What is SAMA?

As our UK research teams visit to India draws to end, it's been an absolute pleasure to work in person together as an India-UK research team delivering SAMA. 🤝🏼 We also want to extend our genuine appreciation to all our SAMA schools, teachers, lay counsellors, adolescents and parents for their continued dedication to this project!👏🏼 We are, together delivering SAMA as planned, learning a lot, and moving towards a viable, and up-scalable whole school intervention for adolescent mental health.👍🏼

🎤Project SAMA held an impact event at the National Institute of Mental Health and Neurosciences in Indian. This was a day of showcasing the co-produced school-based interventions and building knowledge together with local communities about how Project SAMA can and should have impact at regional and national levels in India. The event brought together over 70 stakeholders, including mental health professionals, educators, policymakers, and youth advocates. The progress of Project SAMA over the last two years was shared, including the central role of young people in shaping the whole school approach and informing evaluation of it. Part of this was captured and shared via three youth-led participatory film productions which the students from Adarsha Vidyalay, India produced during a workshop with Professor Paul Cooke. Youth produced films are a critical way that young people can speak directly ‘to power’ rather than their perspectives being mediated through researchers or gatekeeps. Project SAMA continues to enable young people to make films. The event explored the future ambitions of SAMA and barriers and facilitators of the upscaling of Project SAMA across India. Overall, the event was a significant step towards raising awareness of the work that Project SAMA is conducting regarding Indian adolescent mental health and promoting positive change. Big thanks to all that attended, it was great to connect with you!👏🏼💜

On a global scale, adolescent voice and perspective has been largely absent from mental health research. However, this is changing, with the development of the research agender calling for ‘no research about me without me’ (BMC, 2018). This agenda stresses the importance of including the thoughts and experiences of the target population in research, ensuring that the research conducted is reflective of real-life contexts, ultimately adding value to the current research, as well as the wider field. The inclusion of young people’s voice in psychological wellbeing and mental health research is important as this helps to ensure that findings remain relevant to young people (e.g. capturing what is really important to young people), as well as allowing young people to be heard. SAMA’s UK Phd student Amy conducted a series of focus groups with Indian adolescents whilst in India. The aim of these sessions was to elicit the narratives, meanings, process and experiences of emotional wellbeing within young people in India to further understand positive emotional wellbeing within this population. Alongside findings from this study bringing a unique and informative contribution to adolescent emotional wellbeing among young people in India, a further aim for this data is for findings to be used (along with findings from other studies) to develop a theory of wellbeing specific to adolescent in India.

📈 When conducting research in low- and middle-income countries, it is important to contextualise work to local settings and to learn about local agendas and ways of working. The research conducted on project SAMA is based across Bangalore and the Kolar District, India. One of Project SAMAs aims is to feasibility test a health economics assessment (WP6) in preparation for a future effectiveness trial. The purpose of this work is to better understand the feasibility of economic techniques for a future full trial, as well as supply provisional insights into the cost and cost-effectiveness of Project SAMA intervention strategies. During the UK teams’ trip to India, they started work to complete the following three tasks: 📕estimating separate design and delivery costs per intervention component using a bottom-up strategy 📗feasibility testing preference-based outcome measures (with young school-going Indian adolescents as there it limited evidence on their feasibility in this context) 📘conducting a simple cost-consequence analysis. The outcomes from these tasks will inform stakeholders about upscaling costs, the feasibility of preference-based outcome measures, and the potential economic benefits of investing in these interventions.

During our trip to India we met with lay counsellors, students and teachers to hear their perspectives on how SAMA is going. Lay counsellors (SAMA Sneitharus) shared the encouraging journeys they had been on in their schools. Many reported how teachers were initially suspicious and reluctant to have them in school. And some were not immediately supportive of the lessons for students (WP1), nor of the teacher training (WP2). However, their perspectives quickly changed (also reported by the Head Mistress in one school) after the delivery of the first teacher training session. After the programme teachers reported back about the quality and usefulness of the training. Lay counsellors reported the following changes in students: ⭐️reduced smoking, as they now had other stress management techniques. ⭐️ some small changes in aggressive/rude behaviour. ⭐️reduced bullying. ⭐️ students in other grades asking when they will receive the SAMA lessons. Adolescents reported how they face many problems but often they struggle with sharing these problems as they are often very personal. SAMA has helped them to learn how to take care of their feelings and helped them to practically manage their emotions. Teachers we spoke to were very positive about SAMA and felt it was needed in schools. They spoke about: ⭐️the differences they witnessed in students, due to the WP1 programme. ⭐️how some students were opening up more ⭐️ the significant changes in themselves following the teacher training component (WP2). One teacher said they had never really thought about trying to calm themselves before entering the classroom. Another mentioned realising that it might be useful to consider situations from the students' perspective sometimes (e.g. why they might struggle being in school or why they are late with homework) and that "they now feel more connected to their students". Multiple teachers said that having their own stress and pressure recognised by SAMA was important and they welcomed the encouragement for self-care.