Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools
Pinfold V, Toulmin H, Thornicroft G, Huxley P, Farmer P, Graham T;
Commented by , 30 Aug 2003
Aim of the study
Despite the common occurrence of mental health problems, stigma and discrimination associated with mental ill health continue to be widespread.
The World Health Organisation (WHO) has implemented programmes around the world to fight psychiatric stigma and to provide a knowledge base to support these initiatives. Psychiatric stigma research evaluating what is effective in practice, however, is under-developed.
The aim of this pilot study was to assess the effectiveness of an intervention with young people. The intervention tried to increase mental health literacy and to challenge negative stereotypes associated with severe mental illness.
Methods
The study was carried out in four schools based in the County of Kent, England, and comprised two phases. In phase I two mental health awareness work-shops were delivered by a mental health professional.
The first session focused on pupils' understanding of mental illness. The second session among other things challenged the use of negative language known to be part of young people's descriptions of mental illness. In phase II a person who had personal experiences of living with mental health problems was involved in the sessions. The lesson plans were those of phase I but there was also a focus on sharing personal experiences with the students.
Pupils completed a pre-test questionnaire at the start of the first session and a follow-up assessment 1 week after attending the second session. Pupils in phase I schools also completed a 6-month follow-up assessment.
The questionnaires included factual statements (e.g. one in four people will develop mental health problems over the course of their lives) and attitude statements (e.g. people with mental health problems are unpredictable).
The pre-tests also included an open-ended question asking for descriptions of people with mental health problems and a rating to indicate personal experience through knowing someone with mental health problems.
Results
A total of 472 secondary school students were eligible for the analysis. 208 students (44%) reported that they personally knew someone with generalised mental health problems.
The participants used an extensive vocabulary of 270 different words and phrases to describe people with mental health problems. Most terms were derogatory. The sessions led to an improvement of mean positive attitude scores of 1.2 at baseline to 2.8 at 1-week follow-up.
Although they decreased to 2.3 at a 6-month follow-up, the latter value was still higher than before the intervention. It is important to note that reporting personal contact with people with mental illness was associated with an increase of a positive attitude.
Discussion
Consistent with findings from interventions with adult populations, it seems that workshops with students can have some positive impact on the participants’ attitude towards people with mental health problems.
Although the data are of preliminary nature, it is felt that the implementation of mental health awareness in school programmes should be supported.