First aid strategies that are helpful to young people developing a mental disorder: beliefs of health professionals compared to young people and parents

Depression Literacy and Self-Reported Help-Giving Behaviour in Adolescents in Ireland

This questionnaire-based study aimed to explore depression literacy (DL) and help-giving experiences in 12-18-year-old adolescents (N = 535, Mage = 14.9 years, 51.8% male) in Ireland. In response to a vignette depicting a character displaying symptoms of depression, 46.7% labelled these symptoms 'depression', with increasing age and empathy associated with increased likelihood of labelling as such. Almost all (92.1%) believed the character needed help, but the perceived helpfulness of potential responses varied. Over one-third (38.2%) indicated they knew someone who had displayed similar symptoms in the past year, with 85.2% of these reporting having helped this person. Reported help-giving responses included comforting the person, encouraging professional help-seeking, and informing an adult. The findings suggest adolescent DL can be best supported by developmentally-sensitive interventions that encourage empathy and the importance of engaging adults' assistance.

Can #chatsafe support parents and carers beyond Australia? A qualitative study

BACKGROUND

Rates of self-harm and suicide are rising for young people globally and many implicate social media in this problem. To address this concern and to increase the confidence of adults to communicate safely about suicide and social media with young people, the #chatsafe Guide for Parents and Carers was developed in Australia. With significant uptake of the resource among Australian adults, the aim of the current study was to update and contextualise the #chatsafe Guide for Parents and Carers for audiences in 15 countries globally. To improve the relevance of this resource for parents and carers in these countries, the present study sought to understand the concerns held by parents, carers and suicide prevention professionals around the world about these topics and to explore the extent to which a resource such as #chatsafe would be helpful within their communities.

METHODS

Seven focus groups were conducted via Zoom with parents, carers and suicide prevention professionals (n = 40) from 15 countries. Transcribed data were coded and thematically analysed using both inductive and deductive processes.

RESULTS

Six themes are reported: (1) Two scary 'S' words; (2) Country and culture impact who talks (or is silent) about self-harm and suicide; (3) The need for a protective social ecosystem; (4) #chatsafe is a tool that can help parents, carers and young people worldwide; (5) #chatsafe should consider local context and end users to improve its relevance for parents and carers worldwide; and (6) A range of marketing and dissemination strategies are needed to reach adults with #chatsafe information. Findings of this study informed the update and contextualisation of the #chatsafe Guide for Parents and Carers for adult audiences in 15 countries.

CONCLUSIONS

The findings from this study underscore a universal need for psychoeducation initiatives that provide adults with the skills and knowledge to support the mental health of young people, both online and offline, and that resources like #chastafe can play an important role in providing reliable information about these topics to adults across a range of cultures and contexts.

A survey of mental health literacy in parents and guardians of teenagers

Introduction

Parents and guardians (hereafter caregivers) of teenagers need high levels of mental health literacy (MHL) to manage mental health problems arising in teenagers in their care. Previous studies assessing MHL levels in caregivers of teenagers have reported mixed results, making it difficult to clearly estimate caregiver MHL levels. This study aimed to investigate MHL levels in Japanese caregivers of regular teenagers.

Methods

Responses from caregivers (n = 1,397) of students entering junior and senior high schools to a self-administered online questionnaire were analyzed. The questionnaire assessed (a) knowledge about mental health/illnesses and (b) attitudes towards mental health problems in teens in their care (e.g., recognition of depression as a medical illness and intention to engage in helping behaviors).

Results

The average proportion of correct answers to the knowledge questions (n = 7) was 55.4%; about one tenth (9.2%) of caregivers correctly answered only one or none of the questions. Few caregivers correctly answered about the life-time prevalence of any mental illnesses (46.1%) and appropriate sleep duration for teenagers' health (16.5%). The proportions of caregivers who had the intention to listen to the teen in their care, consult another person, and seek professional medical help if the teen suffered from depression were 99.5%, 91.5% and 72.7%, respectively.

Conclusions

Many teenagers' caregivers appeared to be willing to help the teens in their care if they were suffering from mental health problems. However, there was much room for improvement in knowledge on mental health/illnesses and intention to seek help from medical professionals. Efforts toward better education should be made.

Evaluation of beliefs and attitudes among caregivers of child labor about mental disorders first aid and stigma

BACKGROUND

The beliefs and attitudes of caregivers of working children about mental health issues and first aid and their attitudes about the stigma of mental health problems can affect their motivation to seek professional help for affected children. This study aimed to assess the mental health literacy among caregivers of child labor about first aid for mental health and their attitudes about the stigma of mental disorders.

METHODS

The Depression Health Literacy Questionnaire has been used in this cross-sectional study. All caregivers of working children who were willing to participate were included in the study. This group is covered by a Non-Governmental Organization (NGO) located in the 17th district of Tehran.

