February 5, 2021 • 30 mins
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.
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Episode Transcript
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Todd Crooks (00:16):
Greetings. Welcome to Chad chats Episode Three. I'm
Todd Crooks, the executivedirector of Chad's Legacy
Project and your host. Now, inEpisode One, we kind of focused
on something that was brand new.
And that was the stressors forCOVID-19. So we talked a little
(00:37):
bit about that in Episode Two,we launched right into some
really heavy stuff. That episodewas all about the interview with
Professor Elyn Saks and talkingabout involuntary treatment, not
a light topic. We talked aboutsome things that kind of gave us
hope that there could be somecompassion in that arena.
(01:00):
I'm really excited about today'stopic. That is mental health
education, too few schools teachmental health education. Today,
we're going to talk a lot aboutwhy it's important, what we're
doing about it, and where Ithink things are headed in the
future. After you hear fromtoday's guest, we'll go into a
(01:23):
little bit more detail aboutsome work. Chad's Legacy Project
is leading in this very area. Inshort, there's going to be a
comprehensive online catalog orlibrary for mental health
literacy curriculum and programsfor student learning in schools.
The first of its kind. Now, Iwant to draw a distinction here.
(01:45):
There's a lot already developedin the world of what we call
Social and Emotional learning orSEL. There's an important
differentiation between SEL andmental health literacy. They
live on two different parts ofthe timeline with SEL being best
delivered further upstream in asetting like kindergarten
through sixth grade. The corecompetencies include things like
(02:08):
self awareness, self management,social awareness and
relationship skills and evenresponsible decision making.
Mental health literacy is mostappropriately delivered from
grades 7 through 12. Whenstudents begin higher level of
self awareness, that's whenthey're ready to tackle
weightier subjects like mentalhealth disorders, identifying
(02:32):
unhealthy stigma traits,learning to advocate and seek
help for others and themselves.
Both are super important, butonly one really affects the
stigma of mental illness andeffectively shortens the
timeline between first onset ofa crisis and the peer support
and care a youth needs.
To help us understand the howand why of this argument. Our
(02:54):
guest today couldn't be a betterchoice. It's fair to say he's
the father of mental healthliteracy in North America. The
curriculum he authored mentalhealth in high school began as a
national program in Canada andis now spreading across North
America. He's a world renownedpsychiatrist specializing in the
adolescent brain and alsocurrently serves in the Canadian
(03:16):
Senate. His publications andawards are simply too numerous
to mention right now, but youcan learn a little more at teen
mental health.org. He is doctorand Senator Stan Kutcher. Dr.
Kutcher, thank you so much forjoining me today. I've been
really excited to talk to you.
Dr. Kutcher (03:35):
It's a pleasure, pleasure to be here with you.
And also to hear about thetremendous work that you're
doing to advance mental healthliteracy for young people and
for the education system. Ithink it's just first rate.
Todd Crooks (03:50):
Well, thank you for that. When we last Chad, one of
the most important things thatwas missing in Chad's care was
not necessarily care or accessto care, but it was education.
So education wound up being oneof the the pillars that we kind
of built the mission of this newworld in mental health, at least
(04:13):
in Washington State, because wewere so woefully inadequate,
right? in Washington, when welost Chad. I was really
interested in how you identifiededucation as a priority and the
journey that led you to thecreation of the mental health
curriculum that you did createand where you see that going.
Dr. Kutcher (04:35):
Sure. My background was in psychiatry and working
with kids with severe andpersistent mental illnesses. And
I went from that to a lot ofresearch into everything from
those days in the 80s,diagnostic, validity and then
(04:59):
treatment Psychological andother kinds and basic
neuroscience related to theseand, and then mental health
services and policy. Andeventually I realized that what
was really necessary was tostart in the population by
enhancing mental healthliteracy, because that was the
(05:23):
foundation for everything elsethat could be built. And mental
health literacy has fourcomponents. One is understanding
how to obtain and maintain goodmental health. Secondly, how to
identify understand mentaldisorders and understand their
treatments, decreasing stigma,the third, and then increasing a
(05:48):
competency based approachincreasing help seeking efficacy
so that not only if you needhelp that you know, what you
need help for, and where to getit, but also to give
competencies to young people andfamilies, that when they are
seeking help, that they willknow what to look for and what
to ask for, so that they're morelikely to get good help or not.
(06:11):
And realizing this was importantit was it was an outgrowth of
health literacy, which we knowis foundational for health in
any population. And I built themental health literacy approach
from the health literacy modelsof the World Health Organization
had created. And it was prettyobvious that we had to start
(06:35):
with schools, number one schoolsthat were kids are number two,
if we can embed mental healthliteracy into school curricula,
then not only do the youngpeople develop those capacities
and competencies, but theirteachers do, as well. And so we
get horizontal spread of thesecompetencies between the
(06:56):
teachers and their families. Andthen we started to develop these
and we spent seven years indevelopment. This is not just
sort of getting a couple ofresources related to mental
health and plopping them downonto the website. It's a
completely integrated curriculumwith repetition of key points
(07:18):
coming through in differentmodules, entire teacher training
components, and teacher trainingcomponents are now available
online, for free through theUniversity of British Columbia,
Canada, teachers can even get aeducational professional
development certificate by doingit. And then we went into
extensive research, we didlongitudinal studies, cross
(07:41):
sectional studies, cohortstudies, and not only in Canada,
but in many other countriesaround the world. Because we
needed to know whether or notwhat we were thinking was going
to be good actually was good.
