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Table 3 Help-seeking interventions

From: What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review

1st Author, year, country

Sample size

Inclusion criteria

Design

Setting and intervention

Comparison group

Primary outcome

Measures

Results and effect size

Quality

Psychoeducation-mental health

Berridge, 2011, Australia

182

10th grade students (aged 14–16)

Post-test design

Feasibility trial

MAKINGthe LINK. School-based. Five

class room activities provided by teachers who received specialised training.

No control group

Acceptability and feasibility of the programme

A 16-item programme

satisfaction survey.

-Not relevant

n/a1

Casañas, 2019, Spain

.

13–14 year old high school student

Clustered RCT2. Study protocol

EspaiJOVE, 14 h of psychoeducation and activities with the scholar community.

Waiting list

Help seeking behaviours

General Help-Seeking Questionnaire

(GHSQ)

-Not relevant

n/a

Lubman, 2016, Australia

year-9 students (aged 14–15)

Cluster RCT

Study protocol

MAKINGthe LINK. Five class room activities provided by teachers who received a training.

Waiting list

Help seeking behaviours

General

Help Seeking Questionnaire (GSHQ-V)

-Not assessed

n/a

Perry, 2014, Australia

208

9th or 10th grade students (aged 13–16)

Cluster RCT.

Feasibility trial

HeadStrong, school based intervention with educational practical modules during 5 to 8 weeks.

Regular Health and Physical Education classes

Attitudes towards help-seeking

Inventory of Attitudes towards Seeking Mental Health Services (IASMHS)

-Not relevant

Medium

Sharpe, 2016, United Kingdom

6551

Year 7 school student (aged 11–12)

Hierarchical cluster RCT.

Student booklet designed fomenting help-seeking and self-management support.

Waiting list

Help-seeking behaviour

Four-point scale developed by authors

There was no difference in help-seeking behaviour

Odds ratio (95% C.I)

1.01 (0.95–1.07)

Medium

Psychoeducation-depression

Joyce, 2011, Australia

32

Secondary students (aged 14–16)

Post-intervention design.

Pilot study

School based. Information sheet based on evolutionary perspective

Informative sheet about depression

Piloting the sheet.

Linkert scale (5 points)

-Not relevant

n/a

King, 2011, United States.

416

9th to 12th grade high school students

Quasi experimental design

Surviving the Teens is school based programme. Four 50 min session focused on psychoeducation.

No control group

Help seeking attitudes and behaviour

Instrument developed for the study evaluating self-efficacy and help-seeking behaviours.

Increased help-seeking behaviours after intervention and maintained in follow-up (3 months).

(t = 4.634/ p < .001)

Medium

Robinson, 2010, Australia

246

Boys school students

(aged 14–16)

Pre-test, post-test design

School-based developed in one-off, 2-h workshop

focused on depression definition, coping skills and help-seeking.

Waiting list

Help-seeking behaviours

Evaluation of Mental Health First Aid training

Intervention group was more likely to seek for help Adjusted odds

ratio (95% C.I.)=

3.48 (1.93, 6.29)

p < 0.0001

Medium

Ruble, 2013, United States

593

High school students

Pre-test and post-test design

School-based, 3 h curriculum designed to educate students, teachers, and parents about depression and help-seeking.

No intervention

Attitudes towards treatment seeking

Adolescent Depression Knowledge Questionnaire (ADKQ)

Significant increase in the intention to seek help from other

t = 13.658/ p < 0.0001.

Medium

Strunk, 2014, United States

158

Emotionally troubled teens in 9th and 12th grade

Pre- test and Post-test design

Surviving the Teens is school based programme. Four 50 min session focused on psychoeducation.

No control group

Help-seeking behaviours

Survey developed by authors.

Paired t-test showed a significant increase at posttest (p < 0.0005) but not at 3 months follow-up (p = 0.014).

Medium

Beaudry, 2019, United States

481

High school students

RCT.

Interactive classroom curriculum and focus group with parent, students and teachers.

Waiting list

Help seeking behaviours related to depression

Adolescent Depression Knowledge Questionnaire

(ADKQ)

-Not available due to data collection issues

Medium

Howard, 2019, Australia

327

16–19 year old students

Three-arm, pre-posttest, double-blind

RCT.

