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PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION SUBMITTED BY: MISS. NABANITA PAUL. 1ST YEAR. M.Sc. NURSING, PSYCHIATRIC NURSING, 2012- 2014 BATCH, ORIENTAL COLLEGE OF NURSING, BANGALORE -560010 1 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA 2. NAME OF THE INSTITUTE Miss. Nabanita paul. 1st year M.Sc. nursing Oriental college of nursing, #43/52,2nd main, industrial town, west of chord road, Rajajinagar, Bangalore – 560010. Oriental College of Nursing. 3. COURSE OF THE STUDY AND SUBJECT 1st year M.Sc. nursing Psychiatric nursing. 4. DATE OF ADMISSION 11/06/2012 TITLE OF THE STUDY “A quasi experimental study to evaluate the effectiveness of video assisted teaching programme on knowledge and attitude regarding mental illness among students in selected colleges, Bangalore”. NAME OF THE CANDIDATE 1. AND ADDRESS 5. BRIEF RESUME INTENDED WORK: 6. OF THE 6.1 Introduction 6.2 Need for the study 6.3 Review of literature 6.4 Statement of the problem 6.5 Objectives of the study 6.6 Operational definitions 6.7 Assumptions 6.8 Hypotheses of the study 6.9 Inclusion and exclusion criteria Enclosed Enclosed Enclosed Enclosed Enclosed Enclosed Enclosed Enclosed Enclosed MATERIAL AND METHODS: 7.1 Source of data- The data will be collected from students who are studied in selected colleges, Bangalore. 7. 8. 7.2 Method of collection of data - Structured questionnaire and Likert scale. 7.3 Does the study require any investigation or interventions to be conducted on patients or other humans or animals? - Yes. 7.4 Has ethical clearance been obtained from your institution?- Yes, ethical committee’s report is here with enclosed. Enclosed. LIST OF REFERENCES: 2 PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION NAME OF THCANDIDATE AND ADDRESS Miss. Nabanita Paul. 1st year M.Sc. nursing Oriental college of nursing, #43/52,2nd main, industrial town, west of chord road, Rajajinagar, Bangalore – 560010. 2. NAME OF THE INSTITUTE Oriental College of Nursing. 3. COURSE OF THE STUDY 1st year M.Sc. nursing Psychiatric nursing. AND SUBJECT 1. 4. DATE OF ADMISSION 11/06/2012 5. TITLE OF THE STUDY “A quasi experimental study to evaluate the effectiveness of video assisted teaching programme on knowledge and attitude regarding mental illness among students in selected colleges, Bangalore”. 3 6. BRIEF RESUME OF THE INTENDED WORK 6.1 INTRODUCTION: “An investment in knowledge pays the best interest.” Benjamin Franklin People who fail to fulfill their roles and carryout responsibilities or whose behavior is inappropriate to the situation are viewed as Mental Illnesses. Predisposing factors determine an individual’s susceptibility to mental illness. These factors are operating from early life that determines a person’s vulnerability to cause the illness1. Mental health problems refer to the more common struggles and adjustment difficulties that affect everybody from time to time. These problems tend to happen when people are going through difficult times in life, such as a relationship ending, the death of someone close, conflict in relations with family or friends, or stresses at home, school or work. Feeling stressed or having the blues is a normal response to the psychological or social challenges most people encounter at some time or another. The students are also having a significant lack of knowledge about mental illness and also shown quite negative attitude in many studies. In India, maximum research study conducted on knowledge and attitude results poor knowledge about mental illness among students.2 The history of psychiatry gives us the information that at ancient time people had the concept to believe that abnormal behavior was occurring due to the act of ‘devil’ or ‘evil spirit ‘or ‘magical power ‘or ‘anger of God’. But with the change of area those typical thoughts also changed and from the time of Asclepiads (124BC) to the time of Sigmund Freud (156-1893) had brought a revolutionary changes in psychiatric field. People also started to accept all the scientific reason behind the mental illness up to some extend by changing their thoughts. 4 Now in modern period, the stage of psychiatry changing sophisticatedly for the betterment of public mental health and with that how the new generation are getting aware about mental health and illness in very essential to know. It shows how our society coping with the situation of mental health alteration. Though young generation is the future of every nation.3 For young people; to help public understand the issues that matter to public and their health. Here may be surprised to hear that 1 in 5 young people live with a mental illness, and that many mental illnesses develop during adolescence. Although all may not suffer from a mental illness, chances are one may know someone who has or who has been diagnosed with a mental disorder. It is important to remember that even if we don’t have mental illness, everyone has mental health, and there is no health without mental health. 