1
|
Bennett H, Allitt B, Hanna F. A perspective on mental health literacy and mental health issues among Australian youth: Cultural, social, and environmental evidence! Front Public Health 2023; 11:1065784. [PMID: 36741953 PMCID: PMC9891461 DOI: 10.3389/fpubh.2023.1065784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
Mental health literacy (MHL) helps improve mental health outcomes and reduce the impacts of mental illness. This study aims to reflect on scientific evidence on MHL levels, barriers to MHL, their impacts on mental health among Australian youth and interventions to overcome these barriers. The factors explored in the Perspective included; influence of social determinants, culturally and linguistically diverse (CALD) communities, help-seeking attitudes and behaviors. MHL intervention programs and MHL for improving mental health outcomes due to the recent COVID-19 pandemic were also explored. Adequate levels of youth MHL significantly improved one's ability to recognize own mental health status as well as provide peer support. Practical considerations such as designing more gender and culturally specific youth MHL programs are proposed.
Collapse
Affiliation(s)
- Hirukshi Bennett
- Public Health Program, Torrens University Australia, Melbourne, VIC, Australia
| | - Ben Allitt
- Higher Education College, Chisholm Institute, Dandenong, VIC, Australia
| | - Fahad Hanna
- Public Health Program, Torrens University Australia, Melbourne, VIC, Australia,Higher Education College, Chisholm Institute, Dandenong, VIC, Australia,*Correspondence: Fahad Hanna ✉
| |
Collapse
|
2
|
Seo YW, Choi BR, Kim MS, Lim MH. Exploring psychopathological and cognitive factors associated with help-seeking intentions among Korean high school students: A cross-sectional study. Medicine (Baltimore) 2022; 101:e29502. [PMID: 35905237 PMCID: PMC9333469 DOI: 10.1097/md.0000000000029502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Competitive college admissions and academic pressure have continuously increased the psychopathological burden of Korean high school students. Seeking help is one of the primary means of managing mental health, and more attention is required. This study aimed to explore the psychopathological and cognitive factors related to the help-seeking intentions of Korean high school students. This cross-sectional study was conducted between July and August 2020 using the General Help-Seeking Questionnaire, Symptom Checklist-90-R, and Mental Health Literacy Scale. Four hundred and twenty-one Korean high school students (275 males, 146 females; average age 17.44 years [standard deviation = 0.651]) completed self-report questionnaires. We performed analysis of variance, Spearman's correlation analysis, and stepwise regression analysis to explore the factors related to help-seeking intentions. The final model showed an explanatory power of 23.6% for the overall variance in help-seeking intentions. Somatization (β = -0.200; P = .001) and hostility (β = -0.203; P = .001) had a negative effect on help-seeking intentions. Further, knowledge of where to seek information (β = 0.230; P < .001) and attitudes promoting recognition and help-seeking behavior (β = 0.095; P = .030) had a positive effect. Students responded to society's negative awareness of mental illness by converting psychopathology into socially acceptable symptoms. Educational support can improve mental health literacy. This study is expected to help improve mental illness awareness and increase adolescents' access to public services.
Collapse
Affiliation(s)
- Yong-Won Seo
- Department of Psychology, Dankook University, Cheonan, South Korea
| | - Bo-Ram Choi
- Department of Psychology, Dankook University, Cheonan, South Korea
| | - Min-Sun Kim
- Department of Psychology and Psychotherapy, Dankook University, Cheonan, South Korea
| | - Myung-Ho Lim
- Department of Psychology and Psychotherapy, Dankook University, Cheonan, South Korea
- *Correspondence: Myung-Ho Lim, Department of Psychology, College of Health Science, Environmental Health Center, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, South Korea (e-mail: )
| |
Collapse
|
3
|
Health Literacy in Early Childhood: A Systematic Review of Empirical Studies. CHILDREN 2022; 9:children9081131. [PMID: 36010022 PMCID: PMC9406303 DOI: 10.3390/children9081131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013–2022. Results show that research focuses on different domains of health literacy for children. In relation to children’s food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents’ knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children’s health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.
