NUR1022 Public Health

Challenge Based Learning

Topic: Mental Health

What is mental health about?

a state of well-being

can cope with the normal stresses of life

can work productively and fruitfully

to make a contribution to his or her community

(World Health Organization, 2011).

(AM730, 2011)(Man, 2012)

(Ming Pao Health, 2013)

Mental health is important and highly related to stages of

life!

Mental Health

How we handle stress

Social

Psychological

Emotional

What is stress?A non-specific response of the body to any demand for change (Hans Selye, 1936)

The Challenge:To conduct a survey of stress level in tertiary education students, and to provide health education to them.

Survey

Health education

How do we measure the stress level in tertiary education students?

Depression Anxiety Stress Scales(DASS)

抑鬱焦慮壓力測量表 Psychology Foundation of Australia

(Lovibond & Lovibond, 1995)

The DASS is a set of self-report scales designed to measure the negative

emotional states of depression, anxiety and stress.

Depression, Anxiety and Stress Scale (DASS)

Designed for person over 17 years old

3 scales: Depression, Anxiety and Stress

Each scale contain 14 items

Total 42 items should be answered

Depression, Anxiety and Stress Scale (DASS)

The questionnaire were completed on the web by students anonymously

Survey

Depression, Anxiety and Stress Scale (DASS)

Responders should choose the answer best describe him/her in the 4-point frequency scales (0-4 points)

Meaning:0 - Did not apply to me at all1 - Applied to me to some degree, or some of the time2 - Applied to me to a considerable degree, or a good part of time3 - Applied to me very much, or most of the time

I’ve dry mouth

sometimes.

He gets 1 point in this question.

Depression, Anxiety and Stress Scale (DASS)

Responder can sum up the points according to the three scales: depression, anxiety, and stress after answering all 42 questions

Evaluation Table:

Depression, Anxiety and Stress Scale (DASS)

Interpretation of the DASS should be carried out by qualified professional such as a clinical psychologist

Our groups manually sent email to the responder with the test result and some general recommendation on coping stress.

DASS Questionnaires - Result

114 students responded to our questionnaire in total

Deduct 12 students that gave the wrong e-mail address

102 students reply our online questionnaire

Depression Scale

Normal

Mild

Moderate

Severe

Extremely severe

60 students (58.82%) suffer in depression

Level of depression Number of responder

Normal 42

Mild 2

Moderate 26

Severe 10

Extremely severe 22

Anxiety Scale

Normal

Mild

Moderate

Severe

Extremely severe

76 students (74.51%) suffer in anxiety

Level of anxiety Number of responder

Normal 26

Mild 4

Moderate 18

Severe 12

Extremely severe 42

Stress Scale

Normal

Mild

Moderate

Severe

Extremely severe

78 students (76.47%) suffer in stress

Level of stress Number of responder

Normal 24

Mild 8

Moderate 34

Severe 12

Extremely severe 24

What do we observe from the result?

> 58.8% are suffer from depression.> 74.5% are suffer from anxiety.> 76.5% are suffer from stress.

More than half of the tertiary education students are under depression, anxiety or

stress.

HKTIHCWG DASS study

Hong Kong Tertiary Institutions Health Care Working Group(HKTIHCWG) have done a DASS research during 2003 to 2004.

Total 7915 tertiary student responded to the questionnaire 63% girls; 37% boys 86% aged between 19 to 24

Result comparison

0%

10%

20%

30%

40%

50%

60%

70%

HKTIHCWG (Depression)Stress Go Away (Depres-sion)HKTIHCWG (Anxiety)Stress Go Away (Anx-iety)HKTIHCWG (Stress)

The distribution of data obtained by Stress Go Away is similar to that by HKTIHCWG, but higher occurrence of depression case.

It can be explained due to the small sample size, and the sampling error.

Result comparison

No. of participat

or

Studied object

Average score Severity

HKTIHCWG 7915Depression

AnxietyStress

8.669.3613.97

NormalMildNormal

Stress Go Away 102Depression

AnxietyStress

15.8816.3821.08

ModerateSevereModerate

Hong Kong people

(Taouk et al., 2001)

729Depression

AnxietyStress

5.356.5411.17

NormalNormalNormal

We decided to do something for the tertiary education students!

What to do to promote mental health in tertiary education student?