4 It is known that, getting older is filled with exciting challenges and transitions, as well as changes and uncertainty. For most people, the related stress is temporary and manageable, and this guide provides public with tools that can help them live a happy and healthy life. We can use this guide to get inspired, informed and involved in making mental health a priority personally, in our community, and around the world.5 It is a believe that any young person can be a leader provided they are given the tools and support they need to take action, and society strive to give young people a voice. That’s why society can read about inspiring youth who are actively promoting awareness and acceptance about mental illness throughout this guide.6 5 6.2 NEED OF THE STUDY: College students has been considered as a high risk group of great stress, impoverished coping skill and high vulnerability to biological, psychological and educational demands. College students are in the period of exploration and experimentation, but the young people often lack of knowledge, experience and maturity to avoid great risk that confront them. There are a number of reasons for college students to feel stressed. These include problem with peers, family assumes or problem with parents, college related problems or pressures, love-affairs, cheated by love partner, move to a new home, injuries or severe illness, sexual abuse, family or community violence and natural disaster.7 Although young adulthood is often characterized by rapid intellectual and social development, college-aged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. Many types of mental health dilemmas appear to be besetting today’s college students. Mark Reed, M.D, director of counseling and human development at Dartmouth College Health Service, gave Psychiatric News a rundown -"The most common issue for students is mood disorders, followed by general developmental issues—a relationship, intimacy, identity, independence, family issues, plans for the future. Next come anxiety disorders—social phobias, obsessive-compulsive disorder, post traumatic stress disorder, and general anxiety disorder. We also see many students with eating disorders and substance abuse disorders and as is common in all areas of mental health, many of our students deal with more than one issue or disorder." 6 From 2001 to 2011, the percentage of full-time undergraduates who relied on some type of federal loan increased from 30% to 43%, and nearly 80% of undergraduates at postsecondary institutions worked during the 2010–2011 school year. Although working may offset some costs of schooling, employment can also limit students’ learning opportunities and have a negative effect on grades (Megivern, 2012; Megivern & Pellerito, 2012).8 Increased financial strains on students, due to funding cutbacks in scholarships and loans, put additional pressures on students that may precipitate psychological disorders (AUCC, 2007; Reinherz et al., 2007).9 Jackie Ayers, PhD, director of mental health services at the University of Florida and immediate past president of the American College Health Association, provided Psychiatric News with a similar litany: "Some of the most common mental health problems seen in campus these days are depression, stress/anxiety disorders, relationship issues, alcohol and drug use, sleep difficulties, eating disorder problems, learning disability (ADD/ADHD), sexual assault/abuse, obsessive-compulsive disorder, grief and loss issues." Another college mental health difficulty—depression—appears to be widespread today. The American College Health Association in Baltimore surveyed college students’ mental and physical health in spring 2011. It was called the National College Health Assessment and included data from over 16,000 students at 20 public colleges or universities and at 8 private colleges or universities from throughout the United States. The assessment revealed that 10% of all students surveyed had been diagnosed with depression.10 Still, one can hardly dispute the fact that even a few college suicides constitute terrible tragedies—that the suicide of even one student is a devastating loss. There is reason to believe that certain types of mental health problems besides suicide are increasing on college campuses. For instance, from 2009 to 2010 liquor arrests on college campuses were up 4%, 7 drug arrests were up 10% and