Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools

Alan Mcluckie, Stan Kutcher, Yifeng Wei, Cynthia Weaver, Alan Mcluckie, Stan Kutcher, Yifeng Wei, Cynthia Weaver

Abstract

Background: Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools.

Methods: We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change.

Results: There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p < 0.001; d = 0.90) and was maintained at follow-up (p < 0.001; d = 0.73). Similarly, attitude significantly improved between pre- and post-tests (p < 0.001; d = 0.25) and was significantly higher at follow-up than base-line (p < 0.007; d = 0.18) CONCLUSIONS: The Guide, applied by usual teachers in usual classroom curriculum, may help improve student knowledge and attitudes regarding mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.

References

    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR. Lifetime prevalence and age of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62(6):593–602. doi: 10.1001/archpsyc.62.6.593.
    1. Offord DR, Boyle MH, Szatmari P, Rae-Grant NI, Links PS, Cadman DT, Byles JA, Crawford JW, Munroe Blum H, Byrne C, Thomas H, Woodward CA. Ontario child health study: Six-month prevalence of disorder and rates of service utilization. Arch Gen Psychiatry. 1987;44:832–836. doi: 10.1001/archpsyc.1987.01800210084013.
    1. Offord DR, Boyle MH, Fleming JE, Munroe Blum H, Rae Grant NI. Ontario health study: summary of selected results. Can J Psychiatry. 1989;34:483–491.
    1. Kirby MJL, Keon WJ. Mental Health, Mental Illness and Addiction: Overview of Policies and Programs in Canada. Ottawa (ON): Standing Senate Committee on Social Affairs, Science and Technology (CA); 2004. p. 28.
    1. Waddell C, Shepherd C. Prevalence of Mental Disorders in Children and Youth: A Research Update Prepared for the British Columbia Ministry of Children and Family Development. Vancouver (BC): Mental Health Evaluation & Community Consultation Unit (CA); 2002.
    1. World Health Organization . The World Health Report. Mental Health: new Understanding, new Hope. Geneva: WHO; 2001.
    1. Burns BJ, Costello EJ, Angold A, Tweed DL, Stangl DK, Farmer EM, Erkanli A. Children’s mental health service use across service sectors. Health Aff. 1995;14:147–159. doi: 10.1377/hlthaff.14.3.147.
    1. Foster S, Rollefson M, Doksum T, Noonan D, Robinson G, Teich J: School mental health services in the United States, 2002–2003. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; 2005 (DHHS Pub. No. (SMA) 05–4068).
    1. Leaf RJ, Alegria M, Cohen R, Goodman SH, Horowtiz SM, Hoven CW, Narrow WE, Vaden-Kiernan M, Regier DA. Mental Health service use in the community and schools: results from the four-community MECA study. J Am Acad Child Adolesc Psychiatry. 1996;35:889–897. doi: 10.1097/00004583-199607000-00014.
    1. Waddell C, Offord DR, Shepherd CA, Hua JM, McEwan K. Child psychiatric epidemiology and Canadian public policy-making: the state of the science and the art of the possible. Can J Psychiatry. 2002;47(9):825–832.
    1. Bhatia S. Childhood and adolescent depression. Am Fam Physician. 2007;75(1):73.
    1. Kessler RC, Foster CL, Saunders WB, Stang PE. Social consequences of psychiatric disorders I: educational attainment. Am J Psychiatry. 1995;152(7):1026–1032. doi: 10.1176/ajp.152.7.1026.
    1. Kutcher S. Facing the challenge of care for child and youth mental health in Canada: a critical commentary, five suggestions for change and a call to action. Healthc Q. 2011;14:15–21. doi: 10.12927/hcq.2011.22359.
    1. Kutcher S, McLuckie A. Evergreen: A Child and Youth Mental Health Framework for Canada. Calgary, AB: Mental Health Commission of Canada; 2010.
