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Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial

Authors: Ingunn Skre, Oddgeir Friborg, Camilla Breivik, Lars Inge Johnsen, Yngvild Arnesen, Catharina Elisabeth Arfwedson Wang

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

“Mental health for everyone” is a school program for mental health literacy and prevention aimed at secondary schools (13–15 yrs). The main aim was to investigate whether mental health literacy, could be improved by a 3-days universal education programme by: a) improving naming of symptom profiles of mental disorder, b) reducing prejudiced beliefs, and c) improving knowledge about where to seek help for mental health problems. A secondary aim was to investigate whether adolescent sex and age influenced the above mentioned variables. A third aim was to investigate whether prejudiced beliefs influenced knowledge about available help.

Method

This non-randomized cluster controlled trial included 1070 adolescents (53.9% boys, M age14 yrs) from three schools in a Norwegian town. One school (n = 520) received the intervention, and two schools (n = 550) formed the control group. Pre-test and follow-up were three months apart. Linear mixed models and generalized estimating equations models were employed for analysis.

Results

Mental health literacy improved contingent on the intervention, and there was a shift towards suggesting primary health care as a place to seek help. Those with more prejudiced beleifs did not suggest places to seek help for mental health problems. Generally, girls and older adolescents recognized symptom profiles better and had lower levels of prejudiced beliefs.