murders were up 45%, according to statistics released by the U.S. Department of Education in December 2011.11 Another factor affecting college students’ mental health is stress. In fall 2004 researchers from the University of California at Los Angeles polled freshmen on campuses around the United States as to how stressed they felt. 30% said that they felt overwhelmed by what they had to do.12 Moreover, college students’ mental health troubles appear to be more serious than they used to be. "In speaking to colleagues at other college counseling centers, Reed said, "most report a 35% increase in psychiatric hospitalizations over the last five years." At Dartmouth alone, he added, "We have about 50 students a year now taking leave for psychiatric reasons."13 According to Indian report, seven students took the drastic step in IITs across the country in 2011. According to the HRD ministry, IITs reported two suicides in 2010, four in 2009 and five in 2008. National Crime Records Bureau report says that there has been a 26 % rise in student suicides in India between 2006 and 2010. The reasons attributed are academic stress in a high performance environment, peer pressure, depression and high expectations of family. Reportedly student suicides raised 26% in India from 2006 to 2010, according to data released by the National Crime Records Bureau 5,857 student suicides were reported across India in 2006, the figure jumped to 7,379 in 2010 and it will increases approximately double by 2013.14 College students form the cream of student population. According to NIMHANS report, studies have shown that, in India about 50% students suffer from health problems .15% of the students suffer from mental disorder like depression, anxiety, hysteria, somatoform mental disorder, adjust reactions, alcohol and drugs and other emotional problems and not having awareness to seek treatment. 8 Statistical report by NIMHANS of diagnosed mental illness case among college students in Karnataka (2010-2012) are depression among male 7.5% and female 12.0%, stress in male 5% and female 3.4%, anxiety among male 3.5% and among female 3.1%, alcoholic among male 25.5% and among 5.4%, substance abuse mainly heroin among male 1.7% and in female 0.5% and cannabis in male 1.9% and 0.45%.15 Rather than these also we can identify the college students, being key and productive citizens of the future, need to be taken care of, as they are in the transitional period characterized by enormous changes. As the age of college students is the time of both risk and opportunities, it is high time to help and support them and suitable measures are needed to enhance skill of college students in addressing various day to day stressors so that they learn the ways and means of promoting their physical and mental health. Although college students from 19-21% of our population, there is no national program for their betterment in last year of independence, even though they are the best human resources of the country.16 A survey study to know the students perception about mental illness was conducted in Ranchi University, India. A total of 100 samples (50 female and 50 male) were purposively recruited for the study, and the 51 items opinion about mental illness (OMI) scale was administered. With regard to OMI scale, the item, viz. the low should allow a women to divorce her husband as soon as he has been confined in mental hospital with a severe mental illness, both male (46%) and female (56%) students were neutral (significant at 0.014, p< 0.05).17 A study was conducted on the Edge is a drama-based mental health education program designed to support early intervention by increasing knowledge and understanding of early psychosis, depression and reducing the stigma associated with mental health issues. The 9 target audience was young people aged 17 to 22 years in schools and colleges. Sample size was 2500 that took place in 51 schools and colleges. The program was evaluated against its aims with data collected both during and after the tour. Result was quantitative and qualitative evaluation found significant gains with respect to all three aims. 31 schools developed supportive links with local mental health service.18 Investigator have recognize from some previous experiences of caring some college students with mental illness who came for visiting in outpatient department for counseling having some knowledge regarding other illness which is common in our society but very poor knowledge about mental illness though it is a cause of centre disability of our health recently. So the researcher realized that if awareness program on mental illness can be conduct than as young blood college students can get some benefit & also can act as informant regarding mental illness awareness for their neighbor suffering from mental disability and as well as for entire society. These make the investigator to undertake the study as field of interest on knowledge & attitude of mental illness among college students in selected colleges in Bangalore. 