Neuman’s Systems Model Interventions that Decrease Stigma in the Mentally Ill Adolescent Population Anita Stefanek BA| Research Advisor: Barbara Harris RN, PhD | DePaul University Background Findings Summary One in five adolescents live with a mental health condition, with half developing the condition by age 14 and three quarters by age 24 (NIMH, 2016). Many adolescents choose not to seek treatment due to the stigma associated with being labeled by their peer groups. Due to the cost of seeking delayed treatment, as well as the impact that public and self-stigma has on the individual, research on interventions that seek to decrease stigma levels in adolescents is necessary. Knowledge-based and contact-based interventions, remain the most well researched qualitatively, albeit without long term data that show that stigma remained decreased. Recent studies show promising results from researchers that created and implemented a more hybrid approach and combined education and contact- based into a single intervention. Adolescent-led interventions are currently in their infancy in stigma research but do have the potential to successfully reduce mental illness stigma and concurrently increase mental health literacy. This review found that combining education and contact-based interventions together produced the most positive results in decreasing stigma associated with having a mental illness in the high school setting. Most of the research conducted in stigma over the last thirty years has been adult focused and studies that do include adolescents remain primarily qualitative, meta-analytical, and lacking in evidenced-based practice. If future interventions are to decrease stigma in adolescents more research into hybrid and adolescent- led approaches needs to be conducted. Purpose This integrative review aims to explore what interventions in the high school setting exist that lower stigma levels associated with mental illness in adolescents Neuman’s Systems Model Nursing Implications Health education and translation of scientific health information for lay audiences are important roles of the professional nurse Allowing for a debriefing after an intervention such as the In Your Own Voice or LETS allows for the nurse to dispel myths about mental illness and encourage positive attitudes Nurses are in a unique position to facilitate mental health treatment, further develop and evaluate theory-based interventions to reduce stigma, and advocate for their clients by policing the healthcare system for stigmatizing attitudes Methods Research Design This integrative review of literature used Whittemore and Knafl’s updated methodology which allows for a comprehensive understanding of a phenomenon of concern. Furthermore, both qualitative and quantitative studies can be reviewed, summarized, and presented allowing providers to draw conclusions about relevant issues to their practice. Search Methods Articles were pulled from Academic Search Complete, CINAHL, PsychINFO, and PubMed from the years 2006- 2017. The strategy of ancestry was also utilized. Keywords included were: stigma, interventions, mental illness, adolescent, and high school Data Analysis and Synthesis Thirteen articles were collected, ordered, and categorized on a 2 point rigor scale and summarized to answer the research question: What interventions currently exist that decrease mental illness stigma for adolescents? The results were then divided into the three fields of discipline: nursing, public health/education, and medicine. Neuman’s Systems Model states the purpose of the nurse is to retain this system’s stability through three levels of prevention: primary; protecting the normal line and strengthening the flexible line of defense. Secondary, strengthening internal lines of resistance, reducing the reaction, and increasing resistance factors, and tertiary, the patient is taught to readapt, stabilize, and protect reconstitution or return to wellness following treatment (Memmott, R.J., Marett, K.M., Bott, R.L., & Duke, L, 2000). Works Cited Memmott, R.J., Marett, K.M., Bott, R.L., & Duke, L. (2000). Use of the Neuman Systems Model for interdisciplinary teams. Online Journal of Rural Nursing and Health Care, 1(2), 9. NIMH » Any Disorder Among Children. (2010, October). Retrieved October 11, 2016, from https://www.nimh.nih.gov/health/statistics/prevalence/any- disorder-among-children.shtml Whittemore, R., & Knafl, K. (2005). The Integrative Review: Updated Methodology. Journal of Advanced Nursing, 52(5), 546 - 553.