Conclusions

A low cost general school program may improve mental health literacy in adolescents. Gender specific programs and attention to the age and maturity of the students should be considered when mental health literacy programmes are designed and tried out. Prejudice should be addressed before imparting information about mental health issues.
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Literature
1.
go back to reference Jorm AF: Mental health literacy: Public knowledge and beliefs about mental disorders. Brit J Psychiat. 2000, 177: 396-401. 10.1192/bjp.177.5.396.CrossRefPubMed Jorm AF: Mental health literacy: Public knowledge and beliefs about mental disorders. Brit J Psychiat. 2000, 177: 396-401. 10.1192/bjp.177.5.396.CrossRefPubMed
2.
go back to reference Jorm AF: Mental health literacy. Empowering the community to take action for better mental health. Am Psychol. 2012, 67: 231-243.CrossRefPubMed Jorm AF: Mental health literacy. Empowering the community to take action for better mental health. Am Psychol. 2012, 67: 231-243.CrossRefPubMed
3.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Life time prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiat. 2005, 62: 593-602. 10.1001/archpsyc.62.6.593.CrossRefPubMed Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Life time prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiat. 2005, 62: 593-602. 10.1001/archpsyc.62.6.593.CrossRefPubMed
4.
5.
go back to reference Weare K, Nind M: Mental health promotion and problem prevention in schools: what does the evidence say?. Health Promot Int. 2011, 26 (Suppl 1): i29-i69. 10.1093/heapro/dar075.CrossRefPubMed Weare K, Nind M: Mental health promotion and problem prevention in schools: what does the evidence say?. Health Promot Int. 2011, 26 (Suppl 1): i29-i69. 10.1093/heapro/dar075.CrossRefPubMed
6.
go back to reference Gott J: The school: The front line of mental health development?. Pastoral Care Edu. 2003, 21: 5-13. 10.1111/j.0264-3944.2003.00272.x.CrossRef Gott J: The school: The front line of mental health development?. Pastoral Care Edu. 2003, 21: 5-13. 10.1111/j.0264-3944.2003.00272.x.CrossRef
7.
go back to reference Greenberg MT: Current and future challenges in school-based prevention: The researcher perspective. Prev Sci. 2004, 5: 5-13.CrossRefPubMed Greenberg MT: Current and future challenges in school-based prevention: The researcher perspective. Prev Sci. 2004, 5: 5-13.CrossRefPubMed
9.
go back to reference Andersson HW, Bjørngaard JH, Kaspersen SL, Wang CE, Skre I, Dahl T: The effects of individual factors and school environment on mental health and prejudiced beliefs among Norwegian adolescents. Soc Psych Psych Epid. 2010, 45: 569-77. 10.1007/s00127-009-0099-0.CrossRef Andersson HW, Bjørngaard JH, Kaspersen SL, Wang CE, Skre I, Dahl T: The effects of individual factors and school environment on mental health and prejudiced beliefs among Norwegian adolescents. Soc Psych Psych Epid. 2010, 45: 569-77. 10.1007/s00127-009-0099-0.CrossRef
12.
go back to reference Jorm AF, Korten AE, Jacomb PA, Christensen H, Rogers B, Pollitt P: ‘Mental health literacy’: a survey of the public’s ability to recognise mental disorders and their beliefs about effectiveness of treatment. Med J Aust. 1997, 166: 182-186.PubMed Jorm AF, Korten AE, Jacomb PA, Christensen H, Rogers B, Pollitt P: ‘Mental health literacy’: a survey of the public’s ability to recognise mental disorders and their beliefs about effectiveness of treatment. Med J Aust. 1997, 166: 182-186.PubMed
13.
go back to reference Lauber C, Nordt C, Falcato L, Rössler W: Do people recognise mental illness? Factors influencing mental health literacy. Eur Arch Psy Clin N. 2003, 253: 248-251. 10.1007/s00406-003-0439-0.CrossRef Lauber C, Nordt C, Falcato L, Rössler W: Do people recognise mental illness? Factors influencing mental health literacy. Eur Arch Psy Clin N. 2003, 253: 248-251. 10.1007/s00406-003-0439-0.CrossRef
14.
go back to reference Bartlett H, Travers H, Cartwright C, Smith N: Mental health literacy in rural Queensland: results of a community survey. Aust NZ J Psych. 2006, 40: 783-789. 10.1080/j.1440-1614.2006.01884.x.CrossRef Bartlett H, Travers H, Cartwright C, Smith N: Mental health literacy in rural Queensland: results of a community survey. Aust NZ J Psych. 2006, 40: 783-789. 10.1080/j.1440-1614.2006.01884.x.CrossRef
15.
go back to reference Suhail K: A study investigating mental health literacy in Pakistan. J Ment Health. 2005, 14: 167-181. 10.1080/09638230500085307.CrossRef Suhail K: A study investigating mental health literacy in Pakistan. J Ment Health. 2005, 14: 167-181. 10.1080/09638230500085307.CrossRef
16.