And I'm pleased that the studiesare positive, and they're robust
and evidence is solid. And youknow, whether the study was done
(08:02):
in Guatemala, or Tanzania, or,or in Canada, the results are
similar. So we have comfort thatthat approach, actually making a
difference for young people,it's making a difference for
their families. And it's alsomaking a difference for their
teachers. One of the interestingfindings was the teachers own
mental health improves, simplybecause they were teaching the
(08:25):
material because they had tolearn it to teach it. And they
were able to apply it in theirown lives. Wow.
Todd Crooks (08:32):
What can you tell me about the data that has come
out? Where would one find thedata associated with the
Canadian curriculum that'sthere? I don't know that we have
a lot of data yet on thatcurriculum that was adapted to
Washington State, what what haveyou found in...
Dr. Kutcher (08:52):
the website, teen mental health.org, which is now
operated from the Alberta HealthServices and I gifted them all
the material when I wasappointed to the Canadian
Senate, and they are updating itand creating new resources, and
they have a repository of allthe research that's been done,
(09:14):
people can just go there and getthat information. It's
extensive, the research has beendone in many, many different
countries. And it's always Ialways find it important that in
particularly when we're doingsomething, in curriculum and in
schools, that people who areusing the material, have comfort
(09:34):
that there is robust evidencethat it makes a difference,
because there's so many thingsin the educational system that
people put into place, and knowif it works or not, but we know
that this works, it improvesknowledge, it decreases stigma,
and then increases help seekingbehaviors. So all those
(09:56):
important things. The currentversion is a third edition. It
is a more robust because notonly was it done and studied,
additional versions were createdbased on extensive feedback from
educators, educators, not justin Canada, but educators who
were using it in Japan andPortugal and different other
(10:17):
countries getting feedback fromthem.
Todd Crooks (10:19):
So this truly is a broad international program now.
Dr. Kutcher (10:22):
It is available in many different languages. It's
being used in many differentcountries. I don't know all the
countries that are using it, orall the groups that are using
it, because, of course, I'm notinvolved in that now. But it was
designed to meet themulticultural needs of Canada.
(10:43):
And you know, the United Statesis also a multicultural country.
And, you know, we have some ofthe early studies conducted in
in secondary schools indifferent parts of one of
Canada's largest city, Toronto,the schools that was conducted
in were from very, verydifferent economic and cultural
(11:04):
neighborhoods. And yet,regardless of what the school
was, like, in terms of its ethnocultural diversity, and its
economic diversity, the resultsare the same. So so that's good.
That's good.
Todd Crooks (11:17):
I'm interested in the early days in this program,
when you were preaching yourfindings, that education was to
be key in 10 of eradicatingstigma. And I've heard a lot of
objections, as I talked aboutthis. And I know that everybody
else that's been kind ofpreaching mental health literacy
(11:38):
is familiar with similarobjections. But what did you
encounter early on in the way ofobjections to teaching mental
health literacy? And did some ofthose objections pan out? Or
were they all dispelled? Whatwas that journey in getting
through any resistance?
Dr. Kutcher (11:54):
Oh, it was complex.
One of the major challenges wasthe inertia of the educational
system. And yeah, that thingshave always been done this way.
Why would we want to change?
Secondly, was the infatuation ofthe educational system with
shiny new stuff that has noeffect, as opposed to really
(12:20):
addressing substantive thingsthat have a positive effect? So
I know one time, and there areeducational fads. I heard at one
time while we were doing workwith this curriculum in
different schools, you mayremember fidget spinners
remember those things? Yeah. Andthen so the fidget spinners were
(12:41):
touted as the treatment for kidswith attention deficit disorder,
hyperactivity, anxiety, and alsothe things and the education
system just jumped on thesefidget spinners. For about a
year, and then off, it went tosomething new, we definitely
don't take that approach. Wereally do the deep analysis, and
(13:04):
the importance of embedding tocurriculum, once you embed
something to curriculum, it canactually stay in the system, as
opposed to a program that comesinto the system. And when the
funding finishes, the programends. So embedding curriculum
materials, embedding teachertraining, and all this online,
in the systems is so important.
The other thing is that we'veheard a lot of comments about
(13:26):
fear people were afraid ofteaching mental health. And the
response to that is, you're notafraid about teaching physical
health, why would you be afraidabout teaching mental health,
and that, again, was one of themyths. There are all sorts of
myths about mental health. Andthere was a, I think, a lack of
a nuanced understanding of whatmental health actually is in
(13:50):
some quarters. So it took quitea bit of education of decision
makers, for them to really havea better idea of what mental
health was, because theythemselves didn't understand
what it was. So there weremultiple, multiple challenges
along the way.
Todd Crooks (14:06):
One of the things that I've heard, especially
early on was well, okay, we'rereally opening a can of worms
here, if we, if we startteaching mental health, that's
great that the kids know aboutall of this stuff. And what what
we're going to see is we'regoing to see a lot of kids self
diagnosing themselves, and we'regoing to be steering them toward
(14:28):
resources that don't exist. Sowhat's the point because we
don't have access to care tomatch the demand that we're
going to create by telling thesekids what they need to hear.
