Abstract

BackgroundMental 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.MethodsHere 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.ResultsElimination 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.ConclusionsCurricular-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://clinicaltrials.gov/ct2/show/NCT02680899

Highlights

  • Pre-evaluation and introductory activities Engage EvaluateDays 2–5 My brain and IBiogenetic foundations and psychosocial foundations to explore topics of resiliency and nature vs. nurture ContactDays 6–15 Mental health and I Mental health research projects, experimental design and hypothesis generation, execution of scientific Explain experiments, data analysis, creation of mental health promotion art Elaborate ExtendDays 16–18 Sharing my voice Organization of mental health scientific research and artistic voice into multimedia presentation to in mental health share a personal storyExplain Elaborate ExtendPost-evaluation and conclude activities Explain Evaluate

  • The knowledge–attitude–behavior continuum plays a key role in modern definitions of mental health literacy with evidence to suggest that improved knowledge and reduced stigma can result in increased help-seeking and improved outcomes in mental health [10]

  • Targeted improvements in mental health literacy and moderate improvements in help-seeking intentions were accompanied by large decreases in mental health misconceptions

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Summary

Introduction

Pre-evaluation and introductory activities Engage EvaluateDays 2–5 My brain and IBiogenetic foundations (brain anatomy and neurotransmission) and psychosocial foundations (mental Explore healthcare system and barriers) to explore topics of resiliency and nature vs. nurture ContactDays 6–15 Mental health and I Mental health research projects, experimental design and hypothesis generation, execution of scientific Explain experiments, data analysis, creation of mental health promotion art Elaborate ExtendDays 16–18 Sharing my voice Organization of mental health scientific research and artistic voice into multimedia presentation to in mental health share a personal storyExplain Elaborate ExtendPost-evaluation and conclude activities Explain Evaluate. 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. Improvements have been made in recent years to both study and bolster the public’s mental health literacy, but dissemination of accurate information remains a necessary focus for betterment of mental health [5, 6]. This is true for youth, where mental health literacy efforts have traditionally been flagging [7]. Meta-analysis shows that educational programming can alter stigma toward mental illness, for youth audiences [11]

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