go back to reference Cotton SM, Wright A, Harris MG, Jorm AF, McGorry PD: Influence of gender on mental health literacy in young Australians. Aust NZ J Psych. 2006, 40: 790-796. 10.1080/j.1440-1614.2006.01885.x.CrossRef Cotton SM, Wright A, Harris MG, Jorm AF, McGorry PD: Influence of gender on mental health literacy in young Australians. Aust NZ J Psych. 2006, 40: 790-796. 10.1080/j.1440-1614.2006.01885.x.CrossRef
17.
go back to reference Olsson DP, Kennedy MG: Mental health literacy among young people in a small US town: recognition of disorders and hypothetical helping responses. Early Interv Psychiatry. 2010, 4: 291-298. 10.1111/j.1751-7893.2010.00196.x.CrossRefPubMed Olsson DP, Kennedy MG: Mental health literacy among young people in a small US town: recognition of disorders and hypothetical helping responses. Early Interv Psychiatry. 2010, 4: 291-298. 10.1111/j.1751-7893.2010.00196.x.CrossRefPubMed
18.
go back to reference Burns JR, Rapee RM: Adolescent mental health literacy: Young people’s knowledge of depression and help seeking. J Adolescence. 2006, 29: 225-239. 10.1016/j.adolescence.2005.05.004.CrossRef Burns JR, Rapee RM: Adolescent mental health literacy: Young people’s knowledge of depression and help seeking. J Adolescence. 2006, 29: 225-239. 10.1016/j.adolescence.2005.05.004.CrossRef
19.
go back to reference Byrne P: Stigma of mental illness and ways of diminishing it. Adv Psych Treatm. 2000, 2000 (6): 65-72.CrossRef Byrne P: Stigma of mental illness and ways of diminishing it. Adv Psych Treatm. 2000, 2000 (6): 65-72.CrossRef
20.
21.
go back to reference Rüsch N, Angermeyer MC, Corrigan PW: Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. Eur Psychiat. 2005, 20: 529-539. 10.1016/j.eurpsy.2005.04.004.CrossRef Rüsch N, Angermeyer MC, Corrigan PW: Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. Eur Psychiat. 2005, 20: 529-539. 10.1016/j.eurpsy.2005.04.004.CrossRef
22.
go back to reference Wang J, Lai D: The relationship between mental health literacy, personal contacts and personal stigma against depression. J Affective Dis. 2008, 110: 191-196. 10.1016/j.jad.2008.01.005.CrossRef Wang J, Lai D: The relationship between mental health literacy, personal contacts and personal stigma against depression. J Affective Dis. 2008, 110: 191-196. 10.1016/j.jad.2008.01.005.CrossRef
23.
go back to reference Thornicroft G, Rose D, Kassam A, Sartorius N: Stigma: ignorance, prejudice or discrimination?. Brit J Psychiat. 2007, 190: 192-193. 10.1192/bjp.bp.106.025791.CrossRefPubMed Thornicroft G, Rose D, Kassam A, Sartorius N: Stigma: ignorance, prejudice or discrimination?. Brit J Psychiat. 2007, 190: 192-193. 10.1192/bjp.bp.106.025791.CrossRefPubMed
24.
go back to reference Kroger J, Marcia JE, et al: The identity statuses, origins, meanings and interpretations. Handbook of identity theory and research. Edited by: Schwartz. 2011, New York: Springer, 31-52.CrossRef Kroger J, Marcia JE, et al: The identity statuses, origins, meanings and interpretations. Handbook of identity theory and research. Edited by: Schwartz. 2011, New York: Springer, 31-52.CrossRef
25.
go back to reference Corrigan PW, Kerr A, Knudsen L: The stigma of mental illness: Explanatory models and methods for change. Appl Prev Psychol. 2005, 11: 179-190. 10.1016/j.appsy.2005.07.001.CrossRef Corrigan PW, Kerr A, Knudsen L: The stigma of mental illness: Explanatory models and methods for change. Appl Prev Psychol. 2005, 11: 179-190. 10.1016/j.appsy.2005.07.001.CrossRef
26.
go back to reference Wang CE, Berge K, Arnesen Y, Breivik C, Johnsen LI, Bruun-Hansen T, Jentoft G, Skre I: Psykhjelpen på Tvibit: En psykologisk rådgivningstjeneste på ungdommens kulturhus midt i Tromsø sentrum. [Easily accessible psychological counselling for adolescents: A Norwegian example. - English abstract]. J Norw Psychol Assoc. 2007, 44: 247-253. Wang CE, Berge K, Arnesen Y, Breivik C, Johnsen LI, Bruun-Hansen T, Jentoft G, Skre I: Psykhjelpen på Tvibit: En psykologisk rådgivningstjeneste på ungdommens kulturhus midt i Tromsø sentrum. [Easily accessible psychological counselling for adolescents: A Norwegian example. - English abstract]. J Norw Psychol Assoc. 2007, 44: 247-253.
28.
go back to reference Naylor PB, Cowie HA, Walters SJ, Talamelli L, Dawkins J: Impact of a mental health teaching programme on adolescents. Brit J Psychiat. 2009, 194: 365-370. 10.1192/bjp.bp.108.053058.CrossRefPubMed Naylor PB, Cowie HA, Walters SJ, Talamelli L, Dawkins J: Impact of a mental health teaching programme on adolescents. Brit J Psychiat. 2009, 194: 365-370. 10.1192/bjp.bp.108.053058.CrossRefPubMed
29.
go back to reference Barney LJ, Griffiths KM, Jorm AF, Christensen H: Stigma about depression and its impact on help-seeking intentions. Aust NZ J Psych. 2006, 40: 51-54. 10.1080/j.1440-1614.2006.01741.x.CrossRef Barney LJ, Griffiths KM, Jorm AF, Christensen H: Stigma about depression and its impact on help-seeking intentions. Aust NZ J Psych. 2006, 40: 51-54. 10.1080/j.1440-1614.2006.01741.x.CrossRef