6.3 REVIEW OF LITERATURE: ‘Good research does not exist in vacuum’. Review of literature refers to the activities involved in identifying and searching for information on a topic and developing a comprehensive picture of the state of the knowledge on that topic. A review of related literature gives an insight into various aspects of the problem under study. The review serves as an integrated function that facilitates the accumulation of knowledge. 10 Hence review of literature is important to a research in order to know what has been established and documented. In this study, the relevant literature reviewed has been organized and presented under the following headings:1. Literature related to knowledge & attitude and perception towards mental illness. 2. Literature related to teaching given to the college students on mental health and illness. 3. Literature related to mental health training program. 1. Literature related to knowledge & attitude and perception towards mental illness. A descriptive study was conducted in UK to assess the young people’s understanding of mental illness at selected mainstream schools. In this study sample size was 120 young people at the age group of 16 to 20 years. The study shown that clear understanding about mental illness were not possessing anyone of them but 20% of young people expressed their own experience, 40% had expressed their low level of understanding and their own opinion, 60% of them were having myths and total lack of understanding about mental illness towards related questioners and interviews.19 A descriptive study was conducted to assess the public knowledge and beliefs about mental disorders among selected community people in Australia. A narrative review within a conceptual framework was done. The study sample size was 712 community people. The study result shown that many members of the samples cannot recognize specific disorder or different types of psychological distress. Much of the mental health information most readily 11 available to the public is misleading. However, there is some evidence that mental health literacy can be improved.20 A descriptive study was conducted to assess the public perception of mental health in Iraq. The survey was carried out in 500 participants’ homes across to districts of Baghdad, Iraq. Participants were asked to complete a questionnaire which was designed specifically for Iraqi contexts and was made available in two languages. The research design was a nonexperimental random field research survey. The study result shown that 418 questionnaires out of 500 were returned giving a response rate of 86.4% community opinion in Iraq about the etiology of mental illness is broadly compatible with scientific evidence. However, understanding of the nature of mental illness, its implications, for social participation and management remains negative.21 A cross-sectional survey study was conducted on attitudes towards mental illness among patients and care givers in general hospital in Blantyre, Malawi. The sample size was taken 210 and participants were interviewed using an adopted version of the questionnaire developed. Result were showed, most attributed mental disorder to alcohol and illicit drug abuse(95.7%), which is closely followed by brain disease(92.8%), sprit possession(82.8%) and psychological trauma(76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatized beliefs. Contrary to the international literature, having direct personal experience about mental illness seemed to have no positive effect on stigmatizing belief on our sample.22 12 2. Literature related to teaching given to the college students on mental health and illness. A study of diet quality and mental health among young adult was conducted. In this study 3040 Australian young adults were measured in 2005-06 and 2007-08. Study was conducted in selected college in Australia. Information on diet and mental health was collected by self report and anthropometric data by trained researchers and intervention studies were given to test the effectiveness of preventing the common mental disorders through dietary modification. Result shown that an improvement in mental health over the follow up period, while deteriorating diet quality was associated with poorer psychological functioning.23 A quasi experimental study was conducted on evaluate the effectiveness of a training program on attitudes towards mental