Collapse
|
4
|
Afshari R, Kaveh MH, Lankarani KB, Doolub D, Jaafari N, Ostovarfar J. Empowering teachers to screen, guide, and refer schoolchildren with behavioral and mental health problems. A pilot study to promote mental health in Iran. Front Psychiatry 2022; 13:894483. [PMID: 35990076 PMCID: PMC9385954 DOI: 10.3389/fpsyt.2022.894483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Schools are ideal for promoting the mental health of school-age children, but the teachers' current knowledge is insufficient to play an influential role in mental health services at schools. Fortunately, however, teachers have a high sense of responsibility, interest, and talent to receive knowledge and the ability to participate in this field. This study aimed to examine whether a protocol focused on the role of teachers could identify, guide, and care for school-age children with behavioral and mental health problems. METHOD The current research was a "before and after" pilot quasi-experimental study conducted in three elementary, secondary, and high schools. The main intervention consisted of a 5-h workshop based on a ready-to-use booklet for teachers conducted separately in each school. A total of 58 teachers and 872 school-age children were included using a judgmental sampling technique. RESULTS The pre-and post-workshop mean scores of teachers' knowledge about common mental disorders in school-age children were 6.21 ± 4.58 and 12.50 ± 7.27, respectively. According to the Strengths and Difficulties Questionnaire (SDQ), the teachers made 127 referrals, of whom 102 school-age children had problems. Consultants diagnosed 114 school children who reflected 90% of all teachers' recommendations needing psychological care and counseling. Finally, only 50 diagnosed school-age children were followed up and attended therapy sessions at counseling centers. The sensitivity and specificity of this brief intervention in detecting school-age children with psychological problems were respectively 80.3 and 98.0%. CONCLUSIONS This study's results support teacher empowerment training's effectiveness in identifying and guiding school-age children needing mental health care. Psychological counseling programs in schools in various quantitative and qualitative dimensions, including responding to school-age children's needs and psychological problems, should be adequately evaluated, and appropriate measures should be taken to promote mental health services. Collaboration between health systems and the education department will increase the effectiveness of mental health programs' promotion and drug abuse prevention. These pilot data lead the way to designing scientifically sound follow-up studies that will concretely ascertain the benefit of this program.
Collapse
Affiliation(s)
- Ramin Afshari
- Research Center of Social Harms and Substance abuse, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damien Doolub
- Research Center on Cognition and Learning, CeRCA, CNRS UMR, University of Poitiers, University of Tours, Poitiers, France.,Pierre Deniker Clinical Research Unit, Henri Laborit Hospital Centre, Poitiers, France
| | - Nematollah Jaafari
- Pierre Deniker Clinical Research Unit, Henri Laborit Hospital Centre, Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Jeyran Ostovarfar
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
5
|
Patafio B, Miller P, Baldwin R, Taylor N, Hyder S. A systematic mapping review of interventions to improve adolescent mental health literacy, attitudes and behaviours. Early Interv Psychiatry 2021; 15:1470-1501. [PMID: 33393231 DOI: 10.1111/eip.13109] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 12/20/2022]
Abstract
AIM The onset of mental illness is most common in adolescence, therefore mental health promotion efforts frequently target this age group. Evaluation literature in this area is largely segmented into specific domains in terms of settings, countries, and/or groups of young people, but an overall understanding and comparison across these areas is lacking. The current review aims to provide such an overview of interventions/programs which attempt to improve adolescents' mental health literacy, attitudes/stigma and behaviours. METHODS A systematic mapping review synthesized the strengths and weaknesses of published interventions/programs to improve mental health outcomes in youth. Ten databases and grey literature sources were searched, and results were categorized according to sample, location/setting, type of information presented, delivery and testing procedures, mental health outcome/s evaluated, and limitations. RESULTS One hundred and forty articles met the inclusion criteria; 126 were original records and 14 were reviews. Mental health literacy and attitudes/stigma were examined most frequently, and studies were predominantly conducted in school-based environments and high income economies. Intervention/program effectiveness varied across outcome/s measured, setting, and control group usage, with mental health literacy exhibiting the most positive changes overall. Common limitations included no long-term follow up or control group inclusion. CONCLUSIONS Despite generally positive changes seen throughout studies in this area, effectiveness differed across a range of methodological domains. Most research is conducted in schools and higher income economies, but the lack of investigation in other contexts (i.e., internet or community) or lower income countries suggests our understanding in this area is constrained.