RESULTS

Questionnaires completed by 131 caregivers were analyzed. The average age of the participants was 32.6 (± 7.9) years. Of which 130 (99.2%) were mothers. Amongst, only 37 individuals (28.2%) were confident in their ability to help their children in case of depression symptoms. A majority of participants, 109 (83.2%), believed that asking a depressed child about suicidal ideation was harmful.

CONCLUSION

According to the findings of this study, the literacy among caregivers of child labor about mental health first aid in our study needs to be improved. There is also a need for educational and community-based programs to reduce the stigma about mental health disorders, including depression.

Comprehensive approaches to addressing mental health needs and enhancing school security: a hybrid type II cluster randomized trial

BACKGROUND

School safety is fundamental to fostering positive outcomes for children. Violence remains a critical public health issue with 8.1% of elementary and 21.8% of middle school students reporting daily or weekly bullying in 2015-16. Similarly, over half of lifetime mental health concerns become evident before age 14. Thus, elementary school is a key time for comprehensive school safety interventions. Yet, interventions are rarely delivered with fidelity in community settings. Evidence-based interventions must be complemented by implementation strategies to achieve desired public health outcomes.

METHODS

We develop and test an intervention focused on promoting a positive school climate guided by a school-based 3-person leadership team (3-PLT) using a hybrid Type II design. The 3-PLT includes a School Resource Officer, (SRO), administrator and mental health services professional as a newly appointed climate specialist (CS). The interventions to be delivered include 1) Restorative justice, 2) Mental Health First Aid and 3) Crime Prevention Through Environmental Design. The CS will lead the team and coordinate implementation through a process of interactive problem solving and supports, consistent with the implementation facilitation strategy. We will conduct a cluster randomized controlled trial with staged entry over two school years in Genesee County, Michigan (n = 20 elementary schools, with 10 participating per school year). We will use a combination of data sources including data collected by schools (e.g., discipline data), a student survey, and a teacher survey. We will also conduct a process evaluation and assess implementation and sustainability through focus groups with key stakeholders, teachers, and students. Finally, we will conduct a cost-benefit analysis.

DISCUSSION

Results from both the behavioral outcome and implementation strategy evaluations are expected to have significant implications for school safety and student well-being. This study adopts a unique approach by integrating three evidence-based programs and incorporating implementation facilitation led by the CS as part of the 3-PLT to support intervention delivery and enhance public health impact among schools in disadvantaged communities with students at risk of poor health outcomes. This study aims to create a comprehensive, well-integrated model intervention that is sustainable and can be translated to similar high-risk settings.

TRIAL REGISTRATION

Trial was retrospectively registered, registration ISRCTN1226421, May 16, 2019.

A Systematic Review of Parent and Caregiver Mental Health Literacy

This study aimed to systematically review the current body of research on parent and caregiver mental health literacy. Electronic databases were searched in January 2018 with 21 studies meeting inclusion criteria. A narrative synthesis of quantitative and qualitative studies was conducted. Findings across studies suggest that parents and caregivers had limited mental health knowledge. Factors associated with help-seeking included cultural and religious beliefs, financial and knowledge barriers, fear and mistrust of treatment services, and stigma. Notable limitations include non-representative samples, cross-sectional research designs, and use of inconsistent and non-validated study measures. Research would benefit from more diverse samples, an increased focus on prevention, and controlled trials of educational programmes targeting mental health literacy.

Helping intentions of undergraduates towards their depressed peers: a cross-sectional study in Sri Lanka

BACKGROUND

Despite showing high rates of depression, university students prefer to seek assistance for their depression from informal sources, such as their friends, rather than seeking professional assistance. Therefore, the helping behaviours of those who provide informal help to these students need examination. This study examines the helping intentions of undergraduates in Sri Lanka towards their depressed peers and the correlates of their helping intentions.

METHOD

The undergraduates were presented with a vignette of a hypothetical depressed undergraduate. A total of 4442 undergraduates responded to an open-ended question about how the person in the vignette should be helped if this person was someone they knew well. Their responses were coded in reference to established mental health first aid guidelines. Logistic and linear regression models were used to examine the predictors of their helping intentions.

RESULTS

The undergraduates' most common helping intentions were to listen/talk and support their peer. Only around a third considered the need for professional help. The overall quality of their helping intentions was poor, but better among those who recognised the problem as depression and those who had less stigmatising attitudes. There was some evidence that certain helping intentions of the undergraduates which were person-oriented or social network-related were better among females, those in higher years of study and among certain non-medical student groups. Intentions to encourage professional help were better among those who recognised the problem, but poorer among those with personal experiences of this problem and among those who perceived this problem to be a weakness and not a sickness.