Dr. Kutcher (14:40):
And and and that that was a concern that was also
raised, but we have inadequateand world phone access to best
available evidence based mentalhealth care everywhere in the
world. And the fact that we needto improve that is not an
argument to be made to stopteaching people about it. If you
think about the Korea argument,you want to say we don't want to
(15:03):
teach people about heartdisease, because my goodness
gracious, we don't have enoughcardiac clinics, nobody would
ever say that. Right? Right.
plus, plus part of this isunderstanding how to obtain and
maintain good mental health. Andif I can continue the cardiac
analogy, you want to teachpeople exercise, healthy eating,
you know, you want to do thosethings that you can, whatever
things that you can do toprevent having challenges. And
(15:27):
same thing with mental health,when you're teaching them how to
obtain and maintain good mentalhealth, you are doing whatever
you can to both promote andprevent, at the same time that
you're teaching about. So that'sessential. And then the third
thing is, is that we actuallyfound and this was studied in
the province of Alberta, thepeople there did what's called a
(15:48):
cluster controlled study, theybrought this intervention into a
number of schools. And they useda number of other schools as
controls, they didn't bring theintervention. And then they
looked at the impact ofutilization of mental health
services, from students fromboth clusters. And what they
(16:11):
found was contrary to what theexpectations were, they actually
found that the number ofreferrals that came from schools
that had the intervention weresignificantly less than from
schools that didn't have theintervention. So what would that
was telling them was the schoolswere able to better identify
which gives needed help, andwhich gives need help. Second
(16:31):
thing second answered my nextquestion. So the second thing
was that they found that thekids that were sent, were kept
in care, so that they actuallydidn't need the help, that they
had more substantive and severeproblems, and that they were
younger, which meant thatchallenges and problems are
(16:52):
being identified earlier. And weknow that early identification,
and then provision of effectivecare, improves outcomes. So that
research actually dispelled someof the myths and worries that
people have brought to thediscussion.
Todd Crooks (17:10):
What has made it hardest for these curriculums to
be adopted in your mind?
Dr. Kutcher (17:15):
Well, I think that there are a number of different
things, and it varies from placeto place. I think that some
locations want to do things thatare really easy, as opposed to
do things which may be a littlebit more difficult, but have
substantive positive results. Soit's a lot easier for schools
(17:36):
just to put in some resourcesinto a classroom and say, Okay,
we're going to teach you aboutmental health, somebody created
these resources, those peoplecome from the university, we're
going to put them in, andeverything's gonna be fine.
Well, you know, there was astudy done in the city of
Ottawa. And there was arandomized controlled study done
by the University of Ottawa,which actually showed that the
provincial curriculum forOntario and mental health which
(17:58):
was built that way, compared tothe the curriculum that was
developed specifically for this,the kids who were exposed to the
mental health literacycurriculum that you're talking
about, had significantly betteroutcomes, and the kids were
exposed to the existing nowhouse materials. And in fact,
(18:19):
one of the concerning things wasthat in some of the kids, some
of the research that outcomesactually were worse in kids who
were presented, just mentalhealth materials, as opposed to
something that was a concise andcoherent curriculum. So the fact
(18:39):
that people are putting mentalhealth related materials into
schools does not mean thatthey're actually doing the hard
work that they need to do toactually improve mental health
literacy, it could be havingnegative outcomes.
Todd Crooks (18:51):
One of the elephants in any room is the
question of money, and how muchinvestment is necessary to get
something off the ground? Whatwould you say are some of the
costs of implementing acurriculum and maintaining a
curriculum so that it'ssustainable?
Dr. Kutcher (19:11):
Well, when we first when I first decided to do this
work, I chose to make all thematerial free, because I didn't
want cost to be a barrier. Andbecause I had been fortunate
enough to obtain grants tocreate the material, and I
thought that was unethical touse money that had come from the
(19:33):
public, whether it was fromgovernment public or from civil
society public to use that, thatmoney to create profit. So all
the material is free. There costthat is obtained is within a
training of people and we usedto do face to face training
(19:55):
programs and it would take a bitof time to do those because
people had to teach us To bereleased from their classroom
duties, it was backfilling thatwent in to ensure that or
sometimes it was on aprofessional development days,
and many, many things thatteachers have to deal with in
professional development days.
So the training was was it was achallenge. But now, all the
training of that exists for freeon the University of British
(20:19):
Columbia faculty medicinewebsite, so teachers can
actually go in at their ownpace. Go through the learning of
how to apply the curriculum intheir classroom, it's free. So
costs shouldn't be a barrier,because there's no cost
Todd Crooks (20:37):
there or there doesn't have to be. So I can I
can hear a frustration around.
Okay, great. There's thiswonderful curriculum about
mental health, you're telling methat there's no cost to get it.
And we can probably come up withtraining time to get this
implemented. And you're sayingit fits right into health
classes and stuff. So myquestion to you is, what two
(20:59):
weeks of curriculum do not wantus to teach to make room for
this? And I see schools all overthe place that are teaching
mental health curriculum. AndI'm wondering, did they
sacrifice other curriculum tomake this happen? Are they
skipping two weeks in algebra tomake this happen? are they
missing certain aspects ofreproductive health? How are
(21:22):
schools doing this withoutmaking that kind of sacrifice?
Dr. Kutcher (21:28):
Well, I wouldn't call it a sacrifice. First of
all. I would, I would note thatschools change curriculum
constantly. We don't, we don'tuse an abacus in math class
anymore. So schools change whatthey teach all the time. So I
find that as sort of other veryconvincing kind of argument, I
(21:52):
don't, I don't buy that for aminute. I see that more as they
either institutional inertia, ora stigma in itself.
Todd Crooks (22:02):
If you could tell a school principal, or a health
teacher that was on the fenceabout mental health literacy,
one thing to dispel concernsabout opening that Pandora's box
of student knowledge, what wouldit be? What would you tell them
in an elevator speech, to helpthem realize this is something
(22:23):
they needed to do?