    1. McLaughlin MJ, Leone PE, Meisel S, Henderson K. Strengthen school and community capacity. J Emot Behav Disord. 1997;5(1):15–23. doi: 10.1177/106342669700500103.
    1. Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515–1525. doi: 10.1016/S0140-6736(11)60827-1.
    1. McGorry PD, Purcell R, Goldstone S, Amminger GP. Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Curr Opin Psychiatry. 2011;24(4):301–306. doi: 10.1097/YCO.0b013e3283477a09.
    1. Department for Education, UK: Mental Health and Behaviour in Schools []
    1. Atkins M, Hoagwood K, Kutash K, Seidman E. Toward the integration of education and mental health in schools. Adm Policy Ment Health. 2010;37(1–2):40–47. doi: 10.1007/s10488-010-0299-7.
    1. Rowling L. Developing and Sustaining Mental Health and Wellbeing in Australian Schools. In: Kutcher S, Wei Y, Weist M, editors. International School Mental Health for Adolescents: Global Opportunities and Challenges. Cambridge UK: Cambridge University Press; 2015.
    1. U.S. Department of Health and Human Services . Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999.
    1. WHO Regional Office for the Western Pacific . Regional Guidelines Development of Health Promoting Schools: A Framework for Action. Manila, Philippines: WHO Regional Office for the Western Pacific; 1996.
    1. Ontario Ministry of Children and Youth Services . A Shared Responsibility: Ontario’s Policy Framework for Child and Youth Mental Health. Toronto, ON: Ontario Ministry of Child and Youth Services; 2006.
    1. Nova Scotia Government: Kids and learning first: A plan to help every student succeed. NS. Government of Nova Scotia; 2012 [] Accessed 7 Jan 2015.
    1. Children’s Mental Health Ontario []
    1. Kickbusch IS. Health literacy: addressing the health and education divide. Health Promot Int. 2001;16(3):289–297. doi: 10.1093/heapro/16.3.289.
    1. Nielsen-Bohlman L, Panzer AM, Kindig DA, Committee on Health Literacy . Health literacy: A prescription to avoid confusion. Washington DC: The National Academies Press; 2004.
    1. Kickbusch I, Pelikan JM, Apfel F, Tsouros A. Health Literacy: The Solid Facts. Copenhagen: World Health Organization (WHO); 2013.
    1. Mitic W, Rootman I. Approach for Improving Health Literacy for Canadians. Victoria, BC: Public Health Association of British Columbia; 2012.
    1. Public Health Agency of Canada: Canadian perinatal health report, 2008 edition. Health Canada; 2008.
    1. Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. ‘Mental health literacy’: a survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Med J of Aust. 1997;166:182–186.
    1. Wei Y, Hayden J, Kutcher S, Zygmut A, McGrath P. The effectiveness of school-based mental health literacy programs to enhance knowledge, change attitudes and improve help-seeking behaviours in youth: a systematic review. Early Interv Psychiatry. 2013;7(2):109–121. doi: 10.1111/eip.12010.
    1. World Health Organization Ottawa charter for health promotion: first international conference on health promotion. Can J Public Health. 1986;77:425–430.
    1. World Health Organization . Comprehensive Mental Health Action Plan, 2013–2020. Geneva: WHO; 2012.
    1. Wyn J, Cahill H, Holdsworth R, Rowling L, Carson S. MindMatters, a whole-school approach promoting mental health and wellbeing. Aust NZ J of Psychiat. 2000;34:594–601. doi: 10.1080/j.1440-1614.2000.00748.x.
    1. Ringeisen H, Henderson K, Hoagwood K. Context matters: Schools and the “research to practice gap” in children’s mental health. School Psychology Rev. 2003;32:153–168.
    1. Merritt RK, Price JR, Mollison J, Geddes JR. A cluster randomized controlled trial to assess the effectiveness of an intervention to educate students about depression. Psychol Med. 2007;37(3):363–372. doi: 10.1017/S0033291706009056.
