Identifying and Addressing Mental Health Literacy Gaps for School Based Mental Health Programs in Bangladesh

Identifying and Addressing Mental Health Literacy Gaps for School Based Mental Health Programs in Bangladesh | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Identifying and Addressing Mental Health Literacy Gaps for School Based Mental Health Programs in Bangladesh Md Saleh Uddin, Ernesta Sofija, Paul Harris This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9024043/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Despite the prevalence of adolescent mental health problems and a substantial service gap in Bangladesh, school-based mental health interventions remain rare. This study provides a baseline assessment of mental health literacy (MHL) among key stakeholders to inform future promotion and prevention strategies in schools. Methods A cross-sectional survey was conducted with 963 participants (secondary school students, teachers, and parents/caregivers), using a validated Bangla version of the Mental Health Literacy Scale. Data were collected on participant role, residential location, school type, prior mental health training, perceived need for school-based support, and experience of mental health concerns and help-seeking. Binary logistic regression was used to identify sociodemographic and contextual predictors of adequate MHL. Results Overall, MHL levels were low, though teachers demonstrated higher literacy than students and parents. Awareness of mental disorders and treatments was limited, while stigmatised attitudes were prevalent. Higher MHL was associated with being a teacher, urban residence, attendance at mainstream schools, prior mental health training, and perceived need for school-based support. Conversely, lower MHL was concentrated among students, parents, rural communities, and Islamic faith-based schools. Conclusions While teachers demonstrated higher MHL, suggesting their potential as frontline gatekeepers, the significantly lower literacy among parents presents a potential critical barrier to service utilisation. Findings indicate that school-based programs in Bangladesh must go beyond student awareness to include targeted parental engagement and task-shifting training for teachers. This whole-school approach is essential to function effectively as a node in the wider community mental health system. predictor mental health literacy school universal intervention Bangladesh 1 Introduction Bangladesh, home to one of the world’s largest youth populations, is confronting a substantial public health challenge due to the high burden of mental health problems among children and adolescents. Approximately one-third of its 171 million residents are children and adolescents, with an estimated 13.6% experiencing mental disorders (Arafat, 2024 , National Institute of Mental Health Bangladesh, 2021 ). This burden is exacerbated by a 94.5% treatment gap and a severe shortage of specialists, with only 0.01 child and adolescent psychiatrists per 100,000 young people, while services remain concentrated in urban centres (Koly et al., 2024 , World Health Organization, 2020 ). In this resource-limited context, population-level strategies emphasising mental health promotion, prevention, and early intervention are essential to reduce long-term adverse outcomes, with evidence indicating that preventive interventions for children and adolescents are feasible and generally cost-effective (Cho and Shin, 2013 , Le et al., 2021 , Barry et al., 2013 ). Schools represent a critical setting for these strategies, as adolescents spend much of their formative years within educational environments where early signs of distress can be identified and support facilitated (Johnstone. and E. Kemps, 2018 , Leschied et al., 2018). The Health Promoting School (HPS) framework offers a comprehensive approach by integrating school policy, governance, community engagement, environment, curriculum, and access to health services to support student wellbeing (World Health Organization and United Nations Educational Scientific and Cultural Organization, 2021 ). Within this framework, the mental health literacy (MHL) of key school stakeholders—including adolescents, teachers, and parents—is central to enabling early identification, informed support and effective implementation of school-based mental health programmes (SBMHPs) (Johnson et al., 2023 , Splett et al., 2019 ). MHL encompasses the knowledge and skills required to maintain positive mental health, recognise disorders, understand treatment options, reduce stigma, and facilitate help-seeking (Jorm, 2012 ). Evidence indicates that school-based MHL interventions can improve knowledge and attitudes among adolescents (Amado-Rodriguez et al., 2022 ). Moreover, collaboration between parents and teachers plays a crucial role in shaping and supporting positive mental health outcomes for children (Sheridan et al., 2019 , Smith et al., 2020). However, empirical data on Bangladeshi adolescents, teachers, and parents remain limited. Available studies indicate generally low literacy and high stigma, highlighting persistent gaps in awareness and support within communities (Koly et al., 2024 ). These findings align with broader calls to strengthen stakeholder engagement and foster supportive environments in low-resource settings (United Nations International Children's Emergency Fund, 2024 ). Against this backdrop, successful community mental health systems rely on the readiness of all stakeholders, not just students. This study assesses MHL across the school ecosystem (adolescents, teachers, and parents) to determine the feasibility of school-based interventions. Specifically, we aim to identify whether teachers are prepared to act as task-shifting gatekeepers and to pinpoint where systemic barriers, such as low parental literacy or rural disadvantage, might impede service delivery. 2 Methods 2.1 Study design and setting A cross-sectional quantitative survey was conducted between February and May 2025 in Chittagong district, Bangladesh. The district was purposively selected for its demographic diversity, encompassing both the metropolitan Chittagong City and surrounding rural communities (Bangladeh Bureau of Statistics, 2023). This setting enables comparison of MHL across rural-urban and school type contexts. 2.2 Sampling and Participants A multi-stage sampling strategy was used to recruit adolescent students, schoolteachers and parents or caregivers. First, the district was stratified into urban (Chittagong city) and rural areas, from which four subdistricts were randomly selected. Schools within selected subdistricts were further stratified by education stream—mainstream and Islamic faith-based schools (IFBSs), the two predominant secondary education streams in Bangladesh (Bangladeh Bureau of Educational Infromation and Statistics, 2023). Foreign curriculum schools serving predominantly high-income families were excluded to maintain focus on the low- to middle-income contexts representative of the national population (Bangladeh Bureau of Statistics, 2023). Eleven secondary schools consented to participate: three urban mainstream schools, two urban IFBSs, three rural mainstream schools, three rural IFBSs. Within participating schools, students (grades 8–10), teachers and parents or caregivers were invited through school administration. From the list of eligible participants provided by each school, a simple random sampling procedure was applied to select participants. Written informed consent was obtained from teachers and parents or caregivers, while students provided written assent alongside parental consent. 2.3 Sample size Sample size for each stakeholder group was calculated using Cochran’s formula for proportions with a finite population correction (Cochran, 1977 ), assuming a 95% confidence level, 5% margin of error, and a conservative prevalence estimate (p = 0.5). Population estimates for post-primary teachers (N = 587,388) and secondary students (N = 18,430,968) were obtained from the Bangladesh Education Statistics 2022 (Bangladesh Bureau of Educational Information and Statistics, 2023 ). The parent or caregiver population was assumed to be equal to the student population. The target calculated sample size was 385 per group, totalling 1,155. 2.4 Measures Data were collected face-to-face using a structured questionnaire comprising two sections. The first section collected sociodemographic and contextual data. The selection of variables was informed by established literature identifying key predictors of MHL, including age, gender, education level, socioeconomic status, religion, geographical location (urban/rural), prior mental health training, personal or familial experience with mental health issues, professional help-seeking and need for school-based mental health programme (SBMHP) (Farrer et al., 2008 , Furnham and Swami, 2018 , Suwanwong et al., 2024 , Cotton et al., 2006 , Jorm, 2000 ). The second section assessed mental health literacy using the Mental Health Literacy Scale (MHLS-Bangla), the Bangla version of the original 35-item English MHLS (O’Connor and Casey, 2015 ). The instrument underwent a rigorous cultural adaptation and validation process for the Bangladeshi context, following established cross-cultural adaptation guidelines, including forward translation, back-translation, expert review and piloting (Beaton et al., 2000 , Streiner and Kottner, 2014 ). Psychometric evaluation demonstrated good internal consistency (Cronbach’s α = 0.88) and supported the structural validity of the MHLS-Bangla (Uddin et al., 2025 , under review). The scale measures MHL across five subscales: 1) knowledge of mental illness and its treatment, 2) mental health promotion, 3) help-seeking, 4) stigma towards mental illness, and 5) attitude towards persons with mental illness. 2.5 Data analysis Data were analysed using the IBM SPSS Statistics version 29 (IBM Corp, 2022). Descriptive analyses were conducted as part of data screening. Missing values were below 5%, indicating good data quality. Frequency distributions and measures of central tendency (means and medians) were examined. Normality of MHL scores was assessed using the Shapiro–Wilk and Kolmogorov–Smirnov tests, both of which indicated significant deviation from normality (Shapiro–Wilk: W = .983, p < .001; Kolmogorov–Smirnov: D = .062, p < .001). Visual inspection of histograms, stem-and-leaf plots and Q-Q plots supported these findings. Accordingly, nonparametric tests were applied. Mann–Whitney U test, Kruskal–Wallis H test and pairwise Mann–Whitney U test with Bonferroni correction were used to examine differences in MHL scores (dependent variable) across sociodemographic and contextual variables (independent variables). To assess the influence of independent variables on MHL, binary logistic regression was performed. In the absence of validated cut-off score of the original scale, MHL levels were operationally categorised as inadequate (< 50% correct responses) and adequate (≥ 50%, ≥ 18 correct responses), to facilitate comparative analysis across the stakeholder groups. 