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A Review of School-Based Interventions to Reduce Stigma towards Schizophrenia

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Abstract

Schizophrenia is among the most stigmatized mental illness. Adolescence may be a critical time to intervene, before stigmatizing attitudes have been solidified. As such, schools may be in a unique position to provide anti-stigma interventions to a large number of students. The aim of this paper was to review and critically analyze the most recent (2003-present) school-based schizophrenia stigma interventions, with seven studies identified. Studies were analyzed according to their intervention method, outcome measures, and experimental design. Substantial heterogeneity between studies precluded concrete conclusions or recommendations regarding the effectiveness of school-based schizophrenia stigma interventions. However, the most effective and informative studies utilized combinations of rigorous experimental design, psychometrically-validated measures examining multiple different factors related to stigma, and longer-term follow-up analyses. Future researchers are encouraged to utilize intervention methods and outcomes measures that are developed from and relevant to adolescent populations, rather than adapted from that of adults.

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References

  1. Aarons GA, Hazen AL, Leslie LK, Hough RL, Monn AR, Connelly CD, et al. Substance involvement among youths in child welfare. The role of common and unique risk factors. Am J Orthopsychiatry. 2008;78:340–9.

    Google Scholar 

  2. Alessandri G, Zuffianò A, Perinelli E. Evaluating intervention programs with a pretest-posttest design: a structural equation modeling approach. Front Psychol. 2017;8:223.

    Google Scholar 

  3. Allport G. The nature of prejudice. Reading: Addison-Wesley; 1954.

    Google Scholar 

  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-V). Washington, DC: Author; 2013.

    Google Scholar 

  5. Angermeyer MC, Schulze B. Reinforcing stereotypes: how the focus on forensic cases in news reporting may influence public attitudes towards the mentally ill. Int J Law Psychiatry. 2001;24(4):469–86.

    CAS  Google Scholar 

  6. Atkins MS, Hoagwood KE, Kutash K, Seidman E. Toward the integration of education and mental health in schools. Adm Policy Ment Health Ment Health Serv Res. 2010;37(1–2):40–7.

    Google Scholar 

  7. Bustillo JR, Lauriello J, Horan WP, Keith SJ. The psychosocial treatment of schizophrenia: an update. Am J Psychiatr. 2001;158(2):163–75.

    CAS  Google Scholar 

  8. Cangas AJ, Navarro N, Parra J, Ojeda JJ, Cangas D, Piedra JA, et al. Stigma-stop: a serious game against the stigma toward mental health in educational settings. Front Psychol. 2017;8:1385.

    Google Scholar 

  9. Chan JY, Mak WW, Law LS. 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. Soc Sci Med. 2009;68(8):1521–6.

    Google Scholar 

  10. Chandra A, Minkovitz CS. Factors that influence mental health stigma among 8th grade adolescents. J Youth Adolesc. 2007;36(6):763–74.

    Google Scholar 

  11. Corrigan PW. Mental health stigma as social attribution: implications for research methods and attitude change. Clin Psychol Sci Pract. 2000;7(1):48–67.

    Google Scholar 

  12. Corrigan P. How stigma interferes with mental health care. Am Psychol. 2004;59(7):614–25.

    Google Scholar 

  13. Corrigan PW, Penn DL. Lessons from social psychology on discrediting psychiatric stigma. Am Psychol. 1999;54(9):765–76.

    CAS  Google Scholar 

  14. Corrigan PW. On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. Washington, DC: American Psychological Association: 2005.

  15. Corrigan PW, River LP, Lundin RK, Penn DL, Uphoff-Wasowski K, Campion J, et al. Three strategies for changing attributions about severe mental illness. Schizophr Bull. 2001;27(2):187–95.

    CAS  Google Scholar 

  16. Corrigan PW, Larson J, Sells M, Niessen N, Watson AC. Will filmed presentations of education and contact diminish mental illness stigma? Community Ment Health J. 2007;43(2):171–81.

    Google Scholar 

  17. Corrigan PW, Morris SB, Michaels PJ, Rafacz JD, Rüsch N. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012;63(10):963–73.

    Google Scholar 

  18. Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students’ social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011;82(1):405–32.

    Google Scholar 

  19. Economou M, Louki E, Peppou LE, Gramandani C, Yotis L, Stefanis CN. Fighting psychiatric stigma in the classroom: the impact of an educational intervention on secondary school students’ attitudes to schizophrenia. Int J Soc Psychiatry. 2011;58:544–51.

