Positive Mental Health, Fighting Stigma and Promoting Resiliency for Children and Adolescents

Matthew Hodes, Susan Shur-Fen Gau

• Publisher: Academic Press
• Year: 2016
• ISBN:
  9780128044148
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Positive Mental Health for Children and Adolescents: Fighting Stigma and Promoting Resiliency examines the main mechanisms involved in improving mental health in children and adolescents, including social and biological processes, as well as effective treatments.

By taking into account diverse settings and cultures, the book combines academic, research, and clinical contributions and sets forth how it can be translated into effective clinical practice. In addition, the book promotes the study, treatment, care, and prevention of mental and emotional disorders and disabilities involving children, adolescents, and their families, and includes emerging knowledge on mental health problems and good practice in child and adolescent psychiatry as relayed by experts from around the world.

• Focuses on the empirical evidence base for work in child and adolescent mental health
• Appraises the available evidence and underscores where it is lacking
• Demonstrates the implementation of research into practice
• Highlights the relevance of existing knowledge for clinical management
• Considers service and policy implications

III

Interventions and Treatments

Outline

Chapter 8. Mental Health Literacy for Students and Teachers: A “School Friendly” Approach

Chapter 9. Transforming Cultures for the Mental Health Care of Young People: The Service Reform Imperative

Chapter 10. Evidence-Based Parenting Interventions: Current Perspectives and Clinical Strategies

Chapter 11. Psychopharmacological Treatment for Depression in Children and Adolescents: Promoting Recovery and Resilience

Chapter 12. Treatment of Eating Disorders in Children and Adolescents

Chapter 13. Seclusion in the Management of Highly Disturbed Children and Adolescents

Chapter 8

Mental Health Literacy for Students and Teachers

A “School Friendly” Approach

S. Kutcher, Y. Wei, and M. Hashish Dalhousie University and IWK Health Centre, Halifax, NS, Canada

Abstract

Mental health literacy (MHL) encompasses four components: understanding how to obtain and maintain good mental health, understanding mental illness and treatment, reducing stigma, and promoting help-seeking efficacy. MHL is foundational to mental health promotion, early identification/prevention and intervention.

We have created a “School Friendly” MHL intervention, Mental Health and High School Curriculum Guide (the Guide), for secondary school students and teachers, designed to be embedded into the existing school curriculum. A number of cross-sectional studies and a randomized-controlled trial were undertaken to investigate its impact on knowledge, attitudes, and help-seeking efficacy among students (grades 9 and 10) and teachers in Canadian schools and other international educational jurisdictions. We also obtained feedback from educators who taught the Guide with regards to the content, lesson plans, and format of the Guide for its future revisions.

All studies showed significant improvements of knowledge and attitudes among both students and teachers, as well as enhanced help-seeking efficacy among students as a result of delivering the Guide embedded into the school curriculum. Further, the impact of these changes was sustained at three-month follow-up. Teacher feedback demonstrated that they enjoyed teaching the Guide and they considered it to be a better approach to addressing youth mental health compared to other school-based interventions.

The Guide may be a “School Friendly” approach to improving both student and teacher MHL, and building the foundation needed for improving mental health outcomes for young people.

Keywords

Mental health literacy; Mental health promotion; Prevention and intervention; Secondary school students and teachers

Health Literacy and Mental Health Literacy: An Introduction

Mental health literacy (MHL) is the foundation for mental health promotion, effective acknowledgment of prevention of mental disorders, and provision of evidence-based mental health care (Jorm, 2012; Jorm, Korten, Jacomb et al., 1997; Kutcher, Bagnell, & Wei, 2015; Kutcher , Wei, & Coniglio, 2016; Kutcher, Wei, & Weist, 2015; Reavley & Jorm, 2011; McLuckie, Kutcher, Wei, & Weaver, 2014). Anchored in the larger concept of health literacy (HL), which has undergone substantial evolution over time (Nutbeam, 2008; World Health Organization (WHO), 2013), understanding of the nature and impact of MHL has similarly changed from its initial consideration as information about mental disorders to a more comprehensive construct considering MHL as an empowerment competency for people to participate in their own health care (Jorm et al., 1997; Kutcher et al., 2016). Most recently, mental health literacy has been defined to comprise four distinct but related components: understanding how to obtain and maintain good mental health, understanding mental disorders and their treatments, decreasing stigma, and enhancing help-seeking efficacy (knowing when and where to obtain evidence-based mental health care and having competencies to enhance self-care) (Kutcher et al., 2015, 2016).