people with mental illness for secondary school students. The study was conducted in selected schools in Hong Kong. Study sample size was taken 117 students from 13 schools, which composed the treatment group and comparison group consisted of 102 secondary school students who had received no intervention. In result shown that the study revealed significant positive changes, which could last a longer period of time, in specific attitudes on separatism and stigmatization of people with the mental illness among students after the training program.24 A pre-experimental study was conduct to intervene the knowledge level regarding bulimia nervosa among elderly adolescent. Study was conducted at selected colleges in UK and the sample size was 80 was who reporting symptom of bulimia completed, by e-mail, a therapeutic or control writing task. Participants completed questionnaires on bulimic symptoms, mood and potential moderating and mediating factors and were followed up after 4 and 8 weeks. Result shown bulimic symptoms decreased in both groups, although in both 13 groups the number of participants who improved was approximately equal to the member who did not improve.25 A retrospective analysis was conducted to estimated attitudes and beliefs about treatment in a national sample of college students with untreated mental health problems among college students in the United States, was conducted. The random sample included 13,105 survey participants from 26 institutions. Students with untreated depression, anxiety, or suicidal ideation (N=2,350) were classified by attitudes about treatment (stigma), beliefs about effectiveness of treatment, and perceived need for treatment. Results was a majority (65%) of untreated students reported low stigma and positive beliefs about treatment effectiveness, including 42% who perceived a need for help and 23% who did not.26 A non-experimental cross sectional study was conducted to assess the knowledge of college students regarding psychosocial problems of late adolescents in selected collage of Tumkur, Karnataka. The study sample size was taken 60. Result had been shown that overall knowledge of college students was very poor, and need to implement it.27 3. Literature related to mental health training program: A study was conducted in America to assess the impact of a mental health teaching program on adolescent pupils’ understanding. It was an experimental study where two group pre-test post test control group study in two English secondary schools. Sample size was 70 and participants were 14 and 15 years old pupils. Questioners’ were used as tool of the study and the results shown that after intervention gets more knowledge then before intervention i.e., pre-test. Pupils’ valued the intervention highly, in particular the lessons on suicide or self harm.28 14 A pre experimental study was conducted in UK on to assess the effectiveness of a school based intervention to increase teenagers’ knowledge about mental health issues and promoting positive attitude towards people with mental health problems. The study design was a non-controlled intervention study. Knowledge level about mental health problem was measured before and after an educational intervention using the ‘mind out for mental health’ quiz. Sample size was taken 160. Result shown that pupils’ median quiz score was greater following the intervention than before it (p=0.015).29 A study was conducted by combining education and video based contact to reduce stigma of mental illness for secondary school in Hong Kong. The participants, 255 students from three secondary schools in Hong Kong, completed measures of stigmatizing attitudes (Public Stigma Scale), social distance (Social Distance Scale), and knowledge about schizophrenia (Knowledge Test) at pre-test, post-test, and 1-month follow-up. Results suggested that adding video-based contact to education could significantly improve program effectiveness only when video-based contact was presented after but not prior to education. In comparison with the education condition, the education–video condition showed larger improvements in stigmatizing attitudes at post-test, in social distance at both post-test and follow-up, and in knowledge at follow-up. However, such differences were not observed when the education condition was compared with the video–education condition. Implications of these findings for future research are discussed.30 15 6.4 PROBLEM STATEMENT: “A quasi experimental study to evaluate the effectiveness of video assisted teaching program on knowledge and attitude regarding mental illness among students in selected colleges, Bangalore.” 