Grant: Team Grant: GACD Mental Health - Canada-China

Young people are vulnerable to the onset of mental illness. Research shows that delayed treatment of mental illness leads to negative outcomes. In China, prevalence of depression among university students is as high as 20 to 30%. However, 9 out of 10 people diagnosed with a mental disorder never sought mental health care. Stigma and low mental health literacy are among the most important help-seeking barriers. Further, mental health services, largely at specialized hospitals only, are overstretched, while community and informal levels of care are underdeveloped. To address this, the study will examine the implementation of an evidence-based intervention, Acceptance and Commitment to Empowerment – Linking Youth and ‘Xin’ (hearts) (ACE-LYNX), to: (1) decrease stigma (attitude), (2) increase mental health literacy (knowledge), and (3) promote individual well-being (outcomes) and the collective capacity to collaborate (action) to promote mental health and form an integrative network of care for students. ACE-LYNX consists of two components: Acceptance and Commitment Therapy (ACT), a mindfulness-based cognitive-behavioral intervention, and Group Empowerment Psychoeducation (GEP), psychoeducation integrated with principles of equity, empowerment, and social justice. The study will take place in three regions of Jinan, Shandong, China. We will engage one hospital and two universities in each region. We will begin with an assessment of contexts, consisting of a university student survey (n= 600), student focus groups (n=144), and stakeholder and professional focus groups (n=144). The data will inform intervention adaptation. Using a train-the-trainer model, we will train 90 interdisciplinary professionals to become ACE-LYNX-Pro Champions. They will in turn train the “2nd generation” ACELYNX- Pro Champions (n=270) and students to become ACE-LYNX Student Champions(n=360) with a lay version of the intervention. All champions will form a collaborative integrated mental health care network supported by a community of practice through a Learning Management System and Weixin (WeChat). The champions will be followed over 6 months for their outreach and health promotional activities, including using Weixin to form a Student Mental Health Virtual Network. The RE-AIM framework will be used to examine Reach, Effectiveness, Adoption, Implementation, and Maintenance/Sustainability of ACE-LYNX and the integrated network. Psychometric measures will track the intervention’s impact on attitude (CAMI), knowledge (MAKS), empowerment (Bulls-Eye, monthly activity logs), and mental health outcomes (DASS-21, AAQ-II), while service volumes and Social Network Analysis will be used to examine the functioning of the real and virtual networks. We will apply an Integrated Knowledge Translation framework to engage key stakeholders throughout the study to ensure maximal impact and dissemination with the aim of system transformation at the micro, meso, and macro levels.