Alyssia Rossetto

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

BackgroundCourses 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.MethodsParticipants 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.ResultsThe 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.ConclusionsThe 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.

Quality and predictors of adolescents' first aid intentions and actions towards a peer with a mental health problem

While peers are a common source of informal help for young people with a mental health problem, evidence suggests that the help they provide is inadequate. By examining predictors of the quality of mental health first aid provided by adolescents to their peers, future interventions can be targeted to adolescents most at risk of providing poor help. Students (n = 518) from Australian secondary schools were presented with two vignettes, depicting persons experiencing depression with suicidal thoughts, and social phobia. Participants were asked what they thought was wrong with the person, and how they would help them. Stigma towards the person was also assessed. Additionally, participants were asked if they had recently helped anyone in their own lives with a mental health problem, and, if so, what they did. The overall quality of help reported in response to the vignettes or an actual person was low; a particular inadequacy was the low rate of engaging the help of an adult. Being female, and believing that the person is sick rather than weak, consistently predicted better help-giving.

Examining predictors of help giving toward people with a mental illness: Results from a national survey of Australian adults

Little is known about factors influencing helping behaviors toward a person with mental illness. This study explored a range of predictors of helping intentions and behaviors using data from a national survey of Australian adults. Participants (n = 6,019) were randomly assigned one of six vignettes and asked how they would help the character if it was someone they knew and cared about, and asked whether and how they had helped a person in real life with a similar problem. Responses were scored using a system based on the Mental Health First Aid action plan. Regression analyses examined predictors of high helping scores in relation to type of disorder and respondent demographics, mental health literacy, and experiences with mental illness. Predictors of harmful responses and seeking advice on how to help appropriately were also assessed. Significant predictors varied by vignette, with the only consistent predictor being female gender. Participants aged under 30 provided less helpful responses to people with social phobia. Mental health literacy variables were inconsistently related to helping, whereas more stigmatizing attitudes significantly predicted harmful responses and poor helping scores. Targeting males and young people may improve rates of helpful responses. Education campaigns aiming to reduce stigma and increase knowledge of schizophrenia may also minimize potentially harmful actions.

Associations between Beliefs about the Causes of Mental Disorders and Stigmatizing Attitudes: Results of a Mental Health Literacy and Stigma Survey of the Japanese Public

Abstract: This study aimed to examine the associations between beliefs about the causes of depression and schizophrenia and stigmatizing attitudes towards people with these disorders. In 2013, a web-based survey was carried out with 1,000 Japanese adults. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, or chronic schizophrenia and asked about their beliefs about the causes of these disorders and also about their personally-held stigmatizing attitudes, stigmatizing attitudes perceived in others, and the desire for social distance from the person described in the vignette. The results suggested that perceived stigma was significantly associated with several biogenetic, psychosocial, and personality explanations for both depression and schizophrenia. When respondents believed that psychosocial factors caused depression, they were less likely to perceive them as weak rather than sick. Believing that depression and schizophrenia were caused by personality characteristics was associated with stronger personal beliefs about the ill person’s dangerousness and unpredictability. Future research could aim to examine the influence of personality-based causes of mental illnesses in greater detail.

Suicide Prevention Media Campaigns: A Systematic Literature Review

ABSTRACT Suicide prevention media campaigns are gaining traction as a means of combatting suicide. The current review set out to synthesize information about the effectiveness of these campaigns. We searched four electronic databases for studies that provided evidence on the effectiveness of media campaigns. We focused on studies that described an evaluation of the effectiveness of an entire campaign or a public service announcement explicitly aimed at suicide prevention. We identified 20 studies of varying quality. Studies that looked at whether campaign exposure leads to improved knowledge and awareness of suicide found support for this. Most studies that considered whether campaign materials can achieve improvements in attitudes toward suicide also found this to be the case, although there were some exceptions. Some studies found that media campaigns could boost help-seeking, whereas others suggested that they made no difference or only had an impact when particular sources of help or particular types of help-seeking were considered. Relatively few studies had sufficient statistical power to examine whether media campaigns had an impact on the ultimate behavioral outcome of suicides, but those that did demonstrated significant reductions. Our review indicates that media campaigns should be considered in the suite of interventions that might be used to prevent suicide. Evidence for their effectiveness is still amassing, but there are strong suggestions that they can achieve positive results in terms of certain suicide-related outcomes. Care should be taken to ensure that campaign developers get the messaging of campaigns right, and further work is needed to determine which messages work and which ones do not, and how effective messages should be disseminated. There is an onus on those developing and delivering campaigns to evaluate them carefully and to share the findings with others. There is a need for evaluations that employ rigorous designs assessing the most pertinent outcomes. These evaluations should explore the nature of given campaigns in detail – in particular the messaging contained within them – in order to tease out which messages work well and which do not. They should also take into account the reach of the campaign, in order to determine whether it would be reasonable to expect that they might have their desired effect.

