Reducing mental-illness stigma via high school clubs: A matched-pair, cluster-randomized trial.

Abstract

We examined the effectiveness of a student-initiated and guidebook-supported high school club program aimed at reducing mental-illness stigma via humanization—largely through contact—hypothesizing that stigma measures would improve across a school year and as a function of the timing of club initiation. Forty-two Northern California high schools (731 students) participated from 2015–2017. Stigma measures (Knowledge, Attitudes, Social Distance, and Positive Actions) were collected in the fall (Time 1 [T1]), winter (Time 2 [T2]), and spring (Time 3 [T3]). Schools were matched on student-body demographics, then randomized into either an immediate (23 clubs at T1) or delayed (19 clubs at T2) start. The sample was diverse regarding race/ethnicity and class standing. Across both randomized groups, measures of stigma significantly improved from beginning to end of the school year; effect sizes ranged from small to medium (d = .22–.56). The hypothesized pattern of change was partially supported: the immediate group showed significant increases from T1–T2 for Attitudes and Positive Actions; the delayed group showed a stronger increase from T2-T3 for Knowledge. Ceiling effects at baseline were salient. Baseline stigma measures were in a more positive direction than in a prior, quasi-experimental study of the same club model 5 years earlier, with effect sizes ranging from d = .32 to .88, suggesting secular trends regarding lower stigma levels. Findings support the importance of school-based interventions for reducing mental-illness stigma, particularly via student-initiated, contact-based efforts. It is possible that youth mental-illness stigma has decreased in recent years, with more sensitive measures needed in future trials.

Review: School‐based interventions to improve mental health literacy and reduce mental health stigma – a systematic review

“…One study found mixed results, as significant improvement was observed with one of the vignettes only ( p < .001) but not the other ( p = .056; Hart et al., 2018). Four studies found no significant differences in behavioural intentions towards people with mental disorders (Ahmad et al., 2020; Chisholm et al., 2016; DeLuca et al., 2020; Swartz et al., 2017).…”

“…Fifteen studies addressed knowledge and awareness of mental disorders (Ahmad, Leventhal, Nielsen, & Hinshaw, 2020; Aseltine & DeMartino, 2004; Chan, Mak, & Law, 2009; Chisholm et al., 2016; DeLuca, 2020b; DeLuca, Tang, Zoubaa, Dial, & Yanos, 2020; Klingman & Hochdorf, 1993; Link et al., 2020; Milin et al., 2016; Nguyen et al., 2020; Painter et al., 2017; Perry et al., 2014; Pinto‐Foltz, 2009; Pinto‐Foltz et al., 2011; Rahman, Mubbashar, Gater, & Goldberg, 1998; Swartz et al., 2017; Teesson et al., 2020; Yamaguchi et al., 2020).…”

“…Attitudes and beliefs regarding mental disorders. Sixteen studies addressed MH stigma defined as attitudes and beliefs regarding mental disorders (Ahmad et al, 2020;Aseltine & DeMartino, 2004;Chan et al, 2009;DeLuca, 2020b;DeLuca et al, 2020;Economou et al, 2012Economou et al, , 2014Hart et al, 2018;Link et al, 2020;Milin et al, 2016;Nguyen et al, 2020;Painter et al, 2017;Perry et al, 2014;Pinto-Foltz, 2009;Pitre, Stewart, Adams, Bedard, & Landry, 2007;Rahman et al, 1998;Saporito, Ryan, & Teachman, 2011). All studies assessed explicit stigma, while Saporito et al's (2011) was the only study that assessed implicit stigma.…”

Reducing stigma in high school students: A cluster randomized controlled trial of the National Alliance on Mental Illness’ Ending the Silence intervention.

“…This suggestion is also consistent with calls for adolescent stigma reduction programs to consider cognitive and socioemotional features of adolescent development (Newcomb-Anjo, 2019). Other researchers have suggested interactive interventions for youth via active learning strategies, incorporating youth stories, and promoting youth leadership (Ahmad, Leventhal, Nielsen, & Hinshaw, 2020; Austin & Schwartz, 2019; Bulanda, Bruhn, Byro-Johnson, & Zentmyer, 2014).…”

Construction and Analysis of Emotion Recognition and Psychotherapy System of College Students under Convolutional Neural Network and Interactive Technology

“…United Nations (UN) experts have predicted that “from the 21 st century, mental problems will be the chief culprit that plagues people's development and causes many other problems” [ 5 ]. The World Health Organization (WHO) has estimated that six of the top 20 major diseases will be mental diseases by 2020, accounting for 17.4% of all diseases [ 6 ]. As far as the level of mental health teaching in Chinese universities is concerned, some students with mental problems are unable to receive effective mental counseling and treatment in time due to the lack of mental counselors, which in turn leads to more students jumping off buildings and committing suicide [ 7 ].…”