3 Findings 3.1 Sociodemographic profile of stakeholders A total of 963 participants were included, representing an 83.4% response rate. The sample comprised students (44.5%, n = 428), teachers (28.9%, n = 278), and parents or caregivers (26.7%, n = 257). Students were all adolescents, while teachers, parents or caregivers represented adult stakeholder groups. Overall, participants were predominantly female (59.0%), resided mainly in rural areas (53.0%), and identified as Muslim (90.1%). Gender and residence varied across stakeholder groups. Parents or caregivers were predominantly female (88.7%), and more likely to reside in rural areas (61.1%), compared with teachers and students. Educational attainment differed substantially: nearly all teachers had completed tertiary education (93.5%), whereas parents or caregivers reported mixed levels of education, including tertiary (22.9%), secondary (52.9%), or primary or no formal education. Detailed characteristics are presented in Table 1. 3.2 Mental health training, help-seeking and service need Most participants (85.9%) reported no prior mental health training in school. Despite this limited exposure, the majority (86.4%) perceived a need for school-based mental health support for adolescents. Nearly one-third (29.6%) reported personal or familial experience of mental health problems, while 19.5% reported having sought professional support. Teachers consistently reported higher levels across these indicators: 34.2% reported personal or familial mental health problems, 23.0% had sought professional help, and almost all (97.5%) perceived a need for a school-based mental health program (SBMHP), compared with students and parents or caregivers (Table 1). [Insert Table 1 here] 3.3 Mental health literacy scores The overall mean MHL score was 17.68 (SD = 6.46, median = 18.00, range = 0–35). Significant differences were observed across stakeholder groups. Teachers demonstrated the highest score (mean = 21.15, SD = 5.28), followed by students (mean = 16.48, SD = 5.94) and parents or caregivers (mean = 15.93, SD = 7.03). Across sociodemographic variables, adults scored higher than adolescents, and MHL increased with educational attainment. Participants with tertiary education had the highest score, followed by those with secondary education and those with primary/no formal education. Urban participants scored higher than rural participants, and participants from mainstream schools scored higher than those from Islamic faith-based schools (IFBSs). Participants who had received prior mental health training, perceived a need for SBMHP, reported personal or familial experience of mental health problems or had sought professional help demonstrated higher MHL scores than those without (Table 2). 3.4 Awareness of mental illness and associated stigmatised attitudes Subscale analyses indicated generally low scores for knowledge of mental illness and treatment, stigma toward mental illness and attitudes towards individuals with mental illness. In contrast, comparatively higher scores were observed for mental health promotion and help-seeking domains (Table 2). Vignette analyses (Supplementary Table S1) showed that over half of the participants correctly identified substance use disorder (65.1%), autism spectrum disorder and intellectual disability (57.8%), and dementia (52.8%). Recognition of major depressive disorder (42.7%) and anxiety disorders (42.1%) was lower, as was awareness of psychological treatment options (48.6%). In contrast, pharmacological treatment was more frequently recognised as appropriate (76.1%). [Insert Table 2 here] 3.5 Bivariate Associations with Mental Health Literacy Mann–Whitney U test analyses demonstrated significantly higher MHL scores among adults, urban residents, participants from mainstream schools, and those who had received mental health training in school (all p < .01). Higher MHL scores were also observed among participants who perceived a need for school-based mental health support, reported personal or familial experience of mental health problems, and had sought professional help (all p < .01) compared with those without these characteristics (Table 3). [Insert Table 3 here] 3.6 Pairwise group comparisons of Mental Health Literacy Pairwise comparisons revealed significant differences in MHL scores by stakeholder group, education level, and profession (Table 4). Teachers scored significantly higher than both students and parents or caregivers ( p < .01), while no significant difference was observed between students and parents ( p = .744). Participants with tertiary education scored higher than those with secondary or primary/no formal education ( p < .01). Profession-based analyses showed that teachers had significantly higher MHL scores than all other occupational groups. No significant differences were observed by gender or religion . [Insert Table 4 here] 3.7 Independent Predictors of Mental Health Literacy A binary logistic regression model was used to identify independent predictors for adequate MHL. The model was statistically significant (χ²(10) = 175.78, p < .01), explained 22.3% of the variance in MHL (Nagelkerke R²) and demonstrated good model fit (Hosmer–Lemeshow p = .966), with no evidence of multicollinearity (Table 5). [Insert Table 5 here] Five variables emerged as significant predictors. Compared with teachers, students (OR = 0.255, p < .01) and parents or caregivers (OR = 0.288, p < .01) had substantially lower odds of adequate MHL. Participants residing in rural areas (OR = 0.593, p < .01) and those from IFBSs (OR = 0.692, p < .01) were also less likely to demonstrate adequate MHL. In contrast, prior mental health training in school (OR = 1.906, p < .01) and perceiving a need for school-based mental health program (OR = 3.486, p < .01) were associated with higher odds of adequate MHL. Gender, religion, personal or family experience of mental health concerns, and prior help-seeking were not significant predictors in the final model. 4 Discussion This study offers the first multi-stakeholder assessment of MHL in Bangladeshi schools, illuminating a pronounced ‘competency gap' that shapes how school communities understand and respond to adolescent mental health. Framed through the lens of teachers as gatekeepers and parents as partners, our findings identify critical leverage points and structural constraints that must be addressed to enable effective task-shifting interventions in low-resource school settings. Consistent with research from other LMICs, including South Asia, MHL remained low across most stakeholder groups (Parikh et al., 2016 , Krishna K. et al., 2024, Shrestha et al., 2025 , Shrestha et al., 2023 , Ginige et al., 2021 , Ali et al., 2024, Munawar et al., 2020 , Bhugra et al., 2022 ). However, previous studies have largely examined single groups, limiting insights into how school communities’ function collectively. By contrast, our multistakeholder approach revealed clear differences in literacy that have direct implications for intervention design and implementation. Teachers demonstrated substantially higher MHL than students and parents. This likely reflects greater educational attainment, access to information, and social position, roles that position teachers as potential gatekeepers in school-based mental health systems. This finding aligns with the literature showing lower MHL among parents/caregivers with limited education and younger populations (Asl et al., 2024 , Buchanan and Holly, 2025 , Renwick et al., 2024 , Maddox et al., 2025 ), although global evidence regarding teachers is mixed (Phoa et al., 2023). In LMICs where specialist services are scarce, task-shifting model that build teachers’ capacity may be a practical approach, provided that training, support, and incentives are available (Fazel et al., 2014 , Purgato et al., 2020 , Padmanathan and De Silva, 2013 ). Despite some knowledge of mental health promotion and help-seeking, likely reflecting national public health initiatives, awareness of common adolescent conditions and evidence-based interventions remained limited (Al-Zubayer et al., 2023 , Tabassum et al., 2018 ) (Supplementary Table S1 ). Highly stigmatised attitudes toward mental illness were pervasive across groups, consistent with national/regional evidence (Faruk et al., 2023 , Lauber and Rössler, 2007 , Roy and Chowdhury, 2024 ). Although school-based literacy interventions have shown promise in raising awareness and reducing stigma, most evidence originates from high-income countries, and LMIC programmes remain broad and population-based with limited long term effectiveness (Ma et al., 2023, Vaishnav et al., 2023 ). This underscores the need for programmes that move beyond general awareness to include skills training and targeted stigma reduction strategies. Importantly, rural participants exhibited lower MHL than urban counterparts, reflecting entrenched rural–urban disparities in health literacy (Table 4 ) (Aljassim and Ostini, 2020 ). Similar patterns in rural settings have been documented internationally, where limited awareness impedes recognition and help-seeking (He et al., 2024 , Kavanagh et al., 2023 ). These findings point to structural barriers that extend beyond the school environment. School type also influenced MHL. Students from Islamic faith-based schools (IFBSs) had lower literacy than those in mainstream schools, possibly due to limited mental health content in the curriculum and contextual factors (Al-Hasani, 2020 , National Curriculum and Textbook Board, 2025, Uddin, 2020 ). This finding highlights the importance of curriculum content and resources as community-level determinants of MHL. Participants with prior school-based mental health training had higher MHL and greater recognition of intervention need, consistent with LMIC evidence (Table 4 ) (McGuckin and Leavey, 2021 ). However, training alone may not be sufficient to change attitudes or help-seeking behaviour (Amado-Rodriguez et al., 2022 ), reinforcing the need for integrated approaches that combine knowledge, skills, and community engagement. Collectively, these findings highlight teachers as critical gatekeepers whose enhanced literacy can facilitate early recognition and support for adolescent mental health. At the same time, parents emerge as a largely untapped resource who, when meaningfully engaged, can partner with teachers to reinforce mental health awareness, encourage help-seeking, and reduce stigma within families and communities. Low literacy in rural communities and in certain school types, however, continues to pose a barrier that may undermine intervention effectiveness if not addressed. These insights underscore the need for co-designed, contextually tailored interventions that strengthen teacher capacity, actively involve parents as partners, and bridge rural–urban disparities, thereby reducing mental health literacy gaps and promoting adolescent wellbeing across Bangladeshi schools. 4.1 Strengths and limitations This study demonstrated several methodological strengths. Fieldwork was effectively managed by trained assistants, despite local political unrest, and culturally sensitive engagement was achieved through the use of female researchers and local dialects. Randomised, structured sampling enhanced the generalisability of findings. The multi-stakeholder, school-focused approach enabled an accurate assessment of mental health literacy (MHL) across teachers, students, and parents, providing actionable insights to inform future programmes. Limitations include a gender imbalance among parent participants, reliance on education and occupation as proxy indicators of socio-economic status, and the lack of comparable local or regional studies for benchmarking. Despite these limitations, the study offers robust evidence to guide culturally relevant, school-based mental health initiatives in Bangladesh. 