Work by Jessica Tomes final year BSc Hons Psychology and Counselling student, submitted for assessment for the Educational Psychology module in the Directorate of Psychology and Public Health,
Work by Jessica Tomes final year BSc Hons Psychology and Counselling student, submitted for assessment for the Educational Psychology module in the Directorate of Psychology and Public Health, University of Salford.
An educational seminar to reduce the stigma attached to mental ill health by encouraging teachers
to educate their students about mental health and the stigma associated with it
Stigma is ‘a sign of disgrace or discredit which sets a person apart from others’ (Bryne, 2000 p. 65).
The stigma associated with mental health can be detrimental to a person’s recovery (Chandra, 2007)
as admitting they have a mental health issue can often leave them feeling isolated and shamed
(What is Stigma, 2008). Most mental health disorders begin in youth (12-24 years) (Patel, 2007). One
in 10 young people will experience a mental health issue, at least three in an average class in the UK
(Myths and Facts, 2008). Research has shown that people who have reduced stigma about mental
health are more likely to seek help if they need it (Leong & Zachar, 1999). Therefore it is important
that the stigma associated with mental health is reduced at an early age as this could give young
people the confidence to seek the help they need early on.
In recent years the government has acknowledged the problem of stigma with the strategy ‘no
health without mental health: a cross-government outcomes strategy for people of all ages’ which
aims to improve the lives of those suffering from mental health issues (DoH, 2011). This strategy set
out six objectives to improve mental health outcomes for individuals and the whole population, the
sixth objective was that ‘fewer people will experience stigma and discrimination’ (Department of
Health, 2011 pp 6). This strategy stated that in order to change stigma, the government will support
and work with programmes such as ‘Time to Change’ (DoH, 2011). ‘Time to change’ is a leading
stigma and anti-discrimination campaign who help young people pick up new skills and improve
their mental health, as well as working to change public behaviour towards people with mental
health problems (DoH, 2011).
Although this policy is in place and Time to Change have done amazing work, research suggests that
in order for stigma to be significantly reduced, the topic of mental health must be taught in schools.
Students attitudes will be modified and the likelihood of them developing into adults who stigmatize
against people with mental health issue, will be reduced therefore building towards less stigma in
society as a whole (Corrigan et al. 2005).
In a 2012 blog, Simon Barber discusses the stigma attached to mental health problems in schools.
Barber is a head teacher and in his experience he has noticed a decrease in homophobic and racist
language in schools and an increase in mental health stigmatising language, such as ‘mental’. He asks
“Is ‘mental’ the new ‘gay’”? Furthermore Barber has found that when comparing the reactions to
the suicide of Gary Speed and the heart attack of Fabrice Muamba, it was easier to talk about
Fabrice’s heart condition, the reaction from teachers, students and parents was that this could
happen to them, whereas with Gary’s mental health issues discussions were uncomfortable and no
one accepted the idea that this could happen to them or a family member. He also found that
teachers did not feel empowered to talk about the issue. Barber suggests that an open discussion
around the issues surrounding mental health and the stigmatising language is needed in schools, as
they have done in the past with racist and homophobic language. He further argues that young
people need to be given the emotional tools to express and discuss their feelings, as “we are in
danger of avoiding the part that mental health so often plays in their lives” (Barber, 2012).
Research in this area has found that stigma towards people with mental health problems starts at
preschool and continues into early adulthood (Byrne, 2000). With stigma developing this young
surely it can be argued that there is a need to change young peoples’ views, one way of doing this is
through education. Farmer et al (2003) investigated the effectiveness of an intervention with young
people aimed at increasing mental health literacy and challenging negative stereotypes. A total of
472 secondary students attended two mental health awareness workshops, completing pre- and
post-questionnaires. They found young people had a vocabulary of 270 words and phrases to
describe people with mental illness, most were derogatory. They also found an increase in positive
attitudes towards mental illness, particularly in female students and those who have had contact
with a person suffering from mental illness. A similar study was conducted in the US by Corrigan et
al., (2004). They launched a field test of the curriculum supplement The Science of Mental Illness for
middle school students. They found, through pre and post measures, that the curriculum produced
significant improvements in the knowledge and attitudes of the students. These studies show that
short educational interventions can help improve knowledge and reduce the stigma associated with
Reducing the stigma of mental health will improve teaching and learning as it will hopefully
empower teachers to talk about mental illness and the effects it has on people, family and society.
Furthermore reducing stigma can make mental health more comfortable for students to talk about
and, as one in ten young people suffer from mental illness, it is expected that they will be more
willing to seek help; due to research showing that people holding less stigma are more likely to get
support (Chandra, 2007; Guangrong & Mian, 2007; Leong & Zachar, 1999). Finally it is expected that,
as argued above, young people will grow into adults with reduced stigma therefore creating a
reduced stigma society (Corrigan et al, 2005).
This seminar will be available to head of year tutors for secondary schools in the United Kingdom.
