Low and middle-income countries (LMICs) lack trained child mental health professionals. While teachers’ child development experience potentially positions them to fill the gap as lay mental health counselors, they have rarely delivered indicated child mental health care in LMICs. As part of assessing the feasibility of teachers serving as lay counselors, we explored teachers’ perceptions of serving as lay counselors and their mental health attitudes and knowledge. In 2018, with training and supervision, 19 primary school teachers from five rural, low cost private schools in Darjeeling, India, served as lay counselors in their classrooms. Using mixed methods, we examined teacher perceptions of serving as lay counselor and mental health attitudes and knowledge through a survey (n = 15), a summative assessment (n = 14), and semi-structured interviews (n = 17). For the survey and summative assessment, pre-training, post-training, and post-intervention mean scores were compared using paired t tests. Post-intervention interviews were coded for teachers’ perceptions of serving as lay counselor and mental health attitudes and knowledge. Qualitatively, teachers expressed being willing to serve as lay counselor, having more inclusive mental health attitudes, and retaining mental health knowledge as applicable to use during instructional time or incorporation into the knowledge transfer process, their primary duty. By contrast, quantitatively, teachers’ attitudes appeared to become more inclusive on the study-specific survey pre versus post-training, but reverted to pre-training levels post-intervention. Teachers’ mental health knowledge on the summative assessment did not change pre-training versus post-training versus post-intervention. Training, supervision, and serving as lay counselors led to teachers’ willingness to serve as lay counselors. Teachers served as lay counselors by utilizing therapeutic techniques during class time and incorporating them into their typical instruction, not through delivering traditional office-like care. Teacher practices may be pointing to the potential emergence of an “education as mental health therapy” system of care. Their changes in attitudes and knowledge reflected their emerging practices. Quantitative measures of knowledge and attitude changes did not capture these nuanced changes. Trial Registration The parent feasibility trial was registered on January 01, 2018 with Clinical Trials Registry – India (CTRI), reg. no. CTRI/2018/01/011471, ref. no. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27. .

中文翻译：

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中低收入国家/地区作为心理健康教师的观念，态度和知识是辅导员：混合方法，务实的试点研究

低收入和中等收入国家（LMIC）缺乏训练有素的儿童心理健康专业人员。尽管教师在儿童发展方面的经验有可能使他们作为非专业的心理健康顾问来填补空白，但他们很少在中低收入国家提供明确的儿童心理保健服务。在评估教师担任非专业顾问的可行性时，我们探讨了教师对非专业顾问的看法以及他们的心理健康态度和知识。2018年，在培训和监督下，来自印度大吉岭5所农村低成本私立学校的19名小学教师在教室里担任了外行辅导员。通过调查（n = 15），总结评估（n = 14），我们使用混合方法检查了教师对外行辅导员的看法以及心理健康的态度和知识。半结构化访谈（n = 17）。为了进行调查和总结性评估，使用配对t检验比较了训练前，训练后和干预后的平均得分。干预后访谈​​的编码方式是教师对外行辅导员的看法以及心理健康的态度和知识。从质上讲，教师表示愿意担任外行辅导员，拥有更包容的心理健康态度，并保留在教学期间使用或纳入知识转移过程的心理健康知识，这是他们的主要职责。相比之下，从数量上讲，在针对特定研究的培训之前和培训之后，教师的态度似乎变得更具包容性，但在干预后又恢复为培训之前的水平。教师在总结性评估方面的心理健康知识并未改变培训前与培训后与干预后的关系。培训，监督和担任非专业顾问会导致教师愿意担任非专业顾问。老师通过在上课期间利用治疗技术并将其纳入他们的典型指导中，而不是通过提供传统的办公室式照护服务来担任非专业咨询师。教师实践可能指向“精神卫生治疗教育”护理体系的潜在兴起。他们在态度和知识上的变化反映了他们的新兴作法。知识和态度变化的定量测量并未捕获这些细微的变化。试验注册母公司可行性试验已于1月1日注册，2018年，通过印度临床试验注册中心（CTRI）注册。不。CTRI / 2018/01/011471，参考号 不。REF / 2017/11/015895。http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27。。