4.2 Recommendations Given the paucity of research, population norms for MHL in Bangladesh remain unavailable. Future studies should expand coverage to include broader cultural and linguistic diversity, involve more schools, and undertake large-scale research to develop normative data that can inform policy and interventions. Participatory research approaches may further enhance cultural appropriateness and contextual relevance, ensuring that interventions are grounded in community realities. 4.3 Conclusion This study provides the first multi-stakeholder evidence on mental health literacy in Bangladeshi school communities within an LMIC context. The findings demonstrate how literacy disparities shape the feasibility of school-based task-shifting approaches. Teachers appear well positioned to function as gatekeepers for early identification and support, while parents represent essential partners in reinforcing awareness and help-seeking beyond the classroom. Addressing contextual inequities, particularly across rural settings and school types, will be critical to ensuring equitable implementation. Contextually adapted models that integrate teacher capacity-building with meaningful parental engagement offer a pragmatic pathway to strengthening adolescent mental health systems in low-resource school environments. Declarations Clinical Trial Number Not applicable Ethical approval: The study was conducted according to the ethical principles outlined in the Declaration of Helsinki and adhered to all relevant institutional and national research ethics guidelines and regulations. Ethical approval obtained from the Human Research Ethics Committee at Griffith University, Australia (Ref. No. 2024/902). Consent to participate: Informed consent was obtained from all adult participants (teachers and parents or caregivers). Written assent was obtained from the adolescent students, and informed consent was obtained from their parents or caregivers prior to participate in the study. Consent to publish: All participants and the parents or caregivers of adolescent students provided informed consent for the publication of anonymised data from this study. Competing interest: The authors have no competing interests Funding: No external funding was received for this study. Author Contribution M.S.U., E.S., and P.H. contributed to the study conceptualization and methodology. M.S.U. conducted the investigation, performed data curation, and managed project administration and resources. Formal data analysis and visualization were carried out by M.S.U., E.S., and P.H. M.S.U. wrote the original draft of the manuscript. P.H. and E.S. contributed to writing—review and editing. E.S. and P.H. provided supervision. All authors reviewed and approved the final manuscript. Data Availability The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. References AL-HASANI, S. M. A. 2020. 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A mixed methods systematic review of global parental mental health literacy. Current Psychology , 1-18. https://doi.org/10.1007/s12144-025-07727-w MCGUCKIN, N. & LEAVEY, G. 2021. A systematic review to evaluate the effectiveness of mental health literacy interventions implemented in schools and communities in low- and middle- income countries. BJPsych Open, 7 , S271-S271. https://doi.org/10.1192/bjo.2021.721 MUNAWAR, K., ABDUL KHAIYOM, J. H., BOKHAREY, I. Z., PARK, M. S. A. & CHOUDHRY, F. R. 2020. A systematic review of mental health literacy in Pakistan. Asia ‐ Pacific Psychiatry, 12 , e12408. https://doi.org/10.1111/appy.12408 NATIONAL CURRICULUM AND TEXTBOOK BOARD, B. N. 2025. Physical Education, Health Scienses and Sports. https://drive.google.com/file/d/14sWZ1nksPOXiuinfz5chpM5TGfHbxfjf/view NATIONAL INSTITUTE OF MENTAL HEALTH BANGLADESH 2021. National Mental-Health-Survey 2019. https://nimh.gov.bd/english/policy-documents/ O’CONNOR, M. & CASEY, L. 2015. 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Epidemiology and psychiatric sciences, 29 , e150. https://doi.org/10.1017/s204579602000061x RENWICK, L., PEDLEY, R., JOHNSON, I., BELL, V., LOVELL, K., BEE, P. & BROOKS, H. 2024. Mental health literacy in children and adolescents in low-and middle-income countries: a mixed studies systematic review and narrative synthesis. European child & adolescent psychiatry, 33 , 961-985. https://doi.org/10.1007/s00787-022-01997-6 ROY, P. & CHOWDHURY, K. U. A. 2024. Exploring the stigma against people with mental illness in Bangladesh. Cambridge Prisms: Global Mental Health, 11 , e108. https://doi.org/10.1017/gmh.2024.107 SHERIDAN, S. M., SMITH, T. E., MOORMAN KIM, E., BERETVAS, S. N. & PARK, S. 2019. A meta-analysis of family-school interventions and children’s social-emotional functioning: Moderators and components of efficacy. Review of educational Research, 89 , 296-332. https://doi.org/10.3102/0034654318825437 SHRESTHA, A., POUDEL, D. B. & THAPA, P. 2025. Mental Health Literacy among Middle School Students in Private and Community Schools, Kathmandu, Nepal. Psychology, 16 , 333-352. https://doi.org/10.4236/psych.2025.163020 SHRESTHA, M., SINGH, P. S., RANA, D. & JAISWAL, A. 2023. Mental Health Literacy among Secondary School Students Attending Government Schools in Kohalpur Municipality. Journal of Nepalgunj Medical College, 21 , 45-48. https://doi.org/10.3126/jngmc.v21i1.58299 SMITH, T. E., HERMAN, K. C. & REINKE, W. M. 2020. Theories of behavior change. Theories of School Psychology. Routledge. https://psycnet.apa.org/doi/10.4324/9781351064941-6 SPLETT, J. W., GARZONA, M., GIBSON, N., WOJTALEWICZ, D., RABORN, A. & REINKE, W. M. 2019. Teacher recognition, concern, and referral of children’s internalizing and externalizing behavior problems. School mental health, 11 , 228-239. https://psycnet.apa.org/doi/10.1007/s12310-018-09303-z STREINER, D. L. & KOTTNER, J. 2014. Recommendations for reporting the results of studies of instrument and scale development and testing. Journal of advanced nursing, 70 , 1970-1979. https://doi.org/10.1111/jan.12402 SUWANWONG, C., JANSEM, A., INTARAKAMHANG, U., PRASITTICHOK, P., TUNTIVIVAT, S., CHUENPHITTAYAVUT, K., LE, K. & LIEN, L. T. M. 2024. Modifiable predictors of mental health literacy in the educational context: a systematic review and meta-analysis. BMC psychology, 12 , 378. https://doi.org/10.1186/s40359-024-01878-4 TABASSUM, R., FROESCHL, G., CRUZ, J. P., COLET, P. C., DEY, S. & ISLAM, S. M. S. 2018. Untapped aspects of mass media campaigns for changing health behaviour towards non-communicable diseases in Bangladesh. Globalization and health, 14 , 7. https://doi.org/10.1186/s12992-018-0325-1 UDDIN, M. S. 2020. Mental health content in school science textbooks in Bangladesh. The Lancet Psychiatry, 7 , e10. https://doi.org/10.1016/s2215-0366(20)30008-0 UDDIN, M. S., ISLAM, T., ARA, H., SOFIJA, E., HARRIS, P. & ARAFAT, S. M. Y. 2025.Cultural Adaptation and Validation of the Mental Health Literacy Scale Bangla (MHLS-Bangla) Among Undergraduate Nursing Students in Bangladesh. Health Science Report, Under review UNITED NATIONS INTERNATIONAL CHILDREN'S EMERGENCY FUND 2024. Improving students' mental health in Bangladesh. https://www.unicef.org/documents/improving-students-mental-health-bangladesh VAISHNAV, M., JAVED, A., GUPTA, S., KUMAR, V., VAISHNAV, P., KUMAR, A., SALIH, H., NG, B., ALKHOORI, S. & LUGUERCHO, C. 2023. Stigma towards mental illness in Asian nations and low-and-middle-income countries, and comparison with high-income countries: A literature review and practice implications. Indian Journal of Psychiatry, 65 , 995-1011. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_667_23 WORLD HEALTH ORGANIZATION 2020. Mental Health Atlas 2020 Member State Profile (Bangladesh). https://www.who.int/publications/m/item/mental-health-atlas-bgd-2020-country-profile WORLD HEALTH ORGANIZATION AND UNITED NATIONS EDUCATIONAL SCIENTIFIC AND CULTURAL ORGANIZATION 2021. Making every school a health-promoting school: Implementation guidance , World Health Organization. https://www.who.int/publications/i/item/9789240025059 Tables Table 1 Sociodemographic Characteristics, Mental Health Experience, and Perceived Need of MH Support among Students, Teachers, and Parents Variable Category Students n = 428 (%) Teachers n = 278 (%) Parents n = 257 (%) Total N=963 (%) Age group Adolescent 428 (100) 0 (0.0) 0 (0.0) 428 (44.4) Adult 0 (0.0) 278 (100) 257 (100) 535 (55.6) Gender Male 217 (50.7) 149 (53.6) 29 (11.3) 395 (41.0) Female 211 (49.3) 129 (46.4) 228 (88.7) 568 (59.0) Residence Urban 210 (49.1) 143 (51.4) 100 (38.9) 453 (47.0) Rural 218 (50.9) 135 (48.6) 157 (61.1) 510 (53.0) Religion Muslim 408 (95.3) 234 (84.2) 226 (87.9) 868 (90.1) Non-Muslim 20 (4.7) 44 (15.8) 31 (12.1) 95 (9.9) Education Primary NA 0 (0.0) 62 (24.2) 62 (6.5) Secondary 428 (100) 18 (6.5) 136 (52.9) 582 (60.4) Tertiary NA 260 (93.5) 59 (22.9) 319 (33.1) Marital status Unmarried 428 (100) 341 (89.9) 249 (96.9) 465 (48.3) Married NA 32 (8.4) 5 (1.9) 490 (50.9) Other NA 5 (1.3) 3 (1.2) 8 (0.8) MH training experience Yes 78 (18.2) 34 (12.2) 25 (9.7) 136 (14.1) No 350 (81.8) 244 (87.8) 232 (90.3) 827 (85.9) Personal or family members’ MH issues Yes 132 (30.8) 95 (34.2) 58 (22.6) 285 (29.6) No 296 (69.2) 183 (65.8) 199 (77.4) 678 (70.4) Sought professional help Yes 94 (22.0) 64 (23.0) 30 (11.7) 188 (19.5) No 334 (78.0) 214 (77.0) 227 (88.3) 775 (80.5) Felt need for SMBHI Yes 362 (84.6) 271 (97.5) 199 (77.4) 832 (86.4) No 66 (15.4) 7 (2.5) 58 (22.6) 131 (13.6) Note. SBMHI=School Based Mental Health Intervention, MH = Mental Health; N/A = Not Applicable. Table 2 Mental Health Literacy Score Distribution among Teachers, Students and Parents Stake holder Groups Normal score range Illnesses & Treatments 0-14 MH Promotion 0-4 Help Seeking 0-5 Stigma 0-8 Attitude 0-4 Total Score 0-35 Teacher Mean 8.32 3.20 3.54 4.95 1.12 21.15 N 278 278 278 278 278 278 SD 3.19 .81 1.31 1.90 1.11 5.28 Median 8.00 3.00 4.00 5.00 1.00 22.00 Student Mean 5.98 2.75 3.47 3.03 1.21 16.47 N 428 428 428 428 428 428 SD 3.11 1.17 1.42 1.91 1.12 5.93 Median 6.00 3.00 4.00 3.00 1.00 17.00 Parent Mean 5.68 2.75 3.37 2.92 1.19 15.93 N 257 257 257 257 257 257 SD 3.67 1.21 1.51 2.15 1.30 7.032 Median 6.00 3.00 4.00 3.00 1.00 16.00 Total Mean 6.58 2.88 3.47 3.56 1.18 17.68 N 963 963 963 963 963 963 SD 3.47 1.11 1.42 2.16 1.17 6.46 Median 7.00 3.00 4.00 4.00 1.00 18.00 Note. Illnesses & Treatments = Knowledge of mental disorders and treatments, Promotion = Knowledge of mental health promotion or self-treatment, Help seeking = Knowledge of help seeking measures, Stigma = Stigma toward mental illness, Attitude = Attitude toward person with mental illness. N = Number of participants, SD = Standard Deviation Table 3 Mann-Whitney U Test Results for Differences in Mental Health Literacy Scores by Participant Characteristics Variable Group Comparison U Z p Age group Adults vs. Others 95390.50 -5.15 < .01 Residential address Urban vs. Rural 97654.50 -4.79 < .01 School type General vs. Others 94220.50 -4.37 < .01 Prior MH training in school Yes vs. No 49025.50 -2.77 < .01 Need for SBMHI Yes vs. No 33610.00 -8.16 < .01 Family MH issues Yes vs. No 318097.50 -2.55 < .01 Professional help sought Yes vs. No 63973.00 -3.00 < .01 Religion Muslim vs. Non-Muslim 37046.50 -1.88 .060 Gender Male vs. Female 106975.00 -1.41 .156 Note. U = Mann–Whitney