School violence: A preventable public health problem

School health curriculum interventions that change mental illness stigma could help reduce school violence and bullying for students with mental health problems
November 23, 2020

Researchers at Texas A&M University are uncovering effective strategies for reducing school violence including bullying, harassment, weapon use and cyberbullying.

In a recently study published in the Journal of School Health, Melissa DuPont-Reyes, PhD, MPH, assistant professor at the Texas A&M University School of Public Health, investigated the effectiveness of mental illness anti-stigma interventions in reducing peer violence among students with and without mental health problems. The findings of the study suggest that a curriculum intervention lessened peer violence victimization and perpetration.

Although anti-bullying interventions have been successful in reducing school violence in previous studies, no study has evaluated whether anti-bullying interventions can specifically reduce violence for students with mental health problems. This is a particularly important knowledge gap since mental health symptoms are associated with experiencing violence. Those with mental health problems are more likely to be victims than perpetrators of violence, as well as “bully/victims”—those who simultaneously are victims and perpetrators of violence among peers.

Using a randomized-controlled trial among 14 schools in an urban school district in Texas, the study tested the effectiveness of a novel, mental health anti-stigma “curriculum” intervention, and a “contact” intervention with two young adults with mental illness, against a control group. The curriculum intervention was designed to promote the acceptance of differences, foster empathy and change mental illness stigma. The contact intervention involved a discussion with two young adults who shared their experiences relating to their mental illness diagnosis and treatment.

“Previous studies have identified how anti-bullying interventions can effectively reduce school violence, but it is unknown how these interventions extend to students with mental health problems specifically, as these students are more likely to experience bullying and peer violence at school in general compared to not experiencing any bullying or violence at all,” DuPont-Reyes said. “A mental illness anti-stigma intervention that fosters feelings of acceptance and social integration among students with mental health problems may be an effective strategy to reduce stigma and increase help-seeking, as well as reduce peer violence, for students with mental health problems.”

The mental health curriculum intervention was effective in reducing verbal harassment of students with mental health problems, as well as reducing the use of physical, verbal, and social/relational violence among students with mental health problems up to two years post-intervention. The contact intervention was not effective in reducing peer violence for students with or without mental health problems. DuPont-Reyes notes that this finding is perhaps due to the absence of a discussion about empathy and acceptance of differences among peers in the contact intervention.

The researchers believe that sixth-grade is an appropriate time to implement this type of curriculum intervention, especially since the curriculum meets state health education requirements, is easy to use in school settings and ready for dissemination, requiring just three hours to implement with no prior specialized training.

Further, the study results highlight a recommendation for school leaders and stakeholders to examine the state of their current mental health curricula and programs for being evidenced-based, appropriate for the setting, context and student demographic, as well as inclusive of effective anti-stigma strategies.

“To both reduce school violence and promote mental health, it is recommended for school mental health curricula to go beyond teaching students about different types of illnesses and treatments and include discussions about empathy and acceptance of differences,” DuPont-Reyes said. “Implementing evidence-based mental illness anti-stigma strategies, such as the curriculum evaluated in this study, can also help address school violence as a public health concern.”

-by Callie Rainosek

— Rae Lynn Mitchell

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