We are in the midst of a mental health crisis amongst our youth. Mental illness stigma and the lack of youth education in mental health contributes to devasdtating delays in care and a void in informed support amongst peers. In Episode 3, we examine with Dr. and Canadian Senator Stan Kutcher, agruably the father of Mental Health Literacy, the solution to empowering a generation of youth with new tools to turn the tide in this crisis.
We are in the midst of a mental health crisis amongst our youth. Mental illness stigma and the lack of youth education in mental health contributes to devasdtating delays in care and a void in informed support amongst peers. In Episode 3, we examine with Dr. and Canadian Senator Stan Kutcher, agruably the father of Mental Health Literacy, the solution to empowering a generation of youth with new tools to turn the tide in this crisis.
Greetings. Welcome to Chad chats Episode Three. I'm Todd Crooks, the executive director of Chad's Legacy Project and your host. Now, in Episode One, we kind of focused on something that was brand new. And that was the stressors for COVID-19. So we talked a little bit about that in Episode Two, we launched right into some really heavy stuff. That episode was all about the interview with Professor Elyn Saks and talking about involuntary treatment, not a light topic. We talked about some things that kind of gave us hope that there could be some compassion in that arena. I'm really excited about today's topic. That is mental health education, too few schools teach mental health education. Today, we're going to talk a lot about why it's important, what we're doing about it, and where I think things are headed in the future. After you hear from today's guest, we'll go into a little bit more detail about some work. Chad's Legacy Project is leading in this very area. In short, there's going to be a comprehensive online catalog or library for mental health literacy curriculum and programs for student learning in schools. The first of its kind. Now, I want to draw a distinction here. There's a lot already developed in the world of what we call Social and Emotional learning or SEL. There's an important differentiation between SEL and mental health literacy. They live on two different parts of the timeline with SEL being best delivered further upstream in a setting like kindergarten through sixth grade. The core competencies include things like self awareness, self management, social awareness and relationship skills and even responsible decision making. Mental health literacy is most appropriately delivered from grades 7 through 12. When students begin higher level of self awareness, that's when they're ready to tackle weightier subjects like mental health disorders, identifying unhealthy stigma traits, learning to advocate and seek help for others and themselves. Both are super important, but only one really affects the stigma of mental illness and effectively shortens the timeline between first onset of a crisis and the peer support and care a youth needs. To help us understand the how and why of this argument. Our guest today couldn't be a better choice. It's fair to say he's the father of mental health literacy in North America. The curriculum he authored mental health in high school began as a national program in Canada and is now spreading across North America. He's a world renowned psychiatrist specializing in the adolescent brain and also currently serves in the Canadian Senate. His publications and awards are simply too numerous to mention right now, but you can learn a little more at teen mental health.org. He is doctor and Senator Stan Kutcher. Dr. Kutcher, thank you so much for joining me today. I've been really excited to talk to you.
Dr. Kutcher:It's a pleasure, pleasure to be here with you. And also to hear about the tremendous work that you're doing to advance mental health literacy for young people and for the education system. I think it's just first rate.
Todd Crooks:Well, thank you for that. When we last Chad, one of the most important things that was missing in Chad's care was not necessarily care or access to care, but it was education. So education wound up being one of the the pillars that we kind of built the mission of this new world in mental health, at least in Washington State, because we were so woefully inadequate, right? in Washington, when we lost Chad. I was really interested in how you identified education as a priority and the journey that led you to the creation of the mental health curriculum that you did create and where you see that going.
