scholarly journals A Web- and Mobile-Based Map of Mental Health Resources for Postsecondary Students (Thought Spot): Protocol for an Economic Evaluation (Preprint)

2017 ◽  
Author(s):  
Amandeep Kaur ◽  
Wanrudee Isaranuwatchai ◽  
Aliya Jaffer ◽  
Genevieve Ferguson ◽  
Alexxa Abi-Jaoude ◽  
...  

BACKGROUND Youth demonstrate a low propensity to seek help for mental health issues and exhibit low use of health services despite the high prevalence of mental health challenges in this population. Research has found that delivering interventions via the internet and mobile devices is an effective way to reach youth. Thought Spot, a Web- and mobile-based map, was developed to help transition-aged youth in postsecondary settings overcome barriers to help-seeking, thereby reducing the economic burden associated with untreated mental health issues. OBJECTIVE This paper presents the protocol for an economic evaluation that will be conducted in conjunction with a randomized controlled trial (RCT) to evaluate the effectiveness and cost of Thought Spot compared with usual care in terms of self-efficacy for mental health help-seeking among postsecondary students. METHODS A partially blinded RCT will be conducted to assess the impact of Thought Spot on the self-efficacy of students for mental health help-seeking. Students from 3 postsecondary institutions in Ontario, Canada will be randomly allocated to 1 of 2 intervention groups (resource pamphlet or Thought Spot) for 6 months. The economic evaluation will focus on the perspective of postsecondary institutions or other organizations interested in using Thought Spot. Costs and resources for operating and maintaining the platform will be reported and compared with the costs and resource needs associated with usual care. The primary outcome will be change in help-seeking intentions, measured using the General Help-Seeking Questionnaire. The cost-effectiveness of the intervention will be determined by calculating the incremental cost-effectiveness ratio, which will then be compared with willingness to pay. RESULTS The RCT is scheduled to begin in February 2018 and will run for 6 months, after which the economic evaluation will be completed. CONCLUSIONS We expect to demonstrate that Thought Spot is a cost-effective way to improve help-seeking intentions and encourage help-seeking behavior among postsecondary students. The findings of this study will help inform postsecondary institutions when they are allocating resources for mental health initiatives. CLINICALTRIAL ClinicalTrials.gov NCT03412461; https://clinicaltrials.gov/ct2/show/NCT03412461 (Archived at WebCite at http://www.webcitation.org/6xy5lWpnZ)

2018 ◽  
Author(s):  
Tyler S. Jones ◽  
Deborah Rupert

Medical student wellbeing is a topic of growing concern. Medical students experience high levels of stress and burnout and are at increased risk for depression and suicidal ideation compared to the general population. Even more concerning, medical students are disproportionately less likely to seek help for their mental health issues. Identifying and preventing these problems early can have lasting positive consequences over the course of a physician’s lifetime. We implemented a wellness program at our medical school in the spring of 2016 with the goals of decreasing burnout and depression, heightening awareness of mental health issues, and encouraging help-seeking behaviors. To analyze the impact of our program, we have implemented a quality assurance survey. Here we report lifestyle factors associated with positive screens for depression from that data and propose institutional initiatives that can be spearheaded by medical students for medical students to impact positive change.


Author(s):  
Victoria Morris ◽  
Hannah S. Scott

This article explores the victimizing experiences of individuals with mental illness using grounded inductive qualitative research methods, by extracting themes from 15 first-hand accounts of living with mental illness delivered on the TED Talks media platform. Emergent themes included (1) victimizing effects of the illness including the effects of medication and the effects of stigma, (2) normalcy, (3) the importance of help-seeking in the process of overcoming obstacles presented by mental health issues, and (4) victimization by others. We conclude that the speakers in our sample, even though they reflect an extraordinary level of functioning, still view themselves as what Becker (1991 [1963]) describes as outsiders, acting as moral entrepreneurs, crusading to normalize madness through a variety of strategies.


