Table 1.
Characteristics of 15 Included Studies, Ordered by Date of Publication
| Study Name | Focus Area | Design | Sample | Sample SES & Race/ethnicity | Program Length | Knowledge | Attitudes | Help-Seeking | Risk for Bias |
|---|---|---|---|---|---|---|---|---|---|
| Spirito et al. (1988) (unnamed) | Suicide | Solomon 4-groups design | CG: n=182, TG: n=291, Students from 5 high schools | Sample SES and race/ethnicity not reported | 6 week curriculum | TG increased knowledge, F(1,402) = 40.42, p < .001 | No statistically significant effect of intervention on attitudes | No statistically significant effect of intervention on help seeking | High |
| Petchers et al. (1988) (unnamed) | General Mental Health | Nonrandomized experimental trial | 102 students from two high schools | Sample from predominantly White suburban community | Six lesson curriculum supplement + video component | Knowledge and opinions about mental health questionnaire scores higher in TG at posttest. CG: 63.81, TG: 74.77, t (100) = 5.67, p < .001 | Knowledge and opinions about mental health questionnaire scores higher in TG at posttest CG: 63.81, TG: 74.77, t (100) = 5.67, p < .001 | N/A | High |
| Battaglia et al. (1990) - Mental Health Awareness Week | General Mental Health | Nonrandomized experimental trial | TG: n=1380 CG: n=282 From middle and high schools |
Sample SES and race/ethnicity not reported | 45 minute presentation | N/A | TG indicated a significantly greater desire to hear more about mental health issues, (χ2 = 29.5, df = 1, p < .001). Students’ attitudes towards psychiatrists was more positive in the TG compared to the CG, F (1, 1588) = 79.0, p < .001 | TG was more likely to seek psychiatric help when exposed to previous talks: about psychiatrists; F (1, 559) = 6.50, p < 0.05, about depression/suicide; F (1, 1569) = 6.20, p < 0.05, about drugs/alcohol; F (1, 571) = 6.00, p < 0.05. TG more often indicated that they would [tell family, a psychiatrist, a teacher (p < .05)], and a counselor (p < .005) about getting help as a first step. | High |
| Esters et al. (1998) (unnamed) | General Mental Health | Nonrandomized experimental trial | 40 students from one high school | Sample SES and race/ethnicity not reported | Instructional unit presented during 3 days of health class curriculum | N/A | Positive relationship between intervention and score on OMI questionnaire in TG (r =.83). OMI scores did not decrease significantly at 12-week posttest, t (19) = 2.01, p > .025 | Positive relationship between intervention and score on FTAS questionnaire in TG (r = .92). FTAS scores did not decrease significantly at 12-week posttest, t (19) = .47, p > .025 | High |
| Aseltine & DeMartine (2004) – Signs of Suicide (SOS) | Suicide | Randomized Controlled Trial | TG = 1027, CG = 1073, students from 5 high schools | Mixed, diverse SES and race/ethnicity in sample (large % minority) | Educational video, discussion guide, and screening over 2 days | Greater knowledge of depression and suicide seen in TG at posttest (p < .05) | More adaptive attitudes seen in TG at posttest (p < .05) | No statistically significant effect of intervention on help-seeking | Medium |
| Watson et al. (2004) - The Science of Mental Illness | General Mental Health | Pretest/posttest case series | 1566 students from middle schools | 70% White, 16% Hispanic | 5 lesson curriculum supplement,45 minute classroom time | Improvement in mental health knowledge score, t (1,249) −44.575, p = 0.000. | Significant improvement in stigmatizing attitudes, t (1,249) 2.821, p = 0.005. | N/A | High |
| DeSocio & Schrinsky (2006) (unnamed) | General Mental Health | Pretest/posttest case series | 370 elementary and middle school students | Sample SES and race/ethnicity not reported | Six modules taught in six 45 minute class periods | Mean student scores improved from pre to posttest (+1.5 mean increase, p = .000) | N/A | N/A | High |