    Google Scholar 

  20. Finzen A. Der verwaltungsrat ist schizophren: die krankheit und das stigma. Bonn: Psychatrie-Verlag; 1996.

    Google Scholar 

  21. Goffman E. Stigma: notes on the management of spoiled identity. Engelwood Cliffs: Prentice-Hall; 1963.

    Google Scholar 

  22. Greenberg MT, Weissberg RP, O'brien MU, Zins JE, Fredericks L, Resnik H, et al. Enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning. Am Psychol. 2003;58(6–7):466–74.

    Google Scholar 

  23. Greenwood K, Carroll C, Crowter L, Jamieson K, Ferraresi L, Jones A, et al. Early intervention for stigma towards mental illness: promoting positive attitudes towards severe mental illness in primary school children. J Public Ment Health. 2016;15(4):188–99.

    Google Scholar 

  24. Haghighat R. A unitary theory of stigmatisation: pursuit of self-interest and routes to destigmatisation. Br J Psychiatry. 2001;178(3):207–15.

    CAS  Google Scholar 

  25. Head ML, Holman L, Lanfear R, Kahn AT, Jennions MD. The extent and consequences of p-hacking in science. PLoS Biol. 2015;13(3):e1002106.

    Google Scholar 

  26. Holzinger A, Dietrich S, Heitmann S, Angermeyer MC. Evaluation zielgruppenorientierter Interventionen zur Reduzierung des stigmas psychischer Krankheit. Eine systematische Übersicht [Evaluation of target-group oriented interventions aimed at reducing the stigma surrounding mental illness. A systematic review]. Psychiatr Prax. 2008;35:376–86.

    Google Scholar 

  27. Jorm AF, Wright A. Influences on young people's stigmatising attitudes towards peers with mental disorders: national survey of young Australians and their parents. Br J Psychiatry. 2008;192(2):144–9.

    Google Scholar 

  28. Koller M, Stuart H. Reducing stigma in high school youth. Acta Psychiatr Scand. 2016;134:63–70.

    Google Scholar 

  29. Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27(1):363–85.

    Google Scholar 

  30. Mak, W. W. S., & Leung, S. Y. C. . Common sense model on public stigma: Implications on social distance and help-seeking among Chinese community adults. Unpublished manuscript, The Chinese University of Hong Kong: 2008.

  31. Meise U, Sulzenbacher H, Kemmler G, Schmid R, Rossle W, Guenther V. “...not dangerous, but nevertheless frightening:” A program against stigmatization of schizophrenia in schools. Psychiatr Prax. 2000;27:340–6 (In German).

    CAS  Google Scholar 

  32. Mellor C. School-based interventions targeting stigma of mental illness: systematic review. Psychiatr Bull. 2014;38(4):164–71.

    Google Scholar 

  33. Ng P, Chan KF. Attitudes towards people with mental illness: effects of a training program for secondary school students. Int J Adoles Med Health. 2002;14:215–24.

    Google Scholar 

  34. O’Driscoll C, Heary C, Hennessy E, McKeague L. Explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry. 2012;53(10):1054–62.

    Google Scholar 

  35. O'Driscoll C, Heary C, Hennessy E, McKeague L. Adolescents' beliefs about the fairness of exclusion of peers with mental health problems. J Adolesc. 2015;42:59–67.

    Google Scholar 

  36. Pinfold V, Stuart H, Thornicroft G, Arboldea-Florez J. Working with young people: the impact of mental health awareness programmes in schools in the UK and Canada. World Psychiatry Suppl. 2005;4:48–52.

    Google Scholar 

  37. Reinke RR, Corrigan PW, Leonhard C, Lundin RK, Kubiak MA. Examining two aspects of contact on the stigma of mental illness. J Soc Clin Psychol. 2004;23(3):377–89.

    Google Scholar 

  38. Roberts G, Somers J, Dawe J, Passy R, Mays C, et al. On the edge: a drama-based mental health education programme on early psychosis for schools. Early Interv Psychiatry. 2007;1:168–76.

    Google Scholar 

  39. Robson LS, Shannon HS, Goldenhar LM, Hale AR. Quasi-experimental and experimental designs: more powerful evaluation designs. In: Guide to evaluating the effectiveness of strategies for preventing work injuries. Department of Health and Human Services. Cincinnati: National Institute for Occupational Safety and Health; 2001. p. 29–42.

