alternative methods of disciplining, such as positive reinforcement and behavioural management strategies. Teacher trainings and school mandates on the use of restorative practices will be the first step in this direction. Schools can create platforms for student–teacher interactions to strengthen their relationship.
Addressing issues of labelling, prejudices, and biases among the teaching com-munity (Tammana2016) is also an important component of creating a safe school climate in Indian schools. Simple practices like displaying posters of respectful language, and identifying discriminatory and hurtful words and phrases, can reduce hate language in the school premises, and promote a culture of mutual respect. This will require dedicated efforts by the school leaders to steer such practices and motivate their staff and students to sustain it.
The increase in number of LSE programmes shows that the need for socio-emotional skill development has received great prominence. However, the challenges are in executing the programmes effectively and assessing them. It is important to identify how these different bodies and boards can work collabora-tively. How does the DMHP LSE programme compare to the CBSE life-skills curriculum and the AEP? What are the provisions to ensure that DMHP LSE will be implemented across schools affiliated to all boards? How will teachers be trained in implementing these sessions? These are key questions that need to be answered to address the existing challenges. The DMHP currently measures the impact of LSE by reviewing the number of teachers trained and the number of schools covered by the outreach program. However, specific impact indicators to assess shift in stu-dents’ knowledge, attitudes, and behaviours have to be developed.
At Level 1, therefore, the needs and challenges in Indian schools are very unique to the context, and require collaborative efforts from schools, educational boards, as well as the government, in eliminating unsafe teaching practices, promoting a positive learning culture, developing a common framework for life-skills education across all school boards, and developing systems to implement these programmes and monitor them regularly.
becomes a huge barrier in seeking help for mental health concerns (Lyon et al.
2016). Since schools are a reflection of the larger socio-cultural system, it is unfortunate that the stigma and discrimination around mental health is also very common in schools. One way of addressing this is to create awareness about mental health and mental illness through classroom discussions, documentary viewing, or displaying posters about content related to mental health such as stress, psycho-logical and emotional concerns during adolescence, puberty and its effects, role of the brain, seeking assistance, and other similar topics (Hendren et al.1994). Charts and factsheets, about mental health problems and mental illnesses among adoles-cents in India, can help students understand the intensity of the problem. Awareness campaigns will address any biases or misconceived notions within the community.
Schools can also create awareness about mental healthcare services and profes-sionals. Providing information about counselling, medication, and other forms of mental health services, will reduce the stigma associated with help-seeking. Schools may also provide students and families with a list of service providers in and around the school. This will encourage students to develop a non-judgmental attitude towards mental health services, and motivate them to seek help for their concerns.
Another important component at Level 2 involves educating the students, teachers, and school community on mental health and mental illness. These sessions can be conducted by the school counsellor, or a trained mental health professional, with the aim to empower the school to make informed decisions about students’ mental health. Mental health education will focus not only on mental illnesses but also provide strategies to help students enhance their psychological well-being. This ensures that students can relate to the content and translate the learnings in their daily life. It is important for these sessions to be integrated with the whole-school curriculum or included as part of the general health curriculum.
Role of Stakeholders at Level 2
The programmatic interventions at this level require equal involvement of school leaders, educators, and counsellors. School leaders will identify platforms and forums in the school for mental health awareness. Along with the educators, they will identify activities that can be conducted across the whole school to reduce stigma around mental health. School leaders will also play a critical role in intro-ducing mental health as part of the curriculum in the school. Such a move may face resistance from teachers, parents, or the community, because of the stigma asso-ciated with it. It will be important for school leaders to gather sufficient data and evidence to support their decision, and discuss the same with parents and teachers during formal meetings and interactions. School leaders will oversee the process of curriculum designing and development to ensure that it is contextually relevant and age-appropriate. They will create training schedules and trainers to equip teachers with the knowledge and skills. School leaders will also play a role in reviewing the programme regularly and monitoring its progress.
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School educators will play an important role in designing and implementing activities to generate awareness about mental health. However, before they can contribute to this process, they must receive adequate information and training. The current teacher-training courses in India do not have a component on adolescent mental health. It is important, therefore, to build the capacities of the educators before they can become the agents for accurate knowledge. They can mobilize students and champions from all grades to organize events and activities to create mental health awareness. For instance, educators can help students design a small booth in the school where they ask students to complete a short quiz on myths and facts about mental health. This will help reach out to large numbers of students, and demystify the idea of mental health. Since educators interact regularly with stu-dents, they can help make the curriculum specific to students’ needs. At the classroom level, educators can initiate simple strategies like the check-in ritual (University of Michigan 2015) to encourage students to recognize their feelings, and create a safe space for them to talk about emotional experiences. At this level, educators will be involved in executing the plans and engaging in knowledge building with students in the classroom.