Dr. Kutcher (22:24):
I would say that their concerns have been thought
about and raised by others. Andthe research that has been done
to show that their concerns havebeen addressed, and that the
data always go back to the data.
The data shows us that when thisis instituted in schools, there
(22:46):
is improvement for the kids, butalso improvement for the
teachers, I would challengeanybody to find a lot of things
that are going into schoolcurricula, where you can say
with a relative concept, thatwhat we're doing in the
classroom is not only benefitingthe kids in the classroom, but
(23:06):
it's benefiting teachers in theclassroom.
Todd Crooks (23:11):
Turning that a little bit. If you can imagine
yourself with a microphonestanding in a gymnasium to an
all school assembly, and you'readdressing a student body that
was steeped in stigma and didn'thave a mental health literacy
program in their school. Youcould tell them one thing, what
would you stand in front ofthose bleachers, and say?
Dr. Kutcher (23:34):
And when we first started this, I did exactly
that. And I'll share with youwhat I did. I would say to the
assembly, how many of you knowsomeone who has diabetes? All
sorts of hands would shoot up?
How many of you have someone inyour family or know somebody who
has cancer? All sorts of handsshoot up? And then I would say,
(23:58):
how many of you have someone inyour family or know someone who
has a mental illness? And nobodywould say anything? And then I
was and then I would use that?
Unknown (24:12):
How did we feel when that question was asked. And
what were we thinking about whenthat question was?
Dr. Kutcher (24:20):
I see people looking nervously around to see
who raised their hand. What isthat all about? And actually,
even in large assemblies, I wasable to engage with kids to
start to talk about what theywere seeing what they were
thinking what they were feeling.
And labeling that as normal.
(24:41):
Because it's a stigma. We don'teven realize it. Because the
prevalence of mental illness issubstantial. So everybody in
that auditorium actually has afamily member, or actually does
know someone that has a mentalillness. But it's very easy for
(25:02):
them to talk about knowingsomeone who has diabetes, but
it's not easy for them to talkabout someone who has a mental
illness. And what does thatactually mean? So when they're,
Todd Crooks (25:16):
well, I would love nothing more than to have this
mental health literacy librarythat's being developed, become a
silver platter for the entirecountry. To say, here are the
programs here, the curriculumshere is the data that exists
behind each one for you toevaluate. And here's how you
(25:40):
would implement it based on whatother schools have been
successful at. And I would lovefor it to be a nationally
utilized library.
Dr. Kutcher (25:49):
I think that that's a tremendous vision that you
have, because particularly thecurriculum that I know best, and
I can speak to, it's beendemonstrated to be effective in
all sorts of places that it'sbeen implemented and studied.
And we did learn very, veryearly on in the first edition,
(26:10):
the teachers had to be trainedin the use of the curriculum for
it to be effective, because theteachers themselves didn't know
the material, it couldn't teachit, which is exactly how
teachers operate anyway, theyteach what they know, right? So
teachers has to be able tounderstand and utilize the
material and your library mightwant to look at partnering with
(26:32):
the University of BritishColumbia Faculty of Medicine,
provide links to their teachertraining programs, which are
also all free. teacher trainingprograms can be done as
professional development thatcan be done as self interest
that can also be done byfaculties of education, because
(26:53):
the there is a specialcurriculum there that is
designed for faculties ofeducation, and is certified by
the university faculties ofeducation in Canada. So people
can look at it and the Facultyof Education say, Wow, this has
already been done. This is good.
There's good evidence that it'svery effective training
teachers, and there's goodresearch on that. There you go.
(27:13):
So many thanks for doing this.
And and don't give up becauseyou're onto something which can
make a difference in the livesof other kids.
Todd Crooks (27:28):
Well, thank you, Dr. Kutcher. There's no quit in
here. Hopefully, we'll becelebrating together later this
year. And there you have it. Ifyou are an educator still fuzzy
on the need or the feasibilityof offering mental health
literacy to your students, Isuggest you go back and listen
to Dr. Kutcher. Again. This issomething that's time is
(27:50):
overdue. We're still going toturn the tide on the grim
student survey numbers and otherindicators of the youth mental
health crisis we're in. You mustimplement a program as soon as
possible. Now, I can hear youout there. Sure, Todd, where
would I even start I get it.
It's really important, but Idon't have time to hunt for a
(28:13):
program, learn it on my own. getit approved or vetted, then
figure out how to insert it intomy teaching day. First. Remember
what Dr. Kutcher said, teacherslearned mental health literacy
simply through the process ofinitiating a program. And
second, here's the excitingnews. Right now we're working
(28:36):
with the University ofWashington smart center to
create a new mental healthliteracy library. We intend to
roll it out in time for fall2021 in person learning. In
short, it will list availablecurriculum and programs vetted
against the four pillars ofmental health literacy Dr.
Kutcher just described,inventoried in met learning
(28:57):
standards as prescribed by theWashington State Office of the
superintendent of publicinstruction, and will include a
listing of best practicerecommendations for the
implementation of each listingin the library. It'll be a
dedicated website vetted byeducational experts and
available to any educatorwanting to provide their
(29:20):
students the knowledge they'vebeen missing to date, the
knowledge they've been askingfor 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 stigmais near. We'll start with our
(29:40):
youth generation and grow fromthere. You'd like to follow
progress for this work. Keep aneye on our Facebook page at
Chad's Legacy Project. We'll beannouncing some pretty big
updates in February and March,especially the upcoming rollout
of the survey request forcurriculum program stakeholders.
(30:02):
And that's that the problem anda big part of the solution was
just luck as 2021 rolls along.