CONCLUSIONS

Although the undergraduates may attempt to support their distressed peers, they may not show appropriate helping actions and may not encourage the use of professional assistance. Hence, they need to be educated on how best to respond to their distressed peers. Those with higher levels of stigma and inability to recognise the problem may be at greater risk of showing poorer helping responses towards their distressed peers.

Predictors of adults' helping intentions and behaviours towards a person with a mental illness: A six-month follow-up study

Little is known about the relationship between adults' intentions to assist a hypothetical person experiencing a mental illness and their subsequent first aid actions in reality. This study examines whether the quality of respondents' stated first aid intentions predicts the quality of their helping behaviour towards a person they know in real life. A convenience sample of 820 Australian adults completed two surveys six months apart which asked questions about a hypothetical person experiencing depression with suicidal thoughts, and how they had assisted someone with a similar problem in their lives. The quality of helping intentions at baseline predicted the quality of mental health first aid behaviours at follow-up, as did the quality of past behaviours. In particular, people who intended to assess and assist with the crisis situation in the vignette were five times more likely to perform the same action when helping someone they knew. The quality of past intentions and behaviour, and confidence in helping, were the most significant predictors of behaviour at follow-up. These findings suggest that adults' mental health first aid intentions can be used to predict their subsequent behaviours, therefore, educating communities about effective first aid responses may increase future rates of appropriate help.

Beliefs and attitudes towards mental illness: an examination of the sex differences in mental health literacy in a community sample

Objectives. The current study investigated mental health literacy in an Australian sample to examine sex differences in the identification of and attitudes towards various aspects of mental illness. Method. An online questionnaire was completed by 373 participants (M = 34.87 years). Participants were randomly assigned either a male or female version of a vignette depicting an individual exhibiting the symptoms of one of three types of mental illness (depression, anxiety, or psychosis) and asked to answer questions relating to aspects of mental health literacy. Results. Males exhibited poorer mental health literacy skills compared to females. Males were less likely to correctly identify the type of mental illness, more likely to rate symptoms as less serious, to perceive the individual as having greater personal control over such symptoms, and less likely to endorse the need for treatment for anxiety or psychosis. Conclusion. Generally, the sample was relatively proficient at correctly identifying mental illness but overall males displayed poorer mental health literacy skills than females.

Mental health literacy about schizophrenia: a survey of Portuguese youth

AIM

Mental health literacy about psychotic disorders, specifically schizophrenia, may assist in appropriate help seeking and early intervention, preventing the exacerbation of symptoms and improving health outcomes in the medium and long term. The aim of this study was to characterize the level of mental health literacy of Portuguese youth concerning schizophrenia.

METHODS

A mental health literacy questionnaire was administered to a random sample of Portuguese youth aged 14-24 years. This questionnaire evaluated the following components: recognition of disorders, knowledge about professionals and treatments available, knowledge about the effectiveness of self-help strategies, knowledge and skills to support and provide first aid to others, and knowledge of how to prevent mental disorders.

RESULTS

There were 4938 adolescents and young adults who participated in the study. Schizophrenia or psychosis was recognized by 42.17% and 22.21%, respectively. Most young people recognized the potential helpfulness of family doctors, psychologists, psychiatrists and mental health services. There was also widespread belief in the potential helpfulness of family and friends, and lifestyle changes. However, teachers were not generally seen as a source of help. Appropriate mental health first-aid strategies were commonly endorsed, but there was a reluctance to ask about suicidal feelings and many endorsed speaking to the person firmly. Lifestyle factors were also commonly believed to be preventative.

CONCLUSIONS

Although many Portuguese youth have beliefs that may assist early intervention, there was a substantial minority who did not. Given the central role of teachers in the lives of young people, it is notable that they were not seen as a potential source of help. Mental health first-aid skills of young people also need improvement.

Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy

PURPOSE

To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition.

METHODS

Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland.

RESULTS

Mental health problems were perceived as being more severe (p < 0.001) and exerting a larger impact upon the family (e.g., financial impact) than physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p < 0.001). The odds of low health literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p < 0.001); this finding held generally for mental health problem (although only a trend was observable for internalizing problems).

CONCLUSIONS

The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.

Mental Health Literacy and Help-Giving Responses in Irish Adolescents

This study assessed mental health literacy in Irish adolescents ( N = 187), and explored participants’ help-giving responses toward hypothetical depressed peers. Participants read five vignettes, each describing an adolescent experiencing a life difficulty; two of the characters met Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) criteria for depression. The majority of participants could not identify depression or potential suicidality, but felt concerned for the depressed characters’ well-being. Most participants stated they would provide help if they were the depressed characters’ friends. Correct identification of depression did not influence the type of help offered. A significant proportion of participants did not mention engaging an adult’s assistance, and assessing for suicidality was not mentioned by any participant. Gender differences were found in mental health literacy and the type of responses offered. Education that emphasizes the importance of informing an adult and assessing for suicidal risk is recommended.