Psychoeducation of biological and psychosocial conditions and causes of depression

Neutral information about depression

Help-seeking intentions

General Help-Seeking Questionnaire

(GHSQ)

-Small but significant increase in help-seeking (p = 0.015)

Medium

Psychoeducation-stigma

Calear, 2017, Australia

11 and 12 grade male students (15–18 years of age)

Two arm cluster RCT.Study protocol

Silence is Deadly. School based, focused in males. Included classroom presentation (1 h), and supporting website and social media messages.

Waiting list

Help seeking intentions

General Help-Seeking Questionnaire

(GHSQ)

-Not assessed

n/a

Hart, 2016, Australia

241

High school students (aged 15–17)

Pre-test, post-test design

Feasibility trial

Teen Mental Health First Aid program. School based,

3 sessions, delivered to students, parents and teachers.

No control group

Help seeking intentions

Survey questionnaire developed for the study to measure help-seeking.

-Not relevant

Medium

Rickwood, 2004, Australia

457

School students (aged 14–18)

Solomon four-group design (pre-and post-intervention).

School based, interactive presentation by former mental health patients.

No intervention

Help-seeking intentions

General Intentions to Seek Help Questionnaire

Significant effect of the intervention Wilks’ Λ = .942

F (4,417) = 6.428p < 0.001

Medium

Saporito, 2013, United States

156

Adolescents from Public High School

RCT.

School based

Interactive 1 h session, providing basic mental health and video with case example.

Educational presentation with content

unrelated to mental health.

Reduction of

Stigma towards help-seeking

Short for of

Attitudes toward Seeking Professional Psychological Help (ATSPPH)

Increased willingness to seek for help in students with past treatment history F(1, 146) =6.64, p = .01ηp2 = .04

Medium

12. Yang, 2018, United States

14

High school students “at risk” of mental health conditions.

Quasi-experimental

Pilot study

InSciEd-oOut. School based, 20-day anti-stigma classroom activities

No control group

Help-seeking behavioural intentions

General Help-Seeking Questionnaire Vignette Version.

Not assessed

n/a

30. Young, 2013, Canada

254

High school students (aged 14–18)

Pre and Post intervention survey design

School based, combining classroom sessions and talk with person with schizophrenia

No control group

Self-stigma in help-seeking

Self-Stigma of Seeking Help scale

Significant reduction in self-stigma to seeking help after the intervention (p < 0.05)

Medium

Psychoeducation- suicide + self-harm

Aseltine, 2004, United States

2100

Students

in high schools

Cluster RCT

SOS programme, school based interactive intervention based on teaching materials and discussion guide, plus a screening instrument.

Health and social studies classes

Help-seeking behaviour

Questionnaire developed by the authors

Not significant effect of the program in help-seeking β = 0.255

p > 0.05

Medium

Aseltine, 2007, United States

3837

Students

in high schools in Hartford and

in Columbus.

Cluster RCT

SOS programme, school based interactive intervention based on teaching materials and discussion guide, plus a screening instrument.

Health and social studies classes

Help-seeking behaviour

Questionnaire developed by the authors

Not significant effect of the program in help-seeking β = −0.01

p > 0.05

Medium

Freedenthal, 2010, United States.

142 staff

146 student

Staff and students in High school in Denver area.

Pre and Post intervention survey

Pilot study

Yellow-ribbon. School based, 25 min training, card with hotline numbers and t-shirt with mental health messages.

No intervention

Help seeking behaviours

Self-reported survey developed by authors

Not relevant

n/a

Kalafat, 1994, United States

253

10th grade high school students

Solomon four-group design

School based suicide awareness program. 3 psychoeducation sessions.

Physical education classes

Help seeking attitudes

Likert scale developed by the authors.

Significant effect of the intervention F (14,225) =1.87

p < .03

Medium

Schimidt, 2015, United States

5949

High school students (aged 10–18)

Pre and Post intervention design.

Feasibility trial

Yellow-ribbon. School based, 25 min training, card with hotline numbers and t-shirt with mental health messages.

No control group

Help Seeking

9 item scale developed for the study

-Not relevant

n/a

Outreach interventions

Deane, 2007, Australia

506

9th and 10th grade high school students

Post-test design

The Building Bridges to General Practice, school based. GP deliver one session to improve students perception.

