Adolescent mental health education InSciEd Out: a case study of an alternative middle school population

Joanna Yang, Roberto Lopez Cervera, Susannah J Tye, Stephen C Ekker, Chris Pierret, Joanna Yang, Roberto Lopez Cervera, Susannah J Tye, Stephen C Ekker, Chris Pierret

Abstract

Background: Mental illness contributes substantially to global disease burden, particularly when illness onset occurs during youth and help-seeking is delayed and/or limited. Yet, few mental health promotion interventions target youth, particularly those with or at high risk of developing mental illness ("at-risk" youth). Community-based translational research has the capacity to identify and intervene upon barriers to positive health outcomes. This is especially important for integrated care in at-risk youth populations.

Methods: Here the Integrated Science Education Outreach (InSciEd Out) program delivered a novel school-based anti-stigma intervention in mental health to a cohort of seventh and eighth grade at-risk students. These students were assessed for changes in mental health knowledge, stigmatization, and help-seeking intentions via a classroom activity, surveys, and teacher interviews. Descriptive statistics and Cohen's d effect sizes were employed to assess pre-post changes. Inferential statistical analyses were also conducted on pilot results to provide a benchmark to inform future studies.

Results: Elimination of mental health misconceptions (substance weakness p = 0.00; recovery p = 0.05; prevention p = 0.05; violent p = 0.05) was accompanied by slight gains in mental health literacy (d = 0.18) and small to medium improvements in help-seeking intentions (anxiety d = 0.24; depression d = 0.48; substance d = 0.43; psychosis d = 0.53). Within this particular cohort of students, stigma was exceptionally low at baseline and remained largely unchanged. Teacher narratives revealed positive teacher views of programming, increased student openness to talk about mental illness, and higher peer and self-acceptance of mental health diagnoses and help-seeking.

Conclusions: Curricular-based efforts focused on mental illness in an alternative school setting are feasible and integrated well into general curricula under the InSciEd Out framework. Preliminary data suggest the existence of unique help-seeking barriers in at-risk youth. Increased focus upon community-based programming has potential to bridge gaps in translation, bringing this critical population to clinical care in pursuit of improved mental health for all. Trial registration ClinicalTrials.gov, ID:NCT02680899. Registered 12 February 2016, https://ichgcp.net/clinical-trials-registry/NCT02680899.

Keywords: (alternative) Education; Adolescent; Mental health; School-based; Stigma.

Figures

Fig. 1
Fig. 1
Westbrook Mental Health Knowledge Test. Students trend toward gains in mental health knowledge on the Westbrook Mental Health Knowledge Test post-intervention. Pre-scores are white; post-scores are grey; dotted lines indicate maximum possible score; “+” is the mean. a Cumulative score distribution. b Number of correct student responses, out of 14 eligible students, for each question
Fig. 2
Fig. 2
Adolescent Attribution Questionnaire. Student stigma is low at baseline and remains largely unchanged post-intervention. Pre-scores are white; post-scores are grey; dotted lines indicate minimum and maximum possible score; “+” is the mean. a Cumulative score distribution. b Score distribution for each of the different domains measured
Fig. 3
Fig. 3
General Help-Seeking Questionnaire: Vignette Version. Students trend toward more centralized or increased help-seeking post-intervention. Pre-scores are white; post-scores are grey; dotted lines indicate minimum and maximum possible score; “+” is the mean

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Source: PubMed

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