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Advocacy Leadership Plan: Issue

Societal stigma surrounding mental illness discourages many people from seeking care. In addition, lack of understanding or education about mental health, means that those who suffer from mental illness are unaware of what help is available to them. While stereotypes and beliefs about mental illness vary across countries and cultures, adolescents across the world are grossly uniformed (Goodwin, et al. 2016). Due to media influences, Psychiatric facilities, treatments, and professionals are feared, and many people associate mental illness with criminality or violence (Damjanociz, PhD. 2009). All of these attitudes work to prevent both youth and adults from understanding their mental health, and from seeking out treatment.

In the early grades, students are more likely to be identified by the school for learning disabilities or other mental health issues, such as ADHD or Autism. However, mental illnesses such as depression, anxiety, eating disorders, and substance abuse often go unidentified. In a study of mental health care for adolescents, it was found that 64% of youth with the diagnosis of major depressive disorder did not receive any care. Only 22% received consistent treatment, which was identified as a minimum of 7 visits per year (MHA, 2016).

As students begin puberty, they experience physical and hormonal changes to their brains. Depression in adolescents is far greater than that of children, and it is believed to be caused, in part, by these changes during puberty. Adolescents also react more strongly to stressors and emotions than other age groups as their subcortical areas (emotion and reactivity) develop disproportionately faster than the prefrontal cortex (planning and critical thinking). (Broderick & Blewitt, 2020. Pp. 346-351). This advocacy plan will focus on Adolescents, grades 9 to 12. However, because the age of puberty onset varies, it is highly recommended that the interventions proposed be used in pre-adolescence, such as grades 6-8.

Mental health issues can prevent academic success in a variety of ways. Depression is characterized by symptoms such as sleeplessness or being over-tired, and difficulty concentrating. This fatigue may result in missing school to sleep and skipping class. Depression is also associated with a higher risk of drug and alcohol use, Suicide, and comorbid disorders such as anxiety, conduct disorder and substance abuse (Santrock, 2014). Research on psychosis shows that nearly one hundred thousand adolescents and young adults experience their first psychotic episode each year. Without intervention, many students may escalate to suicide or self-harm, while others may drop out of school, become expelled, or face criminal charges. All of which not only affect them as adolescents, but into adulthood (MHA, 2016).

Resources

Goodwin, J., Savage, E., & Horgan, A. (2016). Adolescents’ and Young Adults’ Beliefs about Mental Health Services and Care: A Systematic Review. Archives of Psychiatric Nursing, 30(5), 636–644. https://doi-org.ezp.waldenulibrary.org/10.1016/j.apnu.2016.04.004

Broderick, P. C., & Blewitt, P. (2020). The life span: Human development for helping professionals (5th ed.), pp. 346-351. Hoboken, NJ: Pearson Education.

Santrock, John, W. (2014). Adolescence (15th ed.) Chapter 13, “Problems in Adolescence and Emerging Adulthood” (pp.431-467). NY, New York: McGraw-Hill Education. ISBN: 978-0078035487

Aleksandar Damjanović, Olivera Vuković, Aleksandar A. Jovanović &Miroslava Jašović-Gašić (2009).  Psychiatry and Movies  Psychiatria Danubina, Vol. 21, No. 2, pp 230–235. Retrieved from: https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=62547

MHA: Mental Health America (n.d). Position Statement 41: Early Identification Of Mental Health Issues In Young People. Retrieved on Oct. 8th, 2020 from: https://www.mhanational.org/issues/position-statement-41-early-identification-mental-health-issues-young-people

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Program: Increase Mental Health Literacy

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Program: Increase Mental Health Literacy

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An increase in mental health literacy has been shown to decrease stigma and negative attitudes around mental illness and encourage help-seeking behaviors in adolescents (Lanfredi, et al. 2019). Different studies have found positive increases in adolescent attitudes in even brief interventions when focused on dispelling myths and stereotypes about mental health treatment (Sharp, et al. 2006).

Parents play an essential role in reporting of mental health problems. Educating parents and increasing MHL is meant to increase reporting and decrease anxiety in regard to help-seeking. Students benefit from parent involvement, reporting of symptoms, and from parent feedback on intervention efficacy (Cohen, et al. 2012).

Once a week, students will participate in a lesson in their homeroom classes that addresses a specific mental illness, or practice emotional regulation skills such as “I feel” statements or self-care. With this lesson, students will confront stereotypes, learn about symptoms, treatment, and reporting/help seeking. Parents will receive an infographic or written copy of the lesson each week, along with contact information for the school counselor and other professionals in the community.

Students and parents should be taught about their confidentiality and rights in the case of seeking treatment at the beginning of the program. Students should be reminded once a month with the hopes of decreasing anxiety and barriers to asking for help from counselors.

In order to increase familiarity with the school counseling program, the school will hold a name-drawing contest each month. Each time a student attends an event that is NOT counseling (lunch with a counselor, clubs, or just stopping in to say hello), their name is entered into a drawing for a prize.

Once per semester, each grade level will participate in an assembly or meeting with volunteers from their community, consisting of doctors and mental health professionals. This could also be completed via a graded project, requiring students to interview one of these professionals about mental health and treatment.