Thanks so much for checking inwith us at chat chats, and
we'll chat again.
Greetings. Welcome to Chad chats Episode Three. I'm
Todd Crooks, the executivedirector of Chad's Legacy
Project and your host. Now, inEpisode One, we kind of focused
on something that was brand new.
And that was the stressors forCOVID-19. So we talked a little
(00:37):
bit about that in Episode Two,we launched right into some
really heavy stuff. That episodewas all about the interview with
Professor Elyn Saks and talkingabout involuntary treatment, not
a light topic. We talked aboutsome things that kind of gave us
hope that there could be somecompassion in that arena.
(01:00):
I'm really excited about today'stopic. That is mental health
education, too few schools teachmental health education. Today,
we're going to talk a lot aboutwhy it's important, what we're
doing about it, and where Ithink things are headed in the
future. After you hear fromtoday's guest, we'll go into a
(01:23):
little bit more detail aboutsome work. Chad's Legacy Project
is leading in this very area. Inshort, there's going to be a
comprehensive online catalog orlibrary for mental health
literacy curriculum and programsfor student learning in schools.
The first of its kind. Now, Iwant to draw a distinction here.
(01:45):
There's a lot already developedin the world of what we call
Social and Emotional learning orSEL. There's an important
differentiation between SEL andmental health literacy. They
live on two different parts ofthe timeline with SEL being best
delivered further upstream in asetting like kindergarten
through sixth grade. The corecompetencies include things like
(02:08):
self awareness, self management,social awareness and
relationship skills and evenresponsible decision making.
Mental health literacy is mostappropriately delivered from
grades 7 through 12. Whenstudents begin higher level of
self awareness, that's whenthey're ready to tackle
weightier subjects like mentalhealth disorders, identifying
(02:32):
unhealthy stigma traits,learning to advocate and seek
help for others and themselves.
Both are super important, butonly one really affects the
stigma of mental illness andeffectively shortens the
timeline between first onset ofa crisis and the peer support
and care a youth needs.
To help us understand the howand why of this argument. Our
(02:54):
guest today couldn't be a betterchoice. It's fair to say he's
the father of mental healthliteracy in North America. The
curriculum he authored mentalhealth in high school began as a
national program in Canada andis now spreading across North
America. He's a world renownedpsychiatrist specializing in the
adolescent brain and alsocurrently serves in the Canadian
(03:16):
Senate. His publications andawards are simply too numerous
to mention right now, but youcan learn a little more at teen
mental health.org. He is doctorand Senator Stan Kutcher. Dr.
Kutcher, thank you so much forjoining me today. I've been
really excited to talk to you.
Dr. Kutcher (03:35):
It's a pleasure, pleasure to be here with you.
And also to hear about thetremendous work that you're
doing to advance mental healthliteracy for young people and
for the education system. Ithink it's just first rate.
Todd Crooks (03:50):
Well, thank you for that. When we last Chad, one of
the most important things thatwas missing in Chad's care was
not necessarily care or accessto care, but it was education.
So education wound up being oneof the the pillars that we kind
of built the mission of this newworld in mental health, at least
(04:13):
in Washington State, because wewere so woefully inadequate,
right? in Washington, when welost Chad. I was really
interested in how you identifiededucation as a priority and the
journey that led you to thecreation of the mental health
curriculum that you did createand where you see that going.
Dr. Kutcher (04:35):
Sure. My background was in psychiatry and working
with kids with severe andpersistent mental illnesses. And
I went from that to a lot ofresearch into everything from
those days in the 80s,diagnostic, validity and then
(04:59):
treatment Psychological andother kinds and basic
neuroscience related to theseand, and then mental health
services and policy. Andeventually I realized that what
was really necessary was tostart in the population by
enhancing mental healthliteracy, because that was the
(05:23):
foundation for everything elsethat could be built. And mental
health literacy has fourcomponents. One is understanding
how to obtain and maintain goodmental health. Secondly, how to
identify understand mentaldisorders and understand their
treatments, decreasing stigma,the third, and then increasing a
(05:48):
competency based approachincreasing help seeking efficacy
so that not only if you needhelp that you know, what you
need help for, and where to getit, but also to give
competencies to young people andfamilies, that when they are
seeking help, that they willknow what to look for and what
to ask for, so that they're morelikely to get good help or not.
(06:11):
And realizing this was importantit was it was an outgrowth of
health literacy, which we knowis foundational for health in
any population. And I built themental health literacy approach
from the health literacy modelsof the World Health Organization
had created. And it was prettyobvious that we had to start
(06:35):
with schools, number one schoolsthat were kids are number two,
if we can embed mental healthliteracy into school curricula,
then not only do the youngpeople develop those capacities
and competencies, but theirteachers do, as well. And so we
get horizontal spread of thesecompetencies between the
(06:56):
teachers and their families. Andthen we started to develop these
and we spent seven years indevelopment. This is not just
sort of getting a couple ofresources related to mental
health and plopping them downonto the website. It's a
completely integrated curriculumwith repetition of key points
(07:18):
coming through in differentmodules, entire teacher training
components, and teacher trainingcomponents are now available
online, for free through theUniversity of British Columbia,
Canada, teachers can even get aeducational professional
development certificate by doingit. And then we went into
extensive research, we didlongitudinal studies, cross
(07:41):
sectional studies, cohortstudies, and not only in Canada,
but in many other countriesaround the world. Because we
needed to know whether or notwhat we were thinking was going
to be good actually was good.
