Addressing Mental Health Stigma among Young Adolescents: Evaluation of a Youth-Led Approach

hswYoung people in middle school navigate a tumultuous development period as they become increasingly independent of their parents and families, and cope with complicated peer relationships. Furthermore, they are managing school and home responsibilities, as well as extracurricular activities. On top of this, they are exploring their unique identities. Having a mental illness, which may or may not be exacerbated by these stressors, complicates this time even more for adolescents. Mental illness stigma could prevent adolescents from seeking help for mental and emotional distress, and it could leave youths even more isolated as they experience rejection from their peers.

While the problems of stigma around mental health issues have been known by mental health professionals, very little research has been done on addressing the issue of mental illness stigma. In response to this need, S.P.E.A.K., a youth-led program, was developed to address the problem of mental health stigma. In a recent issue of Health & Social Work, researchers presented findings from an evaluation of this initiative in which high school students lead workshops about mental health for at-risk middle school students.

The “Share, Peace, Equality, Awareness, and Knowledge” (S.P.E.A.K.) program was a youth-led group whose mission as to develop innovative ways to use the “Say It Out Loud” (SIOL) Campaign. The SIOL Campaign was a statewide program designed to decrease stigma attached to mental illness and encourage help-seeking behaviors. Grantees proposed to address stigma among specific at-risk groups. S.P.E.A.K. was awarded a grant to address stigma among middle school students by using peer educators. The project was overseen by two professors of social work and directly run by university students.

In line with a youth-led approach, the seven high school students in S.P.E.A.K. were instrumental in planning and implementing all of the activities associated with this project. The peer health educators were trained in the SIOL Campaign, and the developed a logic model to conceptualize all anticipated inputs and outputs involved with this project. The youth leaders developed presentations that addressed common mental health disorders among adolescents (depression, eating disorders, attention deficit/hyperactivity disorder, anxiety, and autism). In addition, the presentations described the nature of stigma and appropriate ways to help oneself and others experiencing mental or emotional distress. Some of the youth members had personal experience with mental illness and shared their experiences as well. Two short public service announcements were videotaped and incorporated into the presentation; these PSAs showed a teenage girl being teased and then seeking help for her mental illness. Presentations were made at five after-school programs targeting at-risk sixth- through eighth-graders.

The researchers evaluated the effectiveness of the S.P.E.A.K. program using pre- and post-tests to survey the impact of the program on the students. Researchers found that the students had made significant gains in their knowledge of and attitudes toward mental health and stigma as a consequence of minimal intervention. The findings suggest there is promise in the development of peer-led models of mental health awareness. The researchers also suggest that future studies should examine whether youth peers have as meaningful an effect (or possibly a more meaningful effect) than adult presenters on this issue. The researchers noted that some have suggested that peers are a better resource for stigma change because their cognitive styles of communication are synchronous. In other words, they understand and can talk to each other. This could well be a promising direction in reducing the stigma around mental health issues in young people.

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