Dr. Kutcher:Sure. My background was in psychiatry and working with kids with severe and persistent mental illnesses. And I went from that to a lot of research into everything from those days in the 80s, diagnostic, validity and then treatment Psychological and other kinds and basic neuroscience related to these and, and then mental health services and policy. And eventually I realized that what was really necessary was to start in the population by enhancing mental health literacy, because that was the foundation for everything else that could be built. And mental health literacy has four components. One is understanding how to obtain and maintain good mental health. Secondly, how to identify understand mental disorders and understand their treatments, decreasing stigma, the third, and then increasing a competency based approach increasing help seeking efficacy so that not only if you need help that you know, what you need help for, and where to get it, but also to give competencies to young people and families, that when they are seeking help, that they will know what to look for and what to ask for, so that they're more likely to get good help or not. And realizing this was important it was it was an outgrowth of health literacy, which we know is foundational for health in any population. And I built the mental health literacy approach from the health literacy models of the World Health Organization had created. And it was pretty obvious that we had to start with schools, number one schools that were kids are number two, if we can embed mental health literacy into school curricula, then not only do the young people develop those capacities and competencies, but their teachers do, as well. And so we get horizontal spread of these competencies between the teachers and their families. And then we started to develop these and we spent seven years in development. This is not just sort of getting a couple of resources related to mental health and plopping them down onto the website. It's a completely integrated curriculum with repetition of key points coming through in different modules, entire teacher training components, and teacher training components are now available online, for free through the University of British Columbia, Canada, teachers can even get a educational professional development certificate by doing it. And then we went into extensive research, we did longitudinal studies, cross sectional studies, cohort studies, and not only in Canada, but in many other countries around the world. Because we needed to know whether or not what we were thinking was going to be good actually was good. And I'm pleased that the studies are positive, and they're robust and evidence is solid. And you know, whether the study was done in Guatemala, or Tanzania, or, or in Canada, the results are similar. So we have comfort that that approach, actually making a difference for young people, it's making a difference for their families. And it's also making a difference for their teachers. One of the interesting findings was the teachers own mental health improves, simply because they were teaching the material because they had to learn it to teach it. And they were able to apply it in their own lives. Wow.
Todd Crooks:What can you tell me about the data that has come out? Where would one find the data associated with the Canadian curriculum that's there? I don't know that we have a lot of data yet on that curriculum that was adapted to Washington State, what what have you found in...
Dr. Kutcher:the website, teen mental health.org, which is now operated from the Alberta Health Services and I gifted them all the material when I was appointed to the Canadian Senate, and they are updating it and creating new resources, and they have a repository of all the research that's been done, people can just go there and get that information. It's extensive, the research has been done in many, many different countries. And it's always I always find it important that in particularly when we're doing something, in curriculum and in schools, that people who are using the material, have comfort that there is robust evidence that it makes a difference, because there's so many things in the educational system that people put into place, and know if it works or not, but we know that this works, it improves knowledge, it decreases stigma, and then increases help seeking behaviors. So all those important things. The current version is a third edition. It is a more robust because not only was it done and studied, additional versions were created based on extensive feedback from educators, educators, not just in Canada, but educators who were using it in Japan and Portugal and different other countries getting feedback from them.
Todd Crooks:So this truly is a broad international program now.
Dr. Kutcher:It is available in many different languages. It's being used in many different countries. I don't know all the countries that are using it, or all the groups that are using it, because, of course, I'm not involved in that now. But it was designed to meet the multicultural needs of Canada. And you know, the United States is also a multicultural country. And, you know, we have some of the early studies conducted in in secondary schools in different parts of one of Canada's largest city, Toronto, the schools that was conducted in were from very, very different economic and cultural neighborhoods. And yet, regardless of what the school was, like, in terms of its ethno cultural diversity, and its economic diversity, the results are the same. So so that's good. That's good.
Todd Crooks:I'm interested in the early days in this program, when you were preaching your findings, that education was to be key in 10 of eradicating stigma. And I've heard a lot of objections, as I talked about this. And I know that everybody else that's been kind of preaching mental health literacy is familiar with similar objections. But what did you encounter early on in the way of objections to teaching mental health literacy? And did some of those objections pan out? Or were they all dispelled? What was that journey in getting through any resistance?
