Abstract
BackgroundA pilot study about the effectiveness of a universal school-based programme, “The Little Prince is Depressed”, for preventing depression in Chinese adolescents in Hong Kong was conducted and reported previously. This study used a larger sample to examine the effectiveness and sustainability of the programme.MethodsThis study used quasi-experimental design. Twelve schools enrolled in “The Little Prince is Depressed” programme either as an intervention or a control condition. The intervention schools carried out the 12-session programme in two phases: the professional-led first phase and the teacher-led second phase. All participants were required to complete a questionnaire at three time points measuring their (1) depressive, anxiety, and stress levels; (2) knowledge of mental health; (3) attitudes towards mental illness; (4) perceived social support; and (5) help-seeking behaviours.ResultsA total of 3,391 students participated in the study. The level of depressive symptoms did not reduce significantly at post-intervention; however, a delayed effect was observed at follow-up assessment for the participants of the teacher-led group in reducing anxiety and stress levels. Also, the knowledge of mental health and attitudes towards mental illness of the intervention-group participants significantly improved at post-test, and the outcomes were maintained at 4 to 5 months after the intervention in both the professional-led and the teacher-led conditions (p<.05). A preference among schoolchildren for whom to seek help from was identified.ConclusionsThe universal depression prevention programme was effective in enhancing knowledge of mental health and promoting a more positive attitude towards mental illness among adolescents in Hong Kong. In particular, the teacher-led group showed better outcomes than the professional-led group in reducing students’ anxiety and stress at follow-up period. The programme can achieve sustainability in schools if teachers are provided with adequate support.
Highlights
Depressive disorders have been ranked second and first as the cause of disability in developed countries and in developing countries, respectively [1]
The universal depression prevention programme was effective in enhancing knowledge of mental health and promoting a more positive attitude towards mental illness among adolescents in Hong Kong
Schools offer a convenient location for the widespread delivery of depression prevention programmes; according to a review conducted by Spence and Shrott, widespread implementation of school-based universal interventions for the prevention of depression in children and adolescents is difficult to justify until the interventions are found both efficacious and effective [14]
Summary
Depressive disorders have been ranked second and first as the cause of disability in developed countries and in developing countries, respectively [1]. Schools offer a convenient location for the widespread delivery of depression prevention programmes; according to a review conducted by Spence and Shrott, widespread implementation of school-based universal interventions for the prevention of depression in children and adolescents is difficult to justify until the interventions are found both efficacious and effective [14]. They suggested that future research designs should be more rigorous; the content of intervention should include the social environment of the children and adolescents (family, school context, etc.); and training and supervision of those who deliver the intervention should be improved. This study used a larger sample to examine the effectiveness and sustainability of the programme
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