Post-earthquake estimates indicated a rise in depression, anxiety, and stress-related symptoms, with higher needs of support services indicated for women and adolescents under the age of 18. In Nepal, specifically, a violent 7.8 magnitude earthquake struck Nepal’s central region in 2015, resulting in an estimated 9000 deaths and 22,000 injuries as well as significant damage to homes, government buildings, health facilities, and road networks. Prior studies in LMICs have demonstrated a higher prevalence of psychiatric and psychological disorders among children and adolescents exposed to political violence, as well as among youth exposed to a wide range of natural disasters. Though factors contributing to mental health symptomatology among youth are heterogeneous, exposure to environmental and political trauma has emerged remains a consistent risk factor underlying the development of mental health and psychosocial problems. Conclusion: Further research on longitudinal outcome measurement, use of alternatives to retrospective self-report data, and rigorous development of culturally grounded models of emotion regulation is necessary to explore the utility of school-based emotion regulation interventions in Nepal and other LMICs. Students provided suggestions for improvement of the program.
Despite this, there were no significant differences by condition on primary or secondary outcomes at four-week follow-up. Qualitative data suggested high uptake of anger regulation skills, but lower uptake of mindfulness skills. Results: Delivering the intervention was feasible and acceptable, as demonstrated by low dropout (8%) and high program attendance (6.7 of 8 sessions). Preliminary efficacy was examined on primary outcome (emotion regulation) and secondary outcomes (anxiety symptoms, posttraumatic stress symptoms, functional impairment, resilience, coping skills), which were measured at baseline and post-intervention (four weeks). Feasibility and acceptability were examined via attendance, and by qualitative interviews with a subset of students ( n = 15), teachers ( n = 2), and caregivers ( n = 3).
Students ( N = 102 aged 13 to 17 years) were enrolled in the intervention ( n = 42) and waitlist control ( n = 60) conditions. Methods: A mixed-method, non-randomized controlled trial was conducted with Nepali secondary school students in one heavily affected post-earthquake district. To advance the evidence base for adolescent mental health interventions in LMICs, we evaluated the feasibility and acceptability of a school-based emotion regulation prevention intervention (READY-Nepal) for adolescents who had a recent exposure to a humanitarian disaster. Background: Child and adolescent mental health problems are major contributors to the global burden of disease in low- and middle-income country (LMIC) settings.
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