% Student Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • China: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 40.0% Teachers/Counselors 33.2% 8.7% 0.0% 11.8% 10.0% 11.8% 20.0% 27.2% 30.0% Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 27.5% 50.0% 55.0% 61.0% 60.0% 63.8% 70.0% Friends awareness@childpsych.columbia.edu
  • China: Post-Campaign Teacher Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 50.0% 61.5% 60.0% 67.7% 68.2% 70.0% 36.9% 1.5% 1.5% 10.0% 27.3% 20.0% 4.5% 30.0% 30.8% 40.0% 0.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • China: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 60.0% 50.0% 58.5% 70.0% 63.1% 76.9% 80.0% 40.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 24.6% 16.9% 13.8% 0.0% 10.8% 10.0% 12.3% 20.0% 23.1% 30.0% Parents awareness@childpsych.columbia.edu
  • Egypt: Post-Campaign Mental Health Awareness 93.9% 35.1% 51.8% 48.1% 21.6% 31.3% 23.1% 46.7% School campaign Knew enough occurred in last about MH before 6 mo. campaign 97.5% Teacher 64.9% 75.2% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 87.7% Student Now knows enough about MH Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Egypt: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 70.0% 0.0% Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 43.9% 35.1% 20.9% Teachers/Counselors 10.0% 16.9% 20.0% 14.8% 30.0% 35.6% 40.0% 37.2% 49.7% 50.0% 45.9% 60.0% Friends awareness@childpsych.columbia.edu
  • Egypt: Post-Campaign Parent Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 50.0% 61.7% 60.0% 57.0% 64.2% 70.0% 40.0% Parent Feels Talking to Child Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 23.5% 21.5% Child Feels talking to Someone 14.8% 0.0% 21.5% 10.0% 16.0% 20.0% 19.8% 30.0% Parent Discussing Child's Problems w/ Teachers www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Egypt: Post-Campaign Teacher Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 70.0% 58.1% 60.0% 64.5% 78.1% 80.0% 50.0% 40.0% Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 25.8% 25.8% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel 9.7% 0.0% 16.1% 10.0% 9.4% 20.0% 12.5% 30.0% Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • Egypt: Post-Campaign Parent Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 0.0% 9.9% 10.0% 3.7% 20.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 25.0% 30.0% 11.3% 39.5% 40.0% 23.5% 50.0% 50.6% 60.0% 63.8% 72.8% 70.0% Parents awareness@childpsych.columbia.edu
  • Egypt: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 67.7% 70.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 25.8% 16.1% 10.0% 16.1% 20.0% 19.4% 30.0% 32.3% 40.0% 45.2% 48.4% 50.0% 29.0% 60.0% Parents awareness@childpsych.columbia.edu
  • Georgia: Post-Campaign Mental Health Awareness 100.0% 48.5% 51.7% 47.9% 18.8% 32.3% 27.4% 93.1% Teacher 89.7% Parent 84.8% 85.7% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 79.6% Student School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Georgia: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 0.0% Teachers/Counselors Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 26.8% 17.9% 10.0% 16.7% 20.0% 20.9% 30.0% 28.6% 40.0% 12.3% 50.0% 53.4% 62.4% 60.0% 60.9% 70.0% Friends awareness@childpsych.columbia.edu
  • Georgia: Post-Campaign Parent Report: “Campaign Changed How …” Feels about the SAME 85.7% 90.0% 80.0% 68.2% 70.0% Feels MORE comfrotable 95.0% Feels LESS comfortable 100.0% 60.0% 50.0% 0.0% Parent Feels Talking to Child Child Feels talking to Someone Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 22.7% 9.1% 5.0% 10.0% 0.0% 20.0% 0.0% 30.0% 14.3% 40.0% Parent Discussing Child's Problems w/ Teachers www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Georgia: Post-Campaign Teacher Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 44.4% 50.0% 0.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 3.7% 18.5% 10.0% 0.0% 20.0% 27.6% 30.0% 11.1% 40.0% 51.9% 60.0% 70.4% 72.4% 70.0% Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • Georgia: Post-Campaign Parent Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 70.0% 86.4% 80.0% 80.0% 85.0% 90.0% 60.0% 50.0% 40.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 13.6% 0.0% 0.0% 0.0% 15.0% 10.0% 0.0% 20.0% 20.0% 30.0% Parents awareness@childpsych.columbia.edu
