UNARV: A district model for adolescent school mental health programme in Kerala, India

Abstract

Background: About a half of life time cases of mental disorders start by 14 years of age. First sign of mental illness or emotional distress can emerge in school environment. So schools are to be viewed as the potential place for recognition of mental health problems, but an unexplored area. This study describes the working of a new model for district adolescent school mental health programme, UNARV in Kerala. Methods: A descriptive study of adolescents referred from schools, seen at UNARV clinic over a period of 5 years (2007–2012). Study sample consisted of students with behavioral and scholastic problems who were referred by trained teachers from Government and Government aided High School (8th to 10th class) and Higher Secondary School (11th and 12th class) under aegis of District Panchayath, Thiruvananthapuram, Kerala. They were evaluated and given psychosocial and pharmacological interventions by child mental health expert. Results: Total 2432 students attended UNARV clinic during the period. Most common problems observed were involvement in physical fights (38.3%), viewing and showing pornography to others (21.8%), poor scholastic performance (20.7%), skipping classes (19.1%), alcohol abuse (19%), smoking (14.2%), and engaging in love affair (8.5%). Common mental disorder diagnosed was conduct disorder (36.4%). UNARV helped in reintegration of such students back in to schools and stalled the trend of such students from being dismissed or suspended from class. Conclusion: UNARV forms a sustainable alternative district model in a resource poor environment. School teachers were trained as primary counselors and expert intervention was ensured.