Collapse
Affiliation(s)
- Brittany Patafio
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Peter Miller
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Ryan Baldwin
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Nicholas Taylor
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Shannon Hyder
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| |
Collapse
|
6
|
Nobre J, Oliveira AP, Monteiro F, Sequeira C, Ferré-Grau C. Promotion of Mental Health Literacy in Adolescents: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9500. [PMID: 34574427 PMCID: PMC8470967 DOI: 10.3390/ijerph18189500] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022]
Abstract
In recent years, there has been an important commitment to the development of programs to promote mental health literacy (MHL) among adolescents, due to the prevalence of mental health problems and the low level of MHL that affects this group. The aim of this study was to map the structure and context of programmes/interventions for promoting MHL among adolescents in school settings. A scoping review was conducted following the guidelines of The Joanna Briggs Institute. We searched for studies on programmes/interventions promoting at least one of the components of MHL of adolescents, written in Portuguese, English or Spanish, published from 2013 to 2020, in MEDLINE, CINAHL Plus with Full Text, SciELO, SCOPUS, OpenGrey, RCAAP and in the article reference lists. This review included 29 articles. The majority of programmes/interventions addressed one or more of the four components of MHL, with the knowledge of mental disorders and stigma reduction components being the most covered; were taught by adolescent's regular teachers; used face to face interventions; had a height variable duration; used non-validated instruments; were implemented in a classroom environment; and showed statistically significant improvements in adolescent's MHL levels. More research is needed to implement/construct programmes/interventions promoting adolescents' MHL concerning knowledge on how to obtain and maintain good mental health.
Collapse
Affiliation(s)
- Joana Nobre
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal; (A.P.O.); (F.M.)
- Corporate Public Entity, Local Health Unit of North Alentejo, 7300-126 Portalegre, Portugal
- Faculty of Nursing, University of Rovira i Virgili, 43003 Tarragona, Spain;
| | - Ana Paula Oliveira
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal; (A.P.O.); (F.M.)
- Faculty of Nursing, University of Rovira i Virgili, 43003 Tarragona, Spain;
| | - Francisco Monteiro
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal; (A.P.O.); (F.M.)
| | - Carlos Sequeira
- Group Inovation & Development in Nursing (NursID), Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), 4200-450 Porto, Portugal;
- Nursing School of Porto, 4200-072 Porto, Portugal
| | - Carme Ferré-Grau
- Faculty of Nursing, University of Rovira i Virgili, 43003 Tarragona, Spain;
| |
Collapse
|
7
|
Shahwan S, Lau JH, Goh CMJ, Ong WJ, Tan GTH, Kwok KW, Samari E, Lee YY, Teh WL, Seet V, Chang S, Chong SA, Subramaniam M. The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students. BMC Psychiatry 2020; 20:562. [PMID: 33238951 PMCID: PMC7690018 DOI: 10.1186/s12888-020-02960-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The reluctance of young adults to seek mental health treatment has been attributed to poor mental health literacy, stigma, preference for self-reliance and concerns about confidentiality. The purpose of this study was to examine the potential impact of an anti-stigma intervention that includes education about depression, information about help-seeking as well as contact with a person with lived experience, on help seeking attitudes. METHODS A pre-post study design was employed. Changes in help-seeking attitudes were measured using the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) immediately post-intervention and after 3 months. Sociodemographic data, information on past experiences in the mental health field and contact with people with mental illness were collated. Three hundred ninety university students enrolled in the study. Linear mixed models were used to examine the effects of the intervention. RESULTS Scores on all subscales of the IASMHS, Psychological Openness (PO), Help-seeking Propensity (HP) and Indifference to Stigma improved significantly post-intervention and at 3-month follow-up compared to pre-intervention, with HP demonstrating the highest effect size. However, a significant decline was observed on all three scales at 3-month follow-up compared to post-intervention. Gender, having friends/family with mental illness, and previous experience in the mental health field moderated the intervention effects for the PO and HP subscales. CONCLUSION The study showed that the brief anti-stigma intervention was associated with improvements in help-seeking attitudes among university students with differential effects among certain sub-groups. As the beneficial outcomes appeared to decrease over time, booster sessions or opportunities to participate in mental health-related activities post-intervention may be required to maintain the desired changes in help-seeking attitudes.