  • Georgia: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 4.5% 10.0% 20.0% 20.0% 8.0% 30.0% 8.7% 40.9% 40.0% 43.5% 50.0% 47.8% 60.0% 54.5% 72.0% 70.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness Parents awareness@childpsych.columbia.edu
  • Russia: Post-Campaign Mental Health Awareness 72.9% 86.7% 100.0% Teacher 13.3% 39.7% 50.8% 13.3% 36.4% 25.6% 46.8% 70.4% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 88.6% Student School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Russia: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 70.0% 10.0% 47.6% 45.2% 43.0% 7.1% 20.0% 4.7% 30.0% 10.5% 40.0% 43.0% 52.3% 50.0% 46.5% 60.0% 0.0% Teachers/Counselors Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness Friends awareness@childpsych.columbia.edu
  • Russia: Post-Campaign Parent Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 78.4% 80.0% 70.0% 0.0% Parent Feels Talking to Child Child Feels talking to Someone Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 16.2% 5.4% 10.0% 37.8% 20.0% 5.4% 30.0% 8.1% 40.0% 43.2% 51.4% 50.0% 54.1% 60.0% Parent Discussing Child's Problems w/ Teachers www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Russia: Post-Campaign Teacher Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 10.0% 0.0% 0.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 33.3% 20.0% 0.0% 30.0% 8.3% 41.7% 40.0% 41.7% 50.0% 50.0% 58.3% 60.0% 66.7% 70.0% www.childepi.org/awareness Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • Russia: Post-Campaign Parent Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 70.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 41.0% 12.8% 19.4% 10.0% 26.7% 20.0% 20.0% 30.0% 45.2% 40.0% 35.5% 53.3% 50.0% 46.2% 60.0% Students www.childepi.org/awareness Parents awareness@childpsych.columbia.edu
  • Russia: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 50.0% 50.0% 60.0% 58.3% 66.7% 70.0% 40.0% 0.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 25.0% 25.0% 25.0% 16.7% 10.0% 8.3% 20.0% 25.0% 30.0% Parents awareness@childpsych.columbia.edu
  • Uganda: Post-Campaign Mental Health Awareness 80.0% 47.6% 66.7% 69.5% 100.0% Teacher 15.8% 35.5% 26.6% 34.9% 55.0% 63.8% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Parent 94.4% Student School campaign Knew enough occurred in last about MH before 6 mo. campaign Now knows enough about MH Campaign was good idea* *Only asked of those who knew of school MH campaign. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Uganda: Post-Campaign Student Report: “Campaign Changed How Child Feels Talking To …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 50.0% 55.2% 58.8% 60.0% 59.8% 70.0% Teachers/Counselors Parents/Relatives Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 29.6% 15.3% 0.0% 12.4% 10.0% 27.8% 20.0% 8.6% 30.0% 32.6% 40.0% Friends awareness@childpsych.columbia.edu
  • Uganda: Post-Campaign Parent Report: “Campaign Changed How …” Feels LESS comfortable 100.0% Feels about the SAME Feels MORE comfrotable 90.0% 80.0% 50.0% 52.4% 60.0% 50.0% 65.0% 70.0% 40.0% 0.0% Parent Feels Talking to Child Child Feels talking to Someone Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 23.8% 23.8% 25.0% 25.0% 10.0% 15.0% 20.0% 20.0% 30.0% Parent Discussing Child's Problems w/ Teachers www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Uganda: Post-Campaign Teacher Report: “Campaign Changed How …” 80.0% 100.0% 90.0% Feels MORE comfrotable 100.0% Feels about the SAME 100.0% Feels LESS comfortable 100.0% 70.0% 60.0% 50.0% 40.0% 30.0% Teacher Fees Talking to Teacher Feels Talking to Student School Personnel Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 10.0% 0.0% 20.0% Teacher Discussing Student's Problems w/ Child's Parent awareness@childpsych.columbia.edu