Dr. Kutcher:Oh, it was complex. One of the major challenges was the inertia of the educational system. And yeah, that things have always been done this way. Why would we want to change? Secondly, was the infatuation of the educational system with shiny new stuff that has no effect, as opposed to really addressing substantive things that have a positive effect? So I know one time, and there are educational fads. I heard at one time while we were doing work with this curriculum in different schools, you may remember fidget spinners remember those things? Yeah. And then so the fidget spinners were touted as the treatment for kids with attention deficit disorder, hyperactivity, anxiety, and also the things and the education system just jumped on these fidget spinners. For about a year, and then off, it went to something new, we definitely don't take that approach. We really do the deep analysis, and the importance of embedding to curriculum, once you embed something to curriculum, it can actually stay in the system, as opposed to a program that comes into the system. And when the funding finishes, the program ends. So embedding curriculum materials, embedding teacher training, and all this online, in the systems is so important. The other thing is that we've heard a lot of comments about fear people were afraid of teaching mental health. And the response to that is, you're not afraid about teaching physical health, why would you be afraid about teaching mental health, and that, again, was one of the myths. There are all sorts of myths about mental health. And there was a, I think, a lack of a nuanced understanding of what mental health actually is in some quarters. So it took quite a bit of education of decision makers, for them to really have a better idea of what mental health was, because they themselves didn't understand what it was. So there were multiple, multiple challenges along the way.
Todd Crooks:One of the things that I've heard, especially early on was well, okay, we're really opening a can of worms here, if we, if we start teaching mental health, that's great that the kids know about all of this stuff. And what what we're going to see is we're going to see a lot of kids self diagnosing themselves, and we're going to be steering them toward resources that don't exist. So what's the point because we don't have access to care to match the demand that we're going to create by telling these kids what they need to hear.
Dr. Kutcher:And and and that that was a concern that was also raised, but we have inadequate and world phone access to best available evidence based mental health care everywhere in the world. And the fact that we need to improve that is not an argument to be made to stop teaching people about it. If you think about the Korea argument, you want to say we don't want to teach people about heart disease, because my goodness gracious, we don't have enough cardiac clinics, nobody would ever say that. Right? Right. plus, plus part of this is understanding how to obtain and maintain good mental health. And if I can continue the cardiac analogy, you want to teach people exercise, healthy eating, you know, you want to do those things that you can, whatever things that you can do to prevent having challenges. And same thing with mental health, when you're teaching them how to obtain and maintain good mental health, you are doing whatever you can to both promote and prevent, at the same time that you're teaching about. So that's essential. And then the third thing is, is that we actually found and this was studied in the province of Alberta, the people there did what's called a cluster controlled study, they brought this intervention into a number of schools. And they used a number of other schools as controls, they didn't bring the intervention. And then they looked at the impact of utilization of mental health services, from students from both clusters. And what they found was contrary to what the expectations were, they actually found that the number of referrals that came from schools that had the intervention were significantly less than from schools that didn't have the intervention. So what would that was telling them was the schools were able to better identify which gives needed help, and which gives need help. Second thing second answered my next question. So the second thing was that they found that the kids that were sent, were kept in care, so that they actually didn't need the help, that they had more substantive and severe problems, and that they were younger, which meant that challenges and problems are being identified earlier. And we know that early identification, and then provision of effective care, improves outcomes. So that research actually dispelled some of the myths and worries that people have brought to the discussion.
Todd Crooks:What has made it hardest for these curriculums to be adopted in your mind?
