Youth knowledge and attitudes about mental illness

1. Youth knowledge and attitudes about mental illness Otto Wahl & Dayna Zatina University of Hartford Amy Lax, Janet Susin, & Lorraine Kaplan NAMI Queens/Nassau

2. Rationale for the current study • Mental illnesses are common among youth. • Youth knowledge and attitudes will affect treatment seeking. • Youth knowledge and attitudes will affect peers who experience psychiatric disorders. • Youth knowledge attitudes set the foundation for adult attitudes. • Compared to adult attitudes, relatively little is known about youth views of mental illnesses.

3. Highlights of previous research • Multiple measures—survey, story-telling, stick figure drawings of social distance • Limited psychometric evaluation of measures. • Wide range of ages and developmental levels. • Main results: • Knowledge about mental illnesses limited, especially at younger ages. • Specific, consistent attitudes not found • But generally, even younger school age children see mental illnesses in a more negative light than they see physical illnesses.

4. Current Research • Participants = 88 middle school students (7th grade) • From two U.S. schools (Connecticut and South Carolina) • 1 public, 1 private • 50% male and 50% female • 13% Minorities • This was the first part of a larger study to assess the impact of a middle school mental health education curriculum on knowledge and attitudes. Goals of part 1 were: • To establish a measure appropriate for middle school students • To establish a baseline of knowledge and attitudes toward mental illnesses.

5. Instrument Development • Knowledge and attitudes questionnaire • Selected knowledge items based on previous research, current adult instruments, and facts stressed in the teaching curriculum. • Similar selection for attitude items. • Social distance measure modified for middle school experiences • Language reviewed by advisory board of school teachers and educators and modified to fit middle school students • Reading level of items analyzed via Microsoft program, leading to further modification of items. Lower level items were placed earlier in the questionnaires.

6. Study Measures • Knowledge and attitude questionnaire • 35 items • 18 Knowledge and 17 attitude questions • Likert choices from Strongly Agree to Strongly Disagree (5-point scale) • Questionnaire included reverse items (where disagreement rather than agreement indicated greater knowledge and more positive attitudes) • Reverse items were reverse scored so that higher scores indicate greater knowledge and more positive attitudes • Social Distance measure (8 items) • Willingness to interact in specific situations • 5-point Likert choices—Definitely Unwilling to Definitely Willing • Higher scores indicate greater acceptance

7. Psychometric properties of measures • Internal consistency (Kappa) • Knowledge: .45 • Attitudes: .82 • Social Distance: .90 • Test-retest reliability • Knowledge: .67 • Attitudes: .82 • Social Distance: .90

8. Knowledge: The Good News • Overall knowledge was reasonably good • Mean overall knowledge score was 64.82 (max = 90). • The majority of students knew that • mental illness is not contagious (89%) • “psycho” and “maniac” are unacceptable terms to describe people with mental illnesses (63%) • mental illnesses have biological causes (60%) • people with mental illnesses are not violent and dangerous (58%)

9. Knowledge: Not-so-good News There were numerous gaps in specific knowledge. • Only 58% agreed that people with mental illnesses are not violent and dangerous. • Only a minority of students knew that • people with bipolar disorder are sometimes overconfident and overly energetic (10%) • severe forms of mental illness can be treated successfully (11%) • schizophrenia does not involve multiple personalities (18%) • mental illness is often mistaken for drug abuse (23%) • people with mental illnesses have included famous people such as astronauts, presidents, and baseball players (33%) • mental illness and mental retardation are not the same things (41%)

10. Attitudes and Social Distance:The Good News • Expressed attitudes were generally positive. • Overall attitude score: 63.35 (max = 85) • Overall social distance score: 20.56 (max = 40) • The majority of students • Agreed that a person with a mental illness can be a good friend (91%) • Agreed that people with mental illnesses deserve respect (86%) • Indicated they would be willing to have someone with a mental illness • In a class with them (72%) • As a neighbor (67%)

11. Attitudes and Social Distance:No-so-good News • The downside of the good news: • More than 1 in 4 are not willing to have someone with a mental illness in a class with them. • One third are not willing to have someone with a mental illness as a neighbor. • A substantial percentage of students agreed that • it would be embarrassing to have a mental illness (39%) • children with mental illnesses should not be in regular classrooms (28%). • they have little in common with someone with a mental illness (28%) • Only a minority of students indicated they would be willing to • invite someone with a mental illness to their home (44%) • work on a class project with someone with a mental illness (38%) • go on a date with someone with a mental illness (20%)

12. Conclusions • It is possible to develop measures of youth knowledge and attitudes that are reliable, internally consistent, and informative. • Results from these measures suggest: • There is substantial need for improvement in youth knowledge and attitudes related to mental illnesses. • Educational efforts with youth should convey information about specific disorders and their manifestations and differences. • Work with youth should encourage greater acceptance and tolerance of peers with psychiatric disorders.