Is the use of accurate psychiatric labels associated with intentions and beliefs about responses to mental illness in a friend? Findings from two national surveys of Australian youth

Aims. An inherent prerequisite to mental health first-aid (MHFA) is the ability to identify that there is a mental health problem, but little is known about the association between psychiatric labelling and MHFA. This study examined this association using data from two national surveys of Australian young people. Methods. This study involved a national telephonic survey of 3746 Australian youth aged 12-25 years in 2006, and a similar survey in 2011 with 3021 youth aged 15-25 years. In both surveys, respondents were presented with a vignette portraying depression, psychosis or social phobia in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents were asked what they thought was wrong with the person, and reported on their first-aid intentions and beliefs, which were scored for quality of the responses. Results. Accurate labelling of the mental disorder was associated with more helpful first-aid intentions and beliefs across vignettes, except for the intention to listen non-judgementally in the psychosis vignette. Conclusions. Findings suggest that community education programmes that improve accurate psychiatric label use may have the potential to improve the first-aid responses young people provide to their peers, although caution is required in the case of psychosis.

Adapting evidence-based interventions to accommodate cultural differences: where does this leave effectiveness?

Evidence-based interventions are an essential part of delivering contemporary mental health services. Many such interventions, however, are developed with and for mainstream population groups. Practitioners and researchers alike will often adapt tools, practices, processes or programmes to meet the needs of culturally diverse populations groups, but wonder if and how such adaptations will affect outcomes. This paper considers the processes by which evidence-based interventions can be adapted by health professionals in any context; and includes an example of a successful cultural adaptation to an evidence-based intervention. The successful implementation of the Aboriginal Mental Health First Aid programme in Australia illustrates the potential for adapted interventions to support improvements in the health outcomes of people from culturally diverse backgrounds. The paper concludes by outlining the steps mental health professionals can take when adapting evidence-based interventions for use in their own workplace settings.

The associations between psychiatric label use and young people's help-seeking preferences: results from an Australian national survey

Aims. Emerging evidence suggests that psychiatric labels may facilitate help seeking in young people. This study examined whether young people's use of accurate labels for five disorders would predict their help-seeking preferences. Methods. Young people's help-seeking intentions were assessed by a national telephone survey of 3021 Australian youths aged 15-25. Respondents were presented with a vignette of a young person portraying depression, depression with suicidal thoughts, psychosis, social phobia or post-traumatic stress disorder (PTSD). They were then asked what they thought was wrong with the person, and where they would go for help if they had a similar problem. Results. Accurate psychiatric label use was associated with a preference to seek help from a general practitioner or mental health specialist. Accurately labelling the psychosis vignette was also associated with a preference to not seek help from family or friends. Conclusions. Findings add to the emerging evidence that accurate psychiatric labelling may facilitate help seeking for various mental disorders in young people, and support the promise of community awareness campaigns designed to improve young people's ability to accurately identify mental disorders.

Quality of helping behaviours of members of the public towards a person with a mental illness: a descriptive analysis of data from an Australian national survey

BACKGROUND

Courses such as Mental Health First Aid equip members of the public to perform appropriate helping behaviours towards people experiencing a mental illness or mental health crisis. However, studies investigating the general public's knowledge and skills in relation to assisting a person with a mental illness are rare. This study assesses the quality of mental health first aid responses by members of the Australian public using data from a national survey.

METHODS

Participants in a national survey of mental health literacy were assigned one of six vignettes (depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder) and asked an open-ended question about how they would help the character in the vignette. The 6,019 respondents were also asked if and how they had helped a person in real life with a similar problem. Responses to these questions were scored using a system based on an action plan developed from expert consensus guidelines on mental health first aid.

RESULTS

The quality of responses overall was poor, with participants scoring an average of 2 out of 12. The most commonly reported actions for both questions were listening to the person, providing support and information and encouraging them to seek appropriate professional help. Actions such as assessing and assisting with crisis were rarely mentioned, even for the depression with suicidal thoughts vignette.

CONCLUSIONS

The quality of the Australian public's mental health first aid knowledge and skills requires substantial improvement. Particular attention should be given to helping people recognise that anxiety disorders such as social phobia require professional help and to improving responses to a suicidal person.

Public attitudes toward depression and help-seeking in four European countries baseline survey prior to the OSPI-Europe intervention

BACKGROUND

Stigmatizing attitudes toward depression and toward help-seeking are important barriers for people with mental health problems to obtain adequate professional help. This study aimed to examine: (1) population attitudes toward depression and toward seeking professional help in four European countries; (2) the relation between depression stigma and attitudes toward help-seeking; (3) the relation between both attitudes and socio-demographic characteristics; and (4) differences in attitudes across countries.

