A School-Based Intervention to Reduce Stigma & Promote Mental-Health Service Use

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DESCRIPTION (provided by applicant): We propose a school-based field experiment to evaluate a comprehensive multifaceted intervention designed to change attitudes and behaviors regarding mental illnesses during the critical period of early adolescence. Research has documented that stigma and discrimination are painfully present in the lives of people with mental illnesses and their families, blocking opportunities, compromising self-esteem and keeping people from accessing helpful treatments. Efforts designed to address these critical issues have produced only limited success, suggesting the need for new approaches that address these problems in a comprehensive fashion that is informed by research and suited to the ecological circumstances in which the intervention will be implemented. Responding to this critical need, the proposed project seeks a rigorous test, with long term follow-up, of a comprehensive intervention in sixth grade that is designed to 1) improve knowledge attitudes and beliefs about mental illnesses, 2) change behaviors toward people with mental illnesses and 3) facilitate appropriate help seeking for mental health problems. Specifically, we evaluate the individual and combined effects of three arms of a multi-component intervention that includes: 1) a curriculum that actively engages youth to learn about mental illnesses, alter negative attitudes and address negative emotions (e.g. fear), 2) an opportunity for school-based contact with a person who has had a mental illness, and 3) a saturation of the context with positive messages and cues about mental illnesses. Achieved in two phases, Phase 1 of the evaluation assesses changes in knowledge, attitudes and beliefs about mental illnesses before and after the intervention in a fully crossed design of 800 youths arrayed in an 8-cell (2x2x2) design. Phase 2 involves a long-term follow-up at 6, 12 and 24 months of a stratified random sample of the same youth (N=xxx) that oversamples youth with mental health problems. Phase 2 will 1) evaluate the long term effects of the intervention on knowledge, attitudes and beliefs, 2) assess behaviors toward people with mental illnesses that are experienced, delivered or observed by study participants, and 3) examine whether help seeking occurs when mental health problems are experienced. Evidence of effectiveness for intervention components will provide public mental health with a tool it sorely needs to address the critical problems of stigma and discrimination experienced by people with mental illnesses. PUBLIC HEALTH RELEVANCE: Research shows that stigma and discrimination are painfully present in the lives of people with mental illnesses and their families, blocking opportunities, compromising self-esteem and keeping people from accessing helpful treatments. Efforts designed to address these critical issues have produced only limited success, suggesting the need for new approaches that address these problems in a comprehensive fashion. We propose a school-based field experiment to evaluate a comprehensive multifaceted intervention designed to change attitudes and behaviors regarding mental illnesses during the critical period of early adolescence.