Mental Health Awareness Among Parents in an Urban High School

MENTAL HEALTH LITERACY 6 Mental health literacy has been positively correlated with levels of service utilization and negatively correlated with levels of stigmatizing attitudes. The research is sparse in measuring parents’ levels of mental health knowledge and even less research exists measuring parents’ ability to locate resources in their community. The current study focused on parents in an urban high school in Western, New York. In this study, six participants completed a survey assessing their ability to identify the symptoms of mental illness and locate resources in the community. The results showed that participants were able to correctly identify four common mental illnesses. The results also suggested that parents would encourage their children to seek professional help and that most knew of resources in the community that can provide that help. Participants felt less confident in their ability to access community agencies for information and support. Mental Health Awareness Among Parents in an Urban High School MENTAL HEALTH LITERACY 7 The symptoms of mental illness typically arise during childhood and adolescence (Kessler et al., 2007). Despite 1 in 5 children between the ages of 9-17 having a diagnosable mental illness, only 20% of these children receive mental health services (DHHS, 1999; DHHS 2000). Factors preventing children from receiving help include socioeconomic status, parental mental health knowledge, and levels of stigma (Mendenhall, 2012). The American School Counseling Association stated that counselors have a responsibility to collaborate with stakeholders to ensure that families are aware of mental health issues and have access to mental health care (ASCA, 2009). Virtually no research exists that sets to establish a baseline level of understanding in a population of parents of high school students. The purpose of this study is to attempt to establish a baseline understanding of the research questions what do parents know about mental illness and how effective would parents be able to access help for their loved ones if they were experiencing the symptoms of mental illness. Research suggests that cultural factors play a significant role in development of stigmatizing attitudes and views on mental illness. This study sought to examine parental responses specifically from an urban school district. The results of this study will be provided to Student and Family Support Services within the school for possible incorporation into future parent events. The primary research questions are: What do parents know about mental illness and how effectively can parents access help for their loved ones if their loved ones were experiencing the symptoms of mental illness. This study examines these questions using a correlational quantitative non-experimental design. Several themes were explored throughout the research, including the impact of psychoeducational programs on levels of mental health literacy, the effect of stigma on mental health literacy, the need for increasing mental health first aid MENTAL HEALTH LITERACY 8 knowledge, and the impact of both stigma and mental health literacy on levels of service utilization. This study assumes that all returned surveys were completed by parents of the high school targeted. It is technically possible that the survey was received by the student or other member of the household and was completed and returned. This study also assumes that parents answered truthfully. This study was limited in the amount of surveys returned. Caution should be used when applying the results of this study to the sample population. Another limit of this study was the content of the survey. As indicated in the literature, mental illness is more stigmatized in African-American, Latino, and Asian-American populations. Furthermore research indicates that African-American and Asian-American families are less likely to family issues with strangers (Abdullah & Brown, 2011). For the purpose of this study, the term mental health literacy is defined as knowledge of mental illness. The term student refers to any person enrolled in the high school utilized for the sample population. Stigma is defined as a stereotype surrounding an attribute that is discrediting. Parental stigma is defined as stigma held by the parent. Self-stigma is defined as stigma held by an individual about a personal attribute that the individual possesses. In sum, this study aimed to identify a baseline level of understanding of urban high school students’ parents of mental illness and their ability to access help. Understanding the knowledge gaps would be helpful in providing the school with informational needs of parents surrounding mental illness in an attempt to assure that all families have access to mental health care. The low response rate prevents meaningful interpretation of the results as they cannot be confidently applied to the population from which the sample was