Frontline School-Based Stakeholders and the Mental Health Literacy Needs of Adolescents: A Program Evaluation

Title: Frontline School-Based Stakeholders and the Mental Health Literacy Needs of Adolescents: A Program Evaluation Author: Sherrie Page Guyer, DNP, MSN, RN Corresponding Authors: Regina DeGennaro, DNP, APRN, CNS, AOCN, CNL and Richard J. Westphal, PhD, RN, PMHCNS-BC, PMHNP-BC, FAAN Abstract Objective: To obtain frontline feedback from high-school based school nurses, counselors, and health teachers on the mental health literacy needs of their student population. Design: Thematic analysis using data derived from semi-structured focus group interviews and surveys from key frontline stakeholders. Methods: Emphasizing a school-based behavioral health team approach with key stakeholders, five one-hour long focus group interviews were conducted to answer the clinical question: What do schools need in a mental health literacy curriculum? Interviews included semi-structured group discussion and individual stakeholder completion of an online survey. Conducted in-person at five separate schools, each stakeholder group included a minimum of at least one school nurse, one school counselor, and one high school health teacher. Results: Using Qualtrics, a cloud-based platform that allows users to securely create, distribute, and analyze data collection, a total of 19 de-identified surveys were received from 5 school nurses, 8 school counselors, and 6 high school health teachers. Thematic analysis of surveys was conducted to organize stakeholder priorities. Analysis generated five main themes repeatedly emphasized by stakeholders at all schools and across the represented professional disciplines: (1) MHL curriculum topics need to go beyond the current state Standards of Learning (SOLs) requirements; (2) Students need more Mental Health Literacy (MHL) Education than is allotted for in the school schedule within and throughout grade levels; (3) Context matters: Identity relevance embedded into curricula is critical; (4) A culture that supports positive mental health within a school community is essential for students to apply MHL knowledge, especially related to stigma reduction and help-seeking behavior; (5) School-based stakeholders want guidance related to how to navigate the multiple barriers to adolescent mental health care that exist beyond the school setting. Conclusion: School-based experts felt that even when mental health literacy curriculums covered the required SOL material, it wasn't enough to address the mental health needs of students, especially since students only receive health education in 9th and/or 10th grade, where multiple topics are covered, not just mental health. A final take away was that even when schools meet the MHL education required by the Virginia Board of Education, too many obstacles stand in the way of even an educated teen being able to access needed help. Additionally, the outcomes of this study underscore the importance of the culture beyond the classroom (in the school, at home, and in the community) in assisting students to apply mental health literacy education, especially related to stigma reduction and help-seeking behavior. Keywords: school-based, mental health literacy, adolescent, needs assessment, thematic analysis Authors have no disclosure to report.