Dr. Kutcher:Well, I think that there are a number of different things, and it varies from place to place. I think that some locations want to do things that are really easy, as opposed to do things which may be a little bit more difficult, but have substantive positive results. So it's a lot easier for schools just to put in some resources into a classroom and say, Okay, we're going to teach you about mental health, somebody created these resources, those people come from the university, we're going to put them in, and everything's gonna be fine. Well, you know, there was a study done in the city of Ottawa. And there was a randomized controlled study done by the University of Ottawa, which actually showed that the provincial curriculum for Ontario and mental health which was built that way, compared to the the curriculum that was developed specifically for this, the kids who were exposed to the mental health literacy curriculum that you're talking about, had significantly better outcomes, and the kids were exposed to the existing now house materials. And in fact, one of the concerning things was that in some of the kids, some of the research that outcomes actually were worse in kids who were presented, just mental health materials, as opposed to something that was a concise and coherent curriculum. So the fact that people are putting mental health related materials into schools does not mean that they're actually doing the hard work that they need to do to actually improve mental health literacy, it could be having negative outcomes.
Todd Crooks:One of the elephants in any room is the question of money, and how much investment is necessary to get something off the ground? What would you say are some of the costs of implementing a curriculum and maintaining a curriculum so that it's sustainable?
Dr. Kutcher:Well, when we first when I first decided to do this work, I chose to make all the material free, because I didn't want cost to be a barrier. And because I had been fortunate enough to obtain grants to create the material, and I thought that was unethical to use money that had come from the public, whether it was from government public or from civil society public to use that, that money to create profit. So all the material is free. There cost that is obtained is within a training of people and we used to do face to face training programs and it would take a bit of time to do those because people had to teach us To be released from their classroom duties, it was backfilling that went in to ensure that or sometimes it was on a professional development days, and many, many things that teachers have to deal with in professional development days. So the training was was it was a challenge. But now, all the training of that exists for free on the University of British Columbia faculty medicine website, so teachers can actually go in at their own pace. Go through the learning of how to apply the curriculum in their classroom, it's free. So costs shouldn't be a barrier, because there's no cost
Todd Crooks:there or there doesn't have to be. So I can I can hear a frustration around. Okay, great. There's this wonderful curriculum about mental health, you're telling me that there's no cost to get it. And we can probably come up with training time to get this implemented. And you're saying it fits right into health classes and stuff. So my question to you is, what two weeks of curriculum do not want us to teach to make room for this? And I see schools all over the place that are teaching mental health curriculum. And I'm wondering, did they sacrifice other curriculum to make this happen? Are they skipping two weeks in algebra to make this happen? are they missing certain aspects of reproductive health? How are schools doing this without making that kind of sacrifice?
Dr. Kutcher:Well, I wouldn't call it a sacrifice. First of all. I would, I would note that schools change curriculum constantly. We don't, we don't use an abacus in math class anymore. So schools change what they teach all the time. So I find that as sort of other very convincing kind of argument, I don't, I don't buy that for a minute. I see that more as they either institutional inertia, or a stigma in itself.
Todd Crooks:If you could tell a school principal, or a health teacher that was on the fence about mental health literacy, one thing to dispel concerns about opening that Pandora's box of student knowledge, what would it be? What would you tell them in an elevator speech, to help them realize this is something they needed to do?
Dr. Kutcher:I would say that their concerns have been thought about and raised by others. And the research that has been done to show that their concerns have been addressed, and that the data always go back to the data. The data shows us that when this is instituted in schools, there is improvement for the kids, but also improvement for the teachers, I would challenge anybody to find a lot of things that are going into school curricula, where you can say with a relative concept, that what we're doing in the classroom is not only benefiting the kids in the classroom, but it's benefiting teachers in the classroom.
Todd Crooks:Turning that a little bit. If you can imagine yourself with a microphone standing in a gymnasium to an all school assembly, and you're addressing a student body that was steeped in stigma and didn't have a mental health literacy program in their school. You could tell them one thing, what would you stand in front of those bleachers, and say?
Dr. Kutcher:And when we first started this, I did exactly that. And I'll share with you what I did. I would say to the assembly, how many of you know someone who has diabetes? All sorts of hands would shoot up? How many of you have someone in your family or know somebody who has cancer? All sorts of hands shoot up? And then I would say, how many of you have someone in your family or know someone who has a mental illness? And nobody would say anything? And then I was and then I would use that?