test statistic; Z = standardised test statistic; p = significance value. MH = Mental Health; SBMHI = School-Based Mental Health Intervention. Table 4 Pairwise Mann–Whitney Test for Differences in Mental Health Literacy by Sociodemographic and Contextual variables Variable Group Comparison U Z p Bonferroni Corrected Alpha Stakeholder group Teachers vs. Students 39689.00 -8.71 < .01 .017 Teachers vs. Parents 23375.00 -8.15 < .01 .017 Parents vs. Students 54294.50 -0.23 .74 .017 Academic qualification Graduate vs. Secondary 61512.50 -9.71 < .01 .017 Graduate vs. Primary 5546.00 -6.83 < .01 .017 Secondary vs. Primary 16205.00 -1.54 .12 .017 Profession Teacher vs. Housewife 16473.50 -8.97 < .01 .0083 Teacher vs. Businessman 3771.50 -3.67 < .01 .0083 Teacher vs. Unemployed 41439.00 -8.63 < .01 .0083 Note. U = Mann–Whitney test statistic; Z = standardised test statistic; p = significance value; Bonferroni-corrected alpha = adjusted significance level to account for multiple comparisons. Table 5 Predictors of Adequate Mental Health Literacy from a Binary Logistic Regression Model Predictor Variable B SE Wald p OR 95% CI for OR Stakeholder: Student (ref = Teacher) -1.365 0.192 50.56 < .01 0.255 0.179 – 0.365 Stakeholder: Parent (ref = Teacher) -1.244 0.201 38.38 < .01 0.288 0.191 – 0.436 Prior MH Training (Yes vs No) 0.645 0.208 9.61 < .01 1.906 1.260 – 2.883 Perceived Need for School MH Intervention (Yes vs No) 1.249 0.242 26.65 < .01 3.486 2.156 – 5.635 Residence: Rural (ref = Urban) -0.523 0.145 13.00 < .01 0.593 0.446 – 0.788 School Type: Faith-based (ref = Mainstream) -0.368 0.153 5.79 .01 0.692 0.512 – 0.935 Gender (Male vs Female) 0.102 0.135 0.57 .45 1.107 0.851 – 1.441 Religion (Muslim Vs Non-Muslim) -0.097 0.142 0.47 .49 0.908 0.687 – 1.202 Personal or family History of Mental Illness (Yes vs No) 0.165 0.143 1.33 .24 1.179 0.892 – 1.559 Previous Help-Seeking (Yes vs No) 0.194 0.163 1.42 .23 1.214 0.882 – 1.670 Note. Logistic regression analysis examining predictors of adequate mental health literacy. B = unstandardised regression coefficient; SE = standard error; Wald = Wald χ² test of the null hypothesis that the coefficient equals zero; OR = odds ratio; CI = confidence interval; ref = reference category. Significant results are indicated by p < .05. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9024043","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":607100814,"identity":"57414c82-0a7c-458d-9b1b-d8df9a415497","order_by":0,"name":"Md Saleh Uddin","email":"data:image/png;base64,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","orcid":"","institution":"Griffith University","correspondingAuthor":true,"prefix":"","firstName":"Md","middleName":"Saleh","lastName":"Uddin","suffix":""},{"id":607100815,"identity":"8c4cc960-de23-4fd9-b166-3f3f7c70eb95","order_by":1,"name":"Ernesta Sofija","email":"","orcid":"","institution":"Griffith University","correspondingAuthor":false,"prefix":"","firstName":"Ernesta","middleName":"","lastName":"Sofija","suffix":""},{"id":607100818,"identity":"425ef0dd-067b-49f0-b65b-dc930b8824e8","order_by":2,"name":"Paul Harris","email":"","orcid":"","institution":"Griffith University","correspondingAuthor":false,"prefix":"","firstName":"Paul","middleName":"","lastName":"Harris","suffix":""}],"badges":[],"createdAt":"2026-03-03 22:38:48","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9024043/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9024043/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105035149,"identity":"2f923d0d-beb2-47da-a788-5c8115479bb9","added_by":"auto","created_at":"2026-03-20 07:25:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1286206,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9024043/v1/9cae72fc-9fb2-4723-9694-421582401565.pdf"},{"id":104982901,"identity":"7c804bf6-ed99-45de-8fb2-5f6c5b6838cf","added_by":"auto","created_at":"2026-03-19 13:42:00","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":16102,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementarymaterialMHL.docx","url":"https://assets-eu.researchsquare.com/files/rs-9024043/v1/050603afaf2b1d877028fc1f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Identifying and Addressing Mental Health Literacy Gaps for School Based Mental Health Programs in Bangladesh","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eBangladesh, home to one of the world\u0026rsquo;s largest youth populations, is confronting a substantial public health challenge due to the high burden of mental health problems among children and adolescents. Approximately one-third of its 171\u0026nbsp;million residents are children and adolescents, with an estimated 13.6% experiencing mental disorders (Arafat, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2024\u003c/span\u003e, National Institute of Mental Health Bangladesh, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This burden is exacerbated by a 94.5% treatment gap and a severe shortage of specialists, with only 0.01 child and adolescent psychiatrists per 100,000 young people, while services remain concentrated in urban centres (Koly et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2024\u003c/span\u003e, World Health Organization, \u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In this resource-limited context, population-level strategies emphasising mental health promotion, prevention, and early intervention are essential to reduce long-term adverse outcomes, with evidence indicating that preventive interventions for children and adolescents are feasible and generally cost-effective (Cho and Shin, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2013\u003c/span\u003e, Le et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2021\u003c/span\u003e, Barry et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSchools represent a critical setting for these strategies, as adolescents spend much of their formative years within educational environments where early signs of distress can be identified and support facilitated (Johnstone. and E. Kemps, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2018\u003c/span\u003e, Leschied et al., 2018). The Health Promoting School (HPS) framework offers a comprehensive approach by integrating school policy, governance, community engagement, environment, curriculum, and access to health services to support student wellbeing (World Health Organization and United Nations Educational Scientific and Cultural Organization, \u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Within this framework, the mental health literacy (MHL) of key school stakeholders\u0026mdash;including adolescents, teachers, and parents\u0026mdash;is central to enabling early identification, informed support and effective implementation of school-based mental health programmes (SBMHPs) (Johnson et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, Splett et al., \u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMHL encompasses the knowledge and skills required to maintain positive mental health, recognise disorders, understand treatment options, reduce stigma, and facilitate help-seeking (Jorm, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Evidence indicates that school-based MHL interventions can improve knowledge and attitudes among adolescents (Amado-Rodriguez et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Moreover, collaboration between parents and teachers plays a crucial role in shaping and supporting positive mental health outcomes for children (Sheridan et al., \u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e2019\u003c/span\u003e, Smith et al., 2020). However, empirical data on Bangladeshi adolescents, teachers, and parents remain limited. Available studies indicate generally low literacy and high stigma, highlighting persistent gaps in awareness and support within communities (Koly et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). These findings align with broader calls to strengthen stakeholder engagement and foster supportive environments in low-resource settings (United Nations International Children's Emergency Fund, \u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAgainst this backdrop, successful community mental health systems rely on the readiness of all stakeholders, not just students. This study assesses MHL across the school ecosystem (adolescents, teachers, and parents) to determine the feasibility of school-based interventions. Specifically, we aim to identify whether teachers are prepared to act as task-shifting gatekeepers and to pinpoint where systemic barriers, such as low parental literacy or rural disadvantage, might impede service delivery.\u003c/p\u003e"},{"header":"2 Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study design and setting\u003c/h2\u003e \u003cp\u003eA cross-sectional quantitative survey was conducted between February and May 2025 in Chittagong district, Bangladesh. The district was purposively selected for its demographic diversity, encompassing both the metropolitan Chittagong City and surrounding rural communities (Bangladeh Bureau of Statistics, 2023). This setting enables comparison of MHL across rural-urban and school type contexts.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Sampling and Participants\u003c/h2\u003e \u003cp\u003eA multi-stage sampling strategy was used to recruit adolescent students, schoolteachers and parents or caregivers. First, the district was stratified into urban (Chittagong city) and rural areas, from which four subdistricts were randomly selected. Schools within selected subdistricts were further stratified by education stream\u0026mdash;mainstream and Islamic faith-based schools (IFBSs), the two predominant secondary education streams in Bangladesh (Bangladeh Bureau of Educational Infromation and Statistics, 2023). Foreign curriculum schools serving predominantly high-income families were excluded to maintain focus on the low- to middle-income contexts representative of the national population (Bangladeh Bureau of Statistics, 2023). Eleven secondary schools consented to participate: three urban mainstream schools, two urban IFBSs, three rural mainstream schools, three rural IFBSs. Within participating schools, students (grades 8\u0026ndash;10), teachers and parents or caregivers were invited through school administration. From the list of eligible participants provided by each school, a simple random sampling procedure was applied to select participants. Written informed consent was obtained from teachers and parents or caregivers, while students provided written assent alongside parental consent.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Sample size\u003c/h2\u003e \u003cp\u003eSample size for each stakeholder group was calculated using Cochran\u0026rsquo;s formula for proportions with a finite population correction (Cochran, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e1977\u003c/span\u003e), assuming a 95% confidence level, 5% margin of error, and a conservative prevalence estimate (p\u0026thinsp;=\u0026thinsp;0.5). Population estimates for post-primary teachers (N\u0026thinsp;=\u0026thinsp;587,388) and secondary students (N\u0026thinsp;=\u0026thinsp;18,430,968) were obtained from the Bangladesh Education Statistics 2022 (Bangladesh Bureau of Educational Information and Statistics, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The parent or caregiver population was assumed to be equal to the student population. The target calculated sample size was 385 per group, totalling 1,155.