The field test of The Science of Mental Illness curriculum supplement for middle school (grades 6-8) children provided an opportunity to assess knowledge and attitudes about mental illness in more than 1,500 middle school students throughout the United States and to evaluate the impact of an educational intervention on stigma-related attitudes. Two primary questions were examined: (1) what are the baseline knowledge and attitudes about mental illness in this sample of middle school students, and (2) does participation in a curriculum about the science of mental illness increase knowledge and improve attitudes about mental illness? Consistent with findings from other studies, results indicate that students had some understanding of mental illness as a problem of the brain with biological and psychosocial causes; however, they lacked knowledge about treatment and overall were "not sure" about many aspects of mental illness. The students did not strongly endorse negative attitudes about mental illness at baseline. The curriculum produced significant improvements in both knowledge and attitudes at posttest and was most effective in improving attitudes among those with more negative baseline attitudes. These findings suggest that a brief educational program can be an effective intervention to increase knowledge and improve attitudes about mental illness.

One of the most important recommendations to emerge from the meeting discussions is for increased collaboration among clinical and epidemiological investigators whose work focuses in the area of depression with those working primarily in the area of memory disorders. Directions for future research were identified.

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Many advocates have called for more anti-stigma programs targeting the attitudes of children towards people with mental illness as a way to forestall subsequent prejudice and discrimination as they age and develop. In order to better understand how children stigmatize people with mental illness, we reviewed the substantial literature on social cognitive development and ethnic prejudice. This literature suggests a curvilinear relationship. Children as young as three show some endorsement of stereotypes about people of color, which slowly increases and seems to peak around age fi ve to six. Older children, interestingly, show lower rates of ethnic prejudice. Differences between mental illness and ethnicity-related stigma may infl uence the form of this relationship and we provide some hypotheses representing this difference. We then summarize the literature on stigma change, focusing on how specifi c strategies interact with what is known about social cognitive development and prejudice. Strategies that are reviewed include education, contact, social cognitive skills training, role play for empathy, peer interaction, protest and consequences. Implications for continued research in this area are highlighted throughout the article.

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Modern consideration of stigma begins with Irving Goffman, whose seminal Stigma: Notes on the Management of Spoiled Identity (1963) powerfully evokes the interpersonal and psychological processes involved in the creation and maintenance of discrediting personal attributions: Send reprint requests to Dr. E. Otey, DAHBR/NIMH,

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