6.5 OBJECTIVES OF THE STUDY: 1. To assess the pre test and post test knowledge and attitude regarding mental illness among students in both experimental and control group. 2. To evaluate the effectiveness of video-assisted teaching program on knowledge and attitude regarding mental illness of students with the post test scores. 3. To determine the association between the pre test knowledge and attitude scores of experimental and control group with selected socio-demographic variables. 6.6 OPERATIONAL DEFINITIONS: Effectiveness: Refers to gain in knowledge and positive attitude regarding mental illness like depression, stress, suicide, and substance abuse including alcoholism as determined by significant increase in pre and post test knowledge and attitude scores as assessed by structured questionnaires and Likert scale. Video assisted teaching Program: refers to the planned teaching material of lecture combined with video with duration of 45 minutes on mental illness i.e., depression, stress, suicide and substance abuse including alcoholism among students in selected colleges, Bangalore. 16 Knowledge: Refers to awareness and understanding regarding mental illness like depression, stress, suicide and substance abuse including alcoholism through the structured questionnaire among students in selected colleges, Bangalore. Attitude: Refers to opinion, values, feelings or thinking expressed by students about mental illness like depression, stress, suicide and substance abuse including alcoholism which will be assessed by Likert scale. Mental illness: Refers to clinically significant behavior psychological syndrome or pattern that occurs in among students studying in degree colleges and associated with distress or disability or significantly increased risk of psychic pain, lack of freedom and death. Students: Students enrolled in the college who are studying at degree colleges in Bangalore. 6.7 ASSUMPTIONS: 1. Students have inadequate knowledge and inappropriate attitude regarding mental illness. 2. Video assisted teaching program on selected mental illness enhances the knowledge and attitude of students regarding selected mental illness. 6.8 HYPOTHESES: H1: There will be a significant increase in knowledge & attitude on mental illness among students between pre-test and post-test scores in experimental group after video assisted teaching program. H2: There will be a significant association between the pre test knowledge & attitude score on mental illness among students with selected socio-demographic variables. 17 6.9 SAMPLING CRITERIA: INCLUSION CRITERIA: Students who are: - Willing to participate in the study. - Studying in degree colleges at regular basis. - Knows English or Kanada. - Available at the time of data collection. EXCLUSION CRITERIA: Students those are: - From health profession (psychology, psychiatry, medical and nursing department). - Previously participated in any training program of mental illness. - Already participated in the pilot study. DELIMITATIONS OF THE STUDY: 1. The study sample taken is limited only from degree colleges. 2. The study is limited to students who are living in Bangalore. 18 7. MATERIAL AND METHODS: 7.1 Source of data: The data will be collected from students who are studied in selected degree colleges, Bangalore. 7.2 Method of data collection: 7.2.1) Research approach: It will be evaluative research approach. 7.2.2) Research design: Quasi experimental design. The research approach adopted for this study is quasi experimental in nature. Pre-test (O1) Intervention (X) Experimental group: Assessment of existing Video knowledge and assisted Post-test (O2) Assessment of post test knowledge and attitude regarding mental illness teaching attitude program on mental illness. regarding mental illness among students. among students. Control group: Assessment of existing attitude knowledge regarding No Intervention and Assessment of knowledge and mental attitude mental illness among students. students. 19 illness regarding among 7.2.3) Population: The students who studying in degree colleges, Bangalore. 7.2.4) Setting of the study: The study will be conducted in selected degree colleges, Bangalore. 7.2.5) Sample: Students who fulfill the inclusion criteria. 7.2.6) Sampling technique: Non-probability purposive sampling. 7.2.7) Sample size: The sample consists of 60 students who are studying in selected degree colleges, Bangalore. 7.2.8) Method of data collection (including sampling procedure): - The data collection procedure will be carried out for a period of one month. - The investigator will collect data from students by using structured questionnaire to assess the knowledge & Likert Scale to assess the attitude before and after introducing a video assisted teaching program regarding knowledge and attitude about mental illness. The structured questionnaire Section I: Socio-Demographic schedule consists of following sections: data. Section II: Structured questionnaire to assess the knowledge regarding mental illness among students. Section III: Scale to assess the attitude towards mental illness among students. Section IV: Video assisted teaching program. 