No intervention

Help seeking intentions

Adapted version from the General Help Seeking Questionnaire (GHSQ)

Increased help-seeking intentions at follow-up F(2,217) = 3.04/ p < 0.05.

Medium

Rughani, 2011, Australia

260

Year 11 high school students

RCT

Promoting Access to support seeking. School based, two 50 min sessions for building relationships with mental health professionals.

Alternative presentation

Help-seeking intentions

Items adapted from the General Help-Seeking questionnaire (GHSQ)

Short term improvement of help-seeking intentions

F (14,225) =1.87

p < .03

Medium

Wilson, 2008, Australia

291

Year 11 students from 3 high schools in New South Wales

Quasi-experimental

Nested design

The Building Bridges to General Practice, school based. GP deliver one session to improve students perception.

No intervention (year 10 students)

Help-seeking intentions

General Help Seeking Questionnaire

(GHSQ)

Increased help-seeking intentions for psychological problems after the intervention F(2,598) = 4.31p < 0.01

High

Multimedia/Online interventions

Conrad, 2014, Germany

532

High school Students without history of mental health care

Quasi-experimental

Film festival aiming to give a podium to the topic mental health.

No control group

Help seeking attitudes

Seven items Linkert scale developed by authors

Not significant change in help-seeking

t = 0.414

Medium

Nicholas, 2004, Australia

243

High school students aged 13 to 18.

Post-test design

Feasibility trial

School based, classroom presentations of ReachOUT! Website.

No control group

Help-seeking behavioursintentions and the use if the website.

Questionnaire developed by authors

Not relevant

n/a

Rowe, 2018, United Kingdom

23

Teens (aged 12–18) who had self-armed (last 12 months) and basic English speaker.

Two group parallel arm, single blind RCT.Feasibility trial.

My self-help tool. School based, web-personalised decision aid intervention designed to help identify help-seeking alternatives for self-harm.

General information

about mood and feelings.

Help seeking intentions

General Help-Seeking Questionnaire (GHSQ).

Not relevant

n/a

Santor, 2007a, Canada

388

Grade 8th high school students

Pre-post test design

School based help seeking workshop + Information website called “YooMagazine”

No intervention

Help-seeking attitudes

The Help Seeking Attitude Questionnaire

Positive effect of the intervention

β = 0.108, F(1,1037) = 3.85 p < 0.04.

Medium

Santor, 2007b, Canada

455

Grade 7th to 12th students

Pre and Post intervention survey design

Feasibility trial

Information website called “YooMagazine”

No control group

Help-seeking behaviours

Help-seeking indicators (e.g: visits to school

mental health)

Not relevant

n/a

Wiljer, 2016, Canada.

Youth (16–29) college students

Two arm RCT.Study protocol

Thought Spot. College based, web and mobile platform

Usual care

Self-efficacy for mental health

help-seeking

General Help-Seeking Questionnaire

(GHSQ)

Not assessed

n/a

Peer leader training interventions

Calear, 2016, Australia

7 to 10 grade students (aged 12–15)

Two arm cluster RCT.

Study protocol

The sources of Strength. School based, during 1 year (approx.) includes staff and peer leaders training and school messaging.

Waiting list (24 months).

Help seeking intentions

An adapted version of General Help -Seeking Questionnaire(GHSQ)

Not relevant

n/a

O’reilly, 2016, Ireland

30

Teens aged 15–17 with interest in mental health, speaking skills.

Pre and Post intervention survey design

Feasibility trial

School based, four 3 h workshop training peer leaders.

No control group

Stigma for help-seeking behaviours

Perception of Stigmatisation by Others FOR Seeking Help Scale (PSOSH)

Not relevant

n/a

Parihk, 2018, United States

878

High school students

Quasi-experiment

P2P. School based, peer leaders develop a school public awareness campaign

No control group

Help seeking intentions

Adapted version of the P2P Depression Awareness

Questionnaire

78% of students will seek for help after the intervention p < 0.001

Medium

Wyman, 2010, United States

2675

High school students (aged 14 to 18)

RCT.

The sources of Strength. School based, during 1 year (approx.) includes staff and peer leaders training and school awareness campaign.

Waiting list

Acceptability of seeking help

Help Seeking from Adults scale created by authors

Positive effects on help-seeking from adults

Mean differences (95%CI)

=0.58 (0.24, 0.91).

p = 0.04

Medium

  1. 1 n/a: Not applicable