Historically, HL was initially conceptualized as narrowly constructed within the health care delivery environment and focused primarily on the ability of people to be able to understand and apply medical information given to them by their health care providers, particularly with regards to improving adherence to treatment (American Medical Association Ad Hoc Committee on Health Literacy, 1992). Soon thereafter, however, this construct was expanded to include key components of health promotion and individual capacity for improvement of health-related behaviors: “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health” (Nutbeam, 1998).

More recently, understanding of HL has further evolved, now encompassing not only the individual’s capacity to seek health improving and health maintaining interventions but also to include the ability for self-care and for participating in the development of health policy and related activities designed to enhance health outcomes (Kanj & Mitic, 2009; Institute of Medicine, 2012; Schillinger et al., 2003; WHO, 2013). This broader construct is now understood to be a key factor in improving both individual and population health outcomes and has been identified as an important intervention to be applied for the decrease of health inequalities in populations (Berkman et al., 2011; Kickbusch, 2001; WHO, 2013). Indeed, according to WHO (2013), HL is “a stronger predictor of an individual’s health status than income, employment status, education and racial or ethnic group.”

With the increasing application of patient-centered health care interventions (such as the Wagner Chronic Care Model), HL has become an essential competency for health care recipients (Coleman et al., 2009; Schillinger et al., 2005). Educational interventions designed to enhance HL are understood to be an important component of health care capacity-building (Nutbeam, 2008; IoM, 2012; WHO, 2013).

Currently, the construct of HL can be considered to comprise the following components: competencies required to help a person obtain and maintain good health and identify illnesses, understanding of how and where to access and evaluate health information and health care, understanding how to properly apply prescribed treatments, and understanding health-related human rights and how to advocate for health improvements (WHO, 2013). To achieve this, HL needs to be: developmentally appropriate, contextually applied, and widely available through existing institutional and social vehicles such as schools, the workplace, and media (Kanj & Mitic, 2009; Nutbeam, 2008; WHO, 2013).

A similar evolution in understanding of MHL is also underway. The initial important work of Jorm et al. (1997) on an individual’s ability to recognize, manage, or prevent mental disorders, and early evaluations of educational interventions designed to address this focused primarily on one or two mental disorders (such as depression). This early construct was later broadened by Jorm and colleagues (Jorm, 2012; Reavley & Jorm, 2011) to additionally include: recognition of the development of mental disorders, knowledge of effective self-help strategies, and first-aid skills to assist others who have a mental disorder.

As the HL definition has evolved, so have others contributed to the evolving construct of MHL (Kutcher, Bagnell, et al., 2015; Kutcher et al., 2016). In step with the current conceptualization of HL, MHL is currently conceptualized to address the four constructs presented in the previous.section. This approach has integrated historically separate stigma interventions into the broader and more comprehensive construct of MHL. Such integration is supported both by the recognition that knowledge and stigma are not unique and separate constructs, but are related to each other and that knowledge enhancement does impact stigma reduction related to mental health and mental illness (eg, Chan, Mak, & Law, 2009; Corrigan, Morris, Michaels, Rafacz, & Rüsch, 2012; Pinfold et al., 2003; Thornicroft, 2006). This evolving understanding also parallels the WHO integration of human rights constructs into HL and other health care frameworks that have integrated health knowledge with stigma reduction strategies in other health conditions, such as HIV/AIDS and epilepsy (Birbeck, 2006; Brown, Macintyre & Trujillo, 2003; Heijnders & Van Der Meij, 2006; Sermrittirong, Van Brakel, & Bunbers-Aelen, 2014).

Global interest in school mental health is now becoming more evident (Kutcher, Wei, et al., 2015; Rowling & Weist, 2004). Foundational to all different school mental health approaches is the integration of MHL into the existing school curriculum structure because the school setting is contextually established to deliver interventions using a literacy approach (Jorm & Wright, 2007; Kutcher, Bagnell, et al., 2015). Furthermore, using educational strategies, including school curriculum and various knowledge-based interventions delivered in school settings may be more effective in addressing stigma in young people than other types of interventions (Corrigan et al., 2012; Kutcher et al., 2016; Pinfold et al., 2003). Finally, bringing mental health literacy into the school setting is not only consistent with a core activity of schools, but also fits well with the defi...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Contributors
• Introduction
• I. Conceptual Approaches
• II. Risk and Resilience
• III. Interventions and Treatments
• Index