Abstract
The Adolescent Depression Awareness Program, developed by psychiatrists and psychiatric nurses at the Johns Hopkins University School of Medicine, is a depression literacy program delivered to high school students by teachers. This mode of delivery represents an effective and sustainable way to increase awareness of mental health, reduce stigma, improve early detection, and facilitate help-seeking behavior among adolescents. The present study explores the depression literacy and stigma of teachers and their students. Survey responses of 66 teachers and 6679 high school students about depression literacy and stigma pre- and post-education intervention were analyzed using a multilevel model fit in Mplus. Teacher depression literacy was significantly associated with student depression literacy [β = 0.199, SE = 0.095, p = 0.035, 95% CI (0.044, 0.355)] at the post-assessment, but was not associated with student stigma. Teacher stigma was not significantly related to student depression literacy or stigma in the post-assessment. These findings highlight the importance of optimizing teacher depression literacy in order to maximize student depression literacy while also diminishing concerns about the transmission of stigmatized beliefs from teachers to students.
Similar content being viewed by others
References
Avenevoli, S., Swendsen, J., He, J. P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey: Adolescent supplement—Prevalence, correlates and treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1), 37–44.
Calear, A. L., & Christensen, H. (2010). Systematic review of school-based prevention and early intervention programs for depression. Journal of Adolescence, 33, 429–438.
Chen, S. P., Koller, M., Krupa, T., & Stuart, H. (2016). Contact in the classroom: Developing a program model for youth mental health contact-based anti-stigma education. Community Mental Health Journal, 52(3), 281–293.
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., et al. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11–27.
Conner, K. O., McKinnon, S. A., Ward, C. J., Reynolds, C. F., III, & Brown, C. (2015). Peer education as a strategy for reducing internalized stigma among depressed older adults. Psychiatric Rehabilitation Journal, 38(2), 186–193.
Corrigan, P. C., River, L. P., Lundin, R. K., Renn, D. L., Uphoff, W., Campion, J., et al. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27(2), 187–195.
Curtin, S.C., Warner, M., & Hedegaard, H. (2016). Increase in suicide in the United States, 1999–2014. NCHS data brief. https://www.cdc.gov/nchs/products/databriefs/db241.htm. Accessed 3 October 2017.
Dods, J. (2016). Teacher candidate mental health and mental health literacy. Exceptionality Education International, 26, 42–61.
Evans-Lacko, S., Rose, D., Little, K., Flach, C., Rhydderch, D., Henderson, C., et al. (2011). Development and psychometric properties of the reported and intended behaviour scale (RIBS): A stigma-related behavior measure. Epidemiology Psychiatric Sciences, 20(3), 263–271.
Fortier, A., LaLonde, G., Venesoen, P., Legwegoh, A., & Short, K. H. (2017). Educator mental health literacy to scale: From theory to practice. Advances in School Mental Health Promotion, 10(1), 65–84.
Franklin, C. G. S., Kim, J. S., Ryan, T. N., Kelly, M. S., & Montgomery, K. L. (2012). Teacher involvement in school mental health interventions: A systematic review. Children and Youth Services Review, 34, 973–982.
Goffman, E. (1963). Asylums: Essays on the social situation of mental patients and other inmates. Garden City, NY: Anchor Books.
Gove, W. R., McCorkel, J., Fain, T., & Hughes, M. D. (1976). Response bias in community surveys of mental health: Systematic bias or random noise? Social Science and Medicine, 10(9–10), 497–502.
Han, S. S., & Weiss, B. (2005). Sustainability of teacher implementation of school-based mental health programs. Journal of Abnormal Child Psychology, 33(6), 665–679.
Hart, S. R., Kastelic, E. A., Wilcox, H. C., Beaudry, M. B., Heley, K., Ruble, A. E., et al. (2014). Assessing the adolescent depression awareness program using the adolescent depression knowledge questionnaire. School Mental Health, 6(3), 213–223.
Hess, S. G., Cox, T. S., Gonzales, L. C., Kastelic, E. A., Mink, S. P., Rose, L. E., et al. (2004). A survey of adolescents’ knowledge about depression. Archives of Psychiatric Nursing, 18(6), 228–234.
Jones, E. E., Farina, A., Hastorf, A. H., Marcus, H., Miller, D. T., & Scott, R. A. (1984). Social stigma: The psychology of marked relationships. New York, NY: Freeman and Company.