30.
go back to reference Antonovsky AA: Health, Stress and Coping: New perspectives on mental and physical well-being. 1979, London: Jossy-Bass Inc Antonovsky AA: Health, Stress and Coping: New perspectives on mental and physical well-being. 1979, London: Jossy-Bass Inc
31.
go back to reference Freire P: Pedagogy of the oppressed. 1970, New York: Continuum Freire P: Pedagogy of the oppressed. 1970, New York: Continuum
32.
go back to reference Wallerstein N, Bernstein E: Empowerment education: Freire’s ideas adapted to health education. Health Educ Behav. 1988, 15: 379-394. 10.1177/109019818801500402.CrossRef Wallerstein N, Bernstein E: Empowerment education: Freire’s ideas adapted to health education. Health Educ Behav. 1988, 15: 379-394. 10.1177/109019818801500402.CrossRef
33.
go back to reference Bals M, Turi AL, Skre I, Kvernmo S: Internalisation symptoms, perceived discrimination and ethnic identity in indigenous Sami and non-Sami youth in Arctic Norway. Ethnicity and health. 2010, 15: 165-179. 10.1080/13557851003615545.CrossRefPubMed Bals M, Turi AL, Skre I, Kvernmo S: Internalisation symptoms, perceived discrimination and ethnic identity in indigenous Sami and non-Sami youth in Arctic Norway. Ethnicity and health. 2010, 15: 165-179. 10.1080/13557851003615545.CrossRefPubMed
35.
go back to reference Skre I, Arnesen Y, Breivik C, Johnsen LI, Verplanken B, Wang CE: Mestring hos ungdom: Validering av en norsk oversettelse av Adolescent Coping Orientation for Problem Experiences [Validation of a Norwegian translation of the Adolescent Coping Orientation for Problem Experiences - Abstract in English]. J Norw Psychol Assoc. 2007, 8: 236-247. Skre I, Arnesen Y, Breivik C, Johnsen LI, Verplanken B, Wang CE: Mestring hos ungdom: Validering av en norsk oversettelse av Adolescent Coping Orientation for Problem Experiences [Validation of a Norwegian translation of the Adolescent Coping Orientation for Problem Experiences - Abstract in English]. J Norw Psychol Assoc. 2007, 8: 236-247.
36.
go back to reference Wright A, McGorry PD, Harris MG, Jorm AF, Pennell K: Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy. BMC Public Health. 2006, 6: 215-10.1186/1471-2458-6-215. doi:10.1186/1471-2458-6-215CrossRefPubMedPubMedCentral Wright A, McGorry PD, Harris MG, Jorm AF, Pennell K: Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy. BMC Public Health. 2006, 6: 215-10.1186/1471-2458-6-215. doi:10.1186/1471-2458-6-215CrossRefPubMedPubMedCentral
37.
go back to reference Bijl RV, Ravelli A, Van Zessen G: Prevalence of mental disorder in the general population: results of the Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiat Epidemiol. 1998, 33: 587-598. 10.1007/s001270050098.CrossRef Bijl RV, Ravelli A, Van Zessen G: Prevalence of mental disorder in the general population: results of the Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiat Epidemiol. 1998, 33: 587-598. 10.1007/s001270050098.CrossRef
38.
go back to reference Mann CE, Himmelein MJ: Factors associated with stigmatization of persons with mental illness. Psychiat Serv. 2004, 55: 185-187. 10.1176/appi.ps.55.2.185.CrossRef Mann CE, Himmelein MJ: Factors associated with stigmatization of persons with mental illness. Psychiat Serv. 2004, 55: 185-187. 10.1176/appi.ps.55.2.185.CrossRef
39.
go back to reference Kroger J, Martinussen M, Marcia J: Identity status change during adolescence and young adulthood: a meta-analysis. J Adolesc. 2010, 33: 683-698. 10.1016/j.adolescence.2009.11.002.CrossRefPubMed Kroger J, Martinussen M, Marcia J: Identity status change during adolescence and young adulthood: a meta-analysis. J Adolesc. 2010, 33: 683-698. 10.1016/j.adolescence.2009.11.002.CrossRefPubMed
40.
go back to reference Schachter HM, Girardi A, Ly M, Lacroix D, Lumb AB, van Berkom J, Gill R: Effects of school-based interventions on mental health stigmatization: a systematic review. Child Adolesc Psychiatry Ment Health. 2008, 2: 18-10.1186/1753-2000-2-18. doi:10.1186/1753-2000-2-18CrossRefPubMedPubMedCentral Schachter HM, Girardi A, Ly M, Lacroix D, Lumb AB, van Berkom J, Gill R: Effects of school-based interventions on mental health stigmatization: a systematic review. Child Adolesc Psychiatry Ment Health. 2008, 2: 18-10.1186/1753-2000-2-18. doi:10.1186/1753-2000-2-18CrossRefPubMedPubMedCentral
Metadata
Title
A school intervention for mental health literacy in adolescents: effects of a non-randomized cluster controlled trial
Authors
Ingunn Skre
Oddgeir Friborg
Camilla Breivik
Lars Inge Johnsen
Yngvild Arnesen
Catharina Elisabeth Arfwedson Wang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-873

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