兰德-Effects-of-Stigma-and-Discrimination-Reduction-Trainings-Conducted-Under-the-California-Mental-Health-Services-Authority_-An-Evaluation-of-NAMIs-Ending-the-Silence_9页_316kb

Summary of the Document

Core Content

This document presents an evaluation of NAMI's Ending the Silence (ETS), a 50-minute educational presentation designed to reduce mental illness stigma, increase mental health knowledge, and equip high school students with the skills to support peers or themselves. The study was conducted by the California Mental Health Services Authority (CalMHSA) under the Mental Health Services Act (Proposition 63), which funds mental health prevention and early intervention programs. The evaluation focused on three high schools in Northern California, assessing the short-term effects of ETS on students' attitudes, emotional responses, and knowledge about mental illness.

Main Goals of ETS

• Reduce mental illness stigma
• Increase mental health literacy
• Promote help-seeking and support-giving behaviors

Key Components of ETS

• Slide presentation
• Short videos
• Presenter shares personal recovery experiences
• Resource card with mental health contact information and symptoms
• Postcards sent to parents

Methods

• Sample size: 250 students (191 during assemblies, 59 during classroom sessions)
• Age range: 15.93 years (SD = 1.32)
• Demographics: 57% female, 37% male, 6% other; 29% Latino, 39% non-Latino White, 9% non-Latino Asian American, 7% non-Latino African American
• Language: 31% spoke a language other than English at home
• Measures:
  • Attitudes toward people with mental health problems
  • Emotional responses to individuals with mental health challenges
  • Help-seeking and support-giving intentions
  • Mental health knowledge
• Statistical significance: p < 0.05 was considered significant
• Data collection: Pre- and post-test surveys
• Analysis: Paired t-tests and chi-square tests were used to assess changes

Results

Perceptions of the Presentation

• 74% of students found the presentation to be a positive experience
• Over 50% reported feeling emotionally involved with the presentation
• 66% felt the presentation taught them how to respond to peers with mental health challenges from different cultures
• Only 25% rated the program as culturally sensitive to their background
• Latino students were more likely to find the presentation culturally sensitive than non-Latino White students (30% vs. 17%; p < 0.01)

Attitudes Toward People with Mental Health Problems

• Social distance decreased significantly: students were more willing to invite someone with a mental health problem to their house, work on a project, or go on a date
• Perceived dangerousness and unfitness for child care also decreased
• Blame and feelings about being in class with someone with a mental health problem did not change significantly

Emotional Responses

• Negative emotions (anger, fear, disgust) decreased slightly
• Positive emotions (calm, interested, caring) increased
• Pity decreased by 6 percentage points, which may indicate a positive shift in attitudes, though pity has been linked to perceptions of incompetence

Help-Seeking and Support-Giving Intentions

• No significant changes were observed in help-seeking or support-giving intentions
• Participants generally held positive intentions, but the presentation did not significantly alter these views

Mental Health Knowledge

• Knowledge improved significantly in all areas assessed
• Understanding of prevalence, symptoms, treatment effectiveness, and recovery increased
• Knowledge of treatment effectiveness nearly doubled

Discussion

• ETS had a significant immediate impact on stigma indicators and mental health knowledge
• Emotional responses and attitudes were positively influenced, but help-seeking intentions remained unchanged
• The program may be more effective in changing knowledge and attitudes than in encouraging action
• Cultural sensitivity was a mixed perception, with only 25% rating the program as culturally sensitive, though most would recommend it to peers of their own culture
• Long-term effects are unknown, and further research is needed to assess sustainability
• The study was limited to three presentations, which may affect the generalizability of results

Conclusion

• ETS demonstrated immediate and substantial improvements in mental health knowledge and attitudes toward individuals with mental health challenges
• It may be a valuable addition to NAMI's programs, particularly in high school settings
• The study highlights the need for further research on the long-term impact of stigma reduction programs and their effectiveness in promoting help-seeking behavior

Study Limitations

• Only three presentations were evaluated
• No long-term follow-up was conducted
• Pre-test may have influenced attention during the presentation
• Results may be specific to the speakers and audiences involved

References

• Key studies on stigma, mental health literacy, and educational interventions are cited, including works by Corrigan, Pescosolido, and others
• The document is authored by researchers from RAND Corporation and SRI International

Acknowledgments

• The study benefited from peer reviews and input from stakeholders in California
• The RAND Health Quality Assurance process ensured the rigor of the evaluation

About the Authors

• Eunice C. Wong, Rebecca L. Collins, Jennifer L. Cerully, Elizabeth Roth, Joyce S. Marks, and Jennifer Yu are researchers from RAND Corporation and SRI International

Copyright and Distribution

• The document is protected by copyright law and may only be used for non-commercial purposes
• Limited distribution rights apply to both print and electronic versions
• For permissions, visit www.rand.org/permissions.html