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Measures\u003c/h2\u003e \u003cp\u003eData were collected face-to-face using a structured questionnaire comprising two sections. The first section collected sociodemographic and contextual data. The selection of variables was informed by established literature identifying key predictors of MHL, including age, gender, education level, socioeconomic status, religion, geographical location (urban/rural), prior mental health training, personal or familial experience with mental health issues, professional help-seeking and need for school-based mental health programme (SBMHP) (Farrer et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2008\u003c/span\u003e, Furnham and Swami, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2018\u003c/span\u003e, Suwanwong et al., \u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e2024\u003c/span\u003e, Cotton et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2006\u003c/span\u003e, Jorm, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). The second section assessed mental health literacy using the Mental Health Literacy Scale (MHLS-Bangla), the Bangla version of the original 35-item English MHLS (O\u0026rsquo;Connor and Casey, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The instrument underwent a rigorous cultural adaptation and validation process for the Bangladeshi context, following established cross-cultural adaptation guidelines, including forward translation, back-translation, expert review and piloting (Beaton et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2000\u003c/span\u003e, Streiner and Kottner, \u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Psychometric evaluation demonstrated good internal consistency (Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.88) and supported the structural validity of the MHLS-Bangla (Uddin et al., \u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e2025\u003c/span\u003e, under review). The scale measures MHL across five subscales: 1) knowledge of mental illness and its treatment, 2) mental health promotion, 3) help-seeking, 4) stigma towards mental illness, and 5) attitude towards persons with mental illness.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data analysis\u003c/h2\u003e \u003cp\u003eData were analysed using the IBM SPSS Statistics version 29 (IBM Corp, 2022). Descriptive analyses were conducted as part of data screening. Missing values were below 5%, indicating good data quality. Frequency distributions and measures of central tendency (means and medians) were examined. Normality of MHL scores was assessed using the Shapiro\u0026ndash;Wilk and Kolmogorov\u0026ndash;Smirnov tests, both of which indicated significant deviation from normality (Shapiro\u0026ndash;Wilk: W = .983, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001; Kolmogorov\u0026ndash;Smirnov: D = .062, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001). Visual inspection of histograms, stem-and-leaf plots and Q-Q plots supported these findings. Accordingly, nonparametric tests were applied. Mann\u0026ndash;Whitney U test, Kruskal\u0026ndash;Wallis H test and pairwise Mann\u0026ndash;Whitney U test with Bonferroni correction were used to examine differences in MHL scores (dependent variable) across sociodemographic and contextual variables (independent variables). To assess the influence of independent variables on MHL, binary logistic regression was performed. In the absence of validated cut-off score of the original scale, MHL levels were operationally categorised as inadequate (\u0026lt;\u0026thinsp;50% correct responses) and adequate (\u0026ge;\u0026thinsp;50%, \u0026ge;\u0026thinsp;18 correct responses), to facilitate comparative analysis across the stakeholder groups.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Findings","content":"\u003ch2\u003e\u003cstrong\u003e3.1 Sociodemographic profile of stakeholders\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eA total of 963 participants were included, representing an 83.4% response rate. The sample comprised students (44.5%, \u003cem\u003en\u003c/em\u003e = 428), teachers (28.9%, \u003cem\u003en\u003c/em\u003e = 278), and parents or caregivers (26.7%, \u003cem\u003en\u003c/em\u003e = 257). Students were all adolescents, while teachers, parents or caregivers represented adult stakeholder groups. Overall, participants were predominantly female (59.0%), resided mainly in rural areas (53.0%), and identified as Muslim (90.1%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGender and residence varied across stakeholder groups. Parents or caregivers were predominantly female (88.7%), and more likely to reside in rural areas (61.1%), compared with teachers and students. Educational attainment differed substantially: nearly all teachers had completed tertiary education (93.5%), whereas parents or caregivers reported mixed levels of education, including tertiary (22.9%), secondary (52.9%), or primary or no formal education. Detailed characteristics are presented in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3.2 Mental health training, help-seeking and service need\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eMost participants (85.9%) reported no prior mental health training in school. Despite this limited exposure, the majority (86.4%) perceived a need for school-based mental health support for adolescents. Nearly one-third (29.6%) reported personal or familial experience of mental health problems, while 19.5% reported having sought professional support. Teachers consistently reported higher levels across these indicators: 34.2% reported personal or familial mental health problems, 23.0% had sought professional help, and almost all (97.5%) perceived a need for a school-based mental health program (SBMHP), compared with students and parents or caregivers (Table 1).\u003c/p\u003e\n\u003cp\u003e[Insert Table 1 here]\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3.3 Mental health literacy scores\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe overall mean MHL score was 17.68 (SD = 6.46, median = 18.00, range = 0\u0026ndash;35). Significant differences were observed across stakeholder groups. Teachers demonstrated the highest score (mean = 21.15, SD = 5.28), followed by students (mean = 16.48, SD = 5.94) and parents or caregivers (mean = 15.93, SD = 7.03).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcross sociodemographic variables, adults scored higher than adolescents, and MHL increased with educational attainment. Participants with tertiary education had the highest score, followed by those with secondary education and those with primary/no formal education. Urban participants scored higher than rural participants, and participants from mainstream schools scored higher than those from Islamic faith-based schools (IFBSs).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParticipants who had received prior mental health training, perceived a need for SBMHP, reported personal or familial experience of mental health problems or had sought professional help demonstrated higher MHL scores than those without (Table 2).\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3.4 Awareness of mental illness and associated stigmatised attitudes\u0026nbsp;\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eSubscale analyses indicated generally low scores for knowledge of mental illness and treatment,\u0026nbsp;stigma toward mental illness and attitudes towards individuals with mental illness. In contrast, comparatively\u0026nbsp;higher scores were observed for mental health promotion and help-seeking domains (Table 2). Vignette analyses (Supplementary Table S1) showed that over half of the participants correctly identified substance use disorder (65.1%), autism spectrum disorder and intellectual disability (57.8%), and dementia (52.8%). Recognition of major depressive disorder (42.7%) and anxiety disorders (42.1%) was lower, as was awareness of psychological treatment options (48.6%). In contrast, pharmacological treatment was more frequently recognised as appropriate (76.1%).\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e[Insert Table 2 here]\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3.5 Bivariate Associations with Mental Health Literacy\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eMann\u0026ndash;Whitney U test analyses demonstrated significantly higher MHL scores among adults, urban residents, participants from mainstream schools, and those who had received mental health training in school (all \u003cem\u003ep\u003c/em\u003e \u0026lt; .01). Higher MHL scores were also observed among participants who perceived a need for school-based mental health support, reported personal or familial experience of mental health problems, and had sought professional help (all \u003cem\u003ep\u003c/em\u003e \u0026lt; .01) compared with those without these characteristics (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e[Insert Table 3 here]\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3.6 Pairwise group comparisons of Mental Health Literacy\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003ePairwise comparisons revealed significant differences in MHL scores by stakeholder group, education level, and profession (Table 4). Teachers scored significantly higher than both students and parents or caregivers (\u003cem\u003ep\u003c/em\u003e \u0026lt; .01), while no significant difference was observed between students and parents (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= .744). Participants with tertiary education scored higher than those with secondary or primary/no formal education (\u003cem\u003ep\u003c/em\u003e \u0026lt; .01). Profession-based analyses showed that teachers had significantly higher MHL scores than all other occupational groups. No significant differences were observed by gender or religion\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Insert Table 4 here]\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3.7 Independent Predictors of Mental Health Literacy\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eA binary logistic regression model was used to identify independent predictors for adequate MHL. The model was statistically significant (\u0026chi;\u0026sup2;(10) = 175.78, \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .01), explained 22.3% of the variance in MHL (Nagelkerke R\u0026sup2;) and demonstrated good model fit (Hosmer\u0026ndash;Lemeshow \u003cem\u003ep\u003c/em\u003e = .966), with no evidence of multicollinearity (Table 5).