SCHOOL INTEGRATION OF ADOLESCENTS WITH MENTAL DISEASE:
ATTITUDES OF THE GROUP BEFORE AND AFTER INCLUSION
ABSTRACT
This paper is a report on the findings of a project conducted on high school students and on two adolescents with
mental disease included in their class. The project lasted a year and intended to evaluate the effects of the
integration work on the students without mental disease.
In particular, the objectives of the project were:
 Evaluating the efficacy of a task aiming at making high school students aware of the issues involved in
mental disability to favor inclusion of classmates with disability;
 Planning an intervention protocol which could be extended to other schools.
The evaluation was done through the administration of a questionnaire to the students of the classes where the
two adolescents with mental disorders were included. The research followed a quasi-experimental design.
Results were evaluated by using the Q-Sort techniques, the chi squared analysis and the Analysis of Variance.
The analysis of the answers shows different profiles of attitudes toward mental disability. Comparison between
the two administrations reveals that during the school year changes occurred in some students’ opinions on the
personal resources and competencies necessary to interact with individuals with mental disorders and also on the
likelihood of their integration.
Keywords: mental disease, integration, Q-Sort
INTRODUCTION
The integration of adolescents with mental disease is one of the most interesting challenges that psychologists
and psychiatrists, but also teachers and other education specialists, have to face. The school is one of the main
channels through which projects of integration and raised awareness of mental disorders can be promoted from a
conscious perspective and with the help of trained personnel.
This type of projects must necessarily take into account and evaluate the receiving group’s attitudes to mental
disorders and beliefs about them. The class integration process of a student with disability can be evaluated
based on the changes that occur both in the class and in the student with disability. This paper examines the
effects of inclusion on the class as we think this perspective can provide valuable ideas for the operators of this
sector and for future projects of school inclusion.
THE STUDY
Throughout the school year the students taking part in the project had the support of a psychologist in order to
encourage in-depth discussion on disability and help the students acquire new instruments to cope in the best
possible way with the inclusion of the two new classmates.
An ad hoc questionnaire was devised to evaluate changed attitudes toward mental disability. The first section of
the questionnaire asked participants to express their agreement with a number of statements on mental disability
and on the society and school inclusion of individuals with mental disability. The second section – drafted
according to the Q-sort technique – consisted of statements on participants’ relationship with individuals with
mental disability, paying particular attention to daily life events and to situations experienced by the students in
the school year.
The first administration of the instrument for data collection and analysis was done in the initial phase of the
project and the second in the final phase.
FINDINGS
Attitudes to relationships with a person with mental disease
The comparison of the answers given in the two administrations shows increased awareness of the difficulties
encountered in relationships with persons with mental disease and a more problematic and less idealized
conception of disability. In support of this interpretation at the end of the school year some statistically
significant variations can be seen in the attitude variables: increased agreement about the lack of awareness
persons with disability have of their problems (item 2); lower confidence in the belief that these people can lead
the same life as anybody (item 8), and greater agreement about the strong help that they need (item 15). In
addition, the significant variations found for items 7 and 17 show more thoughtful reflection on the complexity
of the integration processes of these persons. The values of the answers go from 1 (totally in disagreement) to 6
(totally in agreement).
Figure 1 - Analysis of variance between first and second administration (attitudes)
In more detail, "The integration of people with disability means making them feel they are your friends" (item
18) shows that there are fewer students who believe that the way toward integration must necessarily involve a
friendly relationship. Though the result is interesting, caution must be used, given the low numerosity of the
sample.
Figure 2 - Chi square test between first and second administration (attitudes)
Affinity with statements on mental disease
The second section of the questionnaire focuses on the students’ closeness to, or distance from, statements on
daily life situations where the interaction with a person with mental disability may create problems or
embarrassment.
The items included in the Q-sort have been ordered according to their semantic valence (negative, neutral,
positive) toward disability.
Negative-valence items:
1. Sleeping with a person with mental disease would worry me
7. Taking a friend with intellectual disability that the others don’t know to a birthday party would make me feel
uncomfortable
9. I find it a bit hard to spend time with a person with mental disease
11. When I am with a person with mental disease I don’t feel free to behave as I would like to
15. I would get worried if an object that’s very dear to me was entrusted to a classmate with mental disease
Neutral-valence items:
2. Becoming the reference point for a person with mental disease would be too difficult for me
3. When I am with a person with mental disease I am afraid I may treat them too abruptly
4. When I am with a person with mental disease I happen not to understand what they really want to tell me
Positive-valence items:
6. Spending time with people with mental disease makes me a more mature person
8. I would lend my clothing to a person with mental disease
12. I would drink from the same glass as a person with mental disease
13. Spending time with people with mental disease helps me understand what life is really like
Although confining ourselves to the description of the variations of the means between the two administrations,
independently from statistical significance, interesting points for reflection do emerge. In particular, an increase
in the mean disagreement with the majority of negative-valence items (items 1, 7, 9), that is, statements that
represent distancing attitudes toward individuals with mental disease. At the same time, an increase can be seen
in the agreement with items that point to the integration of these persons. In particular, there is increased
agreement with the items that underline the importance of the experience as a time of personal growth (items 6
and 13).
These results notwithstanding, the students think it is quite demanding to have a closer relationship with
classmates with mental disease: exchanging dear objects, lending clothing, drinking from the same glass (items
15, 8, 12). This is the result of greater awareness of what mental disease means.
In the same way, we could explain with greater awareness of relational problems the increased agreement with
neutral-valence items (items 2, 3, 4) and the decreased agreement with one negative-valence item (item 11).
The Q-sort items triggered discussion in the class.
Figure 3 –Mean differences between first and second administration (Q-sort)
A relationship with a person with mental disease seen as a step toward maturity
Among the items processed with the Q-sort, the one recording a statistically significant difference (F=8,12;
sig=0.006; N=30) is: “Spending time with people with mental disease makes me a more mature person” (item 6).
This result emphasizes the significance of classroom experience with a classmate with mental disease.
Figure 4 - Analysis of variance between first and second administration (Q-sort)
CONCLUSIONS
The analysis of the answers carried out when school broke up, at the end of the project, shows some interesting
variations in the conception of intellectual disability. Increased awareness of the criticalities typical of mental
disease can be observed. Comparison between the two administrations reveals that during the school year
changes occurred in some students’ opinions about the personal resources and competencies necessary to interact
with individuals with mental disease and also about the likelihood of their integration. In particular, there is
increased perception of greater personal maturity and also increased awareness of the serious problems
experienced by individuals with mental disease and how difficult it is to interact with them. These results
encourage the promotion of projects aiming at increasing sensitization on the issues of disability.
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