Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK.
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ObjectivesTo determine the effectiveness of a universal school-based depression education program.MethodsIn 2012-2015, we matched 6679 students from 66 secondary schools into pairs by state (Maryland, Delaware, Pennsylvania, Michigan, and Oklahoma) and randomized to the Adolescent Depression Awareness Program (ADAP; n = 3681) or to a waitlist control condition (n = 2998). Trained teachers delivered ADAP as part of the health education curriculum to students aged 14 to 15 years. The primary outcome was depression literacy. Secondary outcomes included mental health stigma and, in a subset of the sample, the receipt of mental health services. Follow-up was at 4 months.ResultsADAP resulted in significantly higher levels of depression literacy among participating students than did waitlist controls, after adjusting for pretest assessment depression literacy (P < .001). Overall, ADAP did not significantly affect stigma (P = .1). After ADAP, students approached 46% of teachers with concerns about themselves or others. Of students who reported the need for depression treatment, 44% received treatment within 4 months of ADAP implementation.ConclusionsADAP is an effective public health intervention for improving depression literacy among students.Trial RegistrationClinicaltrials.gov NCT02099305