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Insert Table 5 here]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFive variables emerged as significant predictors. Compared with teachers, students (OR = 0.255, \u003cem\u003ep\u003c/em\u003e \u0026lt; .01) and parents or caregivers (OR = 0.288, \u003cem\u003ep\u003c/em\u003e \u0026lt; .01) had substantially lower odds of adequate MHL. Participants residing in rural areas (OR = 0.593, \u003cem\u003ep\u003c/em\u003e \u0026lt; .01) and those from IFBSs (OR = 0.692, \u003cem\u003ep\u003c/em\u003e \u0026lt; .01) were also less likely to demonstrate adequate MHL. In contrast, prior mental health training in school (OR = 1.906, \u003cem\u003ep\u003c/em\u003e \u0026lt; .01) and perceiving a need for school-based mental health program (OR = 3.486,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt; .01) were associated with higher odds of adequate MHL. Gender, religion, personal or family experience of mental health concerns, and prior help-seeking were not significant predictors in the final model. \u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eThis study offers the first multi-stakeholder assessment of MHL in Bangladeshi schools, illuminating a pronounced \u0026lsquo;competency gap' that shapes how school communities understand and respond to adolescent mental health. Framed through the lens of teachers as gatekeepers and parents as partners, our findings identify critical leverage points and structural constraints that must be addressed to enable effective task-shifting interventions in low-resource school settings.\u003c/p\u003e \u003cp\u003eConsistent with research from other LMICs, including South Asia, MHL remained low across most stakeholder groups (Parikh et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2016\u003c/span\u003e, Krishna K. et al., 2024, Shrestha et al., \u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e2025\u003c/span\u003e, Shrestha et al., \u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, Ginige et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2021\u003c/span\u003e, Ali et al., 2024, Munawar et al., \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e2020\u003c/span\u003e, Bhugra et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). However, previous studies have largely examined single groups, limiting insights into how school communities\u0026rsquo; function collectively. By contrast, our multistakeholder approach revealed clear differences in literacy that have direct implications for intervention design and implementation.\u003c/p\u003e \u003cp\u003eTeachers demonstrated substantially higher MHL than students and parents. This likely reflects greater educational attainment, access to information, and social position, roles that position teachers as potential \u003cem\u003egatekeepers\u003c/em\u003e in school-based mental health systems. This finding aligns with the literature showing lower MHL among parents/caregivers with limited education and younger populations (Asl et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e, Buchanan and Holly, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2025\u003c/span\u003e, Renwick et al., \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e2024\u003c/span\u003e, Maddox et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), although global evidence regarding teachers is mixed (Phoa et al., 2023). In LMICs where specialist services are scarce, task-shifting model that build teachers\u0026rsquo; capacity may be a practical approach, provided that training, support, and incentives are available (Fazel et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2014\u003c/span\u003e, Purgato et al., \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e2020\u003c/span\u003e, Padmanathan and De Silva, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite some knowledge of mental health promotion and help-seeking, likely reflecting national public health initiatives, awareness of common adolescent conditions and evidence-based interventions remained limited (Al-Zubayer et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, Tabassum et al., \u003cspan citationid=\"CR87\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) (Supplementary Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e). Highly stigmatised attitudes toward mental illness were pervasive across groups, consistent with national/regional evidence (Faruk et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, Lauber and R\u0026ouml;ssler, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2007\u003c/span\u003e, Roy and Chowdhury, \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Although school-based literacy interventions have shown promise in raising awareness and reducing stigma, most evidence originates from high-income countries, and LMIC programmes remain broad and population-based with limited long term effectiveness (Ma et al., 2023, Vaishnav et al., \u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This underscores the need for programmes that move beyond general awareness to include skills training and targeted stigma reduction strategies.\u003c/p\u003e \u003cp\u003eImportantly, rural participants exhibited lower MHL than urban counterparts, reflecting entrenched rural\u0026ndash;urban disparities in health literacy (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) (Aljassim and Ostini, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Similar patterns in rural settings have been documented internationally, where limited awareness impedes recognition and help-seeking (He et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2024\u003c/span\u003e, Kavanagh et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These findings point to structural barriers that extend beyond the school environment.\u003c/p\u003e \u003cp\u003eSchool type also influenced MHL. Students from Islamic faith-based schools (IFBSs) had lower literacy than those in mainstream schools, possibly due to limited mental health content in the curriculum and contextual factors (Al-Hasani, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003e, National Curriculum and Textbook Board, 2025, Uddin, \u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This finding highlights the importance of curriculum content and resources as community-level determinants of MHL.\u003c/p\u003e \u003cp\u003eParticipants with prior school-based mental health training had higher MHL and greater recognition of intervention need, consistent with LMIC evidence (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) (McGuckin and Leavey, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, training alone may not be sufficient to change attitudes or help-seeking behaviour (Amado-Rodriguez et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), reinforcing the need for integrated approaches that combine knowledge, skills, and community engagement.\u003c/p\u003e \u003cp\u003eCollectively, these findings highlight teachers as critical gatekeepers whose enhanced literacy can facilitate early recognition and support for adolescent mental health. At the same time, parents emerge as a largely untapped resource who, when meaningfully engaged, can partner with teachers to reinforce mental health awareness, encourage help-seeking, and reduce stigma within families and communities. Low literacy in rural communities and in certain school types, however, continues to pose a barrier that may undermine intervention effectiveness if not addressed. These insights underscore the need for co-designed, contextually tailored interventions that strengthen teacher capacity, actively involve parents as partners, and bridge rural\u0026ndash;urban disparities, thereby reducing mental health literacy gaps and promoting adolescent wellbeing across Bangladeshi schools.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Strengths and limitations\u003c/h2\u003e \u003cp\u003eThis study demonstrated several methodological strengths. Fieldwork was effectively managed by trained assistants, despite local political unrest, and culturally sensitive engagement was achieved through the use of female researchers and local dialects. Randomised, structured sampling enhanced the generalisability of findings. The multi-stakeholder, school-focused approach enabled an accurate assessment of mental health literacy (MHL) across teachers, students, and parents, providing actionable insights to inform future programmes.\u003c/p\u003e \u003cp\u003eLimitations include a gender imbalance among parent participants, reliance on education and occupation as proxy indicators of socio-economic status, and the lack of comparable local or regional studies for benchmarking. Despite these limitations, the study offers robust evidence to guide culturally relevant, school-based mental health initiatives in Bangladesh.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Recommendations\u003c/h2\u003e \u003cp\u003eGiven the paucity of research, population norms for MHL in Bangladesh remain unavailable. Future studies should expand coverage to include broader cultural and linguistic diversity, involve more schools, and undertake large-scale research to develop normative data that can inform policy and interventions. Participatory research approaches may further enhance cultural appropriateness and contextual relevance, ensuring that interventions are grounded in community realities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Conclusion\u003c/h2\u003e \u003cp\u003eThis study provides the first multi-stakeholder evidence on mental health literacy in Bangladeshi school communities within an LMIC context. The findings demonstrate how literacy disparities shape the feasibility of school-based task-shifting approaches. Teachers appear well positioned to function as gatekeepers for early identification and support, while parents represent essential partners in reinforcing awareness and help-seeking beyond the classroom. Addressing contextual inequities, particularly across rural settings and school types, will be critical to ensuring equitable implementation. Contextually adapted models that integrate teacher capacity-building with meaningful parental engagement offer a pragmatic pathway to strengthening adolescent mental health systems in low-resource school environments.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eClinical Trial Number\u003c/h2\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch2\u003eEthical approval:\u003c/h2\u003e\n\u003cp\u003eThe study was conducted according to the ethical principles outlined in the Declaration of Helsinki and adhered to all relevant institutional and national research ethics guidelines and regulations. Ethical approval obtained from the Human Research Ethics Committee at Griffith University, Australia (Ref. No. 2024/902).\u003c/p\u003e\n\u003ch2\u003eConsent to participate:\u003c/h2\u003e\n\u003cp\u003eInformed consent was obtained from all adult participants (teachers and parents or caregivers). Written assent was obtained from the adolescent students, and informed consent was obtained from their parents or caregivers prior to participate in the study.\u003c/p\u003e\n\u003ch2\u003eConsent to publish:\u003c/h2\u003e\n\u003cp\u003eAll participants and the parents or caregivers of adolescent students provided informed consent for the publication of anonymised data from this study.\u003c/p\u003e\n\u003ch2\u003eCompeting interest:\u003c/h2\u003e\n\u003cp\u003eThe authors have no competing interests\u003c/p\u003e\n\u003ch2\u003eFunding:\u003c/h2\u003e\n\u003cp\u003eNo external funding was received for this study.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eM.S.U., E.S., and P.H. contributed to the study conceptualization and methodology. M.S.U. conducted the investigation, performed data curation, and managed project administration and resources. Formal data analysis and visualization were carried out by M.S.U., E.S., and P.H. M.S.U. wrote the original draft of the manuscript. P.H. and E.S. contributed to writing\u0026mdash;review and editing. E.S. and P.H. provided supervision. All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003eAL-HASANI, S. M. A. 2020. Madrasah education in Bangladesh: A comparative study between Aliya and Qawmi. \u003cem\u003eJournal Of Creative Writing (ISSN-2410-6259),\u003c/em\u003e 4.