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Effect of Contact-Based Education on Medical Student Barriers to Treating Severe Mental Illness: a Non-randomized, Controlled Trial



Emerging evidence suggests that contact-based education—learning via structured social interactions designed around intergroup contact theory—could be an important educational adjunct in improving attitudes, beliefs, and behaviors of medical students toward patients with severe mental illness (SMI). However, existing literature in the area lacks structured curriculum, control group designs, or longitudinal analyses. The authors conducted a longitudinal, non-randomized, controlled trial of the National Alliance on Mental Illness (NAMI) Provider Education Program—a 15-h contact-based adjunctive curriculum—on the attitudes, beliefs, and behavior of third-year medical students (MS3) at a single institution.


Two-hundred and thirty-one students were invited to participate. Forty-one students elected to complete the curriculum and eighty served as the control group (response rate = 52%). Participants in both conditions completed questionnaires assessing aspects of caring for patients with SMI at pre-test, 1-week post-curriculum, and at 3-month follow-up.


Results indicated that participants in the curriculum reported improved attitudes, beliefs, and behavior in working with SMI as compared with their cohort-matched peers. The majority of these outcomes were maintained at 3-months post-intervention, with effect sizes in the medium to large range. The largest improvement was in behavioral responses to a vignette describing an acute psychiatric emergency.


The present study provides evidence that a contact-based curriculum leads to improvements in the attitudes, beliefs, and behaviors of MS3 students when offered as an adjunctive program following their first year of clinical rotations.

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The authors would like to thank Sue Huppert, Chief External and Government Affairs Officer, and Jennifer Latterell, DO at Des Moines University for their tireless support of this work. We would also like to thank Nicholas Huth and Stephanie Zobel (DO 2022) whose review and contributions greatly improved the quality of the manuscript.


This project was made possible by generous grants from the Iowa Department of Public Health (#5889MHW01) and the Mid-Iowa Health Foundation (#115-3226). Non-financial support, including facilitators and teaching materials, was provided by the NAMI.

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Correspondence to Jeritt R. Tucker.

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This study was reviewed by the Des Moines University Institutional Review Board and determined to be exempt.

Conflict of Interest

Teri Brister is Director of Information and Support at the National Alliance on Mental Illness. On behalf of all other authors, the corresponding author states that there are no conflicts of interest.

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Tucker, J.R., Seidman, A.J., Van Liew, J.R. et al. Effect of Contact-Based Education on Medical Student Barriers to Treating Severe Mental Illness: a Non-randomized, Controlled Trial. Acad Psychiatry 44, 566–571 (2020).

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  • Medical students
  • Contact-based education
  • Severe mental illness
  • Stigma reduction
  • Psychiatry education