Minding Your Mind

Recently, in Canada and indeed globally, the unmet emotional and mental health needs of young people stand squarely in the spotlight. Many young people navigate the changes of adolescence well, yet some experience serious difficulty. Mental health problems such as anxiety and mood disorders, psychosis, eating disorders, personality disorders and substance abuse begin in childhood, during peaks in brain development and impacted by complex social contexts.[1] One in five Canadian youth is at risk for a mental illness,[2] while only 25 percent of youth get the help they need, in the way they need it.[3]

Stigma is a massive barrier for youth experiencing mental health challenges. It contributes to feelings of shame for being different and perpetuates silence. A young adult describes the burden of stigma during her extended high school experience: “You don’t know how to tell them (peers) and it’s not something they can visibly see is wrong with you… I wish I could go back now, stand in front of my class and just say, Hi I’m Paige and I have an anxiety disorder and that’s that.” Instead of finding support from her peers, she tackled completing high school – something that felt impossible – alone.

Removing the barriers of stigma requires increased understanding and improved recognition of mental health problems, and this can begin in the classroom by incorporating mental health content. A recent Canadian study found that older teens and young adults are most inclined to self-manage or seek support from friends or family before accessing more formal, traditional interventions for mental health care.[4] To support self-care, it is essential for adults and youth to be equipped with knowledge and resources to draw upon in their daily lives.

mindyourmind

Building this knowledge base early is one of the goals of mindyourmind, a not-for-profit program funded in part by the Ontario Ministry of Health and Long Term Care. The program recognizes that young people want credible information and provides a 24-hour-a day space – through a website and social media platforms – where youth can seek out resources about mental health that appeal to them. Resources on the website, designed to reduce the stigma associated with mental illness and increase access and use of both professional and peer-based support, are created in collaboration with youth. This partnership ensures that resources resonate with the user. By engaging youth in mental health promotion online and in person, mindyourmind promotes relevant mental health awareness and inspires youth to act, to “reach out, get help and give help” during difficult times.

Community partnerships

Responding to the need for resources, Learning Coordinators in the Thames Valley District School Board (TVDSB) in Southwestern Ontario approached mindyourmind to develop resources for Grade 11 Physical Health Education and Grade 9/10 Guidance and Learning Strategies. Over several brainstorming sessions, mindyourmind’s clinical and educational staff and TVDSB Learning Coordinators collaborated on the outlines of the “Minding Your Mind” lessons. The lessons are based on Ministry expectations and the unique needs of the TVDSB’s populations, and reflect a comprehensive view of mental health rather than solely a bio-medical model. A teacher’s guide is included in the lessons, which offers class discussion primers and activity extension suggestions. 

The team decided on digital formats because it allowed for student-directed units and for information to be presented using multiple delivery methods, appealing to a variety of learning styles and differentiated learning. Existing interactive digital tools, previously created by mindyourmind’s youth-adult teams during intensive “charette” or design workshops, were integrated into the outlines of written content to provide different representations of facts about mental health. These tools and other resources find a permanent home on the mindyourmind website in addition to being used in other resources. One of the interactive tools in the Grade 11 lessons, “The Anatomy of a Panic Attack,” was co-developed earlier by a group of 10 youth aged 15-24 from across Canada and describes what a panic attack looks and feels like while offering suggestions on coping.

Existing and custom-created videos of youth discussing mental health issues provide concise information, and personal stories written by young people convey an authenticity that learners can identify with and learn from, allowing for reflection and a transfer of knowledge between youth. 

Once the technical and graphic design team added their expertise, field-testing began. As part of testing, Learning Coordinators facilitated meetings between mindyourmind and TVDSB department heads, where lesson delivery was demonstrated. Questions were addressed and then feedback from classroom surveys was collected. During this phase, the Mental Health Commission of Canada[5] put out an offer to evaluate existing programs that aimed to reduce stigma in youth, and an evaluation of the Grade 11 Minding Your Mind lessons was accepted.

