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ReachOut.com: The role of an online service for promoting help-seeking in young people

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Considerable investment over the last decade in strategies to improve mental health and wellbeing in Australia has seen a notable increase in the availability and awareness of youth-specific mental health services as well as an increase in mental health literacy among young people. However, national statistics do not reflect a corresponding increase in help-seeking behaviour among young people. There is limited understanding of how services can promote effective help-seeking in young people - particularly those young people experiencing marginalisation or high levels of psychological distress. In this paper we examine the potential for online mental health services to address the persistent challenge of facilitating help-seeking in young people. This paper presents findings from a study of young people’s use of the online service, ReachOut.com, to examine if and how the service promotes help-seeking. We find that ReachOut.com effectively engages young people - particularly those who are experiencing high levels of psychological distress and supports young people to become service ready. Targeted strategies for young men and other hard-to-reach groups as well as further integration with on and offl ine clinical services are likely to strengthen and systematise the role of ReachOut.com as a gateway service, supporting young people to seek professional support.
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Advances in Mental Health (2011) 10(1): 39–51.
39
© eContent Management Pty Ltd Volume 10, Issue 1, October 2011 ADVANCES IN MENTAL HEALTH
ReachOut.com: The role of an online service for
promoting help-seeking in young people
PHILIPPA J COLLIN*,‡, ATARI T METCALF+, JUSTINE C STEPHENS-REICHER+,¶,
MICHELLE E BLANCHARD+,#,‡, HELEN E HERRMAN#,‡, KITTY RAHILLY+ AND JANE M BURNS+,#,‡
*Centre for Citizenship and Public Policy, University of Western Sydney, Sydney, NSW, Australia;
+Inspire Foundation, Sydney, NSW, Australia; #Orygen Youth Health Research Centre, Centre for
Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Brain Mind Research
Institue, University of Sydney, Sydney, NSW, Australia; Corporative Research center for Young
People, Technology and Wellbeing, Melbourne, VIC, Australia
Abstract
Considerable investment over the last decade in strategies to improve mental health and wellbeing in Australia has seen a
notable increase in the availability and awareness of youth-specifi c mental health services as well as an increase in men-
tal health literacy among young people. However, national statistics do not refl ect a corresponding increase in help-seeking
behaviour among young people. There is limited understanding of how services can promote effective help-seeking in young
people – particularly those young people experiencing marginalisation or high levels of psychological distress. In this paper we
examine the potential for online mental health services to address the persistent challenge of facilitating help-seeking in young
people. This paper presents fi ndings from a study of young people’s use of the online service, ReachOut.com, to examine if and
how the service promotes help-seeking. We fi nd that ReachOut.com effectively engages young people – particularly those who
are experiencing high levels of psychological distress and supports young people to become service ready. Targeted strategies for
young men and other hard-to-reach groups as well as further integration with on and offl ine clinical services are likely to
strengthen and systematise the role of ReachOut.com as a gateway service, supporting young people to seek professional support.
Keywords: internet, mental health, youth, help-seeking, intervention, gateway service
Despite considerable efforts to address the
challenge, the mental ill-health of young
Australians remains an issue of great public
health concern. One in four young Australians
experience a mental health diffi culty (Australian
Bureau of Statistics, 2010), and levels of psycho-
logical distress are rising (Australian Institute of
Health and Welfare, 2007). Despite an increase
in mental health literacy and awareness of help
options (Jorm, 2009), national statistics do not
indicate that more young people are seeking
help. Of the 26.4% of young people experienc-
ing a diagnosable mental disorder in the previ-
ous 12 months, only 13.2% of males and 31.2%
of females accessed a clinical service (Slade et al.,
2009). Compounding this problem is the fact
that many of those who do receive help, do not
receive suitable evidence-based treatments in a
timely manner (Andrews, Sanderson, Corry, &
Lapsely, 2000; Libby et al., 2007). In addition
to signifi cant social impacts (Australian Institute
of Health and Welfare, 2007) left untreated,
mental disorders in young people aged 12–25
directly cost Australia $10.6 billion dollars in
the year 2009 alone (Access Economics, 2009).
Appropriate and timely help-seeking can suc-
cessfully reduce the long-term impact of many
mental health diffi culties (Rickwood, Deane, &
Wilson, 2007).
Whilst it is important to understand the com-
plex reasons why clinical services fail to reach young
people in order to design services which respond
more appropriately to young people’s needs (Burns,
Davenport, Durkin, Luscombe, & Hickie, 2010),
it is essential to understand how help-seeking
can be promoted (Rickwood, Deane, Wilson, &
Ciarrochi, 2005). Rickwood et al. (2005) propose
that help-seeking be conceptualised as a process:
whereby the personal becomes increas-
ingly interpersonal. The process begins with
the awareness of symptoms and appraisal of
having a problem that may require interven-
tion. This awareness and problem-solving
Philippa J Collin et al.
