Students build on their understanding of mental illness as a disease of the brain by modeling the factors that influence whether a person develops depression. They then read about other mental illnesses to determine the risk factors that contribute to those illnesses.
Everyone has some risk for becoming mentally ill. Factors such as genetics, environment, and social influences interact to increase or decrease a person’s risk for developing a mental illness.
After completing this lesson, students will
Consult the following sections in Information about Mental Illness and the Brain:
|Activity||Master||Number of copies|
|1||Master 3.1, The Roll of the Die for Depression
Master 3.2, The Risk Meter
Master 3.3, Mental Illness—More Likely or Less Likely?
Master 3.4, ADHD: What Are the Chances?
Master 3.5, Schizophrenia: What Are the Chances?
|1 copy per team of 3 students*
1 copy per team of 3 students
|*If you have multiple class sections doing this activity, you can reuse Master 3.1 in subsequent classes.
†These numbers are based on a class of 24 students. Adjust the numbers for your class size. Half the teams will need one copy per student of Master 3.4, and the other half will need one copy of Master 3.5. Each team will consider just one of the two diseases.
Gather enough dice so that each team has one die.
In the last part of the activity, students will work in teams to complete readings about ADHD and schizophrenia. Keep track of which disease teams read about so that they can read about the other disease during Lesson 4.
Students might propose several possibilities. For example, some students might say that it is inherited from family or that something in the environment causes some people to have a mental illness. You can challenge students by asking them why one person gets a mental illness and one doesn’t even if they are in similar environments and maybe even related to each other. At this stage, accept all reasonable answers.
If students are interested, you can give them the statistics about the occurrence of mental illness in Section 2, Mental Illness in the Population, in Information about Mental Illness and the Brain.
For example, everyone has some risk, or chance, for getting a cold. One common risk factor for colds is being around someone who has a cold and is coughing or sneezing. Some risks are higher than others. The risk of injury for someone who is walking on the sidewalk in the daytime is low; the risk of injury is much higher if the person is running on uneven ground at night.
Hold up a copy of Master 3.1, The Roll of the Die for Depression, and explain how the teams will roll the die, compare the number on their die to an outcome, and then learn the consequence. Then hold up a copy of Master 3.2, The Risk Meter, and explain that students will make a mark on the meter that corresponds to either a higher risk (chance) for getting depression or a lower risk (chance) for getting depression, depending on the consequence for their die roll. For each roll of the die, students will make a mark (and number it 1st, 2nd, 3rd, and so forth) so they have a record of where the marker was after each roll.
Explain that students will work as a team to decide how far to move on the meter with each roll. Teams can decide not to move the mark on the meter at all. The team members will agree on the move and record on Master 3.2 their reasons for the direction and distance of the move. Some teams can decide not to move the mark on the risk meter in response to a given die roll. The important part is for students to think through the issue and be able to explain their decisions.
For the risk meter, only the first die roll begins at the point labeled “Starting Point.” Subsequent movements begin from the position decided upon during the previous movement.
This activity is an opportunity for students to work collaboratively. The members of each team need to decide who will be responsible for each task in the activity (rolling the die, moving the meter, completing the table). All team members should participate in making decisions about the direction, distance, and reasons for the placement of the new mark.
Tip from the field test: Some teachers drew a diagram of the risk meter on the board (or on a transparency) and asked each team to draw an arrow indicating its final position (after the ninth die roll). In the discussion that follows, students can use this comparison to see easily that different teams ended up in different positions after all the die rolls.
The effect that each factor plays in influencing a person’s risk of getting depression should be considered individually at this point. A sample of a partially completed Master 3.3 is shown below. Each of the categories on the table (and in the dice rolls of the game) represents a factor that scientists are investigating to determine how they affect a person’s risk of getting a mental illness.
Note to teachers: This game models fictitious individuals. It is important that students not apply it to their own, their family’s, or their friends’ lives. You might wish to emphasize the words “model” and “fictitious” during the discussion of this game to help make this point.
Some of the factors that influence a person’s risk of getting depression can be of a sensitive nature and potentially uncomfortable for a class discussion. However, experiences involving family problems and abuse or violence do increase a person’s risk of developing depression. Because these are known risk factors, they are included in this activity. If personal situations arise in the classroom, try to focus the discussion on the activity and reinforce the idea that the affected person (the model) is fictitious. The discussion questions at the end of the activity can also help give students a clearer perspective about risk factors and mental illness. Having one, or even several, risk factors that increase a person’s chances for getting depression does not dictate a certain outcome. If appropriate, discuss the issue with the individual student after the activity is over.
