Effect of a mental health training programme on Nigerian school pupils' perceptions of mental illness

Background: Stigmatizing attitudes and discriminatory behaviour towards persons with mental illness are known to start in childhood. In Nigeria, it is not unusual to see children taunting persons with mental illness. This behaviour continues into adulthood as evidenced by the day-to-day occurrences in the community of negative attitudes and social distance from persons with mental illness. School-based interventions for pupils have been found to increase knowledge about mental illness. Children are recognised as potential agents of change bringing in new ways of thinking. This study determined the effect of a 3-day mental health training for school pupils in Southwest Nigeria, on the perceptions of and social distance towards persons with mental illness. Methods: A total of 205 school pupils drawn from two administrative wards were randomly assigned to control and experimental groups. The mean age of the pupils was 14.91 years (+/- 1.3). The pupils in the intervention group received a 5-h mental health training session spaced out over 3-days. Apart from didactic lectures, case history presentations and discussions and role-play were part the training. Outcome measures were rated using a knowledge, attitude and social distance questionnaire at baseline, immediately following the training for both group and 3-week post intervention for the intervention group. A Student Evaluation Form was administered to evaluate the pupils' assessment of the training programme. Frequencies, Chi square statistics, paired t test were used to analyse the data received. Results: At immediate post-intervention, the intervention group had a significantly higher mean knowledge score compared to controls, 21.1 vs. 22.0; p = 0.097 to 26.1 vs 22.0; p < 0.01. Respondents in the intervention group had a higher mean attitude score of 5.8 compared to 5.6 in the control group although this was not statistically significant (p < 0.627). Comparisons within the intervention group from baseline to immediate post-intervention showed a significant increase in mean knowledge and attitude scores of respondents, 21.0-26.2: p < 0.001 and 4.8-5.8; p = 0.004 respectively. This change was sustained at 3 weeks post intervention. The majority (98.8%) noted that the training was useful to them. Conclusions: Multiple contacts and mixed-method training sessions produced a positive and sustained change in knowledge of and attitude towards persons with mental illness in school pupils in Nigeria.