    1. Durham Region Planning Department . Durham Region Profile Demographics and Socio-Economic Data. Durham (ON): Regional Municipality of Durham (CA); 2009. p. 122.
    1. Pinfold V, Stuart H, Thornicroft G, Arboleda-Florez J. Working with young people: the impact of mental health awareness programs in schools in the UK and Canada. World Psychiatry. 2005;4(suppl. 1):48–52.
    1. Kutcher S, The Canadian Mental Health Association . The mental health & high school curriculum: Understanding mental health and mental illness. Halifax: The Printing House Limited; 2009.
    1. Kutcher S, Wei Y. Challenges and solutions in the implementation of the school-based pathway to care model: the lessons from Nova Scotia and beyond. Can J Sch Psychology. 2013;28:90–102. doi: 10.1177/0829573512468859.
    1. Kutcher S, Wei Y, McLuckie A, Bullock L. Educator mental health literacy: a programme evaluation of the teacher training education on the mental health & high school curriculum guide. Adv Sch Ment Health Promot. 2013;6(2):83–93. doi: 10.1080/1754730X.2013.784615.
    1. Ng P, Chan KF. Attitudes towards people with mental illness: Effects of a training program for secondary school students. Int J Adolesc Med Health. 2002;14(3):215–224.
    1. Corrigan PW, Lurie BD, Goldman HH, Slopen N, Medasani K, Phelan S. How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatr Serv. 2005;56:544–550. doi: 10.1176/appi.ps.56.5.544.
    1. Leavey J. Youth experiences of living with mental health problems: emergence, loss, adaption and recovery. Can J Comm Ment Health. 2005;24:109–126. doi: 10.7870/cjcmh-2005-0018.
    1. Boldero J, Fallon B. Adolescent help-seeking: what do they get help for and from whom? J Adolesc. 1995;18:193–209. doi: 10.1006/jado.1995.1013.
    1. Moses T. Self-labeling and its effects among adolescents diagnosed with mental disorders. Soc Sci Med. 2009;68:570–578. doi: 10.1016/j.socscimed.2008.11.003.
    1. Dalky HF. Mental illness stigma reduction interventions: review of intervention trials. West J Nurs Res. 2012;34(4):520–547. doi: 10.1177/0193945911400638.
    1. Stuart H, Arboleda-Florez J, Sartorius N: Paradigms Lost: Fighting Stigma and the Lessons Learned. New York, Oxford; 2012
    1. Wei Y, Kutcher S, Szumilas M. Comprehensive school mental health, an integrated “School-Based Pathway to Care” model for Canadian secondary schools. McGill J Educ. 2011;46(2):213–230. doi: 10.7202/1006436ar.
    1. School-Based Mental Health and Substance Abuse Consortium Knowledge Translation and Review Team . Survey on School-Based Mental Health and Addictions Services in Canada. Calgary (AB): Mental Health Commission of Canada (CA); 2012.
    1. Parker RM, Williams MV, Weiss BD, Baker DW, Davis TC, Doak CC, Doak LG, Hein K, Meade CD, Nurss J, Schwartzberg JG, Somer SA, Davis RM, Riggs JA, Field H, Champion HC, Howe JP, III, Altman RD, Deitchman SD, Genel M, Karlan MS, Khaleem Khan M, Nielsen NH, Williams MA, Young DC, Schwartzberg J, Bresolin LB, Dickinson BD. Health literacy: report of the council on scientific affairs. JAMA. 1999;281(6):552–557. doi: 10.1001/jama.281.6.552.
    1. Sanders LM, Shaw JS, Guez G, Baur C, Rudd R. Health literacy and child health promotion: implications for research, clinical care, and public policy. Pediatrics. 2009;14(suppl 3):S306–S314. doi: 10.1542/peds.2009-1162G.
    1. Begoray DL, Wharf-Higgins J, MacDonald M. High school health curriculum and health literacy: Canadian student voices. Glob Health Promot. 2009;16(4):35–42. doi: 10.1177/1757975909348101.

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