School-based interventions to address the stigmaassociated with mental health problems.

Section A is a systematic review of the literature surrounding school-based interventions to address the stigma faced by people diagnosed with mental health problems. It asks the question of what the role of these interventions currently and potentially is and what is important for their efficacy. It begins by acknowledging the problem that stigma and discrimination presents, identifying what leads to and perpetuates this stigma. It then presents key theoretical and empirical contributions to our understanding of stigma and also to our understanding of how learning develops and attitudes form. The review goes on to look at what has been done in schools to date and highlights ‘active ingredients’ in these programmes, discussing the extent to which the current picture addresses theoretical and empirical contributions. Suggestions for further research are provided. Section B provides the findings of a grounded theory study investigating how primary school teachers communicate with children about mental health problems. Individual semi-structured interviews were carried out with fifteen teachers in three state schools. A model of communication is presented, which explains why discussions about mental health problems are absent from the primary school classroom. There appear to be a number of reasons for this. Teachers have fears about the implications of talking about mental health problems with children. These are connected to their beliefs and fears regarding those with mental health problems, their beliefs about mental health problems in relation to children and its place in the classroom, and about their professional roles. Relating to theory, teachers perceive themselves as part of a homogenous ‘in-group’ as distinct from a homogenous ‘out-group’ with mental health problems. Fears, beliefs and ingroup perceptions lead teachers to ‘play safe’ and avoid conversations about mental health problems in the classroom. This absence of discussion may reinforce for children that mental health problems are taboo. Greater links are required between schools and mental health services, and clinical psychologists need to be proactive in influencing policymakers by promoting the argument that teaching on mental health problems has an important place within the British school curriculum. Section C is a critical appraisal of this research, including discussion of the experience of being a researcher throughout this process. Consideration is given to the skills developed, areas where they may need to be expanded upon, areas where things could have been done differently, as well as research and clinical implications of the findings.