Effectiveness and Implementation of a School-based Mental Well-being Intervention Among Adolescents of Bharatpur, Nepal

Adolescent mental well‐being is an important public health concern, and schools providean appropriate setting for universal mental health promotion interventions. This studyaims to evaluate CROSS‐MIND, a school‐based mental well‐being intervention designed foradolescents in Nepal.The effectiveness component is a pilot cluster randomized controlled trial in whichclasses from five schools in Bharatpur Metropolitan City will be randomly assigned toeither the CROSS‐MIND intervention or usual school activities. Students in Grades 6‐10will participate in baseline and endline assessments. The primary outcome is mentalwell‐being measured using the Warwick‐Edinburgh Mental Well‐being Scale (WEMWBS).Secondary outcomes include self‐esteem, behavioural and emotional problems, depressivesymptoms, and anxiety symptoms, measured using the Rosenberg Self‐Esteem Scale (RSES),Strengths and Difficulties Questionnaire (SDQ), PHQ‐9‐A, and GAD‐7‐A, respectively.CROSS‐MIND consists of eight weekly storytelling circle sessions of approximately 90minutes, delivered by trained teachers within the school setting. The intervention usesstructured storytelling, reflection, creative expression, and group discussion to supportpositive self‐identity, emotional awareness, social connectedness, coping skills, andpsychological well‐being.The study also includes an implementation component. Implementation will be assessed interms of acceptability, feasibility, appropriateness, and fidelity. Qualitativeinterviews and focus group discussions will explore participants' experiences andidentify barriers and facilitators to implementation.