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      Sustained improvements in students’ mental health literacy with use of a mental health curriculum in Canadian schools

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          Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum ( The Guide) in enhancing mental health literacy in Canadian schools.


          We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students’ mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen’s d value to determine the significance and impact of change.


          There were 265 students who completed all surveys. Students’ knowledge significantly improved between pre- and post-tests ( p < 0.001; d = 0.90) and was maintained at follow-up ( p < 0.001; d = 0.73). Similarly, attitude significantly improved between pre- and post-tests ( p < 0.001; d = 0.25) and was significantly higher at follow-up than base-line ( p < 0.007; d = 0.18)


          The Guide, applied by usual teachers in usual classroom curriculum, may help improve student knowledge and attitudes regarding mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.

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          The online version of this article (doi:10.1186/s12888-014-0379-4) contains supplementary material, which is available to authorized users.

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          "Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment.

          To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy"). A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia. A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette. Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics. If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.
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            Ottawa charter for health promotion.

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              Health literacy: addressing the health and education divide.

               I S Kickbusch (2001)
              Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.

                Author and article information

                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                31 December 2014
                31 December 2014
                : 14
                : 1
                [ ]Faculty of Social Work, University of Calgary, Halifax, Canada
                [ ]Department of Psychiatry, Dalhousie University and Sun Life Financial Chair in Adolescent Mental Health, Halifax, Canada
                [ ]Sun Life Financial Chair in Adolescent Mental Health team, Dalhousie University and IWK Health Centre, Halifax, Canada
                [ ]Adolescent Unit, Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
                [ ]IWK Health Centre, 5980 University Avenue, NS B3K 6R8 Halifax, NS Canada
                © McLuckie et al.; licensee BioMed Central. 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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