Collapse
Affiliation(s)
- Shazana Shahwan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Chong Min Janrius Goh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Wei Jie Ong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Gregory Tee Hng Tan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Kian Woon Kwok
- School of Social Sciences, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| |
Collapse
|
8
|
Mental Health Literacy, Help-Seeking Behaviour and Wellbeing in Young People: Implications for Practice. EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2020. [DOI: 10.1017/edp.2019.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
9
|
Christie GIG, Cheetham A, Lubman DI. Interventions for Alcohol and Drug Use Disorders in Young People: 10 Key Evidence-Based Approaches to Inform Service Delivery. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00336-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
10
|
Aguirre Velasco A, Cruz ISS, Billings J, Jimenez M, Rowe S. What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review. BMC Psychiatry 2020; 20:293. [PMID: 32527236 PMCID: PMC7291482 DOI: 10.1186/s12888-020-02659-0] [Citation(s) in RCA: 191] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. METHODS Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis. RESULTS Ninety studies meet the inclusion criteria for this review for barrier and facilitators (n = 54) and interventions (n = 36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements. CONCLUSION Most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.
Collapse
Affiliation(s)
- Antonia Aguirre Velasco
- Child and Adolescent Mental Health Service, Children’s Hospital Dr. Roberto del Río, Santiago, Chile
| | | | - Jo Billings
- División of Psychiatry, University College London, London, UK
| | | | - Sarah Rowe
- División of Psychiatry, University College London, London, UK
| |
Collapse
|
11
|
Cheetham A, Sandral E, Lubman DI. Outcomes of reducing stigma towards alcohol misuse during adolescence: results of a randomized controlled trial of the MAKINGtheLINK intervention. Child Adolesc Psychiatry Ment Health 2020; 14:11. [PMID: 32206086 PMCID: PMC7085161 DOI: 10.1186/s13034-020-00317-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/05/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND While it is well-recognized that the stigma associated with alcohol use problems can prevent or delay help-seeking, there is limited research examining stigmatising attitudes towards alcohol misuse, or their consequences, during adolescence. The current study examined the results of a school-based intervention on adolescents' stigmatising attitudes towards alcohol misuse among their peers, and how changes in attitudes influenced intentions to encourage help-seeking, as well as participants' personal use and misuse of alcohol. METHODS Participants (n = 463) were a subset of a larger sample participating in a randomized controlled trial of the MAKINGtheLINK intervention. Of the included participants, 287 (62%) were allocated to the intervention group and 176 (38%) to the control group. Assessments were conducted at baseline and 6-weeks, 6-months, and 12-months post-baseline. At each assessment, participants were presented with a vignette describing a peer experiencing alcohol misuse and completed the General Help Seeking Questionnaire as well as a 10-item scale measuring stigmatising attitudes. Alcohol use was also assessed. RESULTS The intervention was associated with a greater reduction in 'weak-not-sick' attitudes over time, which in turn predicted stronger intentions to encourage help-seeking from family members and formal help sources at the 12-month follow-up. Perceptions of dangerousness did not change significantly as a result of the intervention, however overall perceptions of dangerousness demonstrated a trend towards encouraging help-seeking from formal sources. Changes in stigma were not associated with past-year alcohol use or problems. CONCLUSIONS School-based interventions such as MAKINGtheLINK can decrease some stigmatising attitudes towards alcohol misuse during adolescence, and increase adolescents' intentions to encourage help-seeking from both formal and informal help sources. However, results varied depending on both the dimension of stigma examined and the type of help source, highlighting a complex relationship between stigma, intentions, and sources of help that requires further investigation. Importantly, reducing stigma did not appear to result in negative effects due to greater acceptance of drinking (e.g., heavier alcohol use), supporting continued efforts to reduce alcohol-related stigma during adolescence.Trial registration: Registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (ACTRN12613000235707).