METHODS

A representative general population survey (n=4011) was conducted in Germany, Hungary, Ireland, and Portugal, assessing attitudes toward depression and toward help-seeking, and a number of socio-demographic variables.

RESULTS

Respondents showed a moderate degree of personal stigma toward depression and a strikingly higher degree of perceived stigma. Although a substantial majority showed openness to seek professional help, only half of the people perceived professional help as valuable. More negative attitudes were found in Hungary and were associated with male gender, older age, lower educational level and living alone. Also, personal stigma was related to less openness to and less perceived value of professional treatment.

LIMITATIONS

The survey was cross-sectional, so no causal inferences could be drawn.

CONCLUSIONS

Personal and perceived stigma toward depression deserves public health attention, since they impact upon the intention of people with depression to seek professional help. Public media campaigns should focus on the credibility of the mental health care sector, and target males, older people, and those with a lower educational level and living alone. The content of each campaign should be adapted to the cultural norms of the country for which it is intended.

Mental health literacy about depression and schizophrenia among adolescents in Sweden

BACKGROUND

Mental health literacy (MHL) refers to an individual's knowledge of mental disorders, including the ability to recognize psychopathology and being aware of help options. Most studies of MHL have focused on adults.

OBJECTIVE

The purpose of this study was to examine levels of MHL among adolescents.

METHODS

MHL was examined using two pre-established vignettes that presented an adolescent with symptoms of either depression or schizophrenia. The respondents were 426 adolescents (age mean=16). Vignette data were analyzed both qualitatively and quantitatively.

RESULTS

The data showed that 42.7% and 34.7% of the respondents identified depression and schizophrenia, respectively. Depression was recognized more often by females than males. Professional help was suggested by a minority of the respondents for managing symptoms of depression (22.5%) or schizophrenia (32.6%). Altruistic behaviors, examined through the willingness to help an acquaintance with mental illness symptoms, were apparent among 58.2% of the respondents and to a greater extent in females than males. Answers following the schizophrenia vignette also revealed stigmatizing attitudes in 11.5% of the participants.

CONCLUSIONS

There are relatively low levels of MHL among teenagers in Sweden. Awareness campaigns and the implementation of psychoeducation in the school curriculum could increase MHL in this group.

Mental health literacy about depression: a survey of portuguese youth

BACKGROUND

Depression is a common disorder in adolescents and young adults, but help seeking is low. Mental health literacy about depression is a key concept to plan interventions for improving help seeking. This study aimed to evaluate youth mental literacy about depression in order to design school-based interventions.

METHODS

During 2012, a survey was conducted with a stratified cluster sample of 4938 Portuguese young people between 14 and 24 years of age. Following the presentation of a vignette describing depression, a series of questions was asked concerning: recognition of the disorder; knowledge of professional help and treatments available; knowledge of effective self-help strategies; knowledge and skills to give first aid and support to others; and knowledge of how to prevent this disorder.

RESULTS

In response to an open-ended question, around a quarter of the participants failed to recognize depression in the vignette. When asked about the potential helpfulness of various people, most of the participants considered mental health professionals, family and friends to be helpful. However, teachers, social workers and a helpline were less likely to be considered as helpful. With regard to medications, vitamins received more positive views than psychotropics. Some interventions were frequently rated as likely to be helpful, whereas for others there was a lack of knowledge about their effectiveness. A positive finding is that alcohol and tobacco consumption were seen as harmful. When asked about mental health first aid strategies, participants supported the value of listening to the person in the vignette and advising professional help, but some unhelpful strategies were commonly endorsed as well.

CONCLUSION

Deficits were found in some aspects of depression literacy in Portuguese youth. Therefore intervention in this area is needed.

Defining treatment as usual for attenuated psychosis syndrome: a survey of community practitioners

OBJECTIVE

Schizophrenia and related disorders are often preceded by attenuated psychosis symptoms, sometimes referred to as attenuated psychosis syndrome, but little is known about practitioners' current practices with regard to this population. This survey of clinical psychologists, psychiatrists, and general practitioners explored treatment as usual of attenuated psychosis syndrome.

METHODS

In 2008, a total of 1,500 practitioners were mailed surveys containing vignettes describing individuals with full, attenuated, and no psychotic symptoms and a checklist of possible interventions. Practitioners were asked to select interventions that would help or harm the individual.

RESULTS

The responses (N=293, 20%) suggested that practitioners treated attenuated psychosis syndrome similarly to full-threshold psychosis. The use of antipsychotic medications to treat attenuated symptoms was endorsed by 69% of practitioners. Family support groups and family involvement were endorsed by 58% and 49% of respondents, respectively.

CONCLUSIONS

Further development and dissemination of practice guidelines may help providers treat attenuated psychosis syndrome.