Unknown:How did we feel when that question was asked. And what were we thinking about when that question was?
Dr. Kutcher:I see people looking nervously around to see who raised their hand. What is that all about? And actually, even in large assemblies, I was able to engage with kids to start to talk about what they were seeing what they were thinking what they were feeling. And labeling that as normal. Because it's a stigma. We don't even realize it. Because the prevalence of mental illness is substantial. So everybody in that auditorium actually has a family member, or actually does know someone that has a mental illness. But it's very easy for them to talk about knowing someone who has diabetes, but it's not easy for them to talk about someone who has a mental illness. And what does that actually mean? So when they're,
Todd Crooks:well, I would love nothing more than to have this mental health literacy library that's being developed, become a silver platter for the entire country. To say, here are the programs here, the curriculums here is the data that exists behind each one for you to evaluate. And here's how you would implement it based on what other schools have been successful at. And I would love for it to be a nationally utilized library.
Dr. Kutcher:I think that that's a tremendous vision that you have, because particularly the curriculum that I know best, and I can speak to, it's been demonstrated to be effective in all sorts of places that it's been implemented and studied. And we did learn very, very early on in the first edition, the teachers had to be trained in the use of the curriculum for it to be effective, because the teachers themselves didn't know the material, it couldn't teach it, which is exactly how teachers operate anyway, they teach what they know, right? So teachers has to be able to understand and utilize the material and your library might want to look at partnering with the University of British Columbia Faculty of Medicine, provide links to their teacher training programs, which are also all free. teacher training programs can be done as professional development that can be done as self interest that can also be done by faculties of education, because the there is a special curriculum there that is designed for faculties of education, and is certified by the university faculties of education in Canada. So people can look at it and the Faculty of Education say, Wow, this has already been done. This is good. There's good evidence that it's very effective training teachers, and there's good research on that. There you go. So many thanks for doing this. And and don't give up because you're onto something which can make a difference in the lives of other kids.
Todd Crooks:Well, thank you, Dr. Kutcher. There's no quit in here. Hopefully, we'll be celebrating together later this year. And there you have it. If you are an educator still fuzzy on the need or the feasibility of offering mental health literacy to your students, I suggest you go back and listen to Dr. Kutcher. Again. This is something that's time is overdue. We're still going to turn the tide on the grim student survey numbers and other indicators of the youth mental health crisis we're in. You must implement a program as soon as possible. Now, I can hear you out there. Sure, Todd, where would I even start I get it. It's really important, but I don't have time to hunt for a program, learn it on my own. get it approved or vetted, then figure out how to insert it into my teaching day. First. Remember what Dr. Kutcher said, teachers learned mental health literacy simply through the process of initiating a program. And second, here's the exciting news. Right now we're working with the University of Washington smart center to create a new mental health literacy library. We intend to roll it out in time for fall 2021 in person learning. In short, it will list available curriculum and programs vetted against the four pillars of mental health literacy Dr. Kutcher just described, inventoried in met learning standards as prescribed by the Washington State Office of the superintendent of public instruction, and will include a listing of best practice recommendations for the implementation of each listing in the library. It'll be a dedicated website vetted by educational experts and available to any educator wanting to provide their students the knowledge they've been missing to date, the knowledge they've been asking for the knowledge that will create a Healthier Generation, and save lives. And what could be a cooler future than that? The end of mental illness stigma is near. We'll start with our youth generation and grow from there. You'd like to follow progress for this work. Keep an eye on our Facebook page at Chad's Legacy Project. We'll be announcing some pretty big updates in February and March, especially the upcoming rollout of the survey request for curriculum program stakeholders. And that's that the problem and a big part of the solution was just luck as 2021 rolls along. Thanks so much for checking in with us at chat chats, and we'll chat again.