Darjeeling

Researchers are evaluating a new, teacher-delivered mental health care system called Tealeaf-A, designed to support adolescents in rural, low-cost private secondary schools in the Darjeeling Himalayas. This pilot study aims to test the feasibility, acceptability, and preliminary effectiveness of this novel, task-shifted mental health care approach. The intervention adapts strategies previously used with children, focusing on training teachers to provide mental health support integrated into their regular teaching activities, helping adolescents manage symptoms like depression and anxiety through education-based therapy. The study compares the adapted Tealeaf program for adolescents with Enhanced Usual Care (EUC), a less intensive form of care. Teachers receive six days of training and ongoing supervision every two weeks throughout a school year. They identify students needing support, assess their symptoms, develop individualized behavior plans using therapeutic techniques, and encourage caregiver involvement as appropriate. The program emphasizes confidentiality and fitting mental health support into teachers' existing workflows, with teachers coordinating care across subjects. Participants include school principals, teachers, students aged 13 to 17 with identified mental health concerns, and their guardians. Data are collected through mixed methods guided by the RE-AIM framework, measuring teacher delivery fidelity, stakeholder acceptance, and student mental health outcomes over two academic years. Outcome measures include dropout rates and adoption and implementation scores of the intervention. Researchers will also explore the factors affecting the program's success through interviews three months after intervention completion, with overall participation spanning the entire school year.