This is because the head of year tutors will be able to pass on the information gained in the seminar
to the personal tutors, and other tutors they feel the information is relevant to, and introduce the
idea of teaching about mental health and stigma in their school. By the end of the session each head
of year will have worked in a team in order to develop an effective teaching strategy appropriate for
their year group, which can be passed on to the school.
Method of delivery, level of audience participation, and theory justification
This seminar will be split into two sessions. There will be powerpoint presentations and group work
in both sessions and the morning session will also include a short internet video clip and examples of
blogs by young people.
Throughout the day participants will be involved in a number of whole group discussions. Research
has found that discussing controversial issues increases knowledge and encourages a deeper
understanding of the issues presented (Johnson & Johnson, 1999 cited in Slavin, 2003). Furthermore
in social psychology is has been established that group discussion, particularly when members must
be publically committed, is more effective at challenging individual attitudes and behaviours than a
persuasive lecture (Slavin, 2003). In order for group discussions to be effective the participants must
have enough prior knowledge about the topic as this enables an intellectual discussion (Ormrod,
2006). It is for this reason that participants will receive the powerpoint presentations.
As well as whole group discussions, participants will be involved in two small-group tasks. In the first
task they will be put into groups of three or four. They will be given an envelope and asked to each
wear the plaster inside. The plasters will have an age and a mental health disorder written on it. This
idea was developed from Dr Linda Dubrow-Marshall’s (2012) ‘labels hurt’ blog post, where she
describes how she got her psychology of mental health class to wear the plasters, which had a
mental health diagnosis on it. She asked them to reflect on what their life would be like if they had
this diagnosis and then feedback to their group. This task uses experiential learning in order to help
the participants involved understand what it is like to be labelled with a mental health disorder.
Experiential learning theory holds the view that we learn by experience. Within this theory it is made
aware that concrete experience, active conceptualisation, reflective observation and active
experimentation can deepen a persons’ understanding of a topic (Boyatzis, Kolb & Mainemelis,
The second small-group task will take place in the afternoon; the groups will be asked to develop an
effective and appropriate lesson plan for teaching mental health and stigma. The reasoning behind
working in small groups is due to Vygotsky’s sociocultural theory of learning, more specifically the
idea of the Zone of Proximal Development (ZPD). In the traditional sense the ZPD represents a child’s
current development level and with the aid of adults or more able peers they expand their ZPD
therefore expanding their knowledge and understanding of a given topic (Woolfolk, 2007). In this
case each teacher will be bringing with them their own unique experiences. Therefore it is expected
that they will work with each other and discuss where they have failed and succeeded in planning
and delivering lessons in the past in order to develop the most effective lesson plan. Motivating the
participants to learn and become actively involved in the seminar is a key issue. It has been
suggested that working in enjoyable small groups helps motivate people to work and be productive
Finally participants will read two blogs by young people with mental health problems and watch two
video clips about stigma. It is hoped that these tasks will help increase empathy and understanding
as participants will be seeing real world examples of the effects of stigma. These activities offer a
more interactive and dynamic approach to learning about the effects of stigma.
9:00 Before the session begins participants will be involved in a small ice breaker where they will
share their name, the year they are head of and one thing they enjoy about their job. This will
hopefully help relax the environment and help with the group tasks as they will already know each
other’s names. Following this they will be told that the seminar will be split into two sessions, the
first half focusing on the stigma of mental health and the second half focusing on how mental health
can be taught in secondary schools.
9:15 Participants will be asked to write down one word they associate with the following mental
health disorders; schizophrenia, depression, bipolar and social anxiety disorder. These answers will
be collected and discussed. Any negative answers such as ‘violent’, ‘suicidal’, ‘unstable’ or ‘quiet’ will
be discussed in terms of stigma and self-fulfilling prophecy. The self-fulfilling prophecy is usually
described as an authority figure having expectations of someone, and these expectations either
directly or indirectly lead to the expected outcome (Ormrod, 2006). However in a more general
sense they occur when an initially flawed social belief leads to its own fulfilment (Merton, 1948,
cited in Chatman et al., 2000). It can therefore be argued that these self-fulfilling prophecies can be
used to sustain a social stigma, as stigmatizers can point at certain behaviours and call it evidence
therefore justifying their discrimination for a certain group of people (Chatman et al., 2000). In this
seminar the idea that mental health stigma can lead to self-fulfilling prophecies and the impact this
has on society and individuals will be introduced.
9:45 Participants will be presented with a short PowerPoint presentation. This will explain that
mental health stigma is the perception that people with mental health disorders are “weak, flawed,
dangerous and socially incompetent” (Wahl & Harman, 1989; Wahl, 2003; cited in; Chandra, 2007, p.
