Effectiveness of School-Based Interventions on Mental Health Stigmatization

  • Shu-Ping ChenEmail author
  • Elise Sargent
  • Heather Stuart
Part of the The Springer Series on Human Exceptionality book series (SSHE)


This chapter first provides an overview and analysis of current school-based interventions on mental health stigmatization. This includes contact-based education, literacy-based education, and other approaches such as protest, art-based interventions, and the summit approach. The effectiveness of contact-based education in improving knowledge, attitudes, and behavioural intentions towards people with mental illnesses is supported by strong evidence. The student-driven summit approach is also a promising intervention in schools. Next the Opening Minds anti-stigma initiative of the Mental Health Commission of Canada, one of the first national anti-stigma programs to target school youth using contact-based education, is described to illustrate key ingredients and the program logic model for contact-based education in the Canadian school context. Engaging contact and delivery of recovery message are identified as key ingredients for program success. The logic model including four input components (team building, partnerships with schools, preparation, coordination), six process components (who-program deliverers, what-contents, how-pedagogy, materials, where-place, when-time), and four levels of program outcome (reaction, knowledge, behaviours, social changes) are discussed.


Child and youth mental health stigma School programs and stigma 


  1. Chan, J. Y., Mak, W. W., & Law, L. S. (2009). Combining education and video-based contact to reduce stigma of mental illness: “The Same or Not the Same” anti-stigma program for secondary schools in Hong Kong. Social Science & Medicine, 68, 1521–1526. Scholar
  2. Chandra, A., & Minkovitz, C. S. (2006). Stigma starts early: Gender differences in teen willingness to use mental health services. Journal of Adolescent Health, 38, 754.e1–754.e8.CrossRefGoogle Scholar
  3. Chen, S.-P., Dobson, K., Kirsh, B., Knaak, S., Koller, M., Krupa, T., … Szeto, A. (2017). Fighting stigma in Canada: Opening minds anti-stigma initiatives. In W. Gaebel, W. Rossler, & N. Sartorius (Eds.), The stigma of mental illness – end of the story? (pp. 237–261). Switzerland, UK: Springer Inetrnational Publishing.Google Scholar
  4. 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. Scholar
  5. Corrigan, P. W., Larson, J., Michaels, P. J., Vega, E., McClintock, G., Krzyzanowski, R., & Gause, M. (2013). The California schedule of key ingredients for contact-based antistigma programs. Psychiatric Rehabilitation Journal, 36(3), 173–179. Scholar
  6. Corrigan, P. W., Larson, J., Sells, M., Niessen, N., & Watson, A. C. (2007). Will filmed presentations of education and contact diminish mental illness stigma? Community Mental Health Journal, 43(2), 171–181. Scholar
  7. Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rusch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–9733. Scholar
  8. Corrigan, P. W., River, L. P., Lundin, R. K., Penn, D. L., Uphoff-Wasowski, K., Campion, J., … Kubiak, M. A. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27(2), 187–195. Retrieved from Scholar
  9. Corrigan, P. W., & Shapiro, J. R. (2010). Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review, 30(8), 907–922. Scholar
  10. Essler, V., Arthur, A., & Stickley, T. (2006). Using a school-based intervention to challenge stigmatizing attitudes and promote mental health in teenagers. Journal of Mental Health, 15(2), 243–250. Scholar
  11. Esters, I. G., College, L., Cooker, P. G., & Ittenbach, R. F. (1998). Effects of a unit in mental health on rural adolescents’ attitudes about seeking help and concepts of mental illness. Adolescence, 33, 469–476.PubMedGoogle Scholar
  12. (n.d.). Summit. Retrieved 28 Jul 2017, from
  13. Kirkpatrick, D. L., & Kirkpatrick, J. D. (2006). Evaluating training programs: The four levels (3rd ed.). San Francisco, CA: Berrett-Koehler Publishers.Google Scholar
  14. Koller, M., Chen, S.-P., Heeney, B., Potts, A., & Stuart, H. (2013). Opening minds in high school: Durham talking about mental illness (TAMI) in school activities – Post summit. Retrieved 7 June 2017, from Mental Health Commission of Canada:
  15. Koller, M., & Stuart, H. (2016). Reducing stigma in high school youth. Acta Psychiatrica Scandinavica, 134(Suppl 446), 63–70. Scholar
  16. Kutcher, S., Wei, Y., & Morgan, C. (2015). Successful application of a Canadian mental health curriculum resources by usual classroom teachers in significantly and sustainably improving student mental health literacy. Canadian Journal of Psychiatry, 60(12), 580–586.CrossRefGoogle Scholar
  17. Mcluckie, A., Kutcher, S., Wei, Y., & Weaver, C. (2014). Sustained improvements in students’ mental health literacy with use of a mental health curriculum in Canadian schools. BMC Psychiatry, 14, 379–384.CrossRefGoogle Scholar
  18. Mellor, C. (2014). School-based interventions targeting stigma of mental illness: Systematic review. Psychiatirc Bulletin, 38(4), 164–171. Scholar
  19. Mental Health Commission of Canada. (2014a). HEADSTRONG. Retrieved 7 Jul 2017, from Mental Health Commission of Canada:
  20. Mental Health Commission of Canada. (2014b). Planning a youth anti-stigma summit: Summit coordinator toolkit. Retrieved from Mental Health Commission of Canada:
  21. Milin, R., Kutcher, S., Lewis, S. P., Walker, S., Wei, Y., Ferrill, N., & Armstrong, M. A. (2016). Impact of a mental health curriculum on knowledge and stigma among high school students: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 55(5), 383–391. Scholar
  22. Painter, K., Phelan, J. C., DuPont-Reyes, M., Barkin, K. F., Villatoro, A. P., & Link, B. G. (2016). Evaluation of antistigma interventions with sixth-grade students: A school-based field experiment. Psychiatric Services (Washington, D.C.). Scholar
  23. Perry, Y., Petrie, K., Buckley, H., Cavanagh, L., Clarke, D., Winslade, M., … Christensen, H. (2014). Effects of a classroom-based educational resource on adolescent mental health literacy: A cluster randomized controlled trial. Journal of Adolescence, 1143–1151. doi: Scholar
  24. Pinfold, V., Toulmin, H., Thornicroft, G., Huxley, P., Farmer, P., & Graham, T. (2003). Reducing psychiatric stigma and discrimination: Evaluation of educational interventions in UK secondary schools. British Journal of Psychiatry, 182, 342–346. Scholar
  25. Pinto-Foltz, M. D., Hines-Martin, V., & Logsdon, M. C. (2010). How adolescent girls understand and manage depression within their peer group: A grounded theory investigation. School Mental Health, 2, 36–43.CrossRefGoogle Scholar
  26. Pinto-Foltz, M. D., Logsdon, M. C., & Myers, J. A. (2011). Feasibility, acceptability, and initial efficacy of a knowledge-contact program to reduce mental illness stigma and improve mental health literacy in adolescents. Social Science and Medicine, 72, 2011–2019. Scholar
  27. Pitre, N., Stewart, S., Adams, S., Bedard, T., & Landry, S. (2007). The use of puppets with elementary school children in reducing stigmatizing attitudes towards mental illness. Journal of Mental Health, 16(3), 415–429. Scholar
  28. Rickwood, D., Cavanagh, S., Curtis, L., & Sakrouge, R. (2004). Educating young people about mental health and mental illness: Evaluating a school-based programme. International Journal of Mental Health Promotion, 6(4), 23–32. Scholar
  29. Sakellari, E., Leino-Kilpi, H., & Kalokerinou-Anagnostopoulou, A. (2011). Educational interventions in secondary education aiming to affect pupils’ attitudes towards mental illness: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 18, 166–176. Scholar
  30. Sakellari, E., Sourander, A., Kalokerinou-Anagnostopoulou, A., & Leino-Kilpi, H. (2016). Opinions about mental illness among adolescents: The impact of a mental health educational intervention. School Mental Health, 8, 268–277. Scholar
  31. Savaya, R., & Waysman, M. (2005). The logic model. Administration in Social Work, 29, 85–103.CrossRefGoogle Scholar
  32. Schulze, B., Richter-Werling, M., Matschinger, H., & Angermeyer, M. (2003). Crazy? So what! Effects of a school project on students’ attitudes towards people with schizophrenia. Acta Psychiatrica Scandinavica, 107, 142–150.CrossRefGoogle Scholar
  33. Spagnolo, A. B. (2009). Examining the effect of anti-stigma messages on the attitudes of early adolescents. Retrieved from
  34. Stuart, H. (2006). Reaching out to high school youth: The effectiveness of a video-based antistigma program. Canadian Journal of Psychiatry, 51(10), 647–653. Retrieved from Scholar
  35. Stuart, H., Arboleda-Florez, J., & Sartorius, N. (2012). Paradigms lost: Fighting stigma and the lessons learned. Oxford, UK: Oxford University Press.CrossRefGoogle Scholar
  36. Stuart, H., Chen, S.-P., Christie, R., Dobson, K., Kirsh, B., Knaak, S., … Szeto, A. (2014a). Opening minds in Canada: Background and rationale. Canadian Journal of Psychiatry, 59(10 Suppl 1), S8–S12.CrossRefGoogle Scholar
  37. Stuart, H., Chen, S.-P., Christie, R., Dobson, K., Kirsh, B., Knaak, S., … Szeto, A. (2014b). Opening minds in Canada: Targeting change. Canadian Journal of Psychiatry, 59(10 Suppl 1), S13–S18.CrossRefGoogle Scholar
  38. Stuart, H., Patten, S., Koller, M., Modgil, G., & Liinamaa, T. (2014). Stigma in Canada: Results from a rapid response survey. Canadian Journal of Psychiatry, 59(Suppl 1), S27–S33.CrossRefGoogle Scholar
  39. Swartz, K. L., Kastelic, E. A., Hess, S. G., Cox, T. S., Gonzales, L. C., Mink, S. P., & DePaulo, J. R., Jr. (2010). The effectiveness of a school-based adolescent depression education program. Health Education and Behaviour, 37(1), 11–22. Scholar
  40. The World Health Organization. (1996). The health of youth: A cross-national survey. The World Health Organization. Geneva, Switzerland: WHO Regional Publications.Google Scholar
  41. Ventieri, D., Clarke, D. M., & Hay, M. (2011). The effects of a school-based educational intervention on preadolescents’ knowledge of and attitudes towards mental illness. Advances in School Mental Health Promotion, 4(3), 5–17. Scholar
  42. 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, 109–121. Scholar
  43. Zaske, H. (2017). The influence of stigma on the course of illness. In W. Gaebel, W. Rossler, & N. Sartorius (Eds.), The stigma of mental illness – end of the story? (pp. 141–155). Cham, Switzerland: Springer International Publishing.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of AlbertaEdmontonCanada
  2. 2.Queen’s UniversityKingstonCanada

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