Mental Health Literacy for Students and Educators: The Mental Health and High School Curriculum Guide

Issues 

Approximately 1 in 5 youth worldwide will experience a mental illness before they turn 25. This makes adolescence a critical time for mental health promotion, prevention, early identification, and intervention. Not addressing these issues leads to negative short- and long- term outcomes. Mental health literacy is foundational for all mental health improvements.

Mental health literacy (MHL) is: understanding how to obtain and maintain good mental health; understanding mental disorders and their treatments; decreasing stigma; enhancing help-seeking efficacy. For more information on mental health literacy, see these papers for reference:
1. https://www.ncbi.nlm.nih.gov/pubmed/25773321
2. https://link.springer.com/article/10.1007/s00787-016-0867-9 /
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813415/

Enhancing MHL is an essential component of effectively addressing the mental health needs of young people (http://journals.sagepub.com/doi/abs/10.1177/0706743717698670).

The Mental Health & High School Curriculum Guide is the first and only best available evidence-based Canadian mental health literacy curriculum resource designed for use in junior high and secondary schools (grades 8-10). Research studies include: cluster controlled, longitudinal cohort and cross-sectional investigations carried out in a number of different Canadian provinces and internationally. Building on existing pedagogic strengths, it is delivered by classroom teachers in a sustainable and cost-effective manner.

The Guide resource includes:
• Six interactive web-based classroom-ready modules
• A teacher self-study module
• Lesson plans
• Print and video resources
• PowerPoint presentations
• Evaluation options
• Supplementary materials

The curriculum provides a complete set of freely available, on-line educational tools that research has demonstrated to significantly, substantially and sustainably increase mental health literacy (knowledge, attitudes and help-seeking efficacy) of both students and teachers. Because studies of educator baseline literacy show that enhancement of competencies prior to classroom teaching is necessary, a one-day face-to-face learning session for classroom teachers, and a two-day train-the-trainer workshop for key individuals (Master Trainers) is available to help jurisdictions build capacity for program sustainability. This can be achieved using a waterfall approach to educational development that can be adapted to the unique circumstances of any educational jurisdiction, supporting widespread and frugal scale-up.

Recently, the Guide's professional development course has been made available on-line through the Faculty of Education at the University of British Columbia: http://pdce.educ.ubc.ca/MentalHealth/. Educators who complete this course can receive a certificate of professional development from UBC.

Solutions 

Freely available classroom ready mental health literacy materials:
The Guide is designed to be easily embedded into existing educational systems. It is not a program that is added to or parachuted onto already stretched school environments; rather it builds on, enhances and sustains existing educational capacity. A freely available French language version of the hard copy Guide resource will be posted on our website in the summer of 2018.

Easily implemented:
The Guide does not require fidelity of implementation to achieve successful outcomes. Such fidelity is not possible as no two schools are similar and thus no intervention can be similarly developed. Rather, scale out of the intervention uses teacher determined flexible strategies to teach the content. This approach is both frugal and easy to implement (lesson plans and classroom ready resources are embedded in the Guide) and is respectful of the uniqueness of every jurisdiction. The fact that research studies applied across numerous and different locations have demonstrated similar outcomes, supports the implementation approach used herein.

Comprehensive:
The Guide successfully improves both teacher and student mental health literacy concurrently, which to our knowledge is the only such approach ever successfully documented in Canada as well as all other locations where research has been conducted. This is important as teacher mental health is also of concern and this intervention effectively addresses both student and teacher domains concurrently.

Frugal:
The materials are freely available online (http://teenmentalhealth.org/schoolmhl/school-mental-health-literacy/ment...). The Faculty of Education at the University of British Columbia has recently made a certified professional development online course available at a minimal cost: http://pdce.educ.ubc.ca/MentalHealth/.

Impact 

To date, to our knowledge, many thousands of schools in 8 Canadian provinces and territories have been applying The Guide. It is being implemented or studied in over a dozen countries globally.

Briefly put, this approach has been robustly demonstrated to simultaneously enhance the mental health literacy (MHL) of both teachers and students in all studies pertaining to improvement of knowledge, decrease of stigma, and improved help-seeking efficacy. Measures of change have been highly significant, with measures of increased knowledge highly impactful and measures of decreased stigma moderately to highly impactful.

Furthermore, the two Canadian studies that have examined the persistence of these positive impacts have demonstrated that these improvements in both knowledge and stigma have been sustained over time. This finding, to our knowledge, has never before been demonstrated in this population for a MHL intervention. And, these findings are similar for both teachers and students. Another study (a randomized controlled trial in the Ottawa region) that compared the application of the Guide against that of an existing school mental health curriculum reported significantly better outcomes on knowledge and stigma among students who received the Guide. This study also showed the Guide’s positive impact on help-seeking intentions in students receiving the Guide intervention. A recently completed cohort study in British Columbia has demonstrated that significant improvements in outcome measures last for a year – an outcome duration never previously noted with any school based mental health literacy intervention.

Similarly positive robust results have been found in a prospective cohort study of pre-service teacher trainees in British Columbia and in a large cohort of teachers from three different school boards in Alberta. Further studies are ongoing in various provinces and are being planned for other Canadian jurisdictions.

Media interest in this intervention is growing, in both Canada: https://globalnews.ca/video/3876531/north-shore-school-districts-introdu... and the United States: https://www.nbcnews.com/nightly-news/how-one-family-educating-students-t...

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