Beautiful Minds is a program of the Community Development and Education Services team at the Canadian Mental Health Association – Grand River Branch. Our mandate is to create and deliver educational programs that are designed to increase knowledge and promote positive attitudes towards mental health, and thus reduce stigma.
One of our projects—Beautiful Minds in Secondary Schools—is a four-component program delivered in high school classrooms across Waterloo Region and Wellington County in Ontario. Our main objective when we began this project was to update, deliver and evaluate the mental health education program originally called “Talking About Mental Illness”—an education program for high school students designed to help increase knowledge about mental health and promote positive attitudes.
Beautiful Minds in Secondary Schools has reached close to 7000 students and hundreds of teachers and school support staff since it began in February 2006. It is delivered to classrooms upon the request of teachers at participating schools.
Treatment or Prevention?
It is becoming widely accepted that approximately 1 in 5 people will experience a mental health issue over the course of any given year. Youth are certainly no exception to this statistic. Given that the onset of symptoms generally occurs between the ages of 16 – 24, there is no question that there is a need to educate youth about mental health. Currently, much of the focus in the area of youth mental health is related to treatment of existing problems. It has recently been reported that treatment services reach a limited number of youth, with an estimated 75% of those experiencing mental health problems not accessing available services (Waddell, McEwan, Shepherd, et al., 2005). If funding continues to be put into treatment, it is unlikely that an impact will be made, since expansion to health care does not mean improved health (McEwan, Waddell, and Barker, 2007).
A focus on prevention could, over time, reduce the incidence of mental health issues which would relieve the pressure on the mental health system by reducing the need for more intensive and costly intervention. Early identification of symptoms can reduce the severity of mental health issues and promote early intervention, improving quality of life for children and youth (Ontario Ministry of Children and Youth Services, 2006). Through education, it is possible to reduce stigma and encourage the early identification of signs and symptoms of mental health issues and promote mental wellness.
Why School-Linked Mental Health Education?
In keeping with the Ottawa Charter for Health Promotion, the Ontario Ministry of Health Promotion has mental health as one of its priorities in their Strategic Framework, with their overall first priority being “…our children and youth. Behaviours and attitudes developed in childhood last the rest of our lives. Healthy, active children become healthy, active adults. We will build a generation of healthier Ontarians.” (Ontario Ministry of Health Promotion, 2006).
The Mental Health Commission of Canada (2008) states in their anti-stigma campaign that addressing mental health in “youth aged 12 to 18 (is) important because early intervention makes an enormous difference over a lifetime. For more than 70% of adults living with mental illness, onset occurred before they were 18 years old.” Certainly, when it comes to youth, the school setting provides the opportunity to make a significant impact in the area of mental health. Youth spend a great deal of time in the school environment, an atmosphere that naturally fosters learning and acts as a place where youth can connect with peers and adult role models (Barry and Jenkins, 2007).
Many schools have decided to look past strictly academics and are adopting a more holistic approach to education including the promotion of social and emotional competencies. The Ontario Ministry of Education has included mental health as a mandatory unit in two courses offered at the secondary school level – Healthy Active Living Education (Gr. 11) and Introduction to Anthropology, Psychology and Sociology (Gr. 11). In fact, the opportunity exists to introduce the topic of mental health to students in many secondary school courses. As for all areas of study, it is important to deliver the most accurate and up-to-date material to students.
School-linked programs, in which schools reach out to local organizations and take advantage of services they offer, serve to connect schools to the surrounding community and create a network for students, parents and teachers. Collaboration is the key to a holistic approach to learning. Also, by making connections and networking with individuals outside of the school, students and school staff are better able to seek assistance and refer others to available mental health services.
History of Beautiful Minds in Secondary Schools
In 1988, a program called “Beyond the Cuckoo’s Nest” was developed and implemented at the Clarke Institute of Psychiatry in Toronto, Ontario. The program was developed by nurse case managers and geared to senior students. Any or all of the following components were included in each session: a video describing trends in the mental health field, exercises simulating symptoms of mental illness, an interview between a Clarke Institute staff member and a consumer/survivor. Students had the opportunity to ask questions and speak one-on-one with the consumer after witnessing the interview (Mound and Butterill, 1992).
In 1998, The Centre for Addiction and Mental Health partnered with The Canadian Mental Health Association and The Mood Disorders Association of Ontario in an effort to build on “Beyond the Cuckoo’s Nest.” A proposal was submitted to package the program in a user-friendly way and provide professional evaluation in order to track the level of student and teacher satisfaction, changes in students’ attitudes toward people with mental illness and change in their knowledge of mental health. Recommendations from this installment resulted in the program “Talking About Mental Illness.” Two new resources were developed for this program—one for communities wishing to implement an awareness program for youth, and one for teachers wishing to implement such a program in the classroom (The Centre for Addiction and Mental Health, 1999).
Beautiful Minds in Secondary Schools is an extension and adaptation of the program “Talking About Mental Illness.” The program began with a pilot and was then officially launched in 2006. Local organizations, agencies and individuals came together to implement this awareness and anti-stigma program in order to fulfill the needs of Waterloo Region and Wellington County.
Volunteer speakers were recruited through community organizations that offered services to consumers. Posters were distributed and posted at various locations in order to advertise for the opportunity. As people expressed interest, they were required to complete an application form including references and a police records check. Each speaker was required to complete two training sessions, each 4 hours in length. A complete training binder was developed in order to provide volunteers with information around human resources issues, public speaking and communication in general.
