Abstract
Mental disorders are highly prevalent in the general population, and people who experience them are frequently stigmatized. Stigma has a very negative impact on social, academic/professional, and personal life. Considering the high rates of mental disorders among children and adolescents (13.4%) and how critical this age is in the formation of nuclear beliefs, many campaigns to combat stigma have been developed in the last decade, with mixed results. The OBERTAMENT initiative has produced various anti-stigma campaigns in Catalonia (Spain). In the present study, the main objective was to report on the effectiveness of the OBERTAMENT “What’s up!” intervention, a curricular intervention including education and social contact conducted by the teachers in the classroom with teenagers aged between 14 and 18. Prior to this, we examined the psychometric properties of the Youth Program Questionnaire (YPQ), our main outcome measure, in terms of dimensionality, reliability, and validity. A cluster non-randomized controlled trial was conducted to assess this intervention, which was tested in nine high schools situated in the Barcelona region. A convenience sample of 261 students formed the intervention group and 132 the control group (52% women, mean age = 14, SD = 0.47). The assignment to study conditions was conducted by Departament d’Ensenyament (Department of Education), Generalitat de Catalunya (Catalan Government). Participants were evaluated at baseline, post-intervention, and 9-month follow-up. The main outcome measure of this study was the YPQ. The Reported and Intended Behavior Scale (RIBS) was used as secondary outcome measure. The statistical analysis indicated that the YPQ possesses a two-factor structure (stereotypical attitudes and intended behavior) and sound psychometric properties. The multilevel mixed-effects models revealed statistically significant interactions for both study measures and post hoc intragroup analyses revealed a significant but small improvement in the YPQ and RIBS scores in the intervention group. Overall, our results indicate that “What’s up!” produced statistically significant, albeit small improvements in stereotypical attributions and intended behavior toward people with mental disorders. Some methodological limitations and the relatively low levels of stigma observed in our sample may undermine our results. The implications of our results are discussed in relation to stigma research.
Highlights
Mental disorders have a high prevalence in the general population
Without ignoring that our sample may not reflect the whole variability of adolescence as its age variability is very low, our results show that the Youth Program Questionnaire (YPQ) is a valuable instrument for use in further studies addressed to secondary students
AP-A and LA-R made substantial contribution to the analysis and to the interpretation of the data, drafted the manuscript, provided final approval of the version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved
Summary
Mental disorders have a high prevalence in the general population. According to the most recent evidence, 38.2% of the general European population experiences at least one mental disorder, which corresponds to an estimated 164.7 million people (Wittchen et al, 2011). Children and teenagers are a high-risk population since a worldwide prevalence of 13.4% for any mental disorder has been recently reported (Polanczyk et al, 2015) It is noteworthy, that people experiencing mental disorders frequently deal with stigma associated with their condition (Hugo et al, 2003; Ando et al, 2013; Loch et al, 2014). The first one is, in turn, formed out of two constructs: stereotypes, which are related to knowledge (Thornicroft et al, 2007); and prejudices, which are the generalized attitudes toward members of a social group These cognitive aspects of stigma begin to form and consolidate during adolescence (Flavell et al, 2002; Schulze et al, 2003) and their consequence is discrimination, the behavioral aspect of stigma. In the case of mental disorders, a common example would be an employer who, based on the belief that people with a mental disorder are violent (stereotype), has a negative feeling -fear, anxiety- toward them (prejudice) and, decides not to hire a person who experiences one (discrimination) (Crespo et al, 2008; Ke et al, 2015)
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