4.6 Article

How can the utilisation of help for mental disorders be improved? A quasi-experimental online study on the changeability of stigmatising attitudes and intermediate variables in the process of utilisation

Journal

BMC PUBLIC HEALTH
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12889-021-12125-5

Keywords

Mental health; Help-seeking behaviour; Depression; Continuum belief of mental illness; Causal beliefs; Mental health literacy; Self-efficacy; Anti-stigma intervention; Quasi-experimental online-study

Funding

  1. DFG (German Research Foundation) [SCHO 1337/4-2, SCHM 2683/4-2]

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The study aims to develop an anti-stigma intervention to support help-seeking behavior for individuals with depression, using a quasi-experimental online design with various intervention variables. The research could provide insights into understanding mental health care utilization stages and stigmatization theories, as well as inform the design and evaluation of online interventions for individuals with mental illnesses.
Background: Epidemiological studies show that even in highly developed countries many people with depression do not seek help for their mental health issues, despite promising prevention approaches encouraging people to seek help and reduce self-stigma. Therefore, an anti-stigma intervention study to support help-seeking behaviour will be developed on the basis of the newly explicated Seeking Mental Health Care Model. Methods: A quasi-experimental online study will be carried out to assess the effect of different intervention variables relevant for the help-seeking process. The study is conceived as a fractional factorial design. Participants will be screened for depressive complaints (PHQ-9 sum score >= 8) and current psychiatric/psychotherapeutic treatment. After baseline assessment the participants will be randomly allocated into one of the 24 study groups receiving different combinations of the vignette-based intervention aiming to reduce stigma and support help-seeking. Next, relevant outcome measures will be administered a second time. In a 3- and 6-month follow-up help-seeking behaviour will be measured. Gamified elements and avatar-choice techniques will be used to heighten study immersion and adherence. Discussion: On the basis of the project results, promising research and intervention perspectives can be developed. Results, firstly, allow for a more detailed empirical investigation and conceptualisation of the stages of mental health care utilisation, as well as an examination of theoretical approaches to stigmatisation. Secondly, our online study could provide insights for an evidence-based design and evaluation of online interventions for people with a mental illness.

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