Evaluation of the Grade 11 lessons on stigma reduction

As part of the MHCC evaluation, Dr. Heather Stuart’s research team at Queen’s University found that the students’ attitudes moved toward understanding that the course of a mental illness is not entirely in one’s control. One student responded, “… it (having a mental illness) doesn’t make them any less than you.” Beliefs about the potential for recovery from a mental illness were shifted positively. The most positive shift for students occurred in a category focusing on unpredictability and social distance. Questions about unpredictability addressed the myth that all people with mental illnesses are unreliable or unpredictable. Questions about social distance asked about a person’s comfort with being a classmate with or even dating someone with a mental illness. A student responded, “They are normal people too and deserve respect.” Attitudes also changed around valuing socially responsible actions such as volunteering with a program that benefits people with a mental illness.

The changes in stigma and the increased social tolerance in student responses as a result of the Minding Your Minds lessons showed that this digital approach was effective. Together with the TVDSB Research Manager, mindyourmind co-presented preliminary evaluation results to the TVDSB Mental Health and Wellness Committee and then participated as Youth Team Advisors in the five-year School-Based Strategic Mental Health Plan.

In the classroom

Many positive responses indicated that the students enjoyed the delivery of the lessons. In a computer lab, students access and use the modules in either a self-directed or guided way, depending on teacher preference, to learn about and practice increased self-awareness through goal-setting, decision-making, and interpersonal skill building. Students explore the positive and negative effects of stress, describe the influence of mental health on overall well-being, and encounter personal stories about young people dealing with mental health issues ranging from everyday stress all the way to specific illnesses such as anxiety and schizophrenia. 

The digital format is designed to meet youth “where they are,” in terms of readiness and learning preferences. Students determine the speed of learning and return to previously viewed materials, encouraging self-regulation and responsibility. Assessment for and as learning are dispersed throughout units, prompting learners to reflect and to review where necessary. Evaluations are differentiated based on learning preferences, allowing students to work to their strengths to demonstrate learning. 

Students taking next steps 

Using a format that builds on the pillars of youth culture (e.g. music, fashion, technology, art, sports), the modules scaffold learning about mental health in relatable, relevant and practical ways using materials co-created by their peers. Students are better informed about mental health issues and know where to go later if and when information is needed for themselves or for friends. Lessons introduce students to resources in the community as well as mindyourmind’s website. Through the lessons, students see the positive results of their peers’ volunteering in the community. At the end of the lessons, students are invited to initiate activities and get involved in their own personal networks, schools or wider communities to make change.

The most effective change happens when youth, educational teams and community partners work together. In order to engage youth in the discussion, we need to start where they are, using ever-changing youth culture as an entry point for partnerships and in the classroom to participate in dialogues that concern their health, and to build the capacity to reach out, get help give help.

Photo: Ethan Myerson (iStock)

First published in Education Canada, March 2014

EN BREF – L’amélioration des connaissances en santé mentale constitue une façon essentielle de répondre aux besoins non comblés des jeunes en matière de santé mentale. Les jeunes, les équipes pédagogiques et les partenaires communautaires peuvent travailler ensemble pour réduire la stigmatisation et habiliter les enseignants et les jeunes. Grâce à un partenariat entre mindyourmind, un organisme communautaire axé sur l’engagement des jeunes, et le conseil scolaire local, des leçons numériques ont été instaurées en 9^e, 10^e et 11^e années. Une évaluation réalisée par l’initiative « Changer les mentalités » de la Commission de la santé mentale du Canada a constaté des changements en matière de stigmatisation et une tolérance sociale accrue dans les réactions des jeunes par suite des leçons, indiquant que l’approche fonctionne.

[1] T. Paus, M. Keshavan and J. N. Giedd, “Why do many psychiatric disorders emerge during adolescence?” Nature Reviews Neuroscience 9, No. 12 (2008): 947-957.

[2] Canadian Psychiatric Association, Youth and Mental Illness (2013). http://publications.cpa-apc.org/browse/documents/20 

[3] Statistics Canada, Canadian Community Health Survey: Mental health and well being (2002). www.statcan.gc.ca/daily-quotidien/030903/dq030903a-eng.htm

[4] M. Marcus and H. Westra, H., “Mental Health Literacy in Canadian Young Adults: Results of a national survey,” Canadian Journal of Community Mental Health 31, no. 1 (2012): 1-15.

[5] Mental Health Commission of Canada, Opening Minds. www.mentalhealthcommission.ca/English/initiatives-and-projects/opening-minds?routetoken=4e7e3879325d7eb9d62c51a03176d8ac&terminitial=39