Collapse
Affiliation(s)
- Ali Cheetham
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health, 110 Church St, Richmond VIC, Richmond, VIC 3131 Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - Emma Sandral
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health, 110 Church St, Richmond VIC, Richmond, VIC 3131 Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - Dan I. Lubman
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health, 110 Church St, Richmond VIC, Richmond, VIC 3131 Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| |
Collapse
|
12
|
Lubman DI, Cheetham A, Sandral E, Wolfe R, Martin C, Blee F, Berridge BJ, Jorm AF, Wilson C, Allen NB, McKay-Brown L, Proimos J. Twelve-month outcomes of MAKINGtheLINK: A cluster randomized controlled trial of a school-based program to facilitate help-seeking for substance use and mental health problems. EClinicalMedicine 2020; 18:100225. [PMID: 31922118 PMCID: PMC6948229 DOI: 10.1016/j.eclinm.2019.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Young people experiencing mental health problems are often reluctant to seek help, particularly from professionals (i.e., doctors or mental health workers). MAKINGtheLINK is a school-based intervention that aims to help adolescents overcome barriers to seeking professional help for mental health and substance use problems. METHODS A cluster randomised controlled trial was conducted to evaluate the 12-month outcomes of MAKINGtheLINK among 2447 participants (Mean age=14.9 years, SD=0.5 years, 50% male). Randomisation resulted in 1130 students from 11 schools allocated to receive the intervention, and 1317 students from 10 schools allocated to the wait-list control group. After the baseline assessment, follow-ups were conducted at 6-weeks (n = 2045), 6-months (n = 1874), and 12-months (n = 1827). The primary outcome measure was help-seeking behaviour, from both formal (e.g., health professionals) and informal (e.g., friends, family members) sources. The trial was registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (registration number ACTRN12613000235707). FINDINGS The intervention was not associated with overall help-seeking at the 12-month follow-up (p = 0.99, odds ratio [OR]=1.00, 95% CI for OR = 0.70-1.42), or help-seeking for depression (p = 0.28, OR = 1.21, 95%CI =0.86-1.69), stress and anxiety (p = 0.73, OR = 1.04, 95%CI = 0.74-1.47), or alcohol/other drugs (p = 0.84, OR=1.12, CI=0.37-3.37). However, the intervention was associated with increased help-seeking from formal sources (compared to informal sources) both overall (p = 0.005, OR = 1.81, 95%CI = 1.19-2.75), as well as for depression (p = 0.01, OR=2.09, 95%CI=1.19-3.67), and stress and anxiety (p < 0.006, OR = 1.72, 95%CI = 1.17-2.54). INTERPRETATION Rates of help-seeking remained unchanged following the intervention. However, MAKINGtheLINK effectively improved the quality of adolescent help-seeking behaviour by increasing help-seeking from formal sources. As prompt treatment is essential in reducing the long-term impact of early onset mental health problems, MAKINGtheLINK has the potential to make a significant contribution to existing early intervention and prevention efforts. FUNDING National Health and Medical Research Council (APP1047492).
Collapse
Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
- Corresponding author at: Turning Point, 100 Church St, Richmond, Victoria 3121, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Emma Sandral
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Catherine Martin
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Fiona Blee
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Bonita J Berridge
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Anthony F. Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Coralie Wilson
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
- Graduate Medicine, School of Medicine University of Wollongong, Wollongong, NSW 2522, Australia
- Centre for Personal and Professional Development (CPPD), Wollongong 2517, Australia
| | - Nicholas B. Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3052, Australia
- Department of Psychology, University of Oregon, Eugene 6200, United States
| | - Lisa McKay-Brown
- Travancore School, Victorian Department of Education and Training, Travancore, Victoria 6200, Australia
- Melbourne Graduate School of Education, The University of Melbourne, Victoria 6200, Australia
| | - Jenny Proimos
- Victorian Department of Education and Training, Melbourne, Victoria 6200, Australia
| |
Collapse
|
13
|
Predicting Adolescent Adjustment and Well-Being: The Interplay between Socio-Emotional and Personal Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234650. [PMID: 31766641 PMCID: PMC6926821 DOI: 10.3390/ijerph16234650] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/12/2019] [Accepted: 11/20/2019] [Indexed: 01/07/2023]
Abstract
Social and emotional factors such as emotional competence and self-esteem are protective factors that promote adolescent mental health and well-being. In this paper, we will examine the combined contribution of these socio-emotional factors in addition to personal factors, in the prediction of psychological adjustment and subjective well-being in adolescence. The study included 840 adolescents aged between 12 and 16 years old (M = 13.37, SD = 1.16, 51.4% girls). We measured personal variables (sex, age, number of siblings), socio-emotional variables (emotional competence and self-esteem), psychological adjustment (emotional and behavioural problems) and subjective well-being (life satisfaction and affect balance). Besides descriptive analysis and Pearson bivariate correlations, two different methodologies were performed, including hierarchical regression models and a fuzzy-set qualitative comparative analysis (fsQCA). The results show that emotional competence is a protective factor for optimal adjustment and well-being, and suggest that self-esteem reinforces this relation. Different patterns were observed for female and male adolescents of different ages and with different family backgrounds. The practical implications of our findings for intervention programs have been discussed.