\u003c/p\u003e\n\u003cp\u003ehttps://doi.org/10.70771/jocw.v4i2.60\u003c/p\u003e\n\n\u003cp\u003eAL-ZUBAYER, M. A., SHANTO, H. 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Stigma towards mental illness in Asian nations and low-and-middle-income countries, and comparison with high-income countries: A literature review and practice implications. \u003cem\u003eIndian Journal of Psychiatry,\u003c/em\u003e 65\u003cstrong\u003e,\u003c/strong\u003e 995-1011.\u003c/p\u003e\n\u003cp\u003ehttps://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_667_23\u003c/p\u003e\n\n\u003cp\u003eWORLD HEALTH ORGANIZATION 2020. Mental Health Atlas 2020 Member State Profile (Bangladesh). \u003c/p\u003e\n\u003cp\u003ehttps://www.who.int/publications/m/item/mental-health-atlas-bgd-2020-country-profile\u003c/p\u003e\n\n\u003cp\u003eWORLD HEALTH ORGANIZATION AND UNITED NATIONS EDUCATIONAL SCIENTIFIC AND CULTURAL ORGANIZATION 2021. \u003cem\u003eMaking every school a health-promoting school: Implementation guidance\u003c/em\u003e, World Health Organization. https://www.who.int/publications/i/item/9789240025059\u003c/p\u003e\n\n"},{"header":"Tables","content":"\u003cp\u003eTable 1 Sociodemographic Characteristics, Mental Health Experience, and Perceived Need of MH Support among Students, Teachers, and Parents\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudents\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en = 428 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTeachers\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en = 278 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParents\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en = 257 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=963 (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eAge group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eAdolescent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e428 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e428 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eAdult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e278 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e257 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e535 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e217 (50.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e149 (53.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e29 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e395 (41.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e211 (49.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e129 (46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e228 (88.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e568 (59.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eResidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e210 (49.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e143 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e100 (38.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e453 (47.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e218 (50.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e135 (48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e157 (61.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e510 (53.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e408 (95.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e234 (84.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e226 (87.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e868 (90.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNon-Muslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e20 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e44 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e31 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e95 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e62 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e62 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e428 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e18 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e136 (52.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e582 (60.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e260 (93.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e59 (22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e319 (33.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e428 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e341 (89.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e249 (96.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e465 (48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e32 (8.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e5 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e490 (50.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e5 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e3 (1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e8 (0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eMH training experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e78 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e34 (12.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e25 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e136 (14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e350 (81.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e244 (87.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e232 (90.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e827 (85.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003ePersonal or family members\u0026rsquo; MH issues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e132 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e95 (34.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e58 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e285 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e296 (69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e183 (65.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e199 (77.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e678 (70.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eSought professional help\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e94 (22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e64 (23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e30 (11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e188 (19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e334 (78.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e214 (77.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e227 (88.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e775 (80.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eFelt need for SMBHI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e362 (84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e271 (97.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e199 (77.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e832 (86.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e66 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e7 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e58 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e131 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. SBMHI=School Based Mental Health Intervention, MH = Mental Health; N/A = Not Applicable. \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 Mental Health Literacy Score Distribution among Teachers, Students and Parents\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"765\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStake holder Groups\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNormal score range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIllnesses \u0026amp; Treatments\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMH\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePromotion\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHelp Seeking\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStigma\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Score\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0-35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTeacher\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e8.32\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.54\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.95\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e21.15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e278\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e8.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e22.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.98\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.75\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.47\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.21\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16.47\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e6.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e17.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.68\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.75\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.37\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.92\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e15.93\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e6.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e16.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.58\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.88\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.47\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.56\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e17.68\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e963\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e6.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e18.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eNote. Illnesses \u0026amp; Treatments\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e= Knowledge of mental disorders and treatments, Promotion = Knowledge of mental health promotion or self-treatment, Help seeking = Knowledge of help seeking measures, Stigma = Stigma toward mental illness, Attitude = Attitude toward person with mental illness. N = Number of participants, SD = Standard Deviation\u003c/p\u003e\n\u003cp\u003eTable 3 Mann-Whitney U Test Results for Differences in Mental Health Literacy Scores by Participant Characteristics\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup Comparison\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eU\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eZ\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eAge group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eAdults vs. Others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e95390.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-5.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eResidential address\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eUrban vs. Rural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e97654.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-4.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eSchool type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eGeneral vs. Others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e94220.