References

Cohen, E., Calderon, E., Salinas, G., SenGupta, S., & Reiter, M. (2012). Parents’ perspectives on access to child and adolescent mental health services. Social Work in Mental Health, 10(4), 294–310. https://doi-org.ezp.waldenulibrary.org/10.1080/15332985.2012.672318

Sharp, W., Hargrove, D. S., Johnson, L., & Deal, W. P. (2006). Mental Health Education: An Evaluation of a Classroom Based Strategy to Modify Help Seeking for Mental Health Problems. Journal of College Student Development, 47(4), 419–438. https://doi-org.ezp.waldenulibrary.org/10.1353/csd.2006.0051

Lanfredi, M., Macis, A., Ferrari, C., Rillosi, L., Ughi, E. C., Fanetti, A., Younis, N., Cadei, L., Gallizioli, C., Uggeri, G., & Rossi, R. (2019). Effects of education and social contact on mental health-related stigma among high-school students. Psychiatry Research, 281. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2019.112581

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Students, teachers, and parents will complete two questionnaires in the beginning and at the end of the Spring semester. These measure self-stigmas in treatment seeking, and stigmas around mental illness. The first implementation of the program is meant to be completed during the Spring semester because of the extra time. If the intervention is successful, it would be used again in the beginning of the year and continued throughout each school year.

Students, teachers, and parents will decrease their negative attitudes by 25% in one semester and increase willingness to seek help by 25%. Measures will be scored using a Likert Scale of 1-5: Very untrue, Somewhat Untrue, Unsure, Somewhat True, and Very True.

The questionnaires used in the school will be adapted from Vogel’s Self Stigma of Seeking Help Scale (2018), and from Day’s Mental Illness Stigma Scale (2007).

References

Vogel, D. L., Wade, N. G., Haake, S., Rafal, G., Gatto, A., & DeBate, R. (2018). Self-Stigma of Seeking Help Scale. Journal of American College Health, 66(4), 284–291. Retrieved from: https://selfstigma.psych.iastate.edu/wp-content/uploads/sites/204/2016/02/SSOSH_0.pdf

Day, E. N., Edgren, K., & Eshleman, A. (2007). Measuring Stigma Toward Mental Illness: Development and Application of the Mental Illness Stigma Scale. Journal of Applied Social Psychology, 37(10), 2191–2219. https://doi-org.ezp.waldenulibrary.org/10.1111/j.1559-1816.2007.00255.x

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Mindsets

·       “M 1. Belief in development of whole self, including a healthy balance of mental, social/emotional, and physical well-being

·       M 2. Self-confidence in ability to succeed

·       M 5. Belief in using abilities to their fullest to achieve high-quality results and outcomes

·       M 6. Positive attitude toward work and learning” (ASCA 2014)

Behaviors

·       “B-LS 9. Gather evidence and consider multiple perspectives to make informed decisions

·       B-LS 3. Use time-management, organizational and study skills

·       B-SMS 6. Demonstrate ability to overcome barriers to learning

·       B-SS 2. Create positive and supportive relationships with other students

·       B-SS 3. Create relationships with adults that support success

·       B-SS 6. Use effective collaboration and cooperation skills

·       B-SS 8. Demonstrate advocacy skills and ability to assert self, when necessary” (ASCA, 2014)

Resources

American School Counselor Association (2014). ASCA Mindsets & Behaviors for Student Success: k-12 College and Career Readiness Standards for Every Student. Pp.2. Retrieved from: https://www.schoolcounselor.org/asca/media/asca/home/MindsetsBehaviors.pdf

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Essential Stakeholders

Students: Participate in classes and encourage classmates. Assist other students by reporting issues or concerns to staff or parents.

Parents: Collect and read weekly information on mental health lessons. Discuss relevant topics with their family. Communicate concerns or feedback to School counselors, teachers or Admin. Seek professional help if needed.

Teachers: Deliver mental health curriculum and encourage self-care and open discussions of feelings in classes. Provide a good example of acceptance and help-seeking. Be available and welcoming to students to encourage their help seeking. May provide additional gratification for practicing skills learned (prizes, stickers, etc.).

Administrators: Assist teachers and school counselors in providing necessary materials for curriculum, and in communicating with community professionals to organize assemblies or events. Work with School counselors and teachers to provide positive reinforcement for skills taught. Report concerns and feedback to school counselors. Be available for parents, teachers, and students to ask for help.

Community Members: Medical and Mental Health Professionals: Participate in school events aimed towards educating students about treatment. Visit the school for assemblies or classes when able or be available for student interviews if assigned. Stay in contact with school staff for referrals or questions.

School Counselors: Provide guidance and curriculum ideas for weekly classes. Create and maintain a welcoming and safe environment for students and parents. Be available to discuss life stressors and other issues, as well as refer clients to other professionals in the community. Connect with community professionals.

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Mental Illness Stigma Scale (Day, et al. 2007)

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Mental Illness Stigma Scale (Day, et al. 2007)

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Day, E. N., Edgren, K., & Eshleman, A. (2007). Measuring Stigma Toward Mental Illness: Development and Application of the Mental Illness Stigma Scale. Journal of Applied Social Psychology, 37(10), 2191–2219. https://doi-org.ezp.waldenulibrary.org/10.1111/j.1559-1816.2007.00255.x

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Self-Stigma of Seeking Help Scale( Vogel et al. 2018)

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Self-Stigma of Seeking Help Scale( Vogel et al. 2018)

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Vogel, D. L., Wade, N. G., Haake, S., Rafal, G., Gatto, A., & DeBate, R. (2018). Self-Stigma of Seeking Help Scale. Journal of American College Health, 66(4), 284–291. Retrieved from: https://selfstigma.psych.iastate.edu/wp-content/uploads/sites/204/2016/02/SSOSH_0.pdf