Collapse
|
14
|
Cheetham A, Jorm AF, Wilson C, Berridge BJ, Blee F, Lubman DI. Stigmatising Attitudes Towards Depression and Alcohol Misuse in Young People: Relationships with Help-Seeking Intentions and Behavior. ADOLESCENT PSYCHIATRY 2019. [DOI: 10.2174/2210676608666180913130616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background and Objective:
Adolescents experiencing mental health problems
often approach their peers rather than seeking professional help. A better understanding of
adolescents’ stigmatising attitudes towards mental illness will help inform interventions that
aim to improve the quality of advice that young people provide to their peers. In particular,
there is a need for research examining adolescents’ attitudes towards alcohol misuse, given
it’s increase in prevalence during this period as well as the adverse outcomes that are
associated with untreated early drinking problems.
Methods:
High-school students (n=2447) were recruited as part of an intervention focussed
on overcoming barriers to accessing help for mental health and substance use problems.
Participants were presented with two vignettes that described a peer experiencing depression
and alcohol misuse, respectively, and completed the General Help-Seeking Questionnaire as
well as a 10-item scale measuring stigmatising attitudes. Past helping behavior was also
assessed.
Results:
Compared to depression, a peer experiencing alcohol misuse was more likely to be
considered “weak” rather than sick, and was perceived as more dangerous and unpredictable.
The “weak-not-sick” and “dangerousness” dimensions of stigma predicted weaker intentions
to encourage help-seeking from informal sources, while ‘dangerousness’ predicted stronger
intentions to encourage formal help-seeking. Both dimensions were associated with fewer
instances of past helping behavior.
Conclusion:
Young people stigmatise alcohol misuse more severely than depression.
Overall, stigma was associated with weaker intentions to encourage peers to seek help. While
perceptions of ‘dangerousness’ were associated with stronger intentions to seek help from
formal sources, this association may not translate into actual helping behavior.
Collapse
Affiliation(s)
- Ali Cheetham
- Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Anthony F. Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Coralie Wilson
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | | | - Fiona Blee
- Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Dan I. Lubman
- Turning Point, Eastern Health, Richmond, Victoria, Australia
| |
Collapse
|
15
|
Lubman DI, Cheetham A, Berridge BJ, McKay-Brown L. MAKINGtheLINK: A school-based intervention to improve help-seeking for substance use problems. Early Interv Psychiatry 2018; 12:915-921. [PMID: 28516465 DOI: 10.1111/eip.12402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 08/21/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many young people are reluctant to seek professional help for alcohol and other substance use problems, preferring to rely on family and friends. MAKINGtheLINK is a school-based intervention that teaches adolescents how to help their peers overcome barriers to engaging with professional help. The current study examined the effect of the MAKINGtheLINK programme in a sample of 12- to 15-year-old students. METHODS Participants included 247 Grade 8 students (49% male, 51% female) recruited from 3 schools in Victoria, Australia. Participants completed questionnaires measuring barriers to professional help-seeking, help-seeking intentions and confidence to seek help at 3 time points (pre-intervention, post-intervention and 6-week follow-up). A non-controlled repeated measures design was used to assess the effect of the programme on help-seeking across time points. RESULTS The programme decreased barriers, increased intentions to seek help from formal sources, decreased intentions to seek help from family and increased confidence to seek help for a peer. The decrease in barriers was maintained at the 6-week follow-up, as were decreased intentions to seek help from family members, and increased intentions to seek help from school counsellors and alcohol and drug workers. The effects of the intervention did not differ substantially between males and females. CONCLUSIONS The MAKINGtheLINK is the first intervention to focus on overcoming barriers to help-seeking for substance use problems by helping adolescents develop skills to support their peers. The intervention has promise as a means of facilitating help-seeking during adolescence, although further research is needed to test its effectiveness in a more rigorous design.
