Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study

Sandra Kirchhoff; Alexandra M Fretian; Orkan Okan; Ullrich Bauer

doi:10.1186/s12889-023-16825-y

Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study

BMC Public Health. 2023 Oct 10;23(1):1959. doi: 10.1186/s12889-023-16825-y.

Authors

Sandra Kirchhoff^{1

2}, Alexandra M Fretian², Orkan Okan¹, Ullrich Bauer³

Affiliations

¹ Department of Sport and Health Sciences, Technical University of Munich, 80992, Munich, Germany.
² Faculty of Educational Science, Bielefeld University, 33615, Bielefeld, Germany.
³ Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615, Bielefeld, Germany. ullrich.bauer@uni-bielefeld.de.

Abstract

Background: Most mental health problems develop during youth, with about three quarter emerging before age 25. In adolescence, stigmatizing attitudes related to mental illness become more nuanced and consolidate into one's belief system. As the stigma of mental illness is still one of the leading barriers to help-seeking, intervention measures should explicitly address it before it becomes entrenched over time. Preventive measures, for example, based on promoting mental health literacy (MHL), can be used to address and tackle stigmatizing attitudes. The Canadian MHL-based intervention "the Guide" was translated and adapted for the use in German schools. The present study evaluates the effect of the German version of the Guide on attitudes towards mental illness among students in Germany.

Methods: The first-time application of the Guide (German version) was evaluated with a pre-post-evaluation study with an intervention and a control group. The evaluation data of 188 students (intervention group n = 106, control group n = 82) were statistically analyzed focusing on the outcomes social stigma, social distance, and self-stigma.

Results: The analysis showed that participants do not tend to hold stigmatizing attitudes even before the intervention. Nevertheless, the intervention was effective in reducing social stigma, but not in reducing social distance and self-stigma. Neither gender, pre-existing experience with mental illness, nor the delivery modality of the contact element within the intervention (speaker vs. video) seemed to influence the outcomes.

Conclusions: The German version of the MHL-based intervention, the Guide, seems to be a suitable intervention to improve attitudes towards mental illness among students in Germany. More extensive research is necessary to confirm the findings and further explore factors that influence the program's effects on attitudes short- and long-term.

Keywords: Adolescents; Intervention; Mental health; Mental health literacy; School; Stigma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Canada
Germany
Health Literacy* / methods
Humans
Mental Disorders* / psychology
Mental Health
Social Stigma
Students / psychology