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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