title: Impact of contact on adolescents' mental health literacy and stigma: the SchoolSpace cluster randomised controlled trial.
abstract: OBJECTIVE
  To investigate whether intergroup contact in addition to education is more effective than education alone in reducing stigma of mental illness in adolescents.
  
  
  METHODS
  A pragmatic cluster randomised controlled trial compared education alone with education plus contact. Blocking was used to randomly stratify classes within schools to condition. Random allocation was concealed, generated by a computer algorithm, and undertaken after pretest. Data was collected at pretest and 2-week follow-up. Analyses use an intention-to-treat basis.
  
  
  METHODS
  Secondary schools in Birmingham, UK.
  
  
  METHODS
  The parents and guardians of all students in year 8 (age 12-13 years) were approached to take part.
  
  
  METHODS
  A 1-day educational programme in each school led by mental health professional staff. Students in the 'contact' condition received an interactive session with a young person with lived experience of mental illness.
  
  
  RESULTS
  The primary outcome was students' attitudinal stigma of mental illness. Secondary outcomes included knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help-seeking attitudes.
  
  
  RESULTS
  Participants were recruited between 1 May 2011 and 30 April 2012. 769 participants completed the pretest and were randomised to condition. 657 (85%) provided follow-up data. At 2-week follow-up, attitudinal stigma improved in both conditions with no significant effect of condition (95% CI -0.40 to 0.22, p=0.5, d=0.01). Significant improvements were found in the education-alone condition compared with the contact and education condition for the secondary outcomes of knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help-seeking attitudes.
  
  
  CONCLUSIONS
  Contact was found to reduce the impact of the intervention for a number of outcomes. Caution is advised before employing intergroup contact with younger student age groups. The education intervention appeared to be successful in reducing stigma, promoting mental health knowledge, and increasing mental health literacy, as well as improving emotional well-being and resilience. A larger trial is needed to confirm these results.
  
  
  BACKGROUND
  ISRCTN07406026; Results.
authors.affiliation: School of Psychology, University of Birmingham, Birmingham, UK.
authors.forename: Katharine
authors.initials: K
authors.lastname: Chisholm
authors.affiliation: Youth Programme, Birmingham and Solihull Mental Health NHS Foundation Trust, Research & Innovation, Birmingham, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Patterson
authors.affiliation: School of Education, University of Birmingham, Birmingham, UK.
authors.forename: Carole
authors.initials: C
authors.lastname: Torgerson
authors.affiliation: Early Intervention Services, Birmingham and Solihull Mental Health NHS Foundation Trust, Newington Resource Centre, Birmingham, UK.
authors.forename: Erin
authors.initials: E
authors.lastname: Turner
authors.affiliation: School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
authors.forename: David
authors.initials: D
authors.lastname: Jenkinson
authors.affiliation: School of Psychology, University of Birmingham, Birmingham, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D001523:Mental Disorders / Q000523:psychology*; D012574:Schools; D000066908:Simulation Training; D057545:Social Stigma; D006113:United Kingdom
keywords: MENTAL HEALTH; PUBLIC HEALTH