Help-seeking for suicidal thoughts and self-harm in young people: a systematic review

There is a growing body of evidence to suggest that only a minority of young people experiencing suicidal thoughts or self-harm present to any health services. This is of concern given that young people with suicidal thoughts or self-harm often require treatment for mental illness as well as to reduce their risk of completed suicide. We reviewed previously published international community epidemiological studies examining help-seeking for suicidal thoughts or self-harm in young people up to the age of 26. The studies confirm that the majority of these young people do not seek professional help, and this includes seeking medical help after an overdose. The majority of young people studied do, however, seek help from social networks that most commonly are peers. Factors influencing and barriers to help-seeking are discussed and highlight a need for further research into the role that peers and family play in the help-seeking process for young people with suicidal thoughts or self-harm.

Associations between awareness of beyondblue and mental health literacy in Australian youth: Results from a national survey

OBJECTIVES

The aim of this paper is to examine whether Australian young people's awareness of beyondblue is associated with better recognition of depression and anxiety disorders, and better quality of beliefs about possible interventions and first-aid actions for these problems.

METHOD

In 2011, a telephone interview was conducted with a national sample of 3021 Australians aged between 15 and 25 years. Participants were presented with a vignette portraying depression, depression with suicidal thoughts, social phobia, post-traumatic stress disorder or psychosis in a young person. They were then asked about recognition of the disorder portrayed, their beliefs about the helpfulness or harmfulness of various interventions and first-aid actions, and their awareness of beyondblue. The quality of youths' beliefs was scored against health professionals' ratings of the same list of interventions and first-aid actions.

RESULTS

Beyondblue awareness was associated with more accurate recognition of the disorder portrayed in all vignettes except social phobia. It was also associated with beliefs about the helpfulness of first-aid actions that were more closely aligned with professional ratings for the depression, psychosis and social phobia vignettes. However, it was associated with beliefs about interventions for the psychosis vignette only.

CONCLUSIONS

Overall, the associations of beyondblue awareness with better mental health literacy were not specific to depression and anxiety disorders, which are their main focus. Beyondblue awareness is mostly unrelated to treatment beliefs, but seems to have non-specific associations with recognition of disorders and first-aid beliefs.

Young people's mental health first aid intentions and beliefs prospectively predict their actions: findings from an Australian National Survey of Youth

Little is known about whether mental health first aid knowledge and beliefs of young people actually translate into actual behavior. This study examined whether young people's first aid intentions and beliefs predicted the actions they later took to help a close friend or family member with a mental health problem. Participants in a 2006 national survey of Australian youth (aged 12-25 years) reported on their first aid intentions and beliefs based on one of four vignettes: depression, depression with alcohol misuse, psychosis, and social phobia. At a two-year follow-up interview, they reported on actions they had taken to help any family member or close friend with a problem similar to the vignette character since the initial interview. Of the 2005 participants interviewed at follow-up, 608 reported knowing someone with a similar problem. Overall, young people's first aid intentions and beliefs about the helpfulness of particular first aid actions predicted the actions they actually took to assist a close other. However, the belief in and intention to encourage professional help did not predict subsequent action. Findings suggest that young people's mental health first aid intentions and beliefs may be valid indicators of their subsequent actions.

Young people's beliefs about the harmfulness of alcohol, cannabis and tobacco for mental disorders: findings from two Australian national youth surveys

AIMS

Using cross-sectional national survey data, we assessed young peoples' beliefs about the role of alcohol, tobacco and marijuana in the prevention and treatment of mental disorders as well as the predictors of these beliefs. We also compared these findings with those from a similar survey carried out in 2006.

DESIGN, SETTING AND PARTICIPANTS

Between January and May 2011, a national computer-assisted telephone survey was conducted on a representative sample of Australian youths aged 15-25 years. A total of 3021 young people were presented with a case vignette portraying depression, depression with suicidal thoughts, psychosis, social phobia, depression with alcohol misuse or post-traumatic stress disorder in a young person.

MEASUREMENTS

Respondents were asked about their beliefs regarding the role of using alcohol, tobacco and marijuana in preventing or dealing with the mental disorders described in the vignettes. Level of psychological distress was assessed by the Kessler 6 scale (K6).

FINDINGS

More than 75% of respondents agreed that the three substances were harmful for the young people in the vignettes, and that not using marijuana or drinking alcohol in excess is preventive. Males, young adults and more distressed respondents were less likely to endorse these beliefs. No significant changes were observed between surveys.

CONCLUSIONS

Most young people in Australia are aware of the negative impact of substance use on mental disorders, but a few high-risk groups remain: males, young adults and those with more psychological distress. Future public health campaigns need to target these groups and focus on translating young people's substance use beliefs into behavioural change.

Do help-seeking intentions during early adolescence vary for adolescents experiencing different levels of depressive symptoms?

PURPOSE

To investigate whether help-seeking intentions for depressive symptoms vary for adolescents experiencing low, mild-to-moderate, and high levels of depressive symptoms.

