title: Evaluation of Antistigma Interventions With Sixth-Grade Students: A School-Based Field Experiment.
abstract: OBJECTIVE
  School-based interventions for preadolescents provide the opportunity, in a ubiquitous institutional setting, to attack stigmatizing attitudes before they are firmly entrenched, and thus they may reduce mental illness stigma in the overall population. This study evaluated the effectiveness of classroom-based interventions in reducing stigma and increasing understanding of mental illness and positive attitudes toward treatment seeking among sixth-grade students.
  
  
  METHODS
  In an ethnically and racially diverse sample (N=721), 40% of participants were Latino, 26% were white, and 24% were African American; the mean age was 11.5. In a fully crossed design, classrooms from a school district in Texas were randomly assigned to receive all three, two, one, or none of the following interventions: a PowerPoint- and discussion-based curriculum, contact with two college students who described their experiences with mental illness, and exposure to antistigma printed materials. Standard and vignette-based quantitative measures of mental health knowledge and attitudes, social distance, and help-seeking attitudes were assessed pre- and postintervention.
  
  
  RESULTS
  Printed materials had no significant effects on outcomes and were grouped with the control condition for analysis. For eight of 13 outcomes, the curriculum-only group reported significantly more positive outcomes than the control group; the largest between-group differences were for stigma awareness and action, recognition of mental illness in the vignettes, and positive orientation to treatment. The contact-alone group reported significantly more positive outcomes on three vignette-based measures.
  
  
  CONCLUSIONS
  Results were most promising for a classroom-based curriculum that can be relatively easily disseminated to and delivered by teachers, offering the potential for broad application in the population.
authors.affiliation: Dr. Painter is with the Center for Mental Health Services, Division of Service and Systems Improvement, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (email: kirstin.painter@samhsa.hhs.gov ). Dr. Phelan is with the Department of Sociomedical Sciences and Ms. Dupont-Reyes and Dr. Villatoro are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Ms. Barkin is with MHMR of Tarrant County, Fort Worth, Texas. Dr. Link is with the Department of Sociology and School of Public Policy, University of California Riverside.
authors.forename: Kirstin
authors.initials: K
authors.lastname: Painter
authors.affiliation: Dr. Painter is with the Center for Mental Health Services, Division of Service and Systems Improvement, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (email: kirstin.painter@samhsa.hhs.gov ). Dr. Phelan is with the Department of Sociomedical Sciences and Ms. Dupont-Reyes and Dr. Villatoro are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Ms. Barkin is with MHMR of Tarrant County, Fort Worth, Texas. Dr. Link is with the Department of Sociology and School of Public Policy, University of California Riverside.
authors.forename: Jo C
authors.initials: JC
authors.lastname: Phelan
authors.affiliation: Dr. Painter is with the Center for Mental Health Services, Division of Service and Systems Improvement, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (email: kirstin.painter@samhsa.hhs.gov ). Dr. Phelan is with the Department of Sociomedical Sciences and Ms. Dupont-Reyes and Dr. Villatoro are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Ms. Barkin is with MHMR of Tarrant County, Fort Worth, Texas. Dr. Link is with the Department of Sociology and School of Public Policy, University of California Riverside.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: DuPont-Reyes
authors.affiliation: Dr. Painter is with the Center for Mental Health Services, Division of Service and Systems Improvement, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (email: kirstin.painter@samhsa.hhs.gov ). Dr. Phelan is with the Department of Sociomedical Sciences and Ms. Dupont-Reyes and Dr. Villatoro are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Ms. Barkin is with MHMR of Tarrant County, Fort Worth, Texas. Dr. Link is with the Department of Sociology and School of Public Policy, University of California Riverside.
authors.forename: Kay F
authors.initials: KF
authors.lastname: Barkin
authors.affiliation: Dr. Painter is with the Center for Mental Health Services, Division of Service and Systems Improvement, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (email: kirstin.painter@samhsa.hhs.gov ). Dr. Phelan is with the Department of Sociomedical Sciences and Ms. Dupont-Reyes and Dr. Villatoro are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Ms. Barkin is with MHMR of Tarrant County, Fort Worth, Texas. Dr. Link is with the Department of Sociology and School of Public Policy, University of California Riverside.
authors.forename: Alice P
authors.initials: AP
authors.lastname: Villatoro
authors.affiliation: Dr. Painter is with the Center for Mental Health Services, Division of Service and Systems Improvement, Substance Abuse and Mental Health Services Administration, Rockville, Maryland (email: kirstin.painter@samhsa.hhs.gov ). Dr. Phelan is with the Department of Sociomedical Sciences and Ms. Dupont-Reyes and Dr. Villatoro are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City. Ms. Barkin is with MHMR of Tarrant County, Fort Worth, Texas. Dr. Link is with the Department of Sociology and School of Public Policy, University of California Riverside.
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Link
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders; D012574:Schools; D057545:Social Stigma; D013334:Students
keywords: Mental illness stigma; Public attitudes about the mentally ill; Public education