This presentation will address the mental health needs of children and youth in Bhutan as perceived by Bhutanese school counselors. School counseling is a profession slowly gaining momentum as it combines the important topic of children and youth mental health on the one hand and the school setting, a structure playing a central role in children’s development, on the other (Harris, 2013). Consequently, the field of global school counseling research is also becoming increasingly recognised as findings from individual countries can inform school counseling services in other countries (Salmon, 2016). Often referred to as the happiest country in the world, the Kingdom of Bhutan implemented its first 12, full-time school counselors in 2011. Today there are over 179 school counselors active across the kingdom’s nearly 600 schools (Ministry of Education, 2021) but very little is known about them. The growing mental health needs of Bhutanese children and youth exposed to evermore challenges such as substance abuse and rising unemployment (Chaudhuri, Dema, Wangmo, & Gautam, 2021; Dema et al., 2019; Ministry of Health, 2019; Pelden, 2016; Lorelle & Guth, 2013) together with a lack of psychiatric resources throughout the country (Sacra, 2017) and new challenges bought about by the COVID-19 pandemic (Namgyel & Milbert, 2021) underscore the importance of school counseling services in Bhutan. Bhutanese school counselors are at the forefront of the battle to protect Bhutanese students’ mental-health and well-being. That is why this study sought to understand the work of Bhutanese school counselors and the challenges they perceive to students’ mental health and well-being such as cultural factors that may be influencing help-seeking behavior. Specifically, this poster presentation will investigate the question: what are challenges to Bhutanese students’ mental health and well-being as perceived by Bhutanese school counselors? To this end, a mixed methods approach employing an on-line survey followed by on-line as well as in-person interviews of school counselors in Bhutan was carried out between November 2021 and September 2022. All 179 school counselors registered in Bhutan in 2021 were invited to participate in an online survey aimed at investigating their perceived roles, resources, and challenges. Responses were obtained from a representative sample of 162 school counselors of which 28 then participated in semi-structured interviews to obtain more in-depth and nuanced information. Because of the complexity of contemporary school counseling in Bhutan and the inherent interdependence of multi-level factors affecting school counseling (as evident from Bhutan’s published school counseling framework), this investigation was guided by Bronfenbrenner’s Ecological Systems Theory (EST) (Bronfenbrenner, 1979). This model is ideal for investigating school counseling services in Bhutan as it considers Bhutanese school counselors not as isolated persons but as entities existing within and affected by the school environment they work in and the different factors that constitute it such as the physical school environment, school colleagues, the school counseling policy enacted by the government and how all of the above change over time. In addition, to situate the study in Bhutan’s cultural context, this investigation was further guided by Bhutan’s unique economic and political philosophy of Gross National Happiness (GNH) (Dakpa, Rabten, Rai, & Gurung, 2011). As such, Bronfenbrenner’s EST (1979) and the Kingdom of Bhutan’s famous GNH model were both used to guide data-analysis in order to understand the challenges to student’s mental-health including dynamic relations between the student, school system and wider community within Bhutan’s unique cultural context.

This study used a sequential mixed methods analysis: first, quantitative data (using an on-line survey) was collected and analyzed, followed by the collection of qualitative data (using in-depth interviews) to contextualize the findings of the survey in more detail. For the on-line survey, all 179 school counselors registered in Bhutan in 2021 were invited by e-mail to take part in the survey between December 2021 and March 2022. The survey was administered in English and consisted of four parts: (I) demographics and activities, (II) the International Survey of School-Based Counselling Activities (ISSCA) (Carey, Fan, He, & Jin, 2020), (III) school counselor work conditions and (IV) impact of the COVID-19 pandemic on school counseling. The questionnaire was designed based on past research on school counseling and student-mental health in Bhutan and neighboring countries and piloted with the help of 6 Bhutanese school counselors and school staff. Data were collected from 162 school counselors. Next, in-depth interviews were carried out with 28 Bhutanese school counselors between August and September 2022 (19 on-line and 9 in-person) in order to further understand the factors that affect their work. The interviews lasted between 45 and 120 minutes and included questions about the perceived resources and challenges to their work, whether the training they received was sufficient, how school counseling is perceived by the school but also by students and their parents, and the impact of the COVID-19 pandemic. After transcription of the interviews, thematic analysis was conducted on the interview data using Braun and Clark’s (2006) six phases of thematic analysis of qualitative data. Next, triangulation was employed to draw specific conclusions from the quantitative and qualitative data in order to answer the research question by identifying specific mental-health and well-being challenges faced by Bhutanese students.

The results of the survey and interview revealed first of all that the school counseling profession is still very new in Bhutan and needs to find its place in the Bhutanese context. They also provide information on the specific issues Bhutanese students approach school counselors about including academic and family-related issues but also substance abuse, physical abuse and clinical disorders such as depression and suicidal thoughts. School counselors are also involved in crisis situations such as court cases and students going missing. In relation to the research question, school counselors reported that the mental health and well-being of children and youth in Bhutan is negatively impacted by (1) cultural barriers such as stigma around mental health and the role of corporal punishment in schools, (2) the growing complexity of mental health issues for which more resources (such as additional mental health staff) and training (such as on media literacy) are needed, (3) insufficient collaboration between the family, the school and the school counselor, (4) academic pressure in Bhutanese schools which overshadows mental-health and well-being needs of students, especially students in Bhutan’s many boarding schools who are far away from their families, and (5) lock-downs, isolation and lack of privacy due to the COVID-19 pandemic. The latter was in-part reported to be due to lack of communication infrastructure in Bhutan during lock-downs which made it difficult for students to reach counselors. More concise and accurate results are further expected once the interviews are coded by a second, independent coder in order to ascertain inter-rater reliability. Results will be discussed in relation to how they can inform the relation between mental-health and well-being in education settings, including in European countries, as well as suggestions for policy.

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