Abstract
Stigma and limited mental health literacy impede adolescents getting the help they need for depressive symptoms. A serious game coupled with a classroom session led by lived experience workers (LEWs) might help to overcome these barriers. The school-based Strong Teens and Resilient Minds (STORM) preventive program employed this strategy and offered a serious game, Moving Stories. The current study was carried out to assess inhibiting and promoting factors for scaling up Moving Stories once its effectiveness has been ascertained. Moving Stories was offered in three steps: (1) introductory classroom session, (2) students playing the game for five days, (3) debriefing classroom session led by lived experience worker. Data was collected on the number of participating students, costs of offering Moving Stories, and was further based on the notes of the debriefing sessions to check if mental health first aid (MHFA) strategies were addressed. Moving Stories was offered in seven high-schools. Coverage was moderate with 982 participating students out of 1880 (52%). Most participating students (83%) played the Moving Stories app three out of the five days. Qualitative data showed that the MHFAs were discussed in all debriefing sessions. Students showed great interest in lived experience workers' stories and shared their own experiences with depression. Bringing Moving Stories to scale in the high-school setting appears feasible, but will remain logistically somewhat challenging. Future implementation and scale-up of Moving Stories could benefit from improved selection and training of LEWs that played such an important role in grabbing the full attention of students and were able to launch frank discussions about depressive disorder and stigma in classrooms. The study is registered in the Dutch Trial Register: Trial NL6444 (NTR6622: https://www.trialregister.nl/trial/6444).
Highlights
Adolescence is a critical period in developing affective disorders such as major depression [1]
Moving Stories was offered in three steps: (1) introductory classroom session, (2) students playing the game for five days, (3) debriefing classroom session led by lived experience worker
Data was collected on the number of participating students, costs of offering Moving Stories, and was further based on the notes of the debriefing sessions to check if mental health first aid (MHFA) strategies were addressed
Summary
Adolescence is a critical period in developing affective disorders such as major depression [1]. Both depressive symptoms and depressive disorder are associated with a range of psychosocial difficulties first during adolescence such as lower educational attainment, social withdrawal, low self-esteem, possibly even suicidal thoughts and behaviors, and later in adulthood unemployment, financial debt, poorer marital and social functioning, and recurrence of depressive episodes [2]. It is important that preventive programs for adolescents are embedded in a multimodal integrated stepped-care program for early detection and prevention of depression coupled with pathways to professional help. The current study was carried out to assess inhibiting and promoting factors for scaling up Moving Stories once its effectiveness has been ascertained
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