Promoting Mental Health Literacy in Youth November 12, 2009 CACAP Annual Meeting Alexa Bagnell, M.D.
Psychiatric disorders in schools  It is estimated that 7.2 million people in U.S. prematurely terminated their education because of early onset psychiatric disorders.  10% of high school incompletion attributed to mental illness (Kessler et al, 1995; Breslau, 2008)
Prevalence of Mental Disorders in Young People Population Prevalence • Depression (6%) • Psychosis (1%) • Anxiety Disorders (10%) • ADHD (4%) • Anorexia Nervosa (0.2%) • Total (15 – 20%)
• • • • • •
Translation to the “average” Classroom Depression (2) Psychosis (rare) Anxiety Disorders (3) ADHD (1) Anorexia Nervosa (rare) Total (4 – 5)
Do I Have It?
The Problem: Decide this is a problem
Illness
Decide that help is warranted and available
Research studies world wide haver=0.00 shown that 1 in 5 young people have a diagnosable mental illness of some kind
Want to get help and has access
Only 1 in 6 young people receive adequate care
Treatment
Determinants of Help Seeking (Rickwood, 2007)
PROS
CONS
• Knowledge/mental health literacy • Emotional competency • Trust • Family/school support
• Depression • Negative attitudes/experience • Stigma • Lack of access • Handle own problems
Help Seeking Intervention 250
200
Mental Health Visits 150 Grade 8 100
50
Grade 9 Grade 7
0 Grade 7
Grade 8
Santor, Kusumakar, LeBlanc & Poulin (2002).
Grade 9
Sources of Health Information Magazine
21%
Friends
23%
Internet
24%
TV news Doctor
38% 41%
Parents
45%
School
47% Kaiser Family Foundation, 2001
Health Literacy – Conventional literacy – Able to access info – Communicate with health care providers – NAVIGATE the system (Sanders et al, 2009)
Health Information Delivery • • • • • • • •
Internet Pamphlets/Flyers Media Classroom curriculum Manuals Workshops and School Events Health Care Providers Parents, Family and Friends
Interventions to Improve Mental Health Literacy In Young People • School wide (e.g. MindMatters, mental illness curriculums- secondary schools)III-IV evidence • Whole community (e.g. Beyondblue, Compass strategy)III- NRCT • Individual training/gatekeeper (e.g. mental health first aid (II evidenceRCT), suicide intervention project (IV)) (Kelly, 2007)
Your father and I found out you have been blogging. We have no idea what that means, but we want it to stop!
The Internet and Youth • 97% of elementary and secondary schools (Stats Can 2004) • 84% of single family households have internet (ITU, 2008) • Canada: average teen 12.5 hours/wk on line (Ipsos Reid, 2006) • US: 31% of youth have internet usage in bedroom (Kaiser, 2001)
Teen Social Networking 51 % check their sites more than once a day. 39 % posted something they later regretted. 37 % used sites to make fun of other students 24 % have hacked into someone else's social networking account. 13 % have posted nude or seminude pictures or videos of themselves or others online. (www.commonsensemedia.org)
P911/PBB/POS/99/PAW
Health Information Online • 75 % Youth Access Health Info Online • • • •
#1 sexual health #2 mental health #3 substance use and misuse #4 diet and exercise
• 50% reported talking to a parent or adult about health info from internet Generation Rx Survey, Kaiser Family Foundation, 2001
Problems: access, credibility, and relevance of info Gray, 2004
Connecting to the Internet (24/7) • MindMatters- whole school approach to mental health promotion ( teacher, school resources) • YOOMagazine- interactive health literacy tool for youth and schools
– Interactive resources, screening, evaluation, Promoting health and help seeking
- School Mental Health Models - Mental Health Curriculum - Teacher Training Resources - Transition to University Book - Multimedia Presentations - Mental Health Library
Teenmentalhealth.org
Health Literacy and Promoting Early Intervention in Teens
P e rc e n t o f L o g o n s (N = 1 1 ,0 0 0 )
12 10 8 6 4 2
30 Logons
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Time of Day
Goals • • • • • •
Daily presence in lives of youth Universal access Current/Accurate health info Early detection and help seeking Interactive and Flexible Ongoing evaluation and feedback
Nonprofit, free to schools and youth groups
im a 16 year old girl, for the past three months i've been how do u know if ur depressed?? like i feel down alot of times and dont wanna talk to anyone and think about sucide (tho i've never actually tried so dont worry) but it doesnt happen very often. does this mean im depressed?? what are the other things u feel when depressed??
Whe i have a really big project due a get so worried. I can't sleep at night. Even if i know i will finish it on time i get so freaked out. Is there something wrong with me. Non of my friends feal this way. Can u help me?
I know all I can do is be myself, but sometimes I think someone else might do a better job.
SIMPLIFYING WHAT THE EVIDENCE TELLS US
Knowledge Delivery and Utilization • Strongest influence: trusted source • Health curriculums:target youth and youth supports (parent,teacher,health care) appropriate literacy level • Information utilization: Interactive, collaborative, immediate, relevant • Research to date: overall effectiveness of mental health literacy programs improving help seeking has not been well evaluated • EVALUATION as part of any program
Mental Health Literacy Joining Education and Health • Curriculum – Standardized Mental Health School Curriculums
• Teacher training – Mental Health Training for Teachers
• Network with health and education – Mental Health Identification and Navigation
• Parent education • Government advocacy – Mental health training in education – Shared programs
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www.yoomagazine.net ID: demo PW: mydemo Co-Directors Darcy Santor, PhD, University of Ottawa Alexa Bagnell, MD, Dalhousie University