764). They will be shown research evidence that shows that mental illness begins in youth (Patel,
2007) and that one in ten young people will suffer from it (Myths and Facts, 2008). Furthermore they
will be shown evidence that shows stigma is detrimental to a sufferer’s condition (Bradley & Brown,
2002; Downs et al, 2009; Good et al, 2000; & Wahl, 1999) and that the reduction of stigma will
increase the likelihood that a sufferer will seek help (Chandra, 2007; Guangrong & Mian, 2007;
Leong & Zachar, 1999). The government strategy ‘no health without mental health’ (DoH, 2011) will
be addressed. This will lead to introducing the charity Time to Change and details about what the
charity aims to do and how they fight mental health stigma. Simon Barker’s (2012) blog post will also
be shown and participants will be asked to read it and they will be invited to briefly discuss what
they think; is ‘mental’ the new ‘gay’? Do/would they feel uncomfortable talking about mental health
issues with their students? Finally research to show the effectiveness of educational intervention in
reducing stigma in young people (Farmer et al, 2003; & Corrigan et al, 2004) will be presented.
10:30 Participants will be asked to read two blog posts. The first blog is by Stephen (2012), 19, who
talks about his personal struggle with bipolar II; how he was too ashamed to go to school when he
was first diagnosed and ended up working from home, how anxious he was to go to sixth form and
how he found the courage to fight on and continue with education. The second blog is by Sian
(2012), 20, who talks about how before she had experienced mental health problems she did not
know a lot about them and did hold some level of stigma herself. She also talks about how her
condition has been met with ignorance over the years and the stigma she has experienced from
11:00 There will be a short break here.
11:10 Participants will be put in small groups of three or four. They will each receive an envelope
containing a plaster with a mental health disorder written on it and an age, for example ‘bipolar, age
15’ and a piece of paper with a short description of what the disorder involves. They will be asked to
wear the plaster and will be given 10 minutes to reflect on; what it is like to wear the label, how they
think people close to them will treat them and how they feel society will treat them. They will then
be asked to discuss their reflections in their groups. This idea was developed from Dr Linda Dubrow-
Marshall’s (2012) ‘labels hurt’ blog post and uses experiential learning.
11:40 For the concluding part of the morning participants will be shown two videos from the Time to
Change website, the first is called “What Does Mental Health Stigma Feel Like.” This video shows
young girls with mental health difficulties talking about how it felt when they were exposed to
stigma in their schools. One girl, Emily, told her close friends about her mental health problems and
this circulated around the school. Emily was labelled a ‘liar’, ‘attention seeking’ and ‘dangerous’,
leaving her feeling alienated. Another girl, Cassandra, explains that she went to a member of staff in
her school for help when she started hearing voices. The staff member told her that the voices were
“imaginary Friends”, (Time to Change, 2012). The second video that will be shown is “The Stand Up
Kid”, this shows a young man standing up in class talking about his depression and how hard it is to
get out of bed to go to school on his low days. As the video ends the following statement is shown “3
of your classmates will experience a mental health problem...” These are powerful videos to end the
morning session with and it is hoped that participants go away with these issues at the forefront of
their minds, hopefully realising why stigma needs to be reduced in schools.
13:00 Teachers will be given a brief presentation on the following topics:
1) Vygotski’s Socio-cognitive theory: Learning from peers through social interactions,
(Woolfolk, 2007). The ideas of the ZPD and scaffolding will be presented, along with the
advantages of group work (Slavin, 2003). Within this theory is the idea that cultural tools
such as computers can not only allow communication but also create knowledge (Woolfolk,
2007). For this reason technology in the classroom will be discussed.
2) Technology as a learning tool: The benefits of using technology and multimedia in the
classroom will be presented. For example video clips from websites such as YouTube that
are topically relevant can be used to make learning fun, increase understanding and set the
appropriate mood for the lesson (Berk, 2009).
3) Experiential learning: Learning through experience, this can be; concrete experience, active
conceptualisation, reflective observation or active experimentation and can deepen persons’
understanding of a topic, (Boyatzis, Kolb & Mainemelis, 1999). These terms will be explained
4) Motivation: Motivating students to learn can be challenging for teachers. The idea that the
use of incentives and rewards with students to encourage extrinsic motivation (Woolfolk,
2007) will be discussed.
14:30 Participants will be split into five groups, one group per school year; so all year 7 head of years
will be in group one etc. They will be asked to take into consideration; all of the information on
mental health, stigma and self-fulfilling prophecies they have been given, all of the activities from
the morning and the theories discussed above to come up with an effective and age appropriate
lesson plans for their students.
15:00 The lesson plans will be presented and there will be opportunities to ask the groups any
questions at the end of their presentation.
16:00 Participants will then be asked if they think teaching the topic of mental health to their
students is a good idea. Finally they will be encouraged to keep in touch and share any further ideas
they may have by being made aware of the teacher’s online forum ‘TES’.
It is expected that participants will understand the stigma attached to mental health and the affect it
has on young people who suffer from mental illness. Furthermore it will be expected that they will
understand the importance of teaching about mental health and stigma to young people. Finally
their understanding of the socio-cognitive theory, technology as a learning tool, motivation and
experiential learning, will have enabled them to create effective and age appropriate lesson plans for
teaching mental health and stigma. An effective lesson plan will increase not only their students’
knowledge and understanding, but will increase their empathy for people suffering with mental
illness and essentially reduce the stigma they hold.
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