2005 ◽  
Vol 39 (6) ◽  
pp. 514-521 ◽  
Author(s):  
Sarah Wrigley ◽  
Henry Jackson ◽  
Fiona Judd ◽  
Angela Komiti

Objective: To examine the role of perceived stigma and attitudes to seeking care in predicting help-seeking from a general practitioner (GP) for mental health problems. Method: Across-sectional surveyin 2002 with self-repor t questionnaires assessing current levels of symptomatology, disability, attitudes towards mental illness, knowledge of prevalence and causes of mental illness, contact with mental illness and help-seeking behaviour and preferences and attitudes toward seeking professional psychological help. Results: No significant relationship was found between symptom measures and measures of disability and help-seeking. Variables positively associated with general attitudes to seeking professional psychological help were: lower perceived stigma, and biological rather than person-based causal attributions for schizophrenia. Willingness to discuss mental health issues with a GP was predicted by the perceived helpfulness of the GP and by no other variable. Conclusions: Causal attributions and perceivedstigma rather than participants' levels of symptomatology and disability influence attitudes to help-seeking for mental health issues. Efforts to improve attitudes to help-seeking should focus on reducing stigma and improving mental health literacy regarding the causes of disorders.


Author(s):  
Sharon Lawn ◽  
Christine Kaine ◽  
Jeremy Stevenson ◽  
Janne McMahon

Mental health issues are a severe global concern with significant personal, social, and economic consequences and costs. This paper reports results of an online survey disseminated across the Australian community investigating why people with mental health issues choose particular mental health services over others, what causes them to disengage from services, and what factors and qualities of services are important to consumers to support their continued engagement or re-engagement with mental health services. The importance of GPs was evident, given their key role in providing mental healthcare, especially to those referred to as “the missing middle”—consumers with mental health issues who fall through the gaps in care in other parts of the healthcare system. The study found that many respondents chose to engage with mental healthcare providers primarily due to accessibility and affordability, but also because of the relational qualities that they displayed as part of delivering care. These qualities fostered consumers’ sense of trust, feeling listened to, and not being stigmatized as part of help seeking and having their mental health needs met. Implications for education and practice are offered.


2021 ◽  
Author(s):  
Caitlin Joy Davey

First Nations, Inuit and Métis youth in Canada report higher rates of mental health (i.e., depression, anxiety, addiction and suicide) issues than the non-Aboriginal population of youth, which impacts their ability to achieve their educational goals. Understanding mental health from an Aboriginal worldview and through culturally safe strategies designed to translate mental health information to Aboriginal people is lacking. The objectives of the present study were to develop, implement and evaluate a knowledge translation (KT) strategy to enhance wellbeing knowledge and self-efficacy in coping with mental health issues among Aboriginal postsecondary students using a community-based approach. The Tool Development Phase involved focus groups and interviews with Aboriginal post-secondary students (n=9) and community members (n=3) to develop a KT activity. The KT Phase involved a pre/post design where participants (n=4) were asked about their mental health knowledge and self-efficacy in improving their wellbeing prior to and after the KT activity. All students participated in an individual interview one month later about their knowledge and the helpfulness of activity. Key informants (n=4) were interviewed during a Follow-Up and Debriefing phase regarding the community-based approach. Mental health was defined wholistically, as related to community and as being impacted by identity, stigma, cultural connection, intergenerational trauma, and a clash between Aboriginal and positivist Western worldviews. KT preferences included incorporating traditional ceremonies; covering particular topics such as resources, traditional teachings and coping strategies; and incorporating active participation. The KT activity increased knowledge and self-efficacy related to mental health and some knowledge was retained and used at one-month follow-up. As well, participants appreciated the sense of community that the activity created and provided feedback regarding what could be changed (e.g., more active participation). Key informants thought the project addressed some community needs and that it was built on relationships. This study will contribute to increasing the wellbeing of Aboriginal students by expanding upon their mental health knowledge, and sense of self-efficacy in coping with their own mental health issues, with the aim of addressing mental health barriers to the completion of post-secondary education among Aboriginal students.