    Google Scholar 

  40. Rüsch N, Angermeyer MC, Corrigan PW. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry. 2005;20(8):529–39.

    Google Scholar 

  41. Saporito JM, Ryan C, Teachman BA. Reducing stigma toward seeking mental health treatment among adolescents. Stig Res and Action. 2011;1(2):9–21.

    CAS  Google Scholar 

  42. Satcher D, Deleon PH. Mental health: a report of the surgeon general—executive summary. Prof Psychol Res Pract. 2000;31(1):5–13.

    Google Scholar 

  43. Schachter HM, Girardi A, Ly M, Lacroix D, Lumb AB, van Berkom J, et al. Effects of school-based interventions on mental health stigmatization: a systematic review. Child Adolesc Psychiatry Ment Health. 2008;2:18–32.

    Google Scholar 

  44. Schinke SP, Fang L, Cole KC. Substance use among early adolescent girls: risk and protective factors. J Adolesc Health. 2008;43(2):191–4.

    Google Scholar 

  45. Schulze B, Angermeyer MC. Subjective experiences of stigma: a focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med. 2003;56(2):299–312.

    Google Scholar 

  46. Schulze B, Richter-Werling M, Matschinger H, Angermeyer MC. Crazy? So what! Effects of a school project on students’ attitudes towards people with schizophrenia. Acta Psychiatr Scand. 2003;107:142–50.

    CAS  Google Scholar 

  47. Steadman, K. (2015). Working with schizophrenia: employment, recovery, and inclusion in Germany. Lancaster University, Germany: The Work Foundation.

  48. Stevens JP. Intermediate statistics: a modern approach. 3rd ed. New York: Taylor & Francis Group; 2007.

    Google Scholar 

  49. Stier A, Hinshaw SP. Explicit and implicit stigma against individuals with mental illness. Aust Psychol. 2007;42(2):106–17.

    Google Scholar 

  50. Stroup TS, Marder S. Pharmacotherapy for schizophrenia: acute and maintenance phase treatment. 2017. Retrieved Jaunary 1, 2018 from https://www.uptodate.com/contents/pharmacotherapy-for-schizophrenia-acute-and-maintenance-phase-treatment.

  51. Stuart H. Why stigma matters and why it should be beaten. World Psychiatry. 2005;4(supplement 1):4–5.

    Google Scholar 

  52. Stuart H. Reaching out to high school youth: the effectiveness of a video-based antistigma program. Can J Psychiatr. 2006;51(10):647–53.

    Google Scholar 

  53. Stuart H, Arboleda-Florez J. Community attitudes toward people with schizophrenia. Can J Psychiatr. 2001;46(3):245–52.

    CAS  Google Scholar 

  54. Thompson AH, Stuart H, Bland RC, Arboleda-Florez J, Warner R, Dickson RA. Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2002;37(10):475–82.

    Google Scholar 

  55. Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M, INDIGO Study Group. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet. 2009;373(9661):408–15.

    Google Scholar 

  56. Vauth R, Hohagen F, Lotz-Rambaldi W. Schizophrenia as the prototypical psychiatric disorder. Psychiatr Prax. 2012;39(4):153–6.

    Google Scholar 

  57. Wahl OE. Children's views of mental illness: a review of the literature. Psychiatr Rehabil Skills. 2002;6(2):134–58.

    Google Scholar 

  58. Watson AC, Otey E, Westbrook AL, Gardner AL, Lamb TA, Corrigan PW, et al. Changing middle schoolers' attitudes about mental illness through education. Schizophr Bull. 2004;30(3):563–72.

    Google Scholar 

  59. Weisman HL, Kia-Keating M, Lippincott A, Taylor Z, Zheng J. Mental health stigma prevention: pilot testing a novel, language arts curriculum-based approach for youth. J Sch Health. 2016;86(10):709–16.

    Google Scholar 

  60. Weiss MF. Children's attitudes toward mental illness as assessed by the opinions about mental illness scale. Psychol Rep. 1985;57(1):251–8.

    CAS  Google Scholar 

  61. World Health Organization [WHO]. (2005). Promoting mental health: concepts, emerging evidence, practice. Geneva, Switzerland: Department of Mental Health and Substance Abuse, Victorian Health Promotion Foundation, The University of Melbourne.

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Correspondence to Emma A. Climie.

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Table 1 Summary of Reviewed Articles

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Flanigan, L.K., Climie, E.A. A Review of School-Based Interventions to Reduce Stigma towards Schizophrenia. Psychiatr Q 91, 983–1002 (2020). https://doi.org/10.1007/s11126-020-09765-y

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