A mental health promotion approach to reducing discrimination about psychosis in teenagers

Publication Year


Journal Article

Aim: To examine the effectiveness of a psychosocial mental health promotion workshop, involving an ex‐service‐user researcher, in reducing discrimination about psychosis in teenagers.

Hypothesis: Pupils in the intervention condition will express less discrimination about a man characterised as having experienced psychosis immediately after the workshop and at follow‐up, compared with pupils in the control condition.

Method: A cluster randomised trial was carried out in order to take into account the effect of class group. Ninety‐two pupils participated at baseline; 43 pupils were exposed to the intervention and 49 pupils formed the control group. Pupils completed demographic information, questions about their familiarity with people with mental health problems and a questionnaire examining discrimination about psychosis.

Results: Multi‐level modelling was used to analyse the results. Discrimination scores in the intervention group reduced significantly more than the control group immediately after the intervention. This effect was not sustained at 10‐week follow‐up. Brief qualitative feedback from pupils exposed to the intervention indicated that 70% considered the testimonial from the ex‐service‐user researcher to be the most useful.

Conclusion: A short psychosocial intervention involving a testimonial from an ex‐service user can lead to small but significant reductions in teenagers' discrimination about psychosis immediately after the intervention.

Type of Article
Journal Article
Full text

The following is an excerpt of the intervention methodology. For more information, please see the full text of the article on the publisher's website or through your institution's library.


Participants Two hundred and eighteen parents from one secondary school in the North West of England were contacted to invite their children to participate in the study. One hundred and twelve parents provided consent, and 92 of these pupils also opted into the study at baseline. [...] The male to female ratio of the overall sample was 29 (31.5%):63 (68.5%); the age of the participants ranged from 14 to 15; the mean age of the sample was 14.64 (SD=0.48). The majority of pupils described their ethnicity as white British (n=87 [94.6%]), and a small number of pupils described their ethnicity as white other (n=5 [5.4%]). There were 43 pupils in the intervention condition; the male to female ratio of this group was 16 (37.2%):27 (62.8%); the mean age of this group was 14.6 (SD= 0.49). In the control group there were 49 pupils; the male to female ratio of this group was 13 (26.5%):36 (73.5%); the mean age of this group was 14.7 (SD=0.48). [...]

Design A cluster randomised trial was carried out. [...] There were two conditions: an intervention condition where pupils were exposed to the mental health promotion workshop and a control group where pupils only completed the measures at each time point. The three time points for data collection were baseline, immediately after the intervention and at 10-week follow-up.


Personal information Participants completed information about their age in years, gender, ethnicity and their class group.

Corrigan’s Attribution Questionnaire [AQ] This is a measure of attributions, emotions and behaviours relating to people with severe mental “illness”. In the main body of the questionnaire (the 6 familiarity items were administered but not included in the analysis) there are 21-items rated on a 9- point scale (1=not at all, 9=very much). The measure has 8 subscales including responsibility and dangerousness attributions, feelings of pity, fear and anger and behaviours including help, avoidance, and coercion/segregation. [...]

Outcome variable “discrimination” Three of the AQ subscales (fear, anger and coercion/segregation) were selected to form the outcome variable called “discrimination”. A single outcome variable was created to allow for a targeted analysis to be carried out and therefore minimise type 1 error. [...]

Brief qualitative feedback Pupils in the intervention condition were also asked: “what aspect of the workshop did you find most useful?”


Randomisation The population was already divided into 10 clusters (Maths classes) on the basis of ability. There were four high-ability sets, four mid-ability sets and two low-ability sets. Stratified random sampling was employed to ensure that there was an equal level of ability in each of the two conditions (classes were randomised to conditions). Intervention Overall, the workshop was based on the stress–vulnerability model and took a normalising approach to understanding mental health problems and psychosis based on the fully dimensional model. This approach considers psychotic traits to be descriptors of individual differences, just like any other personality characteristics. These traits are seen to predispose people to develop psychosis. The primary aim of the intervention was to normalise all mental health problems, including psychosis. [...] Prior to the intervention the questionnaires were administered (25 minutes). The intervention was divided into two parts. The first part was an interactive presentation (delivered by MC) regarding psychosocial approaches to mental health and mental health problems. This presentation lasted approximately 25 minutes and the main topics covered included good mental health, stress, naming mental health problems, lifetime prevalence statistics, naming famous people who have experienced mental health problems, and mental health and psychosis: how we can all be fooled by our perceptions. The second part was a presentation about a personal experience of psychoticlike experiences by a service user researcher (RB). [...]

Type of Prejudice/Bias