2020 ◽  
Author(s):  
Daniela Vera Cruz dos Santos ◽  
Patrícia Coelho de Soárez ◽  
Victoria Cavero ◽  
Thais Ugeda Rocha ◽  
Suzana Crismanis Almeida Lopes Aschar ◽  
...  

BACKGROUND Mobile health (mHealth) interventions provide significant strategies for improving access to health services [1], offering one potential solution to reduce the mental health treatment gap. Economic evaluation can contribute with evidence to the local policy of and program development in mental health. OBJECTIVE This paper presents the protocol for an economic evaluation conducted alongside two randomized controlled trials (RCTs) to evaluate the effectiveness of a psychological intervention delivered through a technological platform (CONEMO) to treat depressive symptoms in people with diabetes and/or hypertension. METHODS The economic evaluation uses a within-trial analysis to evaluate the incremental costs and health outcomes of CONEMO compared to usual enhanced care from society and public health system perspectives. We recruited participants from the public health systems in Sao Paulo, Brazil (n=880), and Lima, Peru (n=432), and randomized to intervention or enhanced usual care groups RCTs. We will conduct cost-effectiveness and cost-utility analyses, providing estimates of the cost to decrease depressive symptoms by 50% or more. The cost per quality-adjusted life-year (QALY) gained. For effectiveness, our primary outcome is the proportion of participants with a 50% reduction in the Patient Health Questionnaire (PHQ- 9) score at 3-month - calculated through logistic regression. For utility, our primary outcome is the QALYs gained, measured by the EQ-5D-3L. We assessed each dimension at months 3 and 6. Costs will include both direct and indirect costs. The method of measurement will be mixed methods, with a combination of the Top-down and Bottom-up approaches. We will collect unit costs from the RCTs and national administrative databases. We will also calculate incremental cost-effectiveness ratios (ICERs) and display 95% confidence intervals (CI) from non-parametric bootstrapping (1000 replicates). We will calculate the incremental cost-effectiveness rate, as well as a deterministic and probabilistic sensitivity analysis. Finally, we will draw a Cost-Effectiveness Acceptability Curve (CEAC) to compare a range of possible cost-effectiveness limits. RESULTS The economic evaluation project had its project charter in June 2018 and is expected to be completed in September 2021. The final results will be available in the second half of 2021. CONCLUSIONS We expect to assess if CONEMO plus enhanced usual care is a cost-effective strategy to improve depressive symptoms in this population compared to usual enhanced care. This study will assist health managers in allocating additional resources for mental health initiatives and will inform policymakers. It also provides a basis for further research on how this emerging technology and enhanced usual care can improve mental health and well-being in low-income settings. CLINICALTRIAL ClinicalTrials.gov - Brazil NCT02846662 and Peru NCT03026426


2018 ◽  
Vol 63 (12) ◽  
pp. 826-833 ◽  
Author(s):  
Sandra E. Moll ◽  
Scott Patten ◽  
Heather Stuart ◽  
Joy C. MacDermid ◽  
Bonnie Kirsh

