Psychosocial Support Program for Public School Teachers

Psychosocial support skills knowledge and attitudes will be assessed using a multiple choice instrument (Mental health Knowledge & Attitudes Questionnaire) developed for this study and previously piloted in a sample of teachers. Scores will range from 0 to 100%, reflecting the percentage of correct responses.

Same instrument used in the primary outcome

Psychosocial support skills will be assessed using a vignette-based instrument (Psychosocial Support Skills Instrument) developed for this study and previously piloted in a sample of teachers. Each vignette describes a brief clinical scenario, and participants are asked to select the most appropriate level of support for the student. Response options include: (1) Observe and be available; (2) Provide school-based support and accommodations ; (3) Link to a mental health professional ; (4) Act immediately due to safety concerns. Scores will range from 0 to 100%, reflecting the percentage of correct responses.

Assessed using two self-report items developed for this study. One item assesses participants' perceived knowledge of mental health, rated on a five-point scale from very poor to excellent. A second item assesses participants' confidence in their ability to identify students with psychosocial or mental health difficulties, rated on a five-point scale from not at all confident to extremely confident. Higher scores indicate greater self-rated knowledge and confidence. Participants may also select prefer not to answer.

Assessed using a retrospective self-report scale developed to capture mental health-related helping behaviors toward students ("Helping Behaviors Scale"), including identifying emotional distress, providing support, and facilitating referral to appropriate services. The scale includes five items describing specific helping behaviors. Each item is rated as yes, no, or does not apply. Higher endorsement indicates a greater number of supportive actions taken by the respondent in the past week.

Teacher burnout will be assessed using the 12-item version of the Burnout Assessment Tool (BAT-12), a self-report questionnaire developed to assess burnout as a multidimensional psychological syndrome. It evaluates four core dimensions of burnout: exhaustion, mental distance, cognitive impairment, and emotional impairment. Each item is rated on a five-point frequency scale ranging from 1 (never) to 5 (always). A total burnout score will be calculated as the mean of the 12 items, with higher scores indicating greater burnout symptoms.

Assessed using a post-training self-report questionnaire developed for this study. The questionnaire includes one item assessing perceived adequacy of training length, rated as too short, about right, or too long; one item assessing whether the training included sufficient practice of the skills taught, rated on a five-point Likert scale ranging from strongly disagree to strongly agree. Higher ratings indicate greater satisfaction with the training components. An optional open-ended item collects additional qualitative feedback about the training.

Assessed using open-ended questions developed for this study. Participants are asked to describe a classroom situation in which they noticed behaviors that raised a possible concern about a student's mental health, including the behaviors observed and any actions they took to support the student. Participants are also asked whether they would respond in the same way if a similar situation occurred again and, if not, to describe what they would do differently. Responses will be analyzed qualitatively to characterize participants' approaches to identifying and responding to students with possible psychosocial or mental health difficulties. No numerical score is generated.

Cost-effectiveness will be calculated as the cost per improvement unit in the Mental health Knowledge & Attitudes Questionnaire described previously