The Adolescent Depression Awareness Program (ADAP): Preliminary Evidence of Effectiveness in Depression Literacy and Reductions in Mental Health Stigma Pre and Post Intervention

It is estimated that 8.5% of youth ages 12 to 17 experienced at least one major depressive episode in the past year (SAMHSA Office of Applied Studies, 2008), with 21-28% of adolescents experiencing at least one episode of major depression by the age of 19 (Hankin et al.,1998; Lewinsohn et al., 1998; NHMRC, 1997).  Depression in adolescence is associated with increased risks for academic problems, social dysfunction, poor physical health, substance use disorders and other issues into adulthood (Fergusson & Woodward, 2002; McGorry et al., 2007; Merry et al., 2004).  Despite these long reaching effects, there have been few school-based randomized trials exploring the effectiveness of universal interventions targeting depression in adolescence.  Here we present the preliminary results of a randomized control trial of the Adolescent Depression Awareness Program (ADAP) among schools in Maryland and Delaware.  This intervention is delivered by school-based educators who teach health education and is designed to increase depression literacy.  The 32 participating schools were randomized into receiving the intervention in year one or in year two.  The main outcome of interest is depression literacy (a score of 80% or higher) on the Adolescent Depression Knowledge Questionnaire (ADKQ, Swartz et al., 2010), which assessed student’s knowledge about depression and help-seeking attitudes before the intervention, six weeks after the intervention, and four months post intervention.  Additionally, students were given the Reported and Intended Behaviour Scale (RIBS, Thornicroft, 2009) in order to measure mental health stigma.  Preliminary results are focused on comparing pre-, post-test and four month followup results, including how student gender and school type may influence those differences. Average scores on the ADKQ in the control group at pre test were 66.29%.  Average scores on the ADKQ in the intervention group at pre test were 68.84%.  Six weeks after the intervention, the ADKQ score in the control group was 68.58% whereas scores in the intervention group were 80.87%.  Additionally, 60.1% of the intervention participants reached depression literacy (a score of 80% or higher on the ADKQ) after the intervention as compared to 28.4% of the control group.  The goal of the ADAP intervention is to increase knowledge about depression, decrease mental health stigma, and improve help-seeking behavior in a cost-effective and sustainable way.