“It should be something we can talk about, I think.” A mixed-method evaluation of a classroom intervention on psychological problems among adolescents.

Abstract

Background This study evaluates a classroom intervention including peer education in the Netherlands on mental health problems among adolescents (14-23 years old). It focusses on two important barriers towards help-seeking: poor mental health literacy and perceived stigma. Based on social norms theory and Goffman’s stigma theory, the research question was: “What is the perceived impact of the intervention, including peer education, on mental health literacy and perceived stigma on psychological problems among adolescents?”. We expected that the intervention would 1) increase mental health literacy, and 2) reduce the perceived stigma on psychological problems among adolescents. We expected 3) peer education to enhance the effectiveness of the intervention.

Methods A cross-sectional, concurrent mixed-method design was employed. A questionnaire, mainly intended to measure the role of peer education, was taken right after the last session from 302 adolescents (male n = 133, female n = 168). Semi-structured interviews, mainly intended to measure impact on mental health literacy and perceived stigma, were held with another 14 adolescents (male n = 7, female n = 7). Perceived stigma was defined as “easiness to talk about psychological problems”.

Results Adolescents indicated increased mental health literacy (M = 2.46, SD = .597), which consisted mostly of knowledge about potential sources of help. However, much information was already known. The effect on perceived stigma was smaller (M = 2.03, SD = .735), and in the interviews more ambiguous. This may have to do with environmental factors. Peer education was overall rated positively (M = 2.70, SD = .320), which the interviewees linked to the age and personal experience of the peer educators.

Conclusions The intervention is moderately effective in increasing mental health literacy and, to a lesser extent, in reducing perceived stigma. Methodological issues should be resolved in future research. Peer education was an effective tool.