Stigma context for youth: Evidence from 16 Texas schools

There is substantial evidence that stigma and discrimination have disadvantaged people with mental illnesses with respect to many important life circumstances, including employment, income, social network ties, quality of life, mastery, self esteem, depressive symptoms, and access to medical and mental health services. A compelling rationale can be developed for addressing the issue of mental illness stigma relatively early in life. Unfortunately, there is relatively little research on children's knowledge, attitudes and beliefs about mental illnesses and therefore relatively few well established measures that can be applied in studies of youth to determine whether or not interventions designed to improve attitudes and behaviors are indeed effective. We capitalized on existing measures and developed a comprehensive multi-pronged approach to assessment of the stigma related attitudes and behaviors of youth. We applied our approach in the context of 16 schools in Texas that are diverse with respect to race, ethnic origin, religion and socioeconomic circumstances. Based on survey conducted with 721 6th graders from 16 schools, this presentation provides an assessment of the psychometric properties of the measures we created, tests their reliability and construct validity overall and within groups defined by gender, race/ethnicity, socioeconomic status, and school context. The paper further describes the landscape of attitudes and behaviors that interventions confront in seeking to alter attitudes and behaviors for the better.