And I'm pleased that the studiesare positive, and they're robust
and evidence is solid. And youknow, whether the study was done
(08:02):
in Guatemala, or Tanzania, or,or in Canada, the results are
similar. So we have comfort thatthat approach, actually making a
difference for young people,it's making a difference for
their families. And it's alsomaking a difference for their
teachers. One of the interestingfindings was the teachers own
mental health improves, simplybecause they were teaching the
(08:25):
material because they had tolearn it to teach it. And they
were able to apply it in theirown lives. Wow.
Todd Crooks (08:32):
What can you tell me about the data that has come
out? Where would one find thedata associated with the
Canadian curriculum that'sthere? I don't know that we have
a lot of data yet on thatcurriculum that was adapted to
Washington State, what what haveyou found in...
Dr. Kutcher (08:52):
the website, teen mental health.org, which is now
operated from the Alberta HealthServices and I gifted them all
the material when I wasappointed to the Canadian
Senate, and they are updating itand creating new resources, and
they have a repository of allthe research that's been done,
(09:14):
people can just go there and getthat information. It's
extensive, the research has beendone in many, many different
countries. And it's always Ialways find it important that in
particularly when we're doingsomething, in curriculum and in
schools, that people who areusing the material, have comfort
(09:34):
that there is robust evidencethat it makes a difference,
because there's so many thingsin the educational system that
people put into place, and knowif it works or not, but we know
that this works, it improvesknowledge, it decreases stigma,
and then increases help seekingbehaviors. So all those
(09:56):
important things. The currentversion is a third edition. It
is a more robust because notonly was it done and studied,
additional versions were createdbased on extensive feedback from
educators, educators, not justin Canada, but educators who
were using it in Japan andPortugal and different other
(10:17):
countries getting feedback fromthem.
Todd Crooks (10:19):
So this truly is a broad international program now.
Dr. Kutcher (10:22):
It is available in many different languages. It's
being used in many differentcountries. I don't know all the
countries that are using it, orall the groups that are using
it, because, of course, I'm notinvolved in that now. But it was
designed to meet themulticultural needs of Canada.
(10:43):
And you know, the United Statesis also a multicultural country.
And, you know, we have some ofthe early studies conducted in
in secondary schools indifferent parts of one of
Canada's largest city, Toronto,the schools that was conducted
in were from very, verydifferent economic and cultural
(11:04):
neighborhoods. And yet,regardless of what the school
was, like, in terms of its ethnocultural diversity, and its
economic diversity, the resultsare the same. So so that's good.
That's good.
Todd Crooks (11:17):
I'm interested in the early days in this program,
when you were preaching yourfindings, that education was to
be key in 10 of eradicatingstigma. And I've heard a lot of
objections, as I talked aboutthis. And I know that everybody
else that's been kind ofpreaching mental health literacy
(11:38):
is familiar with similarobjections. But what did you
encounter early on in the way ofobjections to teaching mental
health literacy? And did some ofthose objections pan out? Or
were they all dispelled? Whatwas that journey in getting
through any resistance?
Dr. Kutcher (11:54):
Oh, it was complex.
One of the major challenges wasthe inertia of the educational
system. And yeah, that thingshave always been done this way.
Why would we want to change?
Secondly, was the infatuation ofthe educational system with
shiny new stuff that has noeffect, as opposed to really
(12:20):
addressing substantive thingsthat have a positive effect? So
I know one time, and there areeducational fads. I heard at one
time while we were doing workwith this curriculum in
different schools, you mayremember fidget spinners
remember those things? Yeah. Andthen so the fidget spinners were
(12:41):
touted as the treatment for kidswith attention deficit disorder,
hyperactivity, anxiety, and alsothe things and the education
system just jumped on thesefidget spinners. For about a
year, and then off, it went tosomething new, we definitely
don't take that approach. Wereally do the deep analysis, and
(13:04):
the importance of embedding tocurriculum, once you embed
something to curriculum, it canactually stay in the system, as
opposed to a program that comesinto the system. And when the
funding finishes, the programends. So embedding curriculum
materials, embedding teachertraining, and all this online,
in the systems is so important.
The other thing is that we'veheard a lot of comments about
(13:26):
fear people were afraid ofteaching mental health. And the
response to that is, you're notafraid about teaching physical
health, why would you be afraidabout teaching mental health,
and that, again, was one of themyths. There are all sorts of
myths about mental health. Andthere was a, I think, a lack of
a nuanced understanding of whatmental health actually is in
(13:50):
some quarters. So it took quitea bit of education of decision
makers, for them to really havea better idea of what mental
health was, because theythemselves didn't understand
what it was. So there weremultiple, multiple challenges
along the way.
Todd Crooks (14:06):
One of the things that I've heard, especially
early on was well, okay, we'rereally opening a can of worms
here, if we, if we startteaching mental health, that's
great that the kids know aboutall of this stuff. And what what
we're going to see is we'regoing to see a lot of kids self
diagnosing themselves, and we'regoing to be steering them toward
(14:28):
resources that don't exist. Sowhat's the point because we
don't have access to care tomatch the demand that we're
going to create by telling thesekids what they need to hear.