Collapse
Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Ali Cheetham
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Bonita J Berridge
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lisa McKay-Brown
- Travancore School, Victorian Department of Education and Training, Melbourne, Victoria, Australia.,Melbourne Graduate School of Education, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Cheetham A, Lubman DI. Adolescents who seek help for depression report greater lifetime use of alcohol and increased experience of alcohol-related problems. Aust N Z J Psychiatry 2018; 52:902-903. [PMID: 29551077 DOI: 10.1177/0004867418763539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ali Cheetham
- 1 Turning Point, Eastern Health, Richmond, VIC, Australia.,2 Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Dan I Lubman
- 1 Turning Point, Eastern Health, Richmond, VIC, Australia.,2 Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| |
Collapse
|
17
|
Olivari C, Guzmán M. Adaptación y Validación del Cuestionario de Barreras para la Búsqueda de Ayuda para Problemas de Salud Mental, en Adolescentes chilenos. UNIVERSITAS PSYCHOLOGICA 2018. [DOI: 10.11144/javeriana.upsy17-1.avcb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
La presente investigación tuvo como objetivo, adaptar y validar en adolescentes chilenos, el cuestionario de barreras para la búsqueda de ayuda para problemas de salud mental, versión breve (BASH-B). Este cuestionario mide las barreras o razones percibidas por los adolescentes para no buscar ayuda profesional cuando presentan algún problema psicológico. Los participantes fueron 387 adolescentes de entre 14 y 19 años (M = 15.71 años), escolarizados en establecimientos de enseñanza media de la comuna de Talca (Chile). Se analizaron las propiedades psicométricas del instrumento. El análisis confirmatorio corroboró la estructura factorial unidimensional. Además, los índices de confiabilidad fueron adecuados. La escala presentó asociación significativa con las variables depresión y autoeficacia en las direcciones esperadas. En base a estos resultados, es posible decir que el BASH-B es un instrumento que posee propiedades psicométricas adecuadas para medir las barreras de la búsqueda de ayuda en el ámbito de la salud mental en adolescentes.
Collapse
|
18
|
Cheetham A, Lubman DI. The Role of Peers on School-Based Prevention Programs Targeting Adolescent Substance Use. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0165-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
19
|
Lubman DI, Cheetham A, Blee F, Berridge BJ, McKay-Brown L. Australian adolescents' understanding of confidentiality in mental health. Aust N Z J Psychiatry 2017; 51:942-944. [PMID: 28669201 DOI: 10.1177/0004867417715917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dan I Lubman
- 1 Turning Point, Eastern Health, Fitzroy, VIC, Australia.,2 Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Ali Cheetham
- 1 Turning Point, Eastern Health, Fitzroy, VIC, Australia.,2 Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Fiona Blee
- 1 Turning Point, Eastern Health, Fitzroy, VIC, Australia.,2 Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Bonita J Berridge
- 1 Turning Point, Eastern Health, Fitzroy, VIC, Australia.,2 Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Lisa McKay-Brown
- 3 Travancore School, Victorian Department of Education and Training, Travancore, VIC, Australia.,4 Melbourne Graduate School of Education, The University of Melbourne, VIC, Australia
| |
Collapse
|
20
|
Lubman DI, Cheetham A, Jorm AF, Berridge BJ, Wilson C, Blee F, Mckay-Brown L, Allen N, Proimos J. Australian adolescents' beliefs and help-seeking intentions towards peers experiencing symptoms of depression and alcohol misuse. BMC Public Health 2017; 17:658. [PMID: 28814325 PMCID: PMC5559792 DOI: 10.1186/s12889-017-4655-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 07/30/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many young people are reluctant to seek professional help for mental health problems, preferring to rely on their friends for support. It is therefore important to ensure that adolescents can identify signs of psychological distress in their peers, talk to them about these, and help them access appropriate services when necessary. The current study examined adolescents' ability to recognise symptoms of depression and alcohol misuse, perceived barriers to help-seeking, and their intentions to encourage a peer to seek help from a range of informal and formal help sources. METHOD The current study used baseline data from a randomised controlled trial of a school-based intervention that teaches adolescents how to overcome barriers to accessing professional help for mental health and substance use problems (MAKINGtheLINK). Participants (n = 2456) were presented with two