Impact of a Mental Health Curriculum for High School Students on Knowledge and Stigma: A Randomized Controlled Trial

Abstract Objective This study evaluated the effectiveness of a school-based mental health literacy intervention for adolescents, on knowledge and stigma. Method Twenty-four high schools and a total of 534 students in the regional area of Ottawa, Canada participated in this randomized controlled trial (RCT). Schools were randomly assigned to either the curriculum or control condition. The curriculum was integrated into grade 11 and 12 Provincial “Healthy Living” courses, and delivered by teachers. Changes in mental health knowledge and stigma were measured using pre- and post-test questionnaires. Descriptive analyses were conducted to provide sample characteristics, and multilevel modelling was used to examine study outcomes. Results For the curriculum condition, there was a significant change in stigma scores over time ( p = .001) with positive attitudes towards mental illness increasing from pre to post. There was also a significant change in knowledge scores over time ( p < .001), with knowledge scores increasing from pre to post. No significant changes in knowledge or stigma were found for participants in the control condition. A meaningful relationship was found whereby increases in knowledge significantly predicted increases in positive attitudes towards mental health ( p < .001). Conclusion This is the first large RCT to demonstrate the effectiveness in mental health literacy of an integrated, manualized mental health educational resource for high school students on knowledge and stigma. Findings also support the applicability by teachers and suggest the potential for broad-based implementation of the educational curriculum in high schools. Replication and further studies are warranted. Clinical trial registration information Impact of a Mental Health Curriculum for High School Students on Knowledge and Stigma; http://clinicaltrials.gov/ ; NCT02561780