METHODS

A total of 5,362 participants aged 12-14 years had completed the baseline assessment for a randomized controlled trial evaluating the effectiveness of a universal intervention designed to reduce depressive symptoms among high school students. The participants reported their help-seeking intentions in response to a vignette describing an individual experiencing depressive symptoms consistent with a diagnosis of a minor depressive disorder. Standard measures were used to assess participants' level of depressive symptoms and perceived level of social support.

RESULTS

Logistic regression models examined relationships between help-seeking intentions and levels of depression, after adjustment for demographic characteristics and perceived support. As compared with those with low levels of depressive symptoms, adolescents with high levels of symptoms reported less intention to seek help from friends (odds ratio [OR] = .42) or family members (OR = .29). They were also four times more likely to report that they would not seek help from anybody (OR = 4.55). A similar pattern was evident during comparisons of help-seeking intentions reported by adolescents with mild-to-moderate levels of depressive symptoms versus those with low levels of symptoms.

CONCLUSIONS

Targeted and universal interventions need to encourage peers and family members to actively engage with young adolescents experiencing depressive symptoms rather than waiting for them to initiate help-seeking. This is particularly important for adolescents experiencing higher levels of depressive symptoms who may not initiate help-seeking themselves.

Young people's beliefs about preventive strategies for mental disorders: findings from two Australian national surveys of youth

BACKGROUND

Political interest in prevention of mental illness has increased in recent years. However, relatively little is known about the public's beliefs about prevention, and the predictors of these beliefs. Since many disorders start in the first decades of life, a focus on young people is warranted.

METHODS

Young people's prevention beliefs were assessed by a national telephone survey of 3746 Australian youths aged 12-25 years in 2006. A similar survey was repeated in 2011 with 3021 youths aged 15-25. In both surveys, respondents were presented with a vignette portraying depression, psychosis, social phobia, or depression with alcohol abuse in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents rated the helpfulness of seven potential prevention strategies, and reported on any experience of mental health problems and treatment in the past year, exposure to beyondblue and mental health information at school or work.

RESULTS

Most respondents believed that regular contact with friends and family and regular physical activity would be helpful. Respondents who had recently experienced mental health problems, younger respondents, females, and those not exposed to beyondblue or mental health information were more likely to hold beliefs that differed from those of health professionals or available evidence. No significant changes were observed between surveys.

LIMITATIONS

Actual preventive actions and reasons behind respondents' beliefs were not assessed.

CONCLUSIONS

Future prevention efforts should target subgroups with beliefs that differ from professionals' and research evidence. Beyondblue and school and work settings may be promising avenues for these efforts.

Intentions and helpfulness beliefs about first aid responses for young people with mental disorders: findings from two Australian national surveys of youth

BACKGROUND

Youths are important sources of first aid for people close to them who are experiencing mental health problems, but their skills are not optimal. A better understanding of predictors of young people's first aid intentions and beliefs will facilitate future efforts to improve their mental health first aid skills.

METHODS

Young people's first aid intentions and beliefs were assessed by a national telephone survey of 3746 Australian youth aged 12-25 years in 2006. A similar survey was repeated in 2011 with 3021 youths aged 15-25 years. In both surveys, youths were presented with a vignette portraying depression, psychosis, social phobia, or depression with alcohol misuse in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents reported on any past-year experience of mental health problems and treatment, exposure to beyondblue and mental health information at school or work.

RESULTS

The potential value of encouraging professional treatment was not universally recognized, although young people were mostly aware of and reported the intention to take supportive actions. Respondent age, sex, experience of mental health problems, type of mental disorder, and exposure to mental health information at school, work, or beyondblue all predicted some intentions and beliefs. Some improvements in beliefs were observed between surveys.

LIMITATIONS

Actual first aid actions and their helpfulness were not measured.

CONCLUSIONS

Future efforts should target adolescents, males and those with recent mental health problems who had not received help. Beyondblue and school and work settings may be promising avenues for these efforts.

The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth

BACKGROUND

Young people are an important source of first aid for mental health problems in people they are close to, but their first aid skills remain inadequate. Research into the factors that influence mental health first aid skills are required to reveal targets for improving these skills. This study examined the influence of stigma on first aid actions taken by young people to help someone close to them with a mental health problem.

METHODS

Participants in a national telephone survey of Australian youth (aged 12-25 years) reported on their stigmatising attitudes based on one of three disorders in vignettes: depression, depression with alcohol misuse, and social phobia. At a two-year follow-up interview, they were asked if they knew a family member or close friend with a problem similar to the vignette character since the initial interview, and those who did reported on the actions taken to help the person.

RESULTS

Of the 1520 participants interviewed at follow up, 507 reported knowing someone with a similar problem. Young people's stigmatising attitudes (weak-not-sick, social distance and dangerousness/unpredictability) influenced their first aid actions.

