A study on the needs for mental health courses for middle school students based on qualitative interviews from diverse perspectives.

Stakeholders across all groups prioritized four core mental health curriculum areas.

• Priorities clustered around study-methods guidance, interpersonal communication skills, life education, and emotion management.
• These convergent priorities were identified across students, parents, and teachers.
• Data were collected from students (n=1,510), parents (n=1,337), and teachers (n=200) across eight middle schools.
• Semi-structured interviews with 18 participants from diverse school types informed item generation for the questionnaire.

Mental health curriculum needs showed distinct grade-level patterns among middle school students.

• Grade 1 students emphasized transition and adaptation needs.
• Grades 2-3 students increasingly prioritized stress and emotion regulation as academic pressure rose.
• Grade differences in student penetration rates were tested with R×C chi-square and Bonferroni-adjusted pairwise proportion tests (α=0.05).
• The pattern reflects a developmental progression aligned with increasing academic pressures across grade levels.

Respondents expressed preferences for interactive delivery methods and qualified instructors for mental health courses.

• Favored interactive delivery formats included role-play and scenario work.
• Qualified instructors were identified as a preferred feature of mental health course delivery.
• These preferences were expressed across the student, parent, and teacher respondent groups.
• The questionnaire used multiple-response items summarized using penetration rate and per-respondent normalized share.

A mixed-methods design combining qualitative interviews and a self-developed questionnaire was used across eight middle schools in China.

• Semi-structured interviews were conducted with students, parents, and teachers (n=18) from diverse school types.
• Separate questionnaire versions were developed for students, parents, and teachers.
• The survey was administered in eight middle schools with a total of 3,047 respondents (students n=1,510; parents n=1,337; teachers n=200).
• The sample was drawn from a single province, which the authors note tempers generalizability.

The findings support a developmentally sequenced, school-based mental health curriculum aligned with Health Promoting Schools (HPS) principles.

• The recommended curriculum combines universal and grade-differentiated modules.
• Recommended features include interactive pedagogy, trained staff, and school-family-community collaboration with referral pathways.
• Limitations noted include single-province sample, self-developed instrument, self-report bias, and potential selection bias.
• The authors recommend future cross-regional, prospective evaluations to test impacts on wellbeing, help-seeking, academic engagement, and implementation outcomes.