Development and evaluation of a pilot program to reduce stigma of mental illness among rural adolescents

Abstract

Two forms of stigma – social and self – represent barriers to receiving professional help for rural Australian adolescents with mental health issues. Characteristics of rural communities such as self-reliance, social proximity and social exclusion are thought to compound experiences of stigma, creating a fear of seeking professional help. The aim of this project was to design and evaluate a stigma reduction program for rural secondary school students. A two-stage quasi-experimental research design was developed. Study 1 involved working collaboratively with seven students from a rural secondary school to develop a population specific program. The curriculum development process was evaluated and the final form of the intervention documented. Study 2 involved delivering and evaluating the intervention within the same secondary school. The aim of Study 2 was to decrease adolescents‟ stigma of mental illness, as measured by social and self stigmatic attitudes, desired social distance, and help-seeking intentions. The treatment group comprised students from year 7, 8, 9, and 12, and the control comprised a delayed treatment group of comparable students from these year levels. After accounting for attrition, the treatment group comprised 31 (16 females) participants, and the delayed treatment group 36 participants (16 females). Measures of stigmatic attitudes, desired social distance and help-seeking intentions were taken at pre-, post-, and 12-week follow-up. The intervention comprised two sessions each of 90 minutes spaced one week apart. Focus-group discussions held post-intervention expanded evaluations of the program; and suggested areas for improvement. The first hypothesis, that prior to intervention, adolescent boys would have significantly higher social stigma, self stigma, desired social distance from those with mental illness, and perceived barriers to seeking help than females, was supported. The second hypothesis, that participants in the treatment group would report lower social- and self-stigma, desired social distance, and fewer perceived barriers to seeking help post-intervention than pre-intervention and compared to the control group was supported in part. The third hypothesis, that reductions in social stigma, self stigma, desired social distance, and barriers to seeking help would be maintained at follow-up also received mixed support. Qualitative data confirmed that student attitudes towards those with mental health issues improved slightly; however, it also indicated that more change was possible and provided direction for future programs. Results have implications for anti-stigma campaign development and implementation. Suggestions for developing more effective anti-stigma programs that will help to lift the burden of stigma and to increase help-seeking behaviours for rural youth are discussed.Doctor of Psycholog