Preventive mental health programs in school. Implementation and effect evaluation, a longitudinal quasi experimental interventionstudy with Solomon`s design. Bror Just Andersen, Special Advisor for Quality, PhD Bærum DPC

The intervention - VIP VIP is the Norwegian abbreviation for Very Important Problems (Guidance and Information about Mental Health). Started up in 1999 as a result of a initiative from inlying young patients. The program gives students answers on growing curiosity or uncertainty on inner development, and teaches them where they can seek help. Places the topic of mental health on the agenda in school and home.

The intervention - VIP The intervention is universal, quite short and relatively low cost Dialogue and involvement are key words in the intervention  The program has been developed in accordance with the content of the general curriculum for upper secondary schools (but can easily be revisited for lower secondary school)   The target group is youth and teachers in school. Today the intervention is implemented in over 160 schools in Norway.

Scheme of the steps of the intervention VIP - built on dialogue and empowerment Teaching sequence about mental health problems in general and the local support system especially Increased knowledge among Increased knowledge among those with problems those without problems Greater acceptance of mental problems and more openness and contact between the young Behavioral change in everyday life and a lower threshold for seeking help from friends / family / support system Lower-level in problem with mental health among schoolchildren

Purpose of the research project Investigate the effect of implementing a brief preventive intervention on change in knowledge, behavior and the condition of the mental health among youth

Main research question Do youth behavior and attitude in coping with mental health problems and searching for help change with their level of knowledge?

Outcome variables The students' knowledge The ability to recognize signals Attitudes towards and behavior in helpseeking The students' mental health

Method and design Quantitative method, quasiexperimental, Solomon four group design Questionnaire with multiple choice and open response alternatives 85 questions / statements, redefined into indexes focusing on the outcome variables 1368 students in 8 secondary schools in Akershus and Vestfold County The questionnaire was answered before, 1-3 weeks after, 6 m after, 12 m after and 24 m after Stepwise analysis, effect results presented in level of significance and Cohen's d as ES (effect size)

Changes in knowledge indexes from before to after the intervention, and after 12 month Cohens d 1-3 weeks after 12 moth after 1. Knowledge of mental disorders 0,58*** (0,31) 2. General knowledge of mental health 0,30* 0,41* 3. Knowledge about diagnosis and forms of expression - 0,42* 4. Ability of connecting symptoms to diagnosis 0,34** 0,53* 5. Confidence in effect of treatment methods 6. Knowledge of support services within mental health in general 0,51*** 0,38* 7. Knowledge of local community support agencies within the mental health 0,74*** 0,39*

Effects on everyday life Changes in mental health problems over all, peer problems, and anxiety from directly after to 12 month after SDQ-Nor totalscore 0-40   Difference of change 16,5 % Cohens d 0,15 Sig. t-test ,007* Peer problems scale 0-10 31,8 % 0,31 ,009** Anxiety scale 0-10 53,5 % 0,37 ,001***

The results in a international setting In reviews and meta-reviews of preventive mental health within school-based prevention interventions effect sizes ranging from 0.27 to 0.57 In meta-analysis of psychological, psycho educative and behavioral therapy they found an average power of 0.47 To set output targets in an even wider perspective – the average effects in a variety of physical treatment such as bypass surgery, chemotherapy treatment of cancer and different drug treatments also had an average power of 0.50

Implications of the study Universal preventive mental health interventions seems to have an effect on: Knowledge and stigma Behavior Youth mental health Essentially this is about choice of educational organization in which two important points are collaboration and demystification/visibility of available services in mental health among those who report that they have mental health problems 34.2% say that this implicates quite much or a lot on their learning ability in school. That's twice as much as they report in relation to, for example, leisure activities.

Implications of the study To reduce the stigma and because mental health problems greatly influence youth` school situation, ability to work and learn these results have implications for: Decisions about resource allocation for preventive mental health in general Decisions related to the significance of mental health as impact factor in the development of knowledge and in learning situations Enhancing the accessibility and build up low-threshold service to youth

Expectation from a partnership In cooperation with the National secretariat of VIP we can offer all materials for the intervention and homepage translated to English – support for translation to Czech is needed The National secretariat of VIP can offer their experience and competence of 14 years of implementation I can offer my competence of research, a cooperation around effect evaluation, project description for a PhD/Postdoc project, and translation of questionnaire etc. In case of bilateral research cooperation co-authorship is required

Division of Mental Health and Addiction Contactinfo: bror.just.andersen@vestreviken.no +47 41 61 01 27