LIMITATIONS

Social desirability could have affected the assessment of stigma, we could not assess the severity of the first aid recipient's problem or the benefit derived from the first aid provided, and the proportion of variance explained was modest.

CONCLUSIONS

Reducing stigma may help to improve the first aid that people with mental health problems can receive from young people who are close to them.

Adolescent and parent experiences with a primary care/Internet-based depression prevention intervention (CATCH-IT)

This article describes a mixed-methods approach to understand the experience of adolescents involved in the Internet-based intervention for depression, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training (CATCH-IT), as well as the experiences of their parents while they were involved. Qualitative analysis was done with grounded theory-based categorization of interview comments and typed program responses (adolescents only) into themes. Quantitative analysis was done with self-report surveys. The article describes the nine themes reflecting the adolescent experience and the three themes reflecting the parent experience. The article also describes the results of the quantitative surveys of helpfulness and attitudes change, which were favorable of the Internet-based intervention. Separate models explaining the psychological transformation of the adolescents and the experience of the parents are proposed. The positive experience of the adolescents and parents involved in CATCH-IT is discussed in the context of growing interest in how best to utilize Internet-based interventions for mental illness, and suggestions are made for future investigation.

First aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth

This study examined the first aid actions taken by young people to help someone they know and care about who was experiencing a mental health problem and the characteristics of the first aid provider (respondent) and recipient which influence these first aid actions. Participants in a national survey of Australian youth (aged 12-25 years) completed a two-year follow-up phone interview based on one of the following disorders in vignettes: depression, depression with alcohol misuse, social phobia and psychosis. Participants were asked if they knew a family member or close friend who had experienced a similar problem to the vignette character since the initial interview and those who did reported on any actions taken to help the person. Of the 2005 participants interviewed, 609 (30%) reported knowing someone with a similar problem, with depression (with or without alcohol misuse) being the most common problem. Respondent age and gender, recipient gender, and type of mental health problem, all influenced first aid actions. Findings indicate that peers are a major source of support for young people with mental health problems and underscore some important areas and subgroups of young people to target for interventions to improve young people's mental health first aid skills.

Healthy minds for country youth: help-seeking for depression among rural adolescents

OBJECTIVE

To assess depression recognition, barriers to accessing help from health professionals and potential sources of help for depression among rural adolescents.

DESIGN

Cross-sectional survey.

SETTING

Two rural secondary schools in south-east South Australia.

PARTICIPANTS

Seventy-four secondary school students aged 14 to 16 years.

MAIN OUTCOME MEASURE(S)

Depression recognition was measured using a depression vignette. Helpfulness of professionals, barriers to seeking help and help-seeking behaviours for depression were assessed by self-report questionnaire.

RESULTS

Depression was identified in the vignette by 73% (n = 54) of participants. Participants indicated that it would be more helpful for the vignette character to see other health professionals (98.6%, 95% CI, 92.0-100.0%) than a doctor (82.4%, 72.1-89.6%). Barriers to seeking help from doctors and other health professionals were categorised into logistical and personal barriers. Participants agreed more strongly to personal (mean = 2.86) than logistical barriers (mean = 2.67, P < 0.05) for seeing a doctor. Boys and girls responded differently overall, and to personal barriers to seeing an other health professional. Sources of help were divided into three categories: formal, informal and external. Informal sources of help (mean = 4.02) were identified as more helpful than both formal (mean = 3.66) and external sources (mean = 3.72, P < 0.001). Gender differences were observed within and between the three sources of help categories.

CONCLUSIONS

Recognising symptoms of depression was demonstrated in this study. Helpfulness of professionals, barriers to seeking help and potential sources of help for depression were identified. More work is required for improving depression literacy and providing effective interventions specifically for rural adolescents.

Nepalese pharmacy students' perceptions regarding mental disorders and pharmacy education

OBJECTIVE

To determine Nepalese pharmacy students' perceptions of whether mental disorders impact performance in pharmacy school.

METHOD

All first- and third-year undergraduate pharmacy students (n=226) in Nepal were invited to complete a modified version of the Mental Illness Performance Scale.

RESULTS

Among the 200 respondents (response rate 88.5%), 14% reported that they had a mental disorder. The majority (92%) of third-year students agreed or strongly agreed that depression would interfere with a student's academic performance. Almost half of first-year students agreed or strongly agreed that alcohol or drug abuse would be grounds for both rejecting an applicant from pharmacy school (49%) and dismissal of a student from pharmacy school (46%).

CONCLUSIONS

Students perceived a high level of academic impairment associated with mental disorders, but the majority did not perceive that mental disorders were grounds for dismissal from or rejection of entry to pharmacy school. Students' attitudes may discourage them from seeking help or providing mental health support to others.