Dr. Kutcher (14:40):
And and and that that was a concern that was also
raised, but we have inadequateand world phone access to best
available evidence based mentalhealth care everywhere in the
world. And the fact that we needto improve that is not an
argument to be made to stopteaching people about it. If you
think about the Korea argument,you want to say we don't want to
(15:03):
teach people about heartdisease, because my goodness
gracious, we don't have enoughcardiac clinics, nobody would
ever say that. Right? Right.
plus, plus part of this isunderstanding how to obtain and
maintain good mental health. Andif I can continue the cardiac
analogy, you want to teachpeople exercise, healthy eating,
you know, you want to do thosethings that you can, whatever
things that you can do toprevent having challenges. And
(15:27):
same thing with mental health,when you're teaching them how to
obtain and maintain good mentalhealth, you are doing whatever
you can to both promote andprevent, at the same time that
you're teaching about. So that'sessential. And then the third
thing is, is that we actuallyfound and this was studied in
the province of Alberta, thepeople there did what's called a
(15:48):
cluster controlled study, theybrought this intervention into a
number of schools. And they useda number of other schools as
controls, they didn't bring theintervention. And then they
looked at the impact ofutilization of mental health
services, from students fromboth clusters. And what they
(16:11):
found was contrary to what theexpectations were, they actually
found that the number ofreferrals that came from schools
that had the intervention weresignificantly less than from
schools that didn't have theintervention. So what would that
was telling them was the schoolswere able to better identify
which gives needed help, andwhich gives need help. Second
(16:31):
thing second answered my nextquestion. So the second thing
was that they found that thekids that were sent, were kept
in care, so that they actuallydidn't need the help, that they
had more substantive and severeproblems, and that they were
younger, which meant thatchallenges and problems are
(16:52):
being identified earlier. And weknow that early identification,
and then provision of effectivecare, improves outcomes. So that
research actually dispelled someof the myths and worries that
people have brought to thediscussion.
Todd Crooks (17:10):
What has made it hardest for these curriculums to
be adopted in your mind?
Dr. Kutcher (17:15):
Well, I think that there are a number of different
things, and it varies from placeto place. I think that some
locations want to do things thatare really easy, as opposed to
do things which may be a littlebit more difficult, but have
substantive positive results. Soit's a lot easier for schools
(17:36):
just to put in some resourcesinto a classroom and say, Okay,
we're going to teach you aboutmental health, somebody created
these resources, those peoplecome from the university, we're
going to put them in, andeverything's gonna be fine.
Well, you know, there was astudy done in the city of
Ottawa. And there was arandomized controlled study done
by the University of Ottawa,which actually showed that the
provincial curriculum forOntario and mental health which
(17:58):
was built that way, compared tothe the curriculum that was
developed specifically for this,the kids who were exposed to the
mental health literacycurriculum that you're talking
about, had significantly betteroutcomes, and the kids were
exposed to the existing nowhouse materials. And in fact,
(18:19):
one of the concerning things wasthat in some of the kids, some
of the research that outcomesactually were worse in kids who
were presented, just mentalhealth materials, as opposed to
something that was a concise andcoherent curriculum. So the fact
(18:39):
that people are putting mentalhealth related materials into
schools does not mean thatthey're actually doing the hard
work that they need to do toactually improve mental health
literacy, it could be havingnegative outcomes.
Todd Crooks (18:51):
One of the elephants in any room is the
question of money, and how muchinvestment is necessary to get
something off the ground? Whatwould you say are some of the
costs of implementing acurriculum and maintaining a
curriculum so that it'ssustainable?
Dr. Kutcher (19:11):
Well, when we first when I first decided to do this
work, I chose to make all thematerial free, because I didn't
want cost to be a barrier. Andbecause I had been fortunate
enough to obtain grants tocreate the material, and I
thought that was unethical touse money that had come from the
(19:33):
public, whether it was fromgovernment public or from civil
society public to use that, thatmoney to create profit. So all
the material is free. There costthat is obtained is within a
training of people and we usedto do face to face training
(19:55):
programs and it would take a bitof time to do those because
people had to teach us To bereleased from their classroom
duties, it was backfilling thatwent in to ensure that or
sometimes it was on aprofessional development days,
and many, many things thatteachers have to deal with in
professional development days.
So the training was was it was achallenge. But now, all the
training of that exists for freeon the University of British
(20:19):
Columbia faculty medicinewebsite, so teachers can
actually go in at their ownpace. Go through the learning of
how to apply the curriculum intheir classroom, it's free. So
costs shouldn't be a barrier,because there's no cost
Todd Crooks (20:37):
there or there doesn't have to be. So I can I
can hear a frustration around.
Okay, great. There's thiswonderful curriculum about
mental health, you're telling methat there's no cost to get it.
And we can probably come up withtraining time to get this
implemented. And you're sayingit fits right into health
classes and stuff. So myquestion to you is, what two
(20:59):
weeks of curriculum do not wantus to teach to make room for
this? And I see schools all overthe place that are teaching
mental health curriculum. AndI'm wondering, did they
sacrifice other curriculum tomake this happen? Are they
skipping two weeks in algebra tomake this happen? are they
missing certain aspects ofreproductive health? How are
(21:22):
schools doing this withoutmaking that kind of sacrifice?
Dr. Kutcher (21:28):
Well, I wouldn't call it a sacrifice. First of
all. I would, I would note thatschools change curriculum
constantly. We don't, we don'tuse an abacus in math class
anymore. So schools change whatthey teach all the time. So I
find that as sort of other veryconvincing kind of argument, I
(21:52):
don't, I don't buy that for aminute. I see that more as they
either institutional inertia, ora stigma in itself.
Todd Crooks (22:02):
If you could tell a school principal, or a health
teacher that was on the fenceabout mental health literacy,
one thing to dispel concernsabout opening that Pandora's box
of student knowledge, what wouldit be? What would you tell them
in an elevator speech, to helpthem realize this is something
(22:23):
they needed to do?
Dr. Kutcher (22:24):
I would say that their concerns have been thought
about and raised by others. Andthe research that has been done
to show that their concerns havebeen addressed, and that the
data always go back to the data.