vignettes portraying depression and alcohol misuse, respectively, and were asked to identify the problems described. Participants provided data on their past help-seeking behaviour, confidence to help a peer, perceived barriers to help-seeking, and intentions to encourage a peer to seek help. RESULTS Health professionals were the main source of help that participants had relied on for depressive symptoms, followed by friends and parents. In contrast, friends were the main source of help that participants had relied on for alcohol and other drug problems, followed by health professionals and parents. Just over half of the sample correctly identified the problems described in the two vignettes, although the majority of participants were confident that they could talk to a peer and help them seek professional help if needed. Most agreed that the vignettes described problems that warranted professional help, however approximately half the sample was unsure or considered it unlikely that they would seek help if they experienced similar problems. For both disorders, participants were most likely to encourage a peer to seek help from their family, followed by formal help sources and friends. CONCLUSIONS While the results point towards a greater willingness to approach formal help sources, particularly for depression, peers remain an important source of support for young people experiencing mental health and substance use problems.
Collapse
Affiliation(s)
- D. I. Lubman
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - A. Cheetham
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - A. F. Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC Australia
| | - B. J. Berridge
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - C. Wilson
- Illawarra Health and Medical Research Institute, Wollongong, NSW Australia
- School of Medicine, University of Wollongong, Wollongong, NSW Australia
| | - F. Blee
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - L. Mckay-Brown
- Travancore School, Victorian Department of Education and Training, Travancore, VIC Australia
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC Australia
| | - N. Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC Australia
- Department of Psychology, University of Oregon, Eugene, OR USA
| | - J. Proimos
- Victorian Department of Education and Training, Melbourne, VIC Australia
| |
Collapse
|
21
|
Educational Level, Underachievement, and General Mental Health Problems in 10,866 Adolescents. Acad Pediatr 2017; 17:642-648. [PMID: 28456580 DOI: 10.1016/j.acap.2017.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 01/26/2017] [Accepted: 04/17/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Previous research suggests that cognitive functioning is associated with the risk of several adult psychiatric disorders. In this study we investigated whether adolescents who perform worse than expected at secondary school are at a higher risk for general mental health problems. METHODS In a cross-sectional survey comprising 10,866 Dutch adolescents aged 13 to 16 years, underachievement at secondary school was defined as the discrepancy between predicted school grade and actual grade 1 or 3 years later. Mental health problems were assessed using the Strengths and Difficulties Questionnaire. We investigated the association of underachievement with mental health problems using logistic regression, adjusting for potential confounders. RESULTS Underachievement was associated with general psychopathology in pupils aged 13 to 14 years (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.47-2.37) and in pupils aged 15 to 16 years (OR, 2.05; 95% CI, 1.67-2.52) in a multivariate analysis including sociodemographic factors. The association between underachievement and mental health problems was attenuated when school factors such as teacher advice and interaction between underachievement and teacher advice were added, but underachievement remained significantly associated with mental health problems in adolescents in the higher educational tracks (pupils aged 13-14 years: OR, 2.22; 95% CI, 1.07-4.60 and OR, 2.41; 95% CI, 1.10-5.30, age 15-16 years: OR, 2.63; 95% CI, 1.38-5.03). In the multivariate analysis including the interaction between underachievement and teacher advice, a significant interaction effect occurs between underachievement and teacher advice in the higher tracks. Values of OR and CI are given for each significant interaction term. In the younger age group (pupils aged 13-14 years) this results in 2 sets of OR and CI. This association was most pronounced for the hyperactivity subscale of the Strengths and Difficulties Questionnaire. CONCLUSIONS Underachievement at secondary school is associated with general mental health problems, especially with hyperactivity symptoms, in pupils who started at high educational tracks.
Collapse
|