  • Uganda: Post-Campaign Parent Report: “Campaign Increased Understanding about MH Problems Among …” No Don't Know/No Opinion Yes 100.0% 90.0% 80.0% 60.0% 68.4% 70.6% 70.0% 40.0% 13.3% 0.0% 17.6% 10.0% 11.8% 20.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 10.5% 33.3% 30.0% Students www.childepi.org/awareness 21.1% 53.3% 50.0% Parents awareness@childpsych.columbia.edu
  • Uganda: Post-Campaign Teacher Report: “Campaign Increased Understanding about MH Problems Among …” Don't Know/No Opinion 100.0% 100.0% 90.0% 80.0% 80.0% Yes 100.0% No 70.0% 60.0% 50.0% 40.0% 30.0% Teachers Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Students www.childepi.org/awareness 10.0% 10.0% 0.0% 0.0% 0.0% 0.0% 10.0% 0.0% 20.0% Parents awareness@childpsych.columbia.edu
  • Principle Investigator Questionnaires Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Campaign: Ease of Administration Easy Somewhat Easy Somewhat Difficult Difficult 7 6 6 Sites 5 4 5 4 4 4 3 3 2 1 0 3 3 2 1 0 Translations 2 0 IRB 3 2 0 Communication w/ Columbia Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 2 0 Procedures Manual www.childepi.org/awareness 0 0 Awareness Manual awareness@childpsych.columbia.edu
  • Website Somewhat Useful Yes Not Useful Easy to Use? Useful 3 No 1 8 6 Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Informative? Yes www.childepi.org/awareness No 0 7 awareness@childpsych.columbia.edu
  • Sufficient Funding? Sufficient Not Funded Not Sufficient 2 5 2 Major Delays? Adequacy of Funds and Reasons for Delays Yes No 2 7 Main Reason Given for Delays: • Funding (4 sites) • IRB (2 sites) • Translations/ Questionnaires (2 sites) Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Data Entry: Ease and Clarity Easy Somewhat Easy Somewhat Difficult Difficult 4 Sites 3 2 Instructions Clear? 5 4 3 3 2 2 1 3 0 7 1 0 Data Entry No 2 1 0 Yes Data Submission Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI 0 0 CSPro Application www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Neutral Mixed 1 1 7 Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI Opinion Change? Liked it Yes Opinion Improve? Local Community Opinion Yes www.childepi.org/awareness No 1 7 No 1 5 awareness@childpsych.columbia.edu
  • Intentions to Conduct More Campaigns Yes Depends on Funds Local/National? 1 Local National 8 7 6 Sites 5 7 4 7 5 3 2 1 0 Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Recommendations • Revise Awareness Manual according to feedback. • Conduct large-scale, more rigorous study, with controls. • Generate paper and web-based final Awareness Manual in multiple languages. • Make materials available worldwide. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Current Study’s Limitations • Due to time constraints, this project may have been negatively affected by not having sufficient time for adequate Awareness Campaign. • Although translations were requested to be done both forward and backward, this did not always happen. • Translations may not always have been done by individuals who were equally conversant with mental health terminology and English. • For the SDQ, the original algorithm includes parent and teacher questionnaire items in the criteria of hyperactivity disorder. Since the parent and teacher questionnaires did not include the SDQ, these items were excluded from the scoring algorithm and only student items were used (allowed by the SDQ published algorithm). Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu
  • Current Study’s Limitations (Continued) • Due to time requirements for seeking and obtaining a higher level of Institutional Review Board (Ethics Committee) approval, questionnaires were necessarily anonymous and consequently the follow-up assessments were not necessarily with all the same individuals who participated at baseline. • For a variety of reasons, including distance, language differences, literacy, etc., not all parents were able to participate. • For a variety of reasons, some sites were not able to recruit the proposed sample size. Child Psychiatric Epidemiology Group, Columbia University-MSPH/NYSPI www.childepi.org/awareness awareness@childpsych.columbia.edu