The Science of Mental Health Education

Mental Health Education is the practice of teaching people about their own and others’ mental state with the aim to prevent and reduce mental illness (Sarkhel et al., 2020). 

The idea of mental health education, mostly referred to as psychoeducation in the scientific literature, was first published in 1980 (Anderson et al., 1980) with a focus on addressing the family environment of patients with schizophrenia to better manage their symptoms. Since then, lots of studies have validated the efficacy of mental health education to reduce symptom severity in people with schizophrenia, bipolar, PTSD, and pain disorders (Alhadidi et al., 2020; Horn et al., 2020; Joas et al., 2020; Mughairbi et al., 2020; Buizza et al., 2019). In the last decades, researchers have applied mental health education to many other groups, such as military personnel, teachers, expecting mothers, adolescents, and couples (Park et al., 2020; Bevan Jones et al., 2018; Gökçe İsbir et al., 2016; Hourani et al., 2011; Montoya et al., 2011). The essence of all these studies is that educating people about their own and others’ mental state enables them to better understand and address situations that trigger intense reactions, for example the immediate reactions to combat, the aftermath of a traumatic birth, or the consequences of growing up under abuse (Gökçe İsbir et al., 2016; Karatzias et al., 2014; Hourani et al., 2011). While more studies are still needed (for example to better test the long-term effects), it’s encouraging that mental health education is successful in helping so many different groups of people. 

Some mental health education programs are better than others. What makes the difference? 

 Based on published research, three factors influence how effective mental health education is: 

1. Quality of the mental health education program
2. Duration of the mental health education program
3. Adherence to the mental health education program 

The quality of mental health education depends on who is teaching it and how the material was sourced. The mental health educational material should be based on scientific research, in particular when it comes to the active strategies people can take in dealing with stress (Donker et al., 2009). The person teaching it should be trained in mental health educational methods and be an engaging and trusting communicator. 

There are two ways to think about the duration of effective mental health education programs:
1. It is a longer lasting program that happens on a regular basis, for example 1-2 hours weekly.
2. It is an in-depth but recurrent program, for example 2 full days 2-3 times a year.
Since there are fewer studies testing the long-term effects of single mental health education programs, the science is still not clear on whether a single standing program (for example a 6 week course) can have long-term benefits (Donker et al., 2009). At Mind Blossom, we therefore recommend regular or recurrent mental health education programs to achieve the expected results. The main point is that the program enables people to understand and practice effective coping skills, and that they regularly review and build upon their knowledge and skills. 

The third and last factor, adherence, refers to how consistently people engage with the mental health education program. Certain mental illnesses make people less likely to adhere to a consistent program (Sarkhel et al., 2020), which underscores the need for implementing mental health education prior to severe mental illness onset. Adherence can be difficult to study in research settings simply because people are less inclined to attend regular sessions that may fall at inconvenient times that require significant transport. At Mind Blossom, we believe this challenge can be circumvented by bringing mental health education into people’s daily lives in school and work settings. 

In sum, when developing mental health education programs we need to ensure that the material is evidence-based and of high quality, that the program is regular or recurrent and that measures are taken to support adherence. 

There are currently no studies addressing the financial benefit of implementing mental health education into schools or companies. We know that mental illness costs the global economy 1 trillion USD annually and in 2020, the US Government spent around 280 billion USDs to cover mental illness expenses. Mental health education is a low cost, low risk method scientifically proven to prevent and reduce mental illness. To us, it becomes a no-brainer.

Let’s implement mental health education into schools, companies and other programs to reach people before mental illness reaches them.

Scientific Literature

• Gökçe İsbir G, İnci F, Önal H, Yıldız PD. The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study. Appl Nurs Res. 2016 Nov;32:227-232. doi: 10.1016/j.apnr.2016.07.013. Epub 2016 Jul 30. PMID: 27969033.
• Horn A, Kaneshiro K, Tsui BCH. Preemptive and Preventive Pain Psychoeducation and Its Potential Application as a Multimodal Perioperative Pain Control Option: A Systematic Review. Anesth Analg. 2020 Mar;130(3):559-573. doi: 10.1213/ANE.0000000000004319. PMID: 31335400.
• Hourani LL, Council CL, Hubal RC, Strange LB. Approaches to the primary prevention of posttraumatic stress disorder in the military: a review of the stress control literature. Mil Med. 2011 Jul;176(7):721-30. doi: 10.7205/milmed-d-09-00227. PMID: 22128712.
• Joas E, Bäckman K, Karanti A, Sparding T, Colom F, Pålsson E, Landén M. Psychoeducation for bipolar disorder and risk of recurrence and hospitalization – a within-individual analysis using registry data. Psychol Med. 2020 Apr;50(6):1043-1049. doi: 10.1017/S0033291719001053. Epub 2019 May 6. PMID: 31057138; PMCID: PMC7191782.
• Karatzias T, Ferguson S, Chouliara Z, Gullone A, Cosgrove K, Douglas A. Effectiveness and acceptability of group psychoeducation for the management of mental health problems in survivors of child sexual abuse (CSA). Int J Group Psychother. 2014 Oct;64(4):492-514. doi: 10.1521/ijgp.2014.64.4.492. PMID: 25188564.
• Montoya A, Colom F, Ferrin M. Is psychoeducation for parents and teachers of children and adolescents with ADHD efficacious? A systematic literature review. Eur Psychiatry. 2011 Apr;26(3):166-75. doi: 10.1016/j.eurpsy.2010.10.005. Epub 2011 Feb 2. PMID: 21292454.
• Mughairbi FA, Abdulaziz Alnajjar A, Hamid A. Effects of Psychoeducation and Stress Coping Techniques on Posttraumatic Stress Disorder Symptoms. Psychol Rep. 2020 Jun;123(3):710-724. doi: 10.1177/0033294118825101. Epub 2019 Feb 13. PMID: 30760172.
• Park S, Kim J, Oh J, Ahn S. Effects of psychoeducation on the mental health and relationships of pregnant couples: A systemic review and meta-analysis. Int J Nurs Stud. 2020 Apr;104:103439. doi: 10.1016/j.ijnurstu.2019.103439. Epub 2019 Sep 26. PMID: 32058139.
• Sarkhel S, Singh OP, Arora M. Clinical Practice Guidelines for Psychoeducation in Psychiatric Disorders General Principles of Psychoeducation. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S319-S323. doi: 10.4103/psychiatry.IndianJPsychiatry_780_19. Epub 2020 Jan 17. PMID: 32055073; PMCID: PMC7001357.