Objective: This study sought to evaluate whether a contact-based workplace education program was more effective than standard mental health literacy training in promoting early intervention and support for healthcare employees with mental health issues. Method: A parallel-group, randomised trial was conducted with employees in 2 multi-site Ontario hospitals with the evaluators blinded to the groups. Participants were randomly assigned to 1 of 2 group-based education programs: Beyond Silence (comprising 6 in-person, 2-h sessions plus 5 online sessions co-led by employees who personally experienced mental health issues) or Mental Health First Aid (a standardised 2-day training program led by a trained facilitator). Participants completed baseline, post-group, and 3-mo follow-up surveys to explore perceived changes in mental health knowledge, stigmatized beliefs, and help-seeking/help-outreach behaviours. An intent-to-treat analysis was completed with 192 participants. Differences were assessed using multi-level mixed models accounting for site, group, and repeated measurement. Results: Neither program led to significant increases in help-seeking or help-outreach behaviours. Both programs increased mental health literacy, improved attitudes towards seeking treatment, and decreased stigmatized beliefs, with sustained changes in stigmatized beliefs more prominent in the Beyond Silence group. Conclusion: Beyond Silence, a new contact-based education program customised for healthcare workers was not superior to standard mental health literacy training in improving mental health help-seeking or help-outreach behaviours in the workplace. The only difference was a reduction in stigmatized beliefs over time. Additional research is needed to explore the factors that lead to behaviour change.


Author(s):  
Marilyn Anne Campbell ◽  
Kevin Glasheen

A substantial group of young people experience mental health problems, which impact their educational development and subsequent wellbeing. Of those who do suffer from mental health issues, a minority of these seek appropriate professional assistance. This paucity of help seeking behaviours among young people is a challenge for counsellors. Whereas adults who suffer mental health issues have increasingly turned to the internet for assistance, it is interesting that when young people, whose social lives are increasingly dependent on the communication technologies, are not catered to as much as adults by online counselling. One small online counselling pilot program conducted at a Queensland secondary school for three years (from 2005-2007) (Glasheen & Campbell, 2009) offered anonymous live-time counselling from the school counsellor (via a secure chat room) to students through the school’s website. Findings indicated that boys were more likely to use the service than girls. All participants transitioned to face-to-face counselling, and all reported it was beneficial. This pilot study attested to the potential of online counselling. However, school counselors, as a professional group, have been hesitant to utilise online counselling as part of their service delivery to young people in schools. This chapter concludes by identifying reasons for this reluctance and possible initiatives to increase online support for young people in schools.


2019 ◽  
Author(s):  
Penny Reeves ◽  
Zoe Szewczyk ◽  
Nyree Gale ◽  
Josephine Anderson ◽  
Jennifer Nicholas ◽  
...  

BACKGROUND The online ‘StepCare’ Service identifies adults with common mental disorders, recommends evidence-based treatments and monitors symptoms and risk, with feedback to patient and GP. Proof of concept study data indicated that the Service is acceptable and feasible in general practice. OBJECTIVE As part of a larger implementation study of StepCare, we conducted an economic evaluation of the Service from multiple stakeholder perspectives. The economic evaluation included (1) a trial-based cost and cost effectiveness analysis and (2) a modelled cost-consequence analysis. An Australian public finance perspective was used, with costs disaggregated to give transparency to the investment contributed by the various stakeholders. METHODS General practices, GPs, practice staff and adult patients (18 years and over) in two large Australian Primary Health Networks (PHNs), one urban, the other rural/remote, were invited to take part in the full implementation study. For the trial-based analysis, an incremental cost-effectiveness ratio (ICER) was calculated based on one of two metrics identified as appropriate proxy measures for better alignment with stepped mental health care: GP diagnosis rate for anxiety and depression. The expected costs over a twelve-month period associated with usual practice compared to a fully implemented stepped care model were calculated in the modelled extrapolation. RESULTS The trial-based analyses calculated the incremental cost of implementing StepCare to be $54 per person screened, with a cost per newly diagnosed person of $10,750. The modelled evaluation calculated that over a 12 month period, the StepCare Service (screening and treatment) was associated with mean costs of $294 AUD per person compared to (i) usual care assuming no active screening and a quasi-stepped approach to treatment, costing a mean of $535 AUD per person and (ii) usual care assuming no active screening and treatment-as-usual (ie not quasi-stepped) costing a mean of $442 AUD per person. That is, StepCare was associated with lower costs than either of the two comparator scenarios. CONCLUSIONS Compared to current mental health care in general practice, StepCare is a cost-effective screening and patient management tool.


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