LifeSpan Trial of Youth Aware of Mental Health (YAM) Program in ACT Schools.

Intervention: The Youth Aware of Mental Health (YAM) program is a universal, evidence-based program that encourages young people between the ages of 14 to 16 to learn about and discuss everyday mental health. It is a place for young people to express their feelings and talk about mental health freely. In five 1-hour classroom sessions over three weeks, 20-30 students participate in discussions and role-plays guided by two trained adults in the school setting. YAM was created by a group of interdisciplinary researchers from NASP/Karolinska Institutet and Columbia University. All materials involved in program delivery and training of Instructors and Helpers are copyrighted (2014 Youth Aware of Mental Health. All Rights Reserved - info@y-a-m.org). In the first session, the Instructors introduce mental health using the YAM pedagogical materials that include slides, posters, and a booklet for each student to keep. The four sessions that follow differ depending on the group of youth present as the topics to be role-played and discussed are proposed by them. The topics range from relationships with peers and adults, difficulties in and around school, to feeling sad or facing a stressful situation. YAM program delivery materials comprise a booklet, posters, and slide-set that includes information about the following six topics that also serve as a basis for the discussions and role-plays in YAM: (1) What is mental health, (2) Self-help advice, (3) Stress and crisis, (4) Depression and suicidal thoughts, (5) Helping a friend in need, and (6) Getting advice: who to contact. The YAM Instructor Course teaches prospective Instructors about YAM’s theoretical framework, scientific research, program implementation and how best to engage with youth in YAM through workshops, discussions, lectures, role-play and simulations. There is a manual provided to Instructors during the course. Over four and a half days of training by certified trainers, they learn how to foster reciprocal and impartial relationships with youth as well as how to effectively implement all aspects of the program. YAM Instructors can be anyone who has previous experience working with youth, such as psychologists, psychiatrists, social workers, youth counsellors, social assistants, school guidance counsellors, teachers, school nurses, youth advocates, or support group workers. YAM Instructors should have no pre-existing relationship with the youth participating and cannot work in the school in which YAM is being implemented. Instructors are assisted by trained Helpers who provide support to the Instructor and students in the group. Helpers undergo a half day of training by YAM Instructors. There is a brief training guide to assist Helper training. The Helper can either be another accredited Instructor, relevant youth worker or person with lived experience. YAM Instructors and Helpers, who are involved in delivering the program, are expected to complete an online survey immediately after the last session of YAM within the school, as a standard requirement of program delivery. The survey measures the degree to which YAM has been delivered across schools as intended by assessing various aspects of fidelity, including YAM instructor adherence to program delivery, student exposure to the program (ie attendance records), materials prescribed, and quality (rated by instructor and helper) of program delivery. Trial design: YAM will be evaluated in the ACT using a waitlist-controlled design. All Education Directorate (government) mainstream high schools and all Independent and Catholic schools will be invited to trial YAM through an expression of interest process. The active intervention phase will take place over a 12-month period, beginning Term 1 and finishing at the end of Term 4, 2021. Data collected will be in the form of a self-report student survey. Measurement of primary and secondary outcomes will be taken at three time-points: pre-intervention (baseline), post-intervention, and at 3-month follow-up. Parent/guardian consent will be sought for students to participate in the data collection. Information about the implementation process will also be collected via quantitative survey and qualitative interview with school staff, who support the delivery of the YAM program within their schools.