Adolescent Mental Health and Teachers’ Health Literacy: A Mixed-Methods Exploration and Assessment of Coping and Support Mechanisms in Puducherry Schools

Background: Globally, adolescents face a significant mental health burden, with unique challenges in India. Teachers are pivotal in early identification and support but often lack adequate mental health literacy (MHL). This mixed-methods study assessed the prevalence of mental health problems among adolescents, their coping strategies, and teachers' MHL in Puducherry, India. Methods: A convergent parallel design was employed. Cross-sectional surveys using the Strengths and Difficulties Questionnaire (SDQ) were conducted with 420 adolescents (10-19 years) from 4 schools (2 urban, 2 rural). Focus group discussions (FGDs; n=32 students) and in-depth interviews (IDIs; n=16 teachers) explored coping mechanisms, support systems, and MHL. Quantitative data were analysed using SPSS (v21); qualitative data underwent thematic analysis via NVivo 12. Results: 35.2% (n=148) of adolescents screened positive for significant mental health difficulties. Peer problems (43.8%), emotional difficulties (25.7%), conduct problems (24%), and hyperactivity (15.7%) were prevalent. Rural adolescents reported significantly higher domestic violence exposure (28.8% vs. 17.1%; p=0.004) and lower psychosocial support (13.6% vs. 39.2%; p<0.001). Key qualitative themes included: 1) Academic/family stress as primary triggers; 2) Predominant use of maladaptive coping (avoidance, emotional suppression); 3) Critical barriers (teacher training gaps, stigma, absent counselling); 4) Variable teacher MHL reliant on experience, not formal training. Conclusion: High adolescent mental health needs coexist with insufficient teacher capacity and school support systems. Integrating standardized MHL training into teacher education, deploying school counsellors under national programs (e.g., Ayushman Bharat), and implementing student resilience programs are urgent priorities

Community-based randomized controlled trial of non-pharmacological interventions in prevention and control of hypertension among young adults

Context : Hypertension is a major chronic lifestyle disease. Several non-pharmacological interventions are effective in bringing down the blood pressure (BP). This study focuses on the effectiveness of such interventions among young adults. Aims : To measure the efficacy of physical exercise, reduction in salt intake, and yoga, in lowering BP among young (20-25) pre-hypertensives and hypertensives, and to compare their relative efficacies. Settings and Design: The study was done in the urban service area of JIPMER . Pre-hypertensives and hypertensives, identified from previous studies, constituted the universe. The participants were randomized into one control and three interventional groups. Materials and Methods: A total of 113 subjects: 30, 28, 28 and 27 in four groups respectively participated for eight weeks: control (I), physical exercise (II) - brisk walking for 50-60 minutes, four days/week, salt intake reduction (III) - to at least half of their previous intake, and practice of yoga (IV) - for 30-45 minutes/day on at least five days/week. Statistical Analysis Used: Efficacy was assessed using paired t test and ANOVA with Games Howell post hoc test. An intention to treat analysis was also performed. Results : A total of 102 participants (29, 27, 25 and 21 in groups I, II, III and IV) completed the study. All three intervention groups showed a significant reduction in BP (SBP/DBP: 5.3/6.0 in group II, 2.6/3.7 in III, and 2.0/2.6 mm Hg in IV respectively). There was no significant change (SBP/DBP: 0.2/0.5 mmHg) of BP in control group (I). Physical exercise was most effective (considered individually); salt intake reduction and yoga were also effective. Conclusions : Physical exercise, salt intake reduction, and yoga are effective non-pharmacological interventions in significantly reducing BP among young hypertensives and pre-hypertensives. These can therefore be positively recommended for hypertensives. There is also a case to deploy these interventions in the general population

Non-pharmacological Interventions in Hypertension: A Community-based Cross-over Randomized Controlled Trial

Background: Hypertension is the most prevalent non-communicable disease causing significant morbidity/mortality through cardiovascular, cerebrovascular, and renal complications. Objectives: This community-based study tested the efficacy of non-pharmacological interventions in preventing/controlling hypertension. Materials and Methods: This is a cross-over randomized controlled trial (RCT) of the earlier RCT (2007) of non-pharmacological interventions in hypertension, conducted in the urban service area of our Institute. The subjects, prehypertensive and hypertensive young adults (98 subjects: 25, 23, 25, 25 in four groups) were randomly allotted into a group that he/she had not belonged to in the earlier RCT: Control (New Group I), Physical Exercise (NG II)-brisk walking for 50 to 60 minutes, three to four days/week, Salt Intake Reduction (NG III) to at least half of their previous intake, Yoga (NG IV) for 30 to 45 minutes/day, five days/week. Blood pressure was measured before and after eight weeks of intervention. Analysis was by ANOVA with a Games-Howell post hoc test. Results: Ninety-four participants (25, 23, 21, 25) completed the study. All three intervention groups showed significant reduction in BP (SBP/DBP mmHg: 5.3/6.0 in NG II, 2.5/2.0 in NG III, and 2.3/2.4 in NG IV, respectively), while the Control Group showed no significant difference. Persistence of significant reduction in BP in the three intervention groups after cross-over confirmed the biological plausibility of these non-pharmacological interventions. This study reconfirmed that physical exercise was more effective than Salt Reduction or Yoga. Salt Reduction, and Yoga were equally effective. Conclusion: Physical exercise, salt intake reduction, and yoga are effective non-pharmacological methods for reducing blood pressure in young pre-hypertensive and hypertensive adults