Health e-cards as a means of encouraging help seeking for depression among young adults : randomised controlled trail

Abstract

Objective: To evaluate a brief educational intervention on young adult's help seeking for depression. Design: Randomised controlled trial. Participants: Three hundred and forty eight 19-to 24-year-olds drawn from the community. The sample was stratified to include individuals experiencing high levels of distress who could be considered in need of help, and a group without elevated symptoms. Intervention: Participants were randomised to one of three conditions, all of which delivered a short series of health e-cards (personalised emails containing links to brief educational material presented on a Web page). Two active conditions involved the delivery of health e-cards containing depression information -educational material designed to improve mental health literacy (particularly, ability to recognise the symptoms of depression, beliefs about treatments and health professionals, and knowledge and awareness of accessible and appropriate services) and to reduce self-stigmatising attitudes as a means of facilitating help seeking for depression. Outcome measures: The primary outcome measure was formal help-seeking behaviour (help seeking from a health professional for feelings of depression). Secondary outcome measures were change in intention to seek help from a health professional, ability to recognise the symptoms of depression, beliefs about treatments, beliefs about health professionals, knowledge and awareness of accessible and appropriate services, self-stigma, and depressive symptoms. Effects on behaviours, intentions, and beliefs relating to help seeking from informal sources (friends, partner, or family) were also examined. Results: Relative to the control condition, health e-cards containing depression information had no effect on help seeking from health professionals (formal help-seeking behaviour), nor were they associated with increased intentions to seek help from health professionals, improved ability to recognise the symptoms of depression, improved beliefs about treatments, or a reduction in self-stigma or depressive symptoms. Depression health e-cards were associated with improved beliefs about the efficacy of health professionals (z = 2.4, P = .02). Health e-cards had no effect on outcomes relating to informal help seeking (informal help seeking behaviour, intentions, or beliefs). At postintervention, participants in all conditions, relative to preintervention, were more likely to have higher intentions of seeking help for depression from a formal help source (t641 = 5.8, P < .001), were more likely to rate Interpersonal Psychotherapy as being helpful (z = 2.0, P = .047), and were more likely to have lower levels of self-stigma (t641 = 2.0, P = .048). Conclusions: Health e-cards containing depression information had no effect on help-seeking behaviour or intentions, relative to an attention placebo control. This could potentially be attributed to their failure to modify most of the factors thought to mediate help seeking. However, involvement in the study appeared to increase help-seeking intentions among participants in all conditions, suggesting that mechanisms other than educational material may increase help seeking. Show more