The complete program provides all the materials needed to deliver all four components in the classroom. The first two components are taught by the teacher and lay a foundation for the classroom presentation in component three. Teachers are responsible for following up with the students in the final component.
Component #1 – Stigma. What is it? How does it affect people’s lives?
This component introduces stigma and describes how it impacts the lives of those who are experiencing mental health issues.
Component #2 – What is mental illness?
This component includes an overview of the most common mental illnesses, their causes and possible treatment options.
Component #3 – Beautiful Minds Presentation
A facilitator from Beautiful Minds and one or two volunteer speakers come into the classroom and present general information about mental health and share their personal experiences with mental illness. The speakers are required to complete an extensive training session before participating in a presentation. They have a variety of experiences and mental health challenges.
Occasionally, when only one speaker was available for the classroom presentation, an audio tape simulating hallucinations was used or the class played a trivia game called “Mental Health Jeopardy.” Currently, a video is used when a speaker is unavailable. The video is a collection of three personal experiences from speakers who have been involved in the program.
Students are given a Beautiful Minds handbook that includes information about stress, feelings, mental health and resources. In addition, students have an opportunity to collect a number of resource materials from local agencies and organizations (i.e., brochures, pamphlets). Each student receives a wallet card listing all local crisis service contact numbers, with local entertainment and food outlet discounts on the back of the card. As incentive, students receive a brain keychain for participation.
School support staff are strongly encouraged to be present at all presentations and at the very least, be aware of the dates that presentations are occurring at the school in order to be able to support students.
Component #4 – Follow-up Education, Activities and Resources
The teacher resource manual provides suggestions for debriefing after the classroom presentation and provides a number of resources for teachers and students and additional information about mental health and wellness.
Success of the Program
The program was evaluated using pre- and post-tests to measure knowledge and attitudes around mental health. Students were also asked to include feedback about the program, including what they enjoyed the most, the least and any additional comments. Teachers were asked to complete an evaluation rating the contents of the teacher resource binder as well as the contents of the presentation.
Quantitative results indicate the students had a statistically significant increase in their knowledge around mental health, and a significant change around their attitudes about mental health after participating in the program. Qualitative responses indicated that students were generally impressed with the program and wished for it to continue. Teachers indicated that they were very thankful for the program and materials and they felt better equipped to deliver the mental health curriculum.
Favourable results from the evaluation lead us to conclude that Beautiful Minds in Secondary Schools makes a significant change to the knowledge of and attitudes around mental heath in secondary school students.
It is possible to decrease the stigma surrounding mental health by exposing students to individuals who have personal experience with mental health issues and by providing them with materials and resources so that they can recognize changes in their own mental health and be encouraged to seek support and early intervention.
Teachers’ Hopes for What Students Would Learn from the Program
“A working knowledge of mental illness and an empathy for those dealing with mental illness.”
“An understanding of the complexity and prevalence of mental illness. To foster a sensitive and caring environment in our school around these health issues.”
“Better appreciation for the prevalence of mental illness in their population and that it is manageable and treatable but we must have knowledge in order to seek help.”
“I hoped they would gain knowledge and be able to dispel some myths—I also hoped that anyone who is suffering would learn that it is ok to get help and that help is available.”
“That mental health is a real illness like cancer and that it can be treated if diagnosed properly.”
“Gain clearer understanding of mental illness, dispel myths, stigma, stereotypes—understand how to recognize stigma and safe help.”
“The connection between mental and physical health. Theme of hope. Ability to help self, family, others.”
“Appreciate mental illness and how people can lead a relatively normal life with proper support.”
“The prevalence mental illness has in society and the stigma attached to it.”
“How common mental illnesses are. Some common risk factors. What to look for in self and others. How to get help.”
“To empathize with the presenters. Reduce stigma and shame. Give them hope—there is a light at the end of this tunnel.”
Extent Expectations Were Satisfied (Teachers)
“Exactly what I envisioned and then some.”
“Excellent theory and practical applications.”
“The presenters were excellent and students could easily relate to their stories.”
“The students liked the presentation, many were quiet because it hit close to home.”
“The binder includes a lot of useful information and the presenters prove that mental illness exists in our community.”
Sample of Comments from Students
“Although I knew a lot about the issue through experience with a family member, it gave me a clearer thought and opinion on the matter.”
“It’s good to hear a real-life story that happened so close to home.”
“Gave me a good understanding on how to help someone that has a mental illness.”
“I could relate to the depression problems. They talked about a lot of things I experience. It was very relevant to people our age.”
“I liked how you actually brought in someone with a mental disorder. They told us their story and everything. I respected that. It takes a lot of courage to share a personal story like that to a group of complete strangers.”
“I think it’s a very good program to help teenagers understand their emotions and understand what people with mental illness go through.”
“I think that it is great that there are people trying to get rid of the stigma of mental illness, because those with mental illness do not need to be feared.”
“I think the program is a really good way to teach students about mental illness.”
References available upon request.
ABOUT THE AUTHOR
Erin Margetts is the Program Coordinator for Beautiful Minds. She can be reached at firstname.lastname@example.org.
This article is from Canadian Teacher Magazine’s September 2009 issue.