Beliefs about first aid for mental disorders: results from a mental health literacy survey of Japanese high school students

The aim of the study was to carry out a survey of Japanese high school students in order to assess their beliefs about how best to help those with depression, social phobia and psychosis/schizophrenia. In 2011, 311 Japanese high school students aged 15–19 years filled out an anonymous self-report questionnaire distributed via teachers. Participants were given a case vignette describing depression, schizophrenia or social phobia. Subsequent questions covered their beliefs about the best way to help the person (mental health first-aid actions). The first-aid actions most commonly rated as helpful were listening to the persons problems in an understanding way and talking to the person firmly about getting their act together. Less than 20% of respondents rated suggesting professional help seeking as likely to be helpful. First-aid intentions and beliefs about first-aid behaviours in young Japanese people are of relatively low quality. As part of education to improve mental health literacy in Japan, young people need to be informed about avoiding potentially harmful forms of interaction with those developing mental disorders, as well as about potentially helpful ones, with a particular focus on facilitating professional help seeking.

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

BackgroundDespite 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.MethodThe 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.ResultsThe 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.ConclusionsAlthough 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.

Developing a model of help giving towards people with a mental health problem: a qualitative study of Mental Health First Aid participants

BackgroundMembers of the public frequently perform mental health first aid actions in daily life, and people with mental health problems often cite informal supports as motivators of professional treatment seeking. However, a thorough understanding of how, when and why these actions are undertaken is lacking. This research aimed to investigate the helping experiences of community members trained in Mental Health First Aid, understand the factors that might facilitate and deter helping behaviours, and develop a preliminary model that outlines the process of providing help to someone with a mental health problem.MethodsCommunity members who had received Mental Health First Aid training (n = 16) were recruited from an urban Australian university and completed an in-depth, semi-structured interview about their experiences of helping someone with a mental health problem. Data were analysed using thematic analysis. Member checking was used to assess the accuracy and transferability of the findings.ResultsThe results suggested that several common elements were present in participants’ narratives, including recognising a recipient in distress, considering reasons to intervene or not, choosing a course of action, and noting the outcomes of help. These themes were collated to form the main stages of a preliminary model of helping.ConclusionsThe findings of this study highlight the many considerations involved in deciding whether and how to assist a person with a mental health problem, and the complex, dynamic nature of the helping process itself. The preliminary model of helping may be used to enhance the content of educational programs and public health messages.

Importance of Messages for a Suicide Prevention Media Campaign

Background: A suicide prevention media campaign aimed at family members and friends may be one useful population-level suicide prevention strategy for Australia. However, currently there is limited evidence of what messages would be acceptable and appropriate for inclusion. Aims: This expert consensus study aimed to identify messages that experts with lived experience of suicide risk and suicide prevention professionals believed were most important to include in such a suicide prevention campaign. Method: Using an online survey method, 127 participants with lived experience (lived experience group) and 33 suicide prevention professionals (suicide prevention professionals group) rated 55 statements, drawn from an earlier Delphi study, from very low priority to very high priority for inclusion in a suicide prevention campaign. Results: There was significant agreement within and between the two participant groups on the most highly rated messages for inclusion. The mostly highly rated messages were that family members or friends should ask directly about suicidal thoughts and intentions, listen to responses without judgment, and tell the person at risk that they care and want to help. Limitations: We restricted ratings to just one round and may therefore have limited the level of consensus achieved. Use of a predefined set of suicide prevention messages might also have prevented us from identifying other important messages. Lived experience participants were drawn from one source and this might bias their responses through exposure to common suicide prevention messages that influence their points of view. Conclusion: There is substantial agreement between professionals and people with lived experience on the most important messages to include in a suicide prevention campaign. These most highly rated messages could be adopted in a suicide prevention media campaign.

Helping adolescents to better support their peers with a mental health problem: A cluster-randomised crossover trial of teen Mental Health First Aid:

Background: teen Mental Health First Aid (tMHFA) is a classroom-based training programme for students aged 15–18 years to improve supportive behaviours towards peers, increase mental health literacy and reduce stigma. This research evaluated tMHFA by comparing it to a matched emergency Physical First Aid (PFA) training programme. Methods: A cluster-randomised crossover trial matched four public schools in two pairs and then randomised each to first receive tMHFA or PFA for all Year 10 students. In the subsequent calendar year, the new Year 10 cohort received the opposite intervention, giving eight cohorts. Online surveys were administered at baseline and 1 week post-training, measuring quality of first aid intentions, mental health literacy, problem recognition and stigmatising beliefs, towards fictional adolescents with depression and suicidality (John) and social anxiety (Jeanie). Results: A total of 1942 students were randomised (979 received tMHFA, 948 received PFA), 1605 (84%) analysed for the John vignette at baseline and 1116 (69% of baseline) provided post-training data. The primary outcomes, ‘helpful first aid intentions’ towards John/Jeanie, showed significant group-by-time interactions with medium effect sizes favouring tMHFA (ds = 0.50–0.58). Compared to PFA, tMHFA students also reported significantly greater improvements in confidence supporting a peer (ds = 0.22–0.37) and number of adults rated as helpful (ds = 0.45–0.46) and greater reductions in stigmatising beliefs (ds = 0.12–0.40) and ‘harmful first aid intentions’ towards John/Jeanie (ds = 0.15–0.41). Conclusions: tMHFA is an effective and feasible programme for increasing supportive first aid intentions and mental health literacy in adolescents in the short term. tMHFA could be widely disseminated to positively impact on help seeking for adolescent mental illness.