Abstract/Summary

Adolescence is a challenging developmental phase, with a high incidence of the onset of depression. Despite this, many countries in lower-and middle-income countries (LMICs) have faced significant mental health challenges. Thailand is one of LMICs in South-East Asia and has faced a lack of mental health resources and investment in mental health care for young people. There is currently limited self-report of depression validated for adolescents in Thailand. Also, despite the fact that national policy states that schools should support children and adolescents with mental health needs, schools and teachers are not adequately prepared to offer this support. The aim of this thesis is to provide a valid self-report measure to identify depression symptoms in Thai young people and to diminish unmet mental health needs in Thai adolescents by developing evidence-based mental health education for teachers in Thai secondary schools to support adolescents with depression. The Mood and Feelings Questionnaire (MFQ) was examined for its psychometric properties and the optimal cut-off score with a community sample of Thai adolescents (N = 1,275) (Chapter 3). Using the cut-off of 28 of the MFQ, 11% of Thai adolescents in this sample had elevated symptoms of depression. In Chapter 4, the factorial structure and the measurement invariance of the MFQ were examined by using multi-group confirmatory factor analysis (MGCFA) This is a prerequisite for its use in cross-cultural comparisons between Thai (N = 1,275) and British samples (N = 1,817) to better understand cross�cultural variation in depression symptomatology. The findings indicated that a five�factorial structure of the MFQ was confirmed across cultural groups. The measurement invariance examination of the MFQ yielded a partial scalar invariance model across cultural groups. This finding suggests that although the MFQ shows differences on ix individual items, they are generally comparable across the two cultural groups, which provides the possibility for cross-cultural comparison in this study. Cross-cultural comparison of depression symptoms between Thai and British adolescents was then explored Compared to British adolescents, Thai adolescents had a significant lower mean score in four of five factors (Vegetative Symptoms, Suicidality, Cognitive Symptoms, and Agitated Distress) and did not differ on one factor (Core Symptoms). These studies demonstrated that the Thai MFQ is valid and appropriate to use in community settings and might be beneficial to use in primary care and clinical settings. The feasibility of an evidence-based mental health training programme for teachers in Thai secondary schools was also developed and evaluated in a feasibility study (Chapter 5). The data suggests that the training was highly acceptable to Thai teachers and may help improve their understanding and skills related to adolescent depression. This needs further testing in a larger randomised trial. If it is effective it could then be introduced into initial teacher training and/or as post qualification training for Thai secondary school teachers.