| Tacker & Dobie (2008) – MasterMind: Empower Yourself With Mental Health | General Mental Health | Pretest/posttest case series | 30 eighth grade students from one middle school | Sample SES and race/ethnicity not reported | 6 week curriculum, 80 minutes per week | Increase seen in student knowledge of mental health issues, results did not achieve statistical significance. | N/A | N/A | High |
| Spagnolo et al. (2008) – Recovery from Serious Mental Illness is Possible | General Mental Health | Pretest/posttest case series | 277 high school students from 4 high schools | Sample SES and race/ethnicity not reported | 60–90 minute module | N/A | Significant improvement seen in stigmatizing attitudes (p ≤ .00) | Significant improvement seen in willingness to seek help (p ≤ .00) | High |
| Nikitopoulos et al. (2009) – Understanding Violence | Violence | Posttest case series | 224 students from an elementary school | 56% Black, 39% Latino, low SES | Six 60–90 minute modules yearly for 3 years | Moderate understanding of topics related of crime, violence, and law enforcement seen (78–86%). (No analysis beyond descriptive statistics specified) | Students’ indicated the importance of violence issues and community as a topic (>90% of respondents agreeing with all corresponding items). (No analysis beyond descriptive statistics specified) | N/A | High |
| Pinto-Foltz et al. (2011) – In Our Own Voice | General Mental Health | Randomized Controlled Trial | TG: n=95 CG: n=61 From 2 high schools |
69% White, moderate to high SES | 60 minute presentation | No statistically significant effect of intervention on knowledge at immediate posttest. At 4+8 week posttest, TG scored significantly higher on mental health literacy (95% CI = .71–3.53, p =.03) | No statistically significant effect of intervention on stigmatizing attitudes immediately after intervention and at 4+8 week posttest. | N/A | Medium |
| Wahl et al. (2011) – Breaking the Silence | General Mental Health | Nonrandomized experimental trial | TG = 106, CG = 87 7th and 8th graders from 4 middle schools | 45% Caucasian, 21% African American, 19% Hispanic, 5% mixed race | Three 40–50 minute classes held over 1 week during science/health/PE class | TG demonstrated improvement in knowledge at immediate posttest and follow-up, F (2, 382) = 34.6, p < .001 | TG demonstrated improvement in attitudes at immediate posttest and follow-up, F (2, 382) = 4.6, p =.012 | N/A | High |
| Strunk et al. (2014) – Surviving the Teens | Suicide | Nonrandomized experimental trial | TG: n=966 CG: n=581 Students from 9 high schools |
84% White | Four 50-minute sessions over 4 consecutive days. | TG demonstrated significant improvements in knowledge of depression risk factors, F (1, 624) = 9.70, p =.002, suicide risk factors, F (1, 624) = 9.24, p =.002, suicide warning signs, F (1, 624) = 9.66, p = .002, and suicide myths and facts, F (1, 624) = 23.264, p < .001. | TG demonstrated significant improvement in stigmatizing attitudes, F (1, 497) = 33.69, p < .001, and in perceived importance in knowing suicidal warning signs and steps to take with suicidal friends, F (1, 498) = 34.44, p < .001 | TG demonstrated significantly greater improvement in intention to help self or friends if suicidal, F (1, 498) = 102.32, p < .001. | Medium |
| Schmidt et al. (2015) – Yellow Ribbon Ask 4 Help | Suicide | Pretest/posttest case series | 5949 students from middle and high schools | 73% White, 20% African American | Training offered during individual classes for 4 years | Data suggest improvement in students’ knowledge about suicide (No analysis beyond descriptive statistics specified) | N/A | Data suggest improvement in students’ knowledge about help-seeking (No analysis beyond descriptive statistics specified) | High |
| Labouliere et al. (2015) – A Promise For Tomorrow | Suicide | Pretest/posttest case series | 1365 high school students from a school district | 45.1% Hispanic, 26.6% Caucasian, 13.3% mixed race | Three 45–50 minute sessions held during individual health classes within one-week | Significant improvement in suicide related knowledge (p < .001) | N/A | N/A | High |