The school counsellor’s role at this level is extremely important in designing and developing the content for all activities. The counsellor, or a trained mental health professional, will provide expert inputs and knowledge in developing resource materials for whole-school awareness activities. The counsellor will also lead the process of developing a school-based mental health curriculum that is appropriate and relevant to the students. For example, in a community where substance abuse among high school students is high, the mental health curriculum for middle school students can aim to provide information about substance abuse and its effects. It is extremely important for counsellors to work collaboratively with educators and leaders. If the school has a full-time counsellor, he/she may also utilize classroom spaces for small group discussions, role-plays, and other methods of providing information about specific mental health concerns, mental healthcare services, and ethics involved in mental healthcare, such as confidentiality. Counsellors can also develop a directory of service providers around the school as a resource for students and families. If a school does not have a counsellor, the school can connect with off-site or consulting professionals for the same.
Examples of Existing Initiatives
There are very few programmes which focus on providing mental health education and addressing stigma around mental illness within schools. One such programme is the Breaking the Silence (BTS), initiated in 1991 in USA. BTS teaches students about mental health, encourages them to seek help, and breaks the stigma associated with it. BTS was initiated as part of a campaign to end discrimination, launched by the non-profit organization National Alliance on Mental Illness (NAMI). It was only in 1999 that the paper‘Breaking the Silence: Teaching the Next Generation about Mental Illness’ was published and the programme was implemented across
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various States. So far, BTS has made its presence felt across various countries— including Japan, Armenia, Ireland, Canada, Australia, and others—through its lesson plans and posters. It also provides resources, presentations, and teaching videos online. Let’s Talk Mental Illness (LTMI) is a part of the BTS programme, and involves a presentation featuring a first-person narrative by someone living with a mental illness. The objective of LTMI is to destigmatize and change stu-dents’ perceptions about mental illness. While the programme has expanded and reached out to many students, there is absence of data on the impact of the program.
Current Status and Future Possibilities in India
Mental health education has not received much prominence in Indian schools. Most organizations that provide mental health education sessions often offer it as workshops, seminars, or conferences. However, long-term continuous programmes on mental health education and awareness building are not available.‘Reach Out’
was a student-led effort in this direction in a school in Mumbai. Reach Out created awareness about mental health concerns and mental well-being among adolescent students in the school. As part of the programmes, students conducted classroom interactions, created awareness on social media through a Facebook page, and also developed manuals to share information about common adolescent mental health concerns. While the impact of this programme is not documented yet, it serves as a great example of mental health education within a school.
In the absence of such programmes and initiatives, and the increasing number of adolescents experiencing mental health concerns, the need for immediate action at this level is strong. So far, most programmes and interventions, recommended in policies and implemented across schools, have focused on socio-emotional skill development. However, this leaves out the large number of adolescents experi-encing common mental illnesses, and those at risk for suicide, and other severe mental illnesses. Programmatic initiatives at this level are therefore significant to change the discourse around mental health in schools. This will be possible only if mental health finds a mention in the policies and educational frameworks. It is important for the NCF and educational boards to include mental health education as part of the curriculum of the school.
In India, the stigma around mental health is a huge problem, contributing neg-atively to help-seeking behaviours as well as treatment prognosis (Shidhaye and Kermode 2013). It is important, therefore, to create programmes that will break these barriers to help-seeking. In addition to mental health education, schools also need to generate awareness about mental healthcare. Misconceptions about coun-selling and the role of a school counsellor abound in Indian schools and these need to be addressed. The nature of schools and contexts also varies widely in India and it is important for programmes to be aligned with the students’ socio-cultural environment. For example, sessions on substance abuse may focus more on alcohol and smoking for students in the urban private schools, and more on use of ganja and tobacco, in rural government schools.
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Another major challenge in the Indian context is the dearth of mental health professionals. It is important therefore for schools to establish networks of mental health professionals and organizations, NGOs, and academic agencies which can provide services to the school at this level. Schools can then outsource the process of content design, development, and execution. Adopting a cascade model, whereby schools can invite mental health professionals to train the school teachers, can also be effective in the Indian schools.
Therefore, at present, Indian schools need to establish systems and mandates to initiate and effectively implement activities at this level. This will lay the foundation and encourage schools to participate at this level.