We identified several aims in implementing mental health promotion…

Health education

Provide related information

Arouse awareness on mental health

Recommend ways to cope with stress

Set up a facebook fan page

Why to choose Facebook? The most popular mass media for teenagers

Easy to interact with tertiary students

壓力鬆鬆 Zone

Objectives

To provide information about stress

To recommend means to assess stress(e.g. DASS) and ways to relieve stress

To beware of the status of mental health of self and others

Contents of Facebook page

News

To raise the awareness on mental health

Clip arts and information

• What stress is

• Sort out the possible sources of stress

• How people perceive stress

• Possible attributes of stress

• Etc.

DASS questionnaire

Tool to assess ownstress level

Health promotion event in campus

Date: 17th October, 2013

Time: 1330-1530

Venue: Hong Kong Polytechnic University

Number of participants: Nearly 30

走進校園為你打打氣

Objectives

To approach tertiary students in a direct way

To promote the awareness of mental health

To share the stress feelings through conversations

To provide ways to relieve stress

Video

Preparations

Card board For the promotion of the event and Facebook fans page

Paper bags For one of the tricks(blowing air to release stress)

Mobile devices

For people to “like” our Facebook fans page immediately

Sweets As reward for participatingThis event can be sustain with volunteer to do across

campus.

Evaluation – For the DASS survey The DASS questionnaire is easy to administrate, and

simple for us to assess the level of depression, anxiety and stress of our target group

Number of participantso Total 102 responses, it is satisfactory for us to find out

the trend of the stress level

o The result is similar compare with the CUHK report 

Sending e-mail for the test resulto Responder willing to fill in their e-mail address for the

result

o We can provide brief information about depression, anxiety, and stress, and encourage seeking for professional aid

o Promote for “like” our Facebook fan page

Questionnaire is a useful tool for students to evaluate their status of mental health, to

motivate them to find methods to reduce stress, and coherence with our Facebook fans page

Evaluation – For facebook page

Number of people followingo To evaluate the number of the people

participating the programme

Number of “like”o To evaluate the proportion of the

students following our page

Resource of information posted is well supported with academic references

Keep updating the pageo To maintain the programme and expand benefit

to the students

Facebook page is a convenient and sustainable media to reach our target group. The information can influence students if it can be present in a interesting

way.

Evaluation – For PolyU event

Number of participantso Nearly 30 students participate in this event within

2 hours, only 5 people rejected our invitation

Respond from the studentso They enjoyed our event and agree with our event

rational: a simple act can relieve stress

o They said they will try the tricks when they feel stress and promote to their fellows

o Some of them requested to take photo with our group

o Students like our facebook page immediately

The event is an effective mode of promotion. Students are eager to participate in the event. The echo are greater than we expected, even the students pass

by can notice our event and follow our page.

Self-Evaluation

Regular meet upo To evaluate process of work, define goal, brainstorm

ideas, and distribute work

Evaluation session immediately after the health promotion event in PolyU to review the challenges, effectiveness, and discuss for follow-up actions

Advice seeking from our instructors regularly to comment on the feasibility and acceptability of our action

Each of us participate in the work and are responsible

References• AM730. (2011, June 23). 調查發現八成五人受困擾 失眠或抑鬱症先兆 . Am730.

Retrieved from http://www.am730.com.hk/article.php?article=61699

• Selye, H. (1936). A syndrome produced by diverse nocuous agents. Nature, 138,32.

• Lovibond, S.H. & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales (2nd. Ed.). Sydney: Psychology Foundation.

• Ming Pao Health. (2013, November 11). 「睇開啲」掃不走抑鬱 . Ming Pao. Retrieved from http://www.mingpaohealth.com/cfm/health3.cfm?File=20131111/cele/yaa2.txt

• Psychology Foundation of Australia. (2013). Lu Hui Chun adaptation of DASS. Retrieved November 26, 2013, from http://www2.psy.unsw.edu.au/dass/Chinese/Taiwanese%20DASS%20Lu%20Hui%20Chun.pdf

• Man, P. (2012, May 23). One in six falls victim to those dark moods. The Standard. Retrieved from http://www.thestandard.com.hk/news_detail.asp?pp_cat=11&art_id=122710&con_type=1

• World Health Organization. (2011). Mental health: a state of well-being. Retrieved November 26, 2013, from http://www.who.int/features/factfiles/mental_health/en/

Q&A Session