Date of Degree

9-2020

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Philip T. Yanos

Committee Members

Maureen Allwood

Patrick Corrigan

Sara Evans-Lacko

Peggilee Wupperman

Subject Categories

Child Psychology | Clinical Psychology | Community-Based Research | Developmental Psychology | Psychology | School Psychology | Social Psychology

Keywords

stigma, adolescence, high school, mental health, Ending the Silence, National Alliance on Mental Illness

Abstract

This study explored predictors of mental health stigma among adolescents and the effectiveness of a school-based mental health stigma reduction and health promotion program, “Ending the Silence” (ETS), developed by the National Alliance on Mental Illness. Youth mental health service use is impacted by many factors, but concern about stigma and low mental health knowledge have been consistently identified as leading barriers to help-seeking. Beyond education and contact program components, existing research on how to design a successful adolescent stigma reduction intervention has been inconclusive. A diverse sample of 206 high school students in New York City participated in the current study. Using a cluster randomized controlled trial design, fourteen classes (Grade 9-12) were randomly assigned to the ETS program or an active control presentation on careers in psychology. Students completed four surveys throughout the study (pre, immediate post-presentation, 4-weeks post, 8-weeks post). Cross-sectional and longitudinal (over two-months) results were analyzed. Baseline regression analyses (controlling for other predictors of stigma) indicated that lower self-concept predicted self-stigma of seeking help, but lower self-concept also predicted intentions to seek counseling. Longitudinally, mixed effects modelling indicated significant interaction effects (time X group) in favor of the ETS group for reduced negative stereotypes, improved mental health knowledge, and less anticipated risk for disclosing to a counselor. There were also trends in favor of the ETS group for reductions in intended social distancing and negative affect, and improvements in help-seeking intentions. Other predictors of stigma included mental health knowledge, gender, race/ethnicity, prior contact with mental illness, and grade level. Qualitative feedback indicated positive impressions of ETS overall, but suggestions for more interactive activities and discussion. Relatively brief programs such as ETS appear to be a practical vehicle to continue developing and disseminating to reduce stigma and improve mental health outcomes. Future research is warranted on longer-term programs and adolescent development variables.

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