The WHO School Mental Health Program will be evaluated through a cluster randomized controlled trial on a number of outcomes for children, teachers and school climate.

The primary outcome for WHO School Mental Health Program is reduction in total difficulties scores of children on Strengths and Difficulties Questionnaire (SDQ). Parent-rated Strengths and Difficulties Questionnaire (SDQ) will be used to measure socio-emotional difficulties of children.

Some other multilevel contextual components will be explored to evaluate the large scale clinical and implementation effectiveness of WHO School Mental Health Program in rural Pakistan.

The multilevel contextual components will include:

  1. Outcomes on child level: Data on Psychological Outcome Profiles (PSYCHLOPS-Kids), WHO-Disability Assessment Schedule-child version (WHODAS), Paediatric Quality of life Inventory (PedsQL), annual academic grades and parent-teachers involvement questionnaire will be collected to measure psychosocial wellbeing, functioning, quality of life, academic performance of children and parent –teacher interaction.
  2. Outcomes on teachers’ level: Data on Teachers’ Sense of Efficacy Scale (TSES), Self-reported Questionnaire (SRQ) and Determinants of Implementation Behaviour Questionnaire (DIBQ) will be used to assess self-efficacy, wellbeing of teachers and change in teacher’s behaviour to implement SMPH after receiving training in SMHP
  3. Outcomes on school level: WHO Psychosocial profile will be used to evaluate the climate of schools that are part of SMHP.