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

BACKGROUND: Adolescents in middle school face rising socio-emotional and academic pressures. Understanding the convergent and grade-specific needs of students, parents, and teachers is essential to designing effective, developmentally appropriate school mental-health curricula in China. METHODS: A mixed-methods design was used. Semi-structured interviews with students, parents, and teachers (n = 18) from diverse school types informed item generation. A self-developed questionnaire (student/parent/teacher versions) was administered in eight middle schools (students n = 1,510; parents n = 1,337; teachers n = 200). Multiple-response items were summarized using penetration rate and per-respondent normalized share. Grade differences in student penetration rates were tested with R × C chi-square and Bonferroni-adjusted pairwise proportion tests (α = 0.05). RESULTS: Across stakeholders, priorities clustered around study-methods guidance, interpersonal communication skills, life education, and emotion management. Clear grade patterns emerged: Grade 1 emphasized transition/adaptation, whereas Grades 2-3 increasingly prioritized stress and emotion regulation as academic pressure rose. Respondents favored interactive delivery (e.g., role-play, scenario work) and qualified instructors. CONCLUSION: Findings support a developmentally sequenced, school-based mental-health curriculum aligned with HPS principles, combining universal and grade-differentiated modules, interactive pedagogy, trained staff, and school-family-community collaboration with referral pathways. Limitations (single-province sample, self-developed instrument, self-report, potential selection bias) temper generalizability; future cross-regional, prospective evaluations should test impacts on wellbeing, help-seeking, academic engagement, and implementation outcomes.