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. 2018 Dec 29;18(1):1001.
doi: 10.1186/s12913-018-3829-8.

Exploring MEST: a new universal teaching strategy for school health services to promote positive mental health literacy and mental wellbeing among Norwegian adolescents

Hanne Nissen Bjørnsen  1   2 , Regine Ringdal  3   4 , Geir Arild Espnes  3   4 , Mary-Elizabeth Bradley Eilertsen  3   4 , Unni Karin Moksnes  3   4
Affiliations

Exploring MEST: a new universal teaching strategy for school health services to promote positive mental health literacy and mental wellbeing among Norwegian adolescents

Hanne Nissen Bjørnsen et al. BMC Health Serv Res. .

Abstract

Background: Mental health among adolescents is an important public health challenge. School health services perform central public health functions in Norwegian municipalities, where school nurses are uniquely positioned to educate and promote mental health among adolescents. MEST (MEST is not an acronym; MEST is a short version of the Norwegian word for coping) is a newly developed universal working strategy for school health services that aims to promote positive mental health literacy (MHL) and mental wellbeing in the adolescent population. The aim of this study was to investigate the potential outcome mean differences in positive MHL and mental wellbeing between adolescents who participated and those who did not participate in MEST over a school year.

Methods: This study is based on cohort data collected from 357 adolescents (aged 15-21 years) in five Norwegian upper secondary schools at the beginning and end of the 2016/2017 school year. The data were analyzed by describing mean scores and estimating the average treatment effect (ATE) of MEST on positive MHL and mental wellbeing.

Results: Positive MHL increased significantly more among the MEST participants compared to the non-MEST participants (p = .02). No significant change in mental wellbeing was found between MEST and non-MEST participants (p = .98). Estimating the ATE of MEST on positive MHL, the MEST participants showed a significant 2.1% increase (p = .04) in the potential outcome mean of positive MHL compared to the nonparticipants. Estimating the ATE of MEST on mental wellbeing, the girls who attended MEST exhibited a significant 9.7% increase (p = .03) in the potential outcome mean of mental wellbeing compared with the girls who did not attend MEST, while no significant change (p = .99) was detected among boys or the entire sample of both genders combined (p = .12).

Conclusion: This study found a significant ATE of MEST on positive MHL and on mental wellbeing among girls. The results support further investments in studying MEST as a promising work strategy for school health services to promote adolescent mental health. This initial study of MEST may be used as a foundation for investing in future evaluations of MEST.

Keywords: Adolescence; Mental health literacy; Mental health promotion; Mental wellbeing; School health services; School nursing.

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Conflict of interest statement

Authors’ information

Hanne N. Bjørnsen, RN, MS, MPH, PhD Candidate, Department of Public Health and Nursing, Norwegian University of Science and Technology Center for Health Promotion Research and RN at Heimdal Children and Family Services, Trondheim Municipality, Norway; Regine Ringdal MS, PhD Candidate, Department of Public Health and Nursing, Norwegian University of Science and Technology Center for Health Promotion Research and Advisor in Trondheim Municipality, Norway; Geir A. Espnes, RN, MPsych, PhD, Department of Public Health and Nursing, Norwegian University of Science and Technology Center for Health Promotion Research; Mary-Elizabeth B. Eilertsen, RN, PhD, Department of Public Health and Nursing, Norwegian University of Science and Technology Center for Health Promotion Research; Unni K. Moksnes, RN, PhD, Department of Public Health and Nursing, Norwegian University of Science and Technology Center for Health Promotion Research.

Ethics approval and consent to participate

This study was approved by the Regional Committee for Medical and Health Research Ethics (REK midt 2014/1996). All participants were informed that participation was voluntary and anonymous through written letters, a video created by the research group that was available on the school’s e-learning platform, and oral information provided by the teachers in each class prior to distributing the questionnaires. Students aged 16 years or older gave consent for participation by completing the questionnaire, and written parental consent was obtained for students aged 15 years or less.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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