Targeting Pre-Teens to Fight Mental Health Stigma
Despite increasing public awareness and understanding of mental health, stigma surrounding mental illness continues to be major problem.
The stigma, prejudice and discrimination of mental illness can be a major barrier for many people living with mental illness seeking and getting the help they need. It can make people avoid disclosing a mental health condition at work over concerns of being treated differently or even losing their job. Internalizing these negative stereotypes and perceptions (self-stigma) can further contribute to challenges.
A group of researchers from Columbia University, the University of California-Riverside and the Substance Abuse and Mental Health Services Administration (SAMHSA) sought to test an approach to “attack stigmatizing attitudes before they are firmly entrenched.”
They evaluated the effectiveness of classroom-based interventions in reducing stigma and increasing understanding of mental illness and positive attitudes toward seeking treatment among sixth-grade students. The study appeared in the “Psychiatric Services in Advance” in April 2017, and the research was supported by a grant from the National Institute of Mental Health.
Study participants were a diverse group of more than 700 sixth-graders, 40 percent Latino, 26 percent white and 24 percent African American, in a school district in Texas.
Classrooms were randomly assigned to none, one, two or three interventions:
- A discussion-based curriculum. The Eliminating the Stigma of Differences is a three-hour curriculum delivered by teachers over several days. It includes PowerPoint slides, classroom exercises, homework and suggested discussion questions. It uses active learning principles and encourages empathy.
- Presentation by two college students who described their experiences with mental illness. During a 10-minute discussion, each described his/her symptoms, treatments, coping strategies and the impact of the illness and feelings about it.
- Exposure to anti-stigma printed materials. Anti-stigma educational materials were posted in the classrooms for two weeks and students were provided bookmarks.
Researchers assessed knowledge and attitudes about mental health, social distance (from people with mental illness) and attitudes about help-seeking before and after the intervention. The simplest approach tested, written materials, had no significant impact on any outcomes.
Of the three interventions, the curriculum had the most positive impact on stigma. It increased recognition of mental illness and improved attitudes about help-seeking, and increased optimism about the effectiveness of treatment. It also improved attitudes regarding being friends or neighbors with someone with mental illness. The curriculum group did not differ significantly from the control group on broader measures of avoidance, discomfort and social distance from someone with mental illness.
The visits from the college students discussing their experience with mental illness only had minimal effect. It did increase recognition of mental illness and positive attitude about seeking help. This limited response to the personal stories from college students is in line with a previous study of adolescents, but differs from previous studies with adults. Studies with adults have found personal interaction more effective than education in addressing stigma.
The research did not find patterns of difference related to gender, family income or race-ethnicity.
The researchers conclude that this classroom-based curriculum holds promise for addressing stigma. Because it is relatively easy to distribute and for teachers to deliver it could be widely disseminated.