effects of preventive mental health programs in school

1.  effects of preventive mental health programs in school Baerum CMHS Bror Just Andersen, Special Advisor for Quality, PhD

2. the intervention - VIP • VIP is the Norwegian abbreviation for Very Important Problems (Guidance and Information for Mental Health). The program focuses on the ups and downs of life, and helps to make it easier to talk about mental problems and illnesses. • the intervention started up in 1999 as a result of a initiative from inlying young patients. They meant that if they had known what they knew as a patient, before the problems started they probably never had becomed a patient in the specialist mental health service. • VIP places the topic of mental health on the agenda in school and home. The program gives students answers on growing curiosity or uncertainty on inner development, and teaches them where they can seek help. It begins with a training conference for school administrators, advisers, faculty contacts, health service personnel and educational psychology personnel. • as a result of the work in the intervention, students and teachers will have an opportunity to get to know professionals in the mental health sector.

3. the intervention - VIP • the intervention is universal, quite short (takes approximately 5 hours to carry out) with relatively low costs • dialogue and involvement are key words in the intervention.   • a special VIP ring binder has been prepared to provide information and help in implementing the project. The program has been developed in accordance with the content of the general curriculum for upper secondary schools, and many schools have included it in their annual teaching plans.   • the target group is students and teachers in upper secondary school. Today the intervention is implemented in over 160 schools in Norway.

4. scheme of the steps of the intervention VIP - built on dialogue and empowerment teaching sequence about mental health problems in general and the local support system especially increased knowledge among increased knowledge among those with problems those without problems greater acceptance of mental problems and more openness and contact between the young behavioral change in everyday life and a lower threshold for seeking help from friends / family / support system lower-level in problem with mental health among schoolchildren

5. propose of the research investigate the effect of implementing a brief preventive intervention on knowledge, behavior and variations in the condition of the mental health among youth

6. main research question do youth behavior and attituderegard to handling, and searching of help with mental health problems change with the level of knowledge?  if so, does this affect the level of mental health problems?

7. outcome (measured) variables • the students' knowledge about mental health • the ability of recognize signals of mental health problems • attitudes towards and behavior in helpseeking • the students' mental health

8. method and design • quantitative method, quasiexperimental, Solomon four group design • questionnaire with multiple choice and open response alternatives • 85 questions / statements, redefined into indexes focusing on the outcome variables • 1368 students in 8 secondary schools in Akershus and Vestfold County • the questionnaire is filled out before, 1-3 weeks after, 6 m after, 12 m after and 24 m after • stepwise analysis, effect results presented in level of significance and Cohen's d

9. my picture of the field in short and long term... changes in the short term on knowledgeindexes

10. changes from before to after the intervention t0 to t1

11. change in knowledge over time the intervention group had a lasting effect change in relation to the control group (after 12 months, Cohens d) at index: • 2. general knowledge of mental health 0,41* • 3. knowledge about diagnosis forms of expression 0,42* • 4. confidence in treatment methods 0,53* • 6. knowledge of support services within mental health in general 0,38* • 7. knowledge of local community support agencies within the mental health 0,39* • we also found an additional effect change at 0.31 on index 1 “knowledge of mental disorders” (but this was not significant at 0,05).

12. changes in long term12 months after the effects on students' every day life

13. average scores on the SDQ-Nor-total, scale for peerproblems, and anxiety at time t1 and t3 (only those who have completed at both time points)

14. the results in a national setting • few (or maybe none) directly comparative studies nationally • evaluation of "all have a mental health all have results that fall between 0.01 and 0.3 on Cohen's d - however, there are considerable uncertainty about these results because of methodological weaknesses • There are other type of preventive interventions in mental health evaluated, but primarily because of the settings, direct comparisons are difficult to make • among the most cited prevention programs from Norway, the Olweus program against bullying - effect sizes in the best evaluations of the program is presented in relative percentages of reduction of bullying and bullies are between 33 and 47% (quasi-experimental method with a cohort design, Olweus 2010) - according to my calculations, this is 3.1 and 6.5% in absolute terms (VIP change in peerproblems 4,9% and anxiety 6,8%)

15. the results in a international setting • in 6 systematic reviews and meta-reviews of preventive mental health overall effect sizes ranging from -0.62 to 1.91 (SD control) • within school-based primary / universal prevention interventions, about mental health variation is far less from 0.27 to 0.57 (SD mean) • in John Hattie summaries in "Visible Learning" in excess of 800 meta-analysis of effects in knowledge dissemination in schools, the average effect 0.48 (SD mean) • in a study of 156 meta-analysis of psychological, psychoeducative and behavioral therapy they found an average power of 0.47 • to set output targets in an even wider perspective – they found in the same study that the average effects in a variety of physical treatment such as bypass surgery, chemotherapy treatment of cancer and different drug treatments also had an average below 0.50

16. implications - my conclusions • is that universal mental health preventive interventions seem to have effects on the change of: • knowledge, • behavior and • the mental health of the involved youth • essentially this is all in my opinion about the effects of choice of educational organization in which two important points are cooperation and demystification/visibility of available services in mental health

17. implications - my conclusions • because the problems with mental health to the greatest extent influence the situation at the school and pupils learning ability these results ought to have implications for • decisions about resource allocation for preventive mental health in general and • decisions related to the significance of mental health as impact factor in the development of knowledge and in learning situations

18. initiatives for up following of my findings • establish a structure that allows a short annual follow-upsecond and third year at secondary school • enhance the accessibility and evaluation skills in low-threshold service to youth, and • because of the close relation between education and health - establish a "clearinghouse" for educational activities related to the effective factors for knowledge and learning development in school

19. Contactinfo: bror.just.andersen@vestreviken.no +47 41 61 01 27 Baerum CHMS