Knowledge and links to phase 2:

Within the MH knowledge scale, participants achieved a mean score of 20.41 with a SD of 2.49. Participants could achieve a score ranging from 0 (incorrect MH knowledge) to 30 (completely correct MH knowledge) with a neutral score of 18. A mean score of 20.41 indicates an opportunity to enhance Year 8 pupils MHL.

When exploring the responses to individual questions within the MAKS, a lack of knowledge with regards to the effectiveness of medication as a form of treatment

was apparent; 44.8% of responses indicated that they did not know whether medication was an effective treatment for people experiencing MHPs. Only 29.4% of participants responded that they agreed that people with severe MHPs can fully recover; 8.1% strongly agreed and 21.3% agreed slightly. I suggest that these statistics reflect the uncertainty that YP have with regards to MH treatment and prognosis, impacting negatively upon perceived levels of control over their MH (Chisholm, Patterson, Greenfield, Turner & Birchwood, 2018).

These findings indicate an opportunity to increase YP knowledge of effective MH treatments, supporting existing research: Kelly et al., (2007) found that only 40% of a sample of 12-25 year olds considered that antipsychotics would be helpful for a person with psychosis. Furthermore, Wright, McGorry, Harris, Jorm and Pennell., (2006) found that only 40% of 18-25 year olds felt that antidepressants were helpful. In addition, Gulliver, Griffiths & Christensen, (2010) suggested that the belief that treatment would not help, is a main barrier to seeking help for a MHP. These statistics are worrying as limited knowledge of MH care may hinder public acceptance of medication as a form of support (Jorm, 2000). This resonates with other empirical research which suggests that, for those individuals experiencing MHPs, having knowledge of MH is an important factor in accessing MH support (Vanheusden, Mulder, Van der Ende, Van Lenthe, Mackenbach & Verhulst, 2008). Vanheusden et al., (2008) suggested that 65% of young adults (19-32 years of age) do not seek MH care when experiencing MH symptoms due to a number of reasons: inability to recognise symptoms; ignorance about availability of treatment and a belief that formal care would not have an impact upon symptoms.

However, on a positive note, a total of 68.1% of participants responded that they either agreed or strongly agreed that talking therapies can be an effective treatment for people with MHPs. This is promising as it indicates that the accepted consensus is that psychotherapy is effective. Talking therapies have been shown to alleviate symptoms of MHPs for a variety of individuals, with benefits including the facilitation of problem solving (Mind, 2019; Mental Health Foundation, 2019b). Explanations for the success of talking therapies have been attributed to their exploratory nature and thus the opportunity to identify causes of negative feelings, empowering individuals to facilitate change (Mental Health Foundation, 2019b). The National Institute for Health Care Excellence (NICE) recommend

certain types of talking therapies, e.g. cognitive behavioral therapy and counselling, for a range of MHPs such as anxiety, depression, obsessive compulsive disorder and post-traumatic stress disorder (NICE, 2019). Research within the literature supports this: Reavley & Jorm (2011) conducted a survey and found that counsellors were rated amongst the top three sources in terms of ability to help when experiencing a MHP; only close friends and general practitioners scoring higher. Furthermore, Yoshioka, Reavley, Hart and Jorm (2015) carried out a survey using 311 Japanese students, aged 15-19 years, in order to assess recognition and beliefs about treatments for MHPs. They found that for depression and schizophrenia, counsellors received the highest rating for levels of helpfulness.

This finding highlights an avenue to be explored in phase 2: the concept of YP learning about effective treatments as part of a MHL programme.

However, whilst YP do accept talking therapies are an effective treatment, they do not appear to know how to access them. Alarmingly, when presented with the statement ‘If a friend had a mental health problem, I would know what advice to give them to get professional help’ a total of 41.6% of responses indicated that they either disagreed or did not know. It is widely accepted, and empirically supported that people will only seek MH support if they know how to access what is available (Kelly et al., 2007). Therefore, the current finding that YP are not aware of how to access professional help is worrying; research suggests that delaying or avoiding formal care for MHPs results in longer duration and worse outcomes (Clement et al., 2015). Dell’Osso et al., (2013) found that this effect was particularly damaging for those experiencing psychosis, bipolar depression, major depression and anxiety. Research suggests that peer to peer interactions are becoming increasingly important as part of recovery and support (Reavley & Jorm, 2011; Naslund et al., 2016). Moreover, one typically decides to reach out to a peer to discuss personal MH issues at a time when they are experiencing significant distress (Perry & Pescosolido, 2015). Therefore, the response that individuals receive from peers could prove detrimental to their recovery (Naslund et al., 2016).

Responses to ‘If a friend had a mental health problem, I would know what advice to give them to get professional help’ further indicated to me that there is an opportunity for MHL programmes in schools; YP need to be equipped with the

knowledge, not only to support themselves but also their peers. In addition, it highlighted a concept to explore in phase 2; the extent to which YP knew what to do if they, or a peer, was experiencing a MHP.

At this stage, I would like to return to the theory of planned behaviour (TPB) (Ajzen, 1991); a frequently cited and influential model for predicting social behaviour (Ajzen, 2011; Bohon et al, 2016). The TPB suggests that behaviour is determined by INT (a motivational component, determined by an individual’s attitude towards the behavior and subjective norms) and PBC (the extent to which people perceive they have control over engaging in the behaviour and is weighed up between the power of inhibiting factors versus facilitating factors.)

Thus, when applying the TPB to the current research, the more MH knowledge a YP has (INT) together with the extent to which they believe they have control over engaging in accessing support (PBC), both determine whether the YP will participate in the behavior of accessing support.

Therefore, when considering the answer to RQ1 and applying the TPB, it is important to remember the following: the more MHL YP have, the more likely they are to access MH support should they need to.

Results from the MAKS indicate a role for MHL programmes in schools. This supports existing research. For example, Bohon et al., (2016) conducted a study using 279 college students in California, in order to explore whether the TPB could be applied to YP accessing MH services. Participants were asked to complete three scales designed to measure attitudes, social norms and PBC. Bohon et al., (2016) concluded that the more positive the attitudes towards care and the higher the PBC, the greater the intention to seek MH support. Bohon et al., (2016) suggested that educating college students about MHPs and treatment and enhancing knowledge about available support might improve treatment rates for students suffering with depression. However, limitations to this study should be noted: the population sample consisted of American college students and so findings cannot be generalised to the Year 8 pupils in England. Furthermore, 35.9% of participants self-reported symptoms of depression ranging from minor to severe, approximately 10% higher than that of the population of YP (Frith, 2016). This limits the extent to which results can be generalised to the wider population within the current research.

To sum up, the results from the MAKS, which concentrated on the level of MH knowledge, indicate an opportunity to enhance YPs MH knowledge. The limited knowledge within my sample, supports research and suggests a role for MHL programmes in schools (YoungMinds, 2017; Moon et al., 2017; Atkins et al., 2010; Coles et al., 2016; Yoshioka et al., 2015). Concepts to be further explored in phase 2 include: YP learning about effective treatments as part of a MHL programme; the extent to which YP would know what to do if they, or a peer, was experiencing a MHP.