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

High rates of mental illness and addiction (often associated with self-harm) have been reported in China and Central America. Stigma, poor mental health knowledge, and limited awareness and/or accessibility to health services lead to low help-seeking, further compounding the problem. Thus, there is an urgent need for strategies to promote mental health knowledge to enable early identification and treatment and to improve help-seeking behaviour. The aim of this 5-year project is to implement and evaluate a multi-level, integrated mental health education, screening, and intervention program to improve functioning and well-being in youth in China, Honduras and El Salvador. About 5000 students in China, 2000 students in Honduras and 2000 students in El Salvador will be recruited. Participants will receive a 12-week mental wellness and leadership program (MWL) online (at universities) or in class (at vocational/technical schools). Curriculum topics will include mental health education (illness and stigma, help-seeking, stress management), social responsibility (prejudice, violence, gender-based violence), and leadership (values, skills). Students will be assessed on psychosocial function (e.g.distress, coping, stress, academic performance) and physiological measures of stress (saliva and hair cortisol) before and after MWL completion. An open-access phone app will be created to screen for emotional difficulties and addictive behaviours and will be available to MWL and non-MWL students. Those students who screen positive for significant emotional difficulties, as well as those with depression, anxiety and/or addictive behaviours who are referred by health professionals, will receive one of two forms of an 8-week internetbased cognitive-behavioural therapy (iCBT) program. The iCBT emotional well-being program will target mood and anxiety symptoms, and the iCBT addictions program will target substance abuse (including alcohol and tobacco) and problematic internet use. Students will be assessed on symptom and functional improvement as well as on physiological measures of stress before and after program completion. This project offers the opportunity to implement and evaluate the broad benefits of a novel integrated prevention and psychological intervention program for youth in culturally differing regions. The program will be adapted and incorporated into existing postsecondary institutions in the three countries with measurement of cross-cultural acceptability, efficacy, fidelity of implementation, and sustainability. It is proposed that the project will improve the mental wellness of transitional youth with good sustainability in two distinct global regions, and furthermore, it offers an opportunity to objectively evaluate to cost and benefit of this implementation.