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Educational psychology seminar assignment: Jessica Tomes

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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.

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  • 1. 1 Jessica Tomes 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 Rationale 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
  • 2. 2 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 mental health. 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). Intended audience 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
  • 3. 3 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, 1999). 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 (Ormrod, 2006). 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. Planned content Morning (9:00-12:00) 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.
  • 4. 4 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 peers. 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
  • 5. 5 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. Afternoon (13:00-16:30) 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 with examples. 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.
  • 6. 6 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’. Intended outcomes 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. References Barber, S. (2012, 14 April). Time to Stop Stigmatising Mental Health Problems at School. [Weblog]. Retrieved from: http://www.guardian.co.uk/teacher-network/teacher-blog/2012/apr/14/mental- health-stigma-school
  • 7. 7 Berk, R. A. (2009). Multimedia teaching with video clips: T.V., movies, YouTube and MTVU in the college classroom. International journal of technology in teaching and learning, 5 (1), pp 1-21. [Electronic Version]. Retrieved From: http://www.sicet.org Boyatzis, R.E., Kolb, D.A & Mainemelis, C. (1999). Experiental Learning Theory: Previous Research and New Directions. [Electronic version] Retrieved from: http://learningfromexperience.com/research_library/experiential-learning-theory/ Bradley, L. & Brown, K. (2002). Reducing the stigma of mental illness. Journal of Mental Health Counselling, 24 (1), pp 81-87. Retrieved from: http://psycnet.apa.org Byrne, P. (2000). Stigma of mental illness and ways of diminishing it. Advances in Psychiatric Treatment, 6 (1), pp 65-72. DOI: 10.1192/apt.6.1.65 Chandra, A. & Minkovitz, C. (2007). Factors that Influence Mental Health Stigma among 8th Grade Adolescents. Journal of Youth and Adolescence, 36 (6), pp 763-774. DOI: 10.1007/s10964-006-9091-0 Chatman, C., Jessim, L., Madon, S., Palumbo, P., & Smith, A. (2000). Stigma and Self-Fulfilling Prophecies. In T. Heatherton, M. Hebl, J. Hull, & R. Kleck (Eds.), The Social Psychology of Stigma (pp. 374-418). New York: Guilford Press. Corrigan, P.W., Fenton, W. S., Gardner, A.L., Lamb, T. A., Otey, E., Watson, A.C. & Westbrook, A. L. (2004). Changing Middle Schoolers' Attitudes About Mental Illness Through Education. Schizophrenia bulletin, 30 (3), pp 569-572. Retrieved From: http://schizophreniabulletin.oxfordjournals.org Corrigan, P.W., Goldman, H.H., Lurie, B.D., Medasani, K., Phelan, S. & Slopen, N. (2005). How Adolescents Perceive the Stigma of Mental Illness and Alcohol Abuse. Psychiatric Service, 56 (5), 544- 550. Doi: 10.1176/appi.ps.56.5.544 Department of Health. (2011). No health without mental health: a cross-government mental health outcomes strategy for people of all ages. [Electronic Version]. Retrieved from: http://www.dh.gov.uk Department of Health. (2011). £20 million to knock down mental health stigma. Retrieved from: http://mediacentre.dh.gov.uk/2011/10/10/20-million-to-knock-down-mental-health-stigma/ Downs, M., Eisenberg, D., Goldberstein, E., & Zivin, K. (2009). Stigma and Help Seeking for Mental Health Among College Students. Medical care research and Review, 66 (5), pp 522-541. doi:10.1177/1077558709335173 Dubrow-Marshall, L. (2012, 7 November). Labels Hurt. [Weblog]. Retrieved from: http://hub.salford.ac.uk/salfordpsych/2012/11/07/labels-hurt/ Good, G., Komiya, N. & Sherrod, N. Emotional openness as a predictor of college students' attitudes towards seeking psychological help. Journal of Counselling Psychology, 47 (1), pp 138-143. DOI: 10.1037/0022-0167.47.1.138 Guangrong, J & Mian, X. (2007). Relationship among attribution, self-efficacy, perceived social Acceptance, and help-seeking behaviour. Acta Psychologica Sinica, 39 (5), pp. 892–900. Retrieved from: http://118.145.16.229:81/Jweb_xlxb/CN/Y2007/V39/I05/892
  • 8. 8 Leong, F. & Zachar, P. (1999). Gender and opinions about mental illness as predictors of attitudes toward seeking professional psychological help. British Journal of Guidance & Counselling, 27 (1),pp 123-132. DOI:10.1080/03069889908259720 Myths and Facts. (2008). Retrieved 19th December, 2012, from: http://www.time-to- change.org.uk/youngpeople/myths-and-facts Ormrod, J. E. (2006). Educational Psychology: Developing Learners (5th ed.). New Jersey: Pearson Educaton, Inc. Wahl, O. (1999). Mental health consumers' experience of stigma. Schizophrenia Bulletin, 25 (3), pp 467-478. Retrieved from: psycnet.apa.org Patel ,V., Flisher, A., Hetrick S. & McGorry, P. (2007). Mental health of young people: a global public- health challenge. Lancet, 3(69), pp 1302–1313. Farmer, P., Graham, T., Huxley, P., Pinfold, V., Thornicroft, G. & Toulmin, H. (2003). Reducing Psychiatric Stigma and Discrimination: evaluation of educational interventions in UK secondary schools. The British Journal of psychiatry, 182, pp 342-346. DOI: 10.1192/bjp.02.357 Sian. (2012, 27 July). Until it Affected Me, I Knew Nothing about Mental Health. [Weblog]. Retrieved from: http://www.time-to-change.org.uk/blog/knew-nothing-about-depression-until-affected-me Slavin, R. E. (2003). Educational Psychology: Theory and Practice (7th ed.). London: Allyn and Bacon. Steven. (2012, 3 May). Mental Health Discrimination: The Last Taboo? [Weblog]. Retrieved From: http://www.time-to-change.org.uk/blog/mental-health-discrimination-school Time to Change. (2012). The Stand Up Kid. [E-Video]. Retrieved From: http://www.youtube.com/user/ttcnow2008?feature=watch Time to Change. (2012). What Does Stigma Feel Like? [E-Video]. Retrieved From: http://www.youtube.com/user/ttcnow2008?feature=watch What Is Stigma. (2008). Retrieved 19th December, 2012, From: www.time-to- change.org.uk/youngpeople/what-stigma Woolfolk, A. (2007). Educational Psychology (10 ed.). Boston: Pearson Education, Inc.