Abstract
BackgroundMental health and substance use disorders are the main causes of disability among adolescents and young adults yet fewer than half experiencing these problems seek professional help. Young people frequently search the Web for health information and services, suggesting that Web-based modalities might promote help-seeking among young people who need it. To support young people in their help-seeking, we developed a Web-based mental health service navigation website called Link. Link is based on the Theory of Planned Behavior and connects young people with treatment based on the type and severity of mental health symptoms that they report.ObjectiveThe study aimed to investigate the effect of Link on young people’s positive affect (PA) compared with usual help-seeking strategies immediately post intervention. Secondary objectives included testing the effect of Link on negative affect (NA), psychological distress, barriers to help-seeking, and help-seeking intentions.MethodsYoung people, aged between 18 and 25 years, were recruited on the Web from an open access website to participate in a randomized controlled trial. Participants were stratified by gender and psychological distress into either the intervention arm (Link) or the control arm (usual help-seeking strategies). Baseline, immediate postintervention, 1-month, and 3-month surveys were self-reported and administered on the Web. Measures included the PA and NA scales, Kessler psychological distress scale (K10), barriers to adolescent help-seeking scale (BASH), and the general help-seeking questionnaire (GHSQ).ResultsIn total 413 young people were recruited to the trial (intervention, n=205; control, n=208) and 78% (160/205) of those randomized to the intervention arm visited the Link website. There was no evidence to support a difference between the intervention and control arms on the primary outcome, with PA increasing equally by approximately 30% between baseline and 3 months in both arms. NA decreased for the intervention arm compared with the control arm with a difference of 1.4 (95% CI 0.2-2.5) points immediately after the intervention and 2.6 (95% CI 1.1-4.1) at 1 month. K10 scores were unchanged and remained high in both arms. No changes were found on the BASH or GHSQ; however, participants in the intervention arm appeared more satisfied with their help-seeking process and outcomes at 1 and 3 months postintervention.ConclusionsThe process of prompting young people to seek mental health information and services appears to improve their affective state and increase help-seeking intentions, regardless of whether they use a Web-based dedicated youth-focused tool, such as Link, or their usual search strategies. However, young people report greater satisfaction using tools designed specifically for them, which may encourage future help-seeking. The ability of Web-based tools to match mental health needs with appropriate care should be explored further.Clinical TrialAustralian New Zealand Clinical Trials Registry ACTRN12614001223628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366731
Highlights
BackgroundMental ill health is a leading health burden affecting 1 in 4 young people worldwide [1,2,3] with detrimental effects on relationships, academic achievement, work life, and general well-being [4], which often continue into adulthood [5]
There was no evidence to support a difference between the intervention and control arms on the primary outcome, with positive affect (PA) increasing by approximately 30% between baseline and 3 months in both arms
No changes were found on the barriers to adolescent help-seeking scale (BASH) or general help-seeking questionnaire (GHSQ); participants in the intervention arm appeared more satisfied with their help-seeking process and outcomes at 1 and 3 months postintervention
Summary
BackgroundMental ill health is a leading health burden affecting 1 in 4 young people worldwide [1,2,3] with detrimental effects on relationships, academic achievement, work life, and general well-being [4], which often continue into adulthood [5]. Young people may not recognize their symptoms as a mental health problem or know that effective treatments exist [9,10]. Not knowing where or how to access services, perceived costs and inconvenience in accessing care, and fears of being judged or of breaches in confidentiality are other important barriers perceived by young people [10]. Interventions that reduce these barriers and provide a positive experience of help-seeking are needed, interventions that facilitate access to treatments [13] and those that aim to increase young people’s readiness to seek help [14]. Link is based on the Theory of Planned Behavior and connects young people with treatment based on the type and severity of mental health symptoms that they report
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