derived. Review of the Literature MENTAL HEALTH LITERACY 9 The American School Counseling Association (ASCA) states that school counselors have a responsibility to promote mental health awareness. Furthermore, their official position on student mental health states that school counselors will “advocate and collaborate with school and community stakeholders to ensure that students and their families have access to mental health service” (p.50). Mental health issues impact people of all ages, but the symptoms often show up in childhood or adolescence (Kessler et al., 2007). According to the literature, many people struggle to recognize mental illness in others and those that do are unaware of where to turn for help (Jorm, et al., 1997; Mendenhall, 2012). Adults often do not know how to provide help children with mental health symptoms, and thus give advice that may be unhelpful (Jorm, Wright, & Morgan, 2007; Kelly, et al., 2011). Only a fraction of children, experiencing mental health difficulties, utilize services (DHHS, 2000), and often only for a limited time (BurnettZiegler & Lyons, 2010). Mental health symptoms often emerge during the ages in which youth are still living at home with their parents (NIMH, 2005). Although the research is lacking in studies that examine the mental health educational programming for parents, the research does suggest that individuals, who have a better understanding of mental health issues, are able to provide more effective help to those in need (Barrio & Yamada, 2010; Kelly et al., 2011; Mendenhall, 2010). Children living in poverty have been found to be at greater risk of developing mental illness (Farahmand, Grant, Polo & Duffy, 2011). Young people living in urban areas experience discrimination, poverty, and failing schools, which create feelings of powerlessness (Feldman, 2008), increasing their risk of developing mental illness. Programs targeting schools that serve underrepresented urban populations could mitigate the risk of developing these individuals developing a mental illness. MENTAL HEALTH LITERACY 10 Community-based interventions are still needed to help dispel myths of mental illness and decrease stigmatizing attitudes (Elkington et al., 2010). Studies show increasing mental health knowledge reduces stigma (Fritz, 2007; Jorm, Kitchener, Fischer, & Cvetkovski, 2010; Lopez et al., 2007, Pinto Foltz, Logsdon, & Myers, 2011, Wang & Lai, 2008; Yau, Pun, & Tang, 2011). Interventions aimed at increasing this knowledge are necessary in combating childhood mental illness. Children are often unable to initiate treatment without the assistance of a caregiver. Even if the child is willing to enter treatment, parental views can impact whether they ultimately receive services. If stigmatizing views held by parents can be changed by increased education and awareness, it could have a positive impact on children’s likelihood of receiving services. Rates of mental illness vary by gender, race, socioeconomic status. The majority of the research shows that Caucasians have higher rates of mental illness than their African-American and Latino counterparts (NIMH, 2008; SAMHSA, 2010). Some of the research, however, indicates that Latino females have the highest rates of mental illness (McLaughlin, Costello, Leblanc, Sampson, & Kessler, 2012) and other research indicates that African-Americans have higher rates of mental illness (DHHS, 1999). The research is consistent in finding that AsianAmericans have lower rates of diagnosed mental illness than Caucasian, Latino, or AfricanAmerican individuals. Self-reported levels of discrimination have been linked to a higher risk of mental illness (Gee, Ryan, Laflamme, & Holt, 2006; Williams, Yan, & Jackson, 1997). Although there may be discrepancies in the prevalence of mental illness among different racial groups, groups experiencing larger amounts of discrimination are at a higher risk of developing mental illness. Mental Health Literacy MENTAL HEALTH LITERACY 11 Jorm et al. (1997) defined mental health literacy as the “knowledge and beliefs about mental disorders which aid in their recognition, management, or prevention” (p. 182). Research revealed that levels of mental health literacy were negatively correlated with stigmatizing attitudes (Chandra & Minkovitz, 2006; Wang & Lai, 2008) and positively correlated with increased service utilization (Amone-P’Olak et al., 2010; Masuda, Anderson, & Edmonds, 2012; Mendenhall, 2012). Research was conducted on levels of mental health literacy in both the general population and within specific cultures (Lazaratou, Anagnostopoulos, Alevizos, Haviara, & Ploumpidis, 2007; Lopez et al., 2009). Power (2010) suggested that evidence-based promotion of mental health information would increase both public understanding and acceptance of mental health disorders. A few studies that examined the effect of different programs aimed at increasing mental health literacy (Barrio & Yamada, 2010; Dietrich, Mergl, Freudenberg, Althaus, & Hegerl, 2010; Lo