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-4.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003ePrior MH training in school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes vs. No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e49025.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-2.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNeed for SBMHI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes vs. No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e33610.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-8.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eFamily MH issues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes vs. No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e318097.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-2.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eProfessional help sought\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eYes vs. No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e63973.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMuslim vs. Non-Muslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e37046.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.060\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eMale vs. Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e106975.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.156\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. U = Mann\u0026ndash;Whitney test statistic; Z = standardised test statistic; p = significance value. MH = Mental Health; SBMHI = School-Based Mental Health Intervention.\u003c/p\u003e\n\u003cp\u003eTable 4 Pairwise Mann\u0026ndash;Whitney Test for Differences in Mental Health Literacy by Sociodemographic and Contextual variables\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup Comparison\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eU\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eZ\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBonferroni Corrected Alpha\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eStakeholder group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eTeachers vs. Students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e39689.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-8.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eTeachers vs. Parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e23375.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-8.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eParents vs. Students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e54294.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eAcademic qualification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eGraduate vs. Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e61512.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-9.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eGraduate vs. Primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5546.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-6.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSecondary vs. Primary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e16205.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003eProfession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eTeacher vs. Housewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e16473.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-8.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.0083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eTeacher vs. Businessman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3771.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.0083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eTeacher vs. Unemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e41439.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-8.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e.0083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. U = Mann\u0026ndash;Whitney test statistic; Z = standardised test statistic; p = significance value; Bonferroni-corrected alpha = adjusted significance level to account for multiple comparisons.\u003c/p\u003e\n\u003cp\u003eTable 5 Predictors of Adequate Mental Health Literacy from a Binary Logistic Regression Model\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"935\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePredictor Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWald\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI for OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003eStakeholder: Student (ref = Teacher)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-1.365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e50.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.179 \u0026ndash; 0.365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003eStakeholder: Parent (ref = Teacher)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-1.244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e38.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.191 \u0026ndash; 0.436\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003ePrior MH Training (Yes vs No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.906\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.260 \u0026ndash; 2.883\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003ePerceived Need for School MH Intervention (Yes vs No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e26.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.156 \u0026ndash; 5.635\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003eResidence: Rural (ref = Urban)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.523\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e13.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt; .01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.446 \u0026ndash; 0.788\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 434px;\"\u003e\n \u003cp\u003eSchool Type: Faith-based (ref = Mainstream)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.512 \u0026ndash; 0.935\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003eGender (Male vs Female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.851 \u0026ndash; 1.441\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003eReligion (Muslim Vs Non-Muslim)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.687 \u0026ndash; 1.202\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003ePersonal or family History of Mental Illness (Yes vs No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.892 \u0026ndash; 1.559\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 434px;\"\u003e\n \u003cp\u003ePrevious Help-Seeking (Yes vs No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0.882 \u0026ndash; 1.670\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. Logistic regression analysis examining predictors of adequate mental health literacy. B = unstandardised regression coefficient; SE = standard error; Wald = Wald \u0026chi;\u0026sup2; test of the null hypothesis that the coefficient equals zero; OR = odds ratio; CI = confidence interval; ref = reference category. Significant results are indicated by p \u0026lt; .05.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dimh","sideBox":"Learn more about [Discover Mental Health](https://www.springer.com/44192)","snPcode":"","submissionUrl":"","title":"Discover Mental Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"predictor, mental health literacy, school, universal intervention, Bangladesh","lastPublishedDoi":"10.21203/rs.3.rs-9024043/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9024043/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDespite the prevalence of adolescent mental health problems and a substantial service gap in Bangladesh, school-based mental health interventions remain rare. This study provides a baseline assessment of mental health literacy (MHL) among key stakeholders to inform future promotion and prevention strategies in schools.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional survey was conducted with 963 participants (secondary school students, teachers, and parents/caregivers), using a validated Bangla version of the Mental Health Literacy Scale. Data were collected on participant role, residential location, school type, prior mental health training, perceived need for school-based support, and experience of mental health concerns and help-seeking. Binary logistic regression was used to identify sociodemographic and contextual predictors of adequate MHL.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOverall, MHL levels were low, though teachers demonstrated higher literacy than students and parents. Awareness of mental disorders and treatments was limited, while stigmatised attitudes were prevalent. Higher MHL was associated with being a teacher, urban residence, attendance at mainstream schools, prior mental health training, and perceived need for school-based support. Conversely, lower MHL was concentrated among students, parents, rural communities, and Islamic faith-based schools.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eWhile teachers demonstrated higher MHL, suggesting their potential as frontline gatekeepers, the significantly lower literacy among parents presents a potential critical barrier to service utilisation. Findings indicate that school-based programs in Bangladesh must go beyond student awareness to include targeted parental engagement and task-shifting training for teachers. This whole-school approach is essential to function effectively as a node in the wider community mental health system.\u003c/p\u003e","manuscriptTitle":"Identifying and Addressing Mental Health Literacy Gaps for School Based Mental Health Programs in Bangladesh","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-19 13:41:43","doi":"10.21203/rs.3.rs-9024043/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-20T23:28:42+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-20T03:46:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"216403739887268274379577083226945238972","date":"2026-04-17T09:54:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"243579657429705467356450654421974790227","date":"2026-04-16T20:17:04+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-07T23:18:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"115680532528601000319799647269563156597","date":"2026-04-01T15:45:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-16T07:51:10+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-15T12:15:16+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-14T07:33:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-13T15:51:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Mental Health","date":"2026-03-13T03:05:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dimh","sideBox":"Learn more about [Discover Mental Health](https://www.springer.com/44192)","snPcode":"","submissionUrl":"","title":"Discover Mental Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"00fe2b4e-7a66-41fc-a421-5e20a2a263c1","owner":[],"postedDate":"March 19th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-19T13:41:43+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-19 13:41:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9024043","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9024043","identity":"rs-9024043","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}