20 7.2.9 Tool for data collection: A structured questionnaire and a scale to assess the attitude will be use to collect data from students studying in degree colleges, Bangalore. The tool consists of the following sections: Section A: Demographic data of college students such as age, sex, religion, type of family, income of family, occupation of head of family, source of information, area of residence(urban/ rural). Section B: Structured self-administered questionnaire to assess the knowledge of students regarding (a) the ability to recognize specific disorders or different types of psychological distress; (b) knowledge and beliefs about risk factors and causes; (c) knowledge and beliefs about self-help interventions; (d) knowledge and beliefs about professional help available; (e) attitudes which facilitate recognition and appropriate help-seeking of mental illness like depression, stress, suicide and substance abuse including alcoholism. Section C: 4 point Likert Scale to assess the attitude of students towards mental illness like depression, stress, suicide and substance abuse including alcoholism. Section D: Video assisted teaching program on (a) the ability to recognize specific disorders or different types of psychological distress; (b) knowledge and beliefs about risk factors and causes; (c) knowledge and beliefs about self-help interventions; (d) knowledge and beliefs about professional help available; (e) attitudes which facilitate recognition and appropriate help-seeking of mental illness i,e. depression, stress, suicide and substance abuse including alcoholism which will be used to teach the students in selected degree Colleges, Bangalore. 21 7.2.10 Method of data analysis and presentation: The data collected will be analyzed by using descriptive and inferential statistics. Descriptive Statistics: Frequency and percentage for analysis of demographic data and mean, mean percentage and standard deviation will be used for assessing the level of knowledge and attitude of students. Inferential Statistics: Chi- square test will be used to find out the association between knowledge & attitude with selected demographic variables. And paired t’ test will be used for assessing the effectiveness of video assisted teaching program. Duration of study: 4 weeks. VARIABLES: Variables are qualities, properties or characteristics of persons, things or situations that change or vary. Variables of present study were the following:*Independent variables: - Video assisted teaching program. *Dependent variables: - knowledge and attitude regarding mental illness among students. *Demographic variables: - age, sex, religion, source of information, types of family and area of residence (urban or rural). PROJECTED OUTCOME: The investigator will assess the existing knowledge and attitude regarding mental illness among college students. Following which the investigator will administer video assisted teaching programme and by this the knowledge and attitude regarding mental illness will improve. 22 7.3) DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS? Yes. As intervention, a video assisted teaching program will be administered on the students on selected mental illness in selected degree colleges, Bangalore. 7.4) ETHICAL CLEARANCE: Yes. 23 8. LIST OF REFERENCE: 1. Kermode M, Bowen K, Arole S, and Jag K, Jorm A. Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. Social Psychiatry and Psychiatric Epidemiology 2009; 44: 1087-1096. 2. Smith Valerie, Reddy Jairus, Foster Kenneth, Asbury Edward T and Brooks Jennifer. Public perceptions, knowledge and stigma towards people with schizophrenia. Journal of Public Mental Health 2011; 10: 45 – 56. 3. Neeraja KP. Essential of mental health and psychiatric nursing. 1st Ed. New Delhi. Jaypee brothers medical publishers (P) LTD. 2008. P.36-54. 4. Seeker J, Armstrong C, Hill M. Health education research theory and practical: young peoples’ understanding of mental health illness. London. Mental health foundation publication 1999; 14: 729-739. 5. Stuart H, Arbodela-Florez J. Community attitudes towards people with schizophrenia. Canadian Journal of Psychiatry 2001; 46: 245-252. 6. Beinecke Richard H, Spencer Justin. Leadership Training Programs and Competencies for Mental Health, Substance Use, Health, and Public Administration in Eight Countries. International Initiative International Initiative for Mental Health Leadership 2007 April; 8: 4-5. 