STUDENTS HEALTH AND WELL-BEING PROJECT, PAKISTAN
Authors: Abbasi Muhammad Tahir , Rameez Sehar , Tahir Ayesha , Usman Rabia , Islam Alia , Munazza  
Published: May 2024

Background:
Most undergraduate students in low-middle-income countries fall into a vulnerable age group between 19 and 24 years, where the initial onset of mental illnesses is most common. Additionally, students face elevated levels of stress, financial difficulties, increased autonomy, and social pressures and interact more frequently with social media and technology, which can hinder self-esteem and feelings of inclusion (Caitlin Monaghan, 2020). In the last two years, young students' mental health and well-being challenges have escalated worldwide due to the mental health impacts of COVID-19. This is an important challenge faced by global public health, as mental health is foundational to academic success, employment outcomes, and the formation of personal relationships. In Pakistan, approximately 64% of young people are under the age of 30 (Imran, 2018). More than 90 million Pakistanis are suffering from physiological and mental illnesses, and most of them are young people. Unfortunately, mental health issues are a highly neglected area in LMICs, like Pakistan. Thus, the youth in the country are facing numerous mental issues that are destroying their physical health, leading to increased substance use and suicidal deaths (Imran, 2018).
Suggested implementation framework and strategy for improving mental health in Pakistani youth:
While there have been several initiatives and tools released by global organizations over the past several years designed to address post-secondary mental health, there is currently no overarching national policy or guiding framework to steer action related to post-secondary mental health in Pakistan.
We suggest local delivery of a customized mental health framework to Pakistani institutions to create a long-lasting impact on youth mental health.
Proposed actions of Project SHAW PRISM:
SHAW- Pakistan will be working with health agencies, national nongovernmental organizations (NGOs), educational institutes, health organizations, and youth-serving organizations to promote collaboration and reduce negative health outcomes by creating concrete steps for educational institutions, to play a vital role in promoting youth mental health by:

Creating a framework of connectedness between educational institutions, faculties, families, and healthcare providers through an effective digital health
Supporting educational institutions in the implementation of health prevention strategies, policies, and
Providing tools and resources for universities to help promote the importance of early prevention of mental and physical health

Institutional Benefits:
Some highlights of how the institutions will be benefitted from SHAW-Pakistan are:

Provide professional development on classroom management. Faculty members can reinforce positive health behaviors in classrooms and referrals to relevant services after receiving training programs from SHAW–PRISM.
SHAW- PRISM will support student-led clubs at school. These clubs will create a safe space for students to socialize, support each other, and connect with supportive health
Facilitate positive youth development Implementing mentoring programs, providing opportunities to volunteer in the community; or connecting students to community-based programs can provide youth with a network of supportive adults.
Provide faculty, students, and their parents and families with resources that support positive healthy lifestyle
Reduce stigma by creating dialogue such as open, honest communication and empathy.

SHAW- Digital Healthcare Providers will:

Ask about family relationships, PTDS, school experiences, etc as a part of routine health
Encourage the early prevention of mental and physical health problems by referral to available health programs
Promote prevention interventions over treatment
Engage parents in discussions about how to connect with their adolescents, communicate effectively, and monitor activities and health behaviors.
Educate parents and youth about adolescent development and health risks.

Expected Health Outcomes:
We aim to assess the effectiveness of a customized step-wise approach to the nationwide implantation of the Mental Health Framework in Pakistani educational institutes, to promote mental health literacy at a vulnerable life stage for the prevention of future mental health disorders and substance uptake and also reduce the risk factors associated with it. Promote digital mental health services for students in Pakistan and investigate the process and outcomes. By sharing the knowledge with local stakeholders and policymakers, we intend to create a long-lasting impact and advocate for introducing mandatory mental health services in Pakistani educational institutions.

Reduce the noncommunicable disease burden in the country by helping to create healthier doctors who know and practice a healthier lifestyle and will, in turn, transfer their skills and knowledge to their patients. Thereby, promoting population health and reducing the burden of not only mental health issues but also other NCDs that are invariably linked to poor mental health and lifestyle choices.
Create a continuous knowledge translation and sustainability of this project by preparing future doctors in mental health prevention strategies, mental health literacy, introducing digital mental health navigation tools for existing services, reduction of stigma, and creating compassion in medical professionals. Highlight the impact of implementation outcomes at the health policy level for a mandatory recommendation of mental health and wellness services in the region.
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