Jorm, A. F., Kitchener, B. A., Sawyer, M. G., Scales, H., & Cvetkovski, S. (2010). Mental health first aid training for high school teachers: A cluster randomized trial. BMC Psychiatry, 10(1), 51.
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166(4), 182–186.
Kutcher, S., Wei, Y., McLuckie, A., & Bullock, L. (2013). Educator mental health literacy: A programme evaluation of the teacher training education on the mental health and high school curriculum guide. Advances in School Mental Health Promotion, 6(2), 83–93.
Lai, E. S., Kwok, C. L., Wong, P. W., Fu, K. W., Law, Y. W., & Yip, P. S. (2016). The effectiveness and sustainability of a universal school-based programme for prevention depression in Chinese Adolescents: A follow-up study using quasi-experimental design. PLoS ONE, 11(2), 1–20.
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.
McLaughlin, K. A. (2011). The public health impact of major depression: A call for interdisciplinary prevention efforts. Prevention Science, 12, 361–371.
Muthén, L. K., & Muthén, B. O. (1998–2011). Mplus user’s guide. Sixth Edition. Los Angeles, CA: Muthén & Muthén.
Ojio, Y., Yonehara, H., Taneichi, S., Yamasaki, S., Ando, S., Togo, F., et al. (2015). Effects of school-based mental health literacy education for secondary school students to be delivered by school teachers: A preliminary study. Psychiatry and Clinical Neurosciences, 69(9), 572–579.
Olsson, D. P., & Kennedy, M. G. (2010). Mental health literacy among young people in a small US town: Recognition of disorders and hypothetical helping responses. Early Intervention Psychiatry, 4(4), 291–298.
Rubie-Davies, C., Flint, A., & McDonald, L. G. (2012). Teacher beliefs, teacher characteristics, and school contextual factors: What are the relationships? British Journal of Educational Psychology, 82(2), 270–288.
Ruble, A. E., Leon, P. J., Gilley-Hensley, L., Hess, S. G., & Swartz, K. L. (2013). Depression knowledge in high school students: Effectiveness of the adolescent depression awareness program. Journal of Affective Disorders, 150, 1025–1030.
Rüsch, N., Evans-Lacko, S. E., Henderson, C., Flach, C., & Thornicroft, G. (2011). Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatric Services, 62(6), 675–678.
Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147–177.
Swartz, K. L., Kastelic, E. A., Hess, S. G., Cox, T. S., Gonzales, L. C., Mink, S. P., et al. (2010). The effectiveness of a school-based adolescent depression education program. Health Education and Behavior, 37(1), 11–22.
Swartz, K. L., Musci, R. J., Beaudry, M. B., Heley, K., Miller, L., Alfes, C., et al. (2017). School-based curriculum to improve depression literacy among US secondary school students: A randomized effectiveness trial. American Journal of Public Health, 107(12), 1970–1976.
Townsend, L., Musci, R., Stuart, E., Ruble, A., Beaudry, M. B., Schweizer, B., et al. (2017). The association of school climate, depression literacy, and mental health stigma among high school students. Journal of School Health, 87(8), 567–574.
U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institutes of Mental Health.
Wang, P. S., Berglund, P., & Olfson, M. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 603–613.
Wei, Y., Hayden, J. A., Kutcher, S., Zygmunt, A., & McGrath, P. (2013). The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth. Early Intervention in Psychiatry, 7(2), 109–121.
Whitley, J., Smith, J. D., & Vaillancourt, T. (2012). Promoting mental health literacy among educators: Critical in school-based prevention and intervention. Canadian Journal of School Psychology, 28(1), 56–70.
Wright, A., Jorm, A. F., Harris, M. G., & McGorry, P. D. (2007). What’s in a name? Is accurate recognition and labelling of mental disorders by young people associated with better help-seeking and treatment preferences? Social Psychiatry and Psychiatric Epidemiology, 42(3), 244–250.
Acknowledgements
Holly Wilcox has received research grants from Janssen Research & Development.
Funding
This study was funded by NIH Grants R01MH095855 and K23MH090246.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Leslie Miller, Rashelle Musci, Douglas D’Agati, Clarissa Alfes, Mary Beth Beaudry, Karen Swartz declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Miller, L., Musci, R., D’Agati, D. et al. Teacher Mental Health Literacy is Associated with Student Literacy in the Adolescent Depression Awareness Program. School Mental Health 11, 357–363 (2019). https://doi.org/10.1007/s12310-018-9281-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12310-018-9281-4