7. Teen mental health 2012 Feb. Available at, www.teenmentalhealth.org/guide2action. 8. Benton, S. A, Robertson, J. M., Tseng, W., Newton, F. B., & Benton, S. L. Changes in counselling centre client problems across 13 years. Professional Psychology: Research and Practice 2003; 34: 66–72. 24 9. Adams. T. & Moore. M. High-risk health and credit behaviour among 18- to 25-yearold college students. Journal of American College Health 2007; 56: 101–108. 10. Canadian Mental Health Association Mental Health and High School Curriculum Guide 2011. Available at, http://www.teenmentalhealth.org/curriculum. 11. World Health Report 2001, World Health Organization - Mental Health: New Understanding, New Hope. Available at, http://www.who.int/whr/2001/en/index.html 12. National Institute for Mental Health (NIMH) 2011, Available at, http://www.nimh.nih.gov/ 13. Teen mental health 2012 June. Available at, http://teenmentalhealth.org/images/pages/Just_Ask_for_Young_Adults_ _Web.pdf 14. Krishnaswamy. Ram. Suicide at IIT’s. Indian Express, Chennai 2012 September 27, 01:34 hrs. 15. Dr. Chandrasekhar C.R., Dr. Suresh B.M., Dr. Moily Sundar, Dr. Sakar K. NIMHANS, Bangalore. Manual on students counselling for collage teachers 2007; 3rd: 26-28. 16. Hill M, Laybown A, Borland M, Seeker. Promoting mental and emotional wellbeing: the perceptions of younger children. 1st ed. Avebury. Aldershot publishers. 2009. P.54-65. Vol.5. 17. Mahto R. K. , Verma P. K. , Verma A. N. , Singh A. R. , Chaudhury S. and Shantna K . Students’ perception about mental illness. Industrial Psychiatry Journal 2009 Jul-Dec; 18(2): 92–96. 18. Roberts Glenn, Somers John, Dawe Jocelyn, Passy Rowena, Mays Carly, Carr Graham, et al. On the Edge: a drama-based mental health education programme on early psychosis for schools. Early Intervention in Psychiatry 2007; 1: 168-176. 25 19. Wahl Otto, Susin Janet, M Lax Amy, Kaplan Lorraine, Zatina Dayna. Knowledge and Attitudes about Mental Illness: A Survey of Middle School Students. Psychiatric Services 2012 July; 63: 649–654. 20. Jorm A. Mental health literacy Public knowledge and beliefs about mental disorders. British Journal of Psychiatry 2000; 177: 396-401. 21. Sadik Sabah, Bradley Marie, Al-Hasoon Saad and Jenkins Rachel. Public perception of mental health in Iraq. International Journal of Mental Health Systems 11 October 2010; 4: 26-29. 22. Crabb Jim, Stewart Robert C, Kokota Demoubly, Masson Neil, Chabunya Sylvester and Krishnadas Rajeev. Attitudes towards mental illness in Malawi: a cross-sectional survey. BMC Public Health 2012; 12: 541. 23. Jacka Felice N, Kremer Peter J, Berk Michael, Sanigorski Andrea M. de Silva, Moodie Marjorie, Leslie Eva R, ET la. ) A Prospective Study of Diet Quality and Mental Health in Adolescents. International mental health 2011; 6: 26-29. 24. P Ng, KF Chan. Attitudes towards people with mental illness. Effects of a training program for secondary school students. International Journal of Adolescent Medicine and Health 2002; 14: 215-224. 25. Johnston Olwyn, Startup Helen, Lavender Anna, Godfrey Emma. Therapeutic writing as an intervention for symptoms of bulimia nervosa: Effects and mechanism of change. International Journal of Eating Disorders 2010 July; 43: 405-419. 26. Armstrong Gregory, Kermode Michelle, Raja Shoba, Suja Sujatha, Chandra Prabha and Jorm Anthony F. A mental health training program on beliefs about treatment for college 26 students in India: impact on knowledge and attitudes. International Journal of Mental Health Systems 5 august 2011; 5: 17. 27. Prof. Subramanian N. Assessment of early adolescent problem among collage students. Nursing journal India2009; 17: 14. 28. Battaglia, J., Coverdale, J. H. & Bushong, C. P. Evaluation of a mental illness awareness week program in public schools. American Journal of Psychiatry 1990; 14: 324 -329. 29. Gureje O, Olley O, Ephraim-Olowanuga O, Olley B, Kola L: school based study to evaluate of knowledge to mental illness in Nigeria. British Journal of Psychiatry 2005; 186: 436-441. 30. Chan Jenny Y.N , Mak Winnie W.S, Lawrence S.C. Combining education and video- based contact to reduce stigma of mental illness: “The Same or Not the Same” anti-stigma program for secondary schools in Hong Kong . Social Science & Medicine 2009 April; 68: 1521–1526. ___________________________ 27 9. SIGNATURE CANDIDATE OF THE 10. REMARKS OF GUIDE 11. NAME AND DESIGNATION ( IN BLOCK LETTERS) 11.1) THE GUIDE: Study can be proceed. MRS. B VIJAYAKUMARI. PROFESSOR, HOD OF PSYCHIATRIC NURSING. 11.2) SIGNATURE OF GUIDE: 11.3) HEAD OF THE DEPARTMENT: 11.4) SIGNATURE: 12. 12.1) REMARKS OF THE CHAIRMAN OR PRINCIPAL : 12.2) SIGNATURE: 28 29