|Category||Is this a risk factor for depression? Why?||Is this a risk factor for ADHD? Why?||Is this a risk factor for schizophrenia? Why?|
|Gender||Yes—depression is more common in females.|
|Age||No—depression can occur at any age.|
|Family relationships||Yes—an individual who has a good family relationship is less likely to become depressed.|
|Occurrence of disease in family||Yes—a person’s risk for depression increases if a family member has depression (or a history of depression).|
|Smoking||Yes—smoking cigarettes increases a person’s risk for depression.|
|Attitude||Yes—a person who has a negative attitude is more likely to have depression.|
|Ending a relationship||Yes—stressful events such as a romantic breakup can make depression more likely.|
|Death of a family member or friend||Yes—the stress of losing a close relative or friend can make a person more susceptible to depression.|
|Experiencing abuse or violence||Yes—a person who has experienced abuse or violence is more likely to become depressed.|
Different teams of students likely will make different decisions about how far to move the mark with each roll of the die. Some teams might move an equal distance for each factor, and other teams might move a larger or smaller distance based on their judgment about the importance of the factor. Some teams may decide that for a given factor, the risk doesn’t change; therefore, the position of the arrow would not change. For example, they might get a 5 on the first roll, which indicates that the person they are modeling is male. The information tells them that depression is more common in females. Some teams might decide that being male doesn’t increase the chances for getting depression and would not move the arrow. Other teams might interpret this as the chance for their individual to become depressed is decreased because depression is more common in females. Based on this logic, this group should move the arrow to the left.
The differences among rolls reflect decisions and judgments that each group made during the game. The important idea addressed with this question is that students think about why they made their decisions.
If the students moved the marker a greater distance for some factors than others, they are assigning greater importance to those factors.
This question provides an opportunity to talk about the use of models in science and the importance of continuing scientific studies. The game models the risk for getting depression. It does not attempt to rank the significance of the different types of risk factors. Scientists continue to investigate whether some factors have a larger influence than others in determining if someone gets a mental illness. The influence that a risk factor has may depend on the individual’s age, whether other risk factors occur at the same time, whether the factor exists for a long time or repeatedly, and the individual’s vulnerability.
Most likely, students will move the mark in different directions based on the roll of the die.
Students should recognize that moving the marker in different directions means that some factors increase the chance of getting depression and some decrease the chance.
This question asks students to relate the model to what happens in real life. Students should relate the movement of the marker in different directions to increased or decreased chances for getting depression. If they moved the arrow in different directions, they are indicating that some things increase the chance and other things decrease the chance. This is based in reality for depression (and other diseases, including other mental illnesses). Some social and environmental factors, such as a good relationship within the family or with a trusted, supportive adult with whom to talk, can decrease the risk for developing depression or other mental illnesses.
In this model, the final position is the culmination of nine die rolls. In real life, the risk of getting depression or another mental illness does not depend on a person having a single factor that increases or decreases the chance that he or she will get depression or another mental illness. Many factors, including environmental, genetic, and social factors, combine to determine a person’s risk for getting a mental illness. Implicit in this model is that everyone has risk factors for mental illness and that most people have some factors that increase their risk and others that decrease their risk for depression.
Students should recognize that there is nothing in this model that indicates that the fictitious person actually develops depression. On the other hand, nothing in this model indicates that the individual will not get depression. This model only includes the concept that a variety of factors can influence whether someone has a higher or lower chance of getting depression.
This model does reflect real life; even if a person has factors that increase the chance for depression, he or she may not actually get the illness. Conversely, a person could get depression even if his or her risk factors would seemingly decrease the chance. This is an opportunity to reinforce that scientists use models to learn more about what might happen in real life.
Although this activity only models risk for (and not the actuality of) getting depression, you might want to remind students that a specific mental illness such as depression does not affect all people the same way. Like other diseases, some cases are mild and some are severe.
A key point is that a risk factor does not say anything about what causes the illness. This might be a challenging distinction for some students, but it is an important one. At present, scientists do not understand what happens on a chemical level in the brain to cause someone to get depression or other mental illnesses. The final question in Step 10 will revisit this idea.
You might choose to display the transparency of Master 3.3 as you begin this step. Some teams will read about ADHD and some will read about schizophrenia. Inform students that they will read information about a disease and then make decisions about risk factors based on the reading.
Half of the teams will consider the risk factors for ADHD and the other half will consider the risk factors for schizophrenia. Record which teams analyze each of the mental illnesses so you can assign the other mental illness to the teams in Lesson 4. It is likely that you will need to help students with some words that appear on the masters. You might choose to write difficult words, such as schizophrenia, hallucination, hyperactivity, and deficit, on the board and help students recognize the written words and pronounce them.
Note to teachers: Depending on your school’s organization and emphasis, this activity might be one in which you collaborate with your colleagues to have students “read across the curriculum.”
Next: Lesson 3 (Page 2 of 2)