title: A school mental health literacy curriculum resource training approach: effects on Tanzanian teachers' mental health knowledge, stigma and help-seeking efficacy.
abstract: BACKGROUND
  Mental health literacy (MHL) is foundational for mental health promotion, prevention, stigma reduction, and care; School supported information pertaining to MHL in sub-Saharan Africa is extremely limited, including in Tanzania. Successful application of a school MHL curriculum resource may be an effective way to increase teacher MHL and therefore help to improve mental health outcomes for students.
  
  
  METHODS
  Secondary school teachers in Tanzania were trained on the African Guide (AG) a school MHL curriculum resource culturally adapted from a Canadian MHL resource (The Guide) for use in Africa. Teacher training workshops on the classroom application of the AG were used to evaluate its impact on mental health literacy in a sample of Tanzanian Secondary school teachers. Pre-post training assessment of participant knowledge and attitudes was conducted. Help-seeking efficacy for teachers themselves and their interventions for students, friends, family members and peers were determined.
  
  
  RESULTS
  Paired t test (n = 37) results demonstrate highly significant improvements in teacher's overall knowledge (p < 0.001; d = 1.14), including mental health knowledge, (p < 0.001; d = 1.14) and curriculum specific knowledge (p < 0.01; d = 0.63). Teachers' stigma against mental illness decreased significantly following the training (p < 0.001; d = 0.61). Independent t tests comparing the paired sample against unpaired sample also demonstrated significant differences between the groups for teacher's overall knowledge (p < 0.001). Teachers also reported high rates (greater than ¾ of the sample) of positive help-seeking efficacy for themselves as well as for their students, friends, family members and peers. As a result of the training, the number of students teachers identified for potential mental health care totaled over 200.
  
  
  CONCLUSIONS
  These positive results, when taken together with other research, suggest that the use of a classroom-based resource (the AG) that integrates MHL into existing school curriculum through training teachers may be an effective and sustainable way to increase the MHL (improved knowledge, decreased stigma and positive help-seeking efficacy) of teachers in Tanzania. As this study replicated the results of a previous intervention in Malawi, consideration could be given to scaling up this intervention in both countries and applying this resource and approach in other countries in East Africa.
authors: Dalhousie University and the Izaak Walton Killam (IWK) Health Centre, 5850 University Avenue, PO Box 9700, Halifax, NS B3K 6R8 Canada.
authors: Stan
authors: S
authors: Kutcher
authors: Sun Life Financial Chair in Adolescent Mental Health team, Dalhousie University and IWK Health Centre, Halifax, Canada.
authors: Yifeng
authors: Y
authors: Wei
authors: Farm Radio International, Ottawa, Canada.
authors: Heather
authors: H
authors: Gilberds
authors: Muhimbili National Hospital, Kalenga Street, PO Box 65000, Dar es Salaam, Tanzania.
authors: Omary
authors: O
authors: Ubuguyu
authors: Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania.
authors: Tasiana
authors: T
authors: Njau
authors: Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, Halifax, Canada.
authors: Adena
authors: A
authors: Brown
authors: Mental Health and Substance Abuse, Ministry of Health, PO Box 9083, Dar es Salaam, Tanzania.
authors: Norman
authors: N
authors: Sabuni
authors: Non Communicable Disease, Ministry of Health, PO Box 9083, Dar es Salaam, Tanzania.
authors: Ayoub
authors: A
authors: Magimba
authors: Farm Radio International, Ottawa, Canada.
authors: Kevin
authors: K
authors: Perkins
keywords: Adolescents; Africa; Knowledge; Mental health; Mental health literacy; School-based intervention; Stigma; Tanzania; Teachers