The data shows us that when thisis instituted in schools, there
(22:46):
is improvement for the kids, butalso improvement for the
teachers, I would challengeanybody to find a lot of things
that are going into schoolcurricula, where you can say
with a relative concept, thatwhat we're doing in the
classroom is not only benefitingthe kids in the classroom, but
(23:06):
it's benefiting teachers in theclassroom.
Todd Crooks (23:11):
Turning that a little bit. If you can imagine
yourself with a microphonestanding in a gymnasium to an
all school assembly, and you'readdressing a student body that
was steeped in stigma and didn'thave a mental health literacy
program in their school. Youcould tell them one thing, what
would you stand in front ofthose bleachers, and say?
Dr. Kutcher (23:34):
And when we first started this, I did exactly
that. And I'll share with youwhat I did. I would say to the
assembly, how many of you knowsomeone who has diabetes? All
sorts of hands would shoot up?
How many of you have someone inyour family or know somebody who
has cancer? All sorts of handsshoot up? And then I would say,
(23:58):
how many of you have someone inyour family or know someone who
has a mental illness? And nobodywould say anything? And then I
was and then I would use that?
Unknown (24:12):
How did we feel when that question was asked. And
what were we thinking about whenthat question was?
Dr. Kutcher (24:20):
I see people looking nervously around to see
who raised their hand. What isthat all about? And actually,
even in large assemblies, I wasable to engage with kids to
start to talk about what theywere seeing what they were
thinking what they were feeling.
And labeling that as normal.
(24:41):
Because it's a stigma. We don'teven realize it. Because the
prevalence of mental illness issubstantial. So everybody in
that auditorium actually has afamily member, or actually does
know someone that has a mentalillness. But it's very easy for
(25:02):
them to talk about knowingsomeone who has diabetes, but
it's not easy for them to talkabout someone who has a mental
illness. And what does thatactually mean? So when they're,
Todd Crooks (25:16):
well, I would love nothing more than to have this
mental health literacy librarythat's being developed, become a
silver platter for the entirecountry. To say, here are the
programs here, the curriculumshere is the data that exists
behind each one for you toevaluate. And here's how you
(25:40):
would implement it based on whatother schools have been
successful at. And I would lovefor it to be a nationally
utilized library.
Dr. Kutcher (25:49):
I think that that's a tremendous vision that you
have, because particularly thecurriculum that I know best, and
I can speak to, it's beendemonstrated to be effective in
all sorts of places that it'sbeen implemented and studied.
And we did learn very, veryearly on in the first edition,
(26:10):
the teachers had to be trainedin the use of the curriculum for
it to be effective, because theteachers themselves didn't know
the material, it couldn't teachit, which is exactly how
teachers operate anyway, theyteach what they know, right? So
teachers has to be able tounderstand and utilize the
material and your library mightwant to look at partnering with
(26:32):
the University of BritishColumbia Faculty of Medicine,
provide links to their teachertraining programs, which are
also all free. teacher trainingprograms can be done as
professional development thatcan be done as self interest
that can also be done byfaculties of education, because
(26:53):
the there is a specialcurriculum there that is
designed for faculties ofeducation, and is certified by
the university faculties ofeducation in Canada. So people
can look at it and the Facultyof Education say, Wow, this has
already been done. This is good.
There's good evidence that it'svery effective training
teachers, and there's goodresearch on that. There you go.
(27:13):
So many thanks for doing this.
And and don't give up becauseyou're onto something which can
make a difference in the livesof other kids.
Todd Crooks (27:28):
Well, thank you, Dr. Kutcher. There's no quit in
here. Hopefully, we'll becelebrating together later this
year. And there you have it. Ifyou are an educator still fuzzy
on the need or the feasibilityof offering mental health
literacy to your students, Isuggest you go back and listen
to Dr. Kutcher. Again. This issomething that's time is
(27:50):
overdue. We're still going toturn the tide on the grim
student survey numbers and otherindicators of the youth mental
health crisis we're in. You mustimplement a program as soon as
possible. Now, I can hear youout there. Sure, Todd, where
would I even start I get it.
It's really important, but Idon't have time to hunt for a
(28:13):
program, learn it on my own. getit approved or vetted, then
figure out how to insert it intomy teaching day. First. Remember
what Dr. Kutcher said, teacherslearned mental health literacy
simply through the process ofinitiating a program. And
second, here's the excitingnews. Right now we're working
(28:36):
with the University ofWashington smart center to
create a new mental healthliteracy library. We intend to
roll it out in time for fall2021 in person learning. In
short, it will list availablecurriculum and programs vetted
against the four pillars ofmental health literacy Dr.
Kutcher just described,inventoried in met learning
(28:57):
standards as prescribed by theWashington State Office of the
superintendent of publicinstruction, and will include a
listing of best practicerecommendations for the
implementation of each listingin the library. It'll be a
dedicated website vetted byeducational experts and
available to any educatorwanting to provide their
(29:20):
students the knowledge they'vebeen missing to date, the
knowledge they've been askingfor 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 stigmais near. We'll start with our
(29:40):
youth generation and grow fromthere. You'd like to follow
progress for this work. Keep aneye on our Facebook page at
Chad's Legacy Project. We'll beannouncing some pretty big
updates in February and March,especially the upcoming rollout
of the survey request forcurriculum program stakeholders.
(30:02):
And that's that the problem anda big part of the solution was
just luck as 2021 rolls along.
Thanks so much for checking inwith us at chat chats, and
we'll chat again.
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