40 ADVANCES IN MENTAL HEALTH Volume 10, Issue 1, October 2011 © eContent Management Pty Ltd
a mental health professional and an increase in
those saying they would not seek help of any kind
(Hickie, Luscombe, Davenport, & Burns, 2007).
The authors highlight the need for more informa-
tion on the range, nature and benefi ts of different
treatment options for mental health diffi culties
such as depression and anxiety. This echoes previ-
ous calls for research into the types of support that
young people do use, the relationship between
help-seeking and other forms of coping, and the
factors that inhibit and facilitate help-seeking
(Rickwood et al., 2005).
In young people experiencing mental health
diffi culties the challenge of promoting help-
seeking is further complicated by the ‘help-
negation effect’ – the idea that higher levels of
psychological distress and suicidal ideation predict
lower intention to seek help from a number of
available formal and informal help sources (e.g.,
mental health professionals and general practitio-
ners or friends and parents,) and higher intention
to seek help from ‘no one’ (Wilson & Deane,
2001; Wilson, Deane, Biro, & Ciarrochi, 2003;
Wilson, Deane, & Ciarrochi, 2005; Wilson,
Deane, Marshall, & Dalley, 2010). In a major
multi-study project to understand help-seeking in
young people, Rickwood et al. (2005) found that
help-negation was present amongst young people
experiencing suicidal thoughts for all sources of
help except anonymous telephone help lines.
While the role of the internet was not investi-
gated in these studies, the authors argue that the
internet, as an anonymous source of information
and support, could be preferred. Indeed, research
has found that young people feel empowered
online, are able to access immediate feedback and
feel more confi dent in accessing information and
talking about sensitive topics (Gould et al., 2002)
including: depression (Burns, Morey, Lagelee,
Mackenzie, & Nicholas, 2007); sexuality or sexu-
ally transmitted diseases (Suzuki & Calzo, 2004);
and, physical activity and nutrition (Spittaels &
De Bourdeaudhuij, 2006). The internet is an
important and effective setting in which to deliver
youth mental health interventions (Blanchard,
Metcalf, Degney, Hermann, & Burns, 2008;
Burns, Durkin, & Nicholas, 2008; Burns et al.,
2010; Collin & Burns, 2009). There is emerging
appraisal must then be able to be articulated
or expressed in words that can be understood
by others and which the potential help-seeker
feels comfortable expressing. Sources of help
must be available and accessible. Finally, the
help-seeker must be willing and able to disclose
their inner state to that source. (Rickwood
et al., 2005, p. 5)
Though not always linear, this conceptualisa-
tion allows us to think of help-seeking as com-
plex, variable and deeply embedded in everyday
life. It is a process that can be supported through
the accumulation of knowledge, skills and posi-
tive social relationships (Rickwood et al., 2005).
Further, it may be supported by ‘positive brand
association’ whereby young people develop strong
awareness, trust and loyalty to services and profes-
sionals (Nicholas, 2010).
A young person’s willingness to seek help is
negatively affected by a number of factors includ-
ing having no experience of previous professional
mental health care (Carlton & Deane, 2000), neg-
ative beliefs about the usefulness of therapy and
therapists (Kuhl, Jarkon-Horlick, & Morrissey,
1997) and low levels of emotional competence
(Rickwood et al., 2005). Young people tend
to prefer informal sources of help such as fam-
ily and friends (Offer & Schonert-Reichl, 1992;
Rickwood & Braithwaite, 1994) and support via
the internet (Gould, Munfakh, Lubell, Kleinman,
& Parker, 2002). Recent Australian data indicate
that investment in awareness and education has
increased knowledge and beliefs about mental
health diffi culties but not shifted young peo-
ple’s attitudes or intention with regards to help-
seeking. For example, beyondblue, the national
depression initiative conducted two cross-
sectional computer-assisted telephone interview
surveys in 2002 and 2004/5. The surveys included
2003 and 3200 persons, respectively, with 285
and 400 aged between 18 and 25 years. Whilst
over time small improvements in mental health
knowledge and beliefs in young people could be
detected, there was a marked trend towards infor-
mal sources of help and support, such as family
and friends and a small decline in the number of
young people saying they would seek help from
ReachOut.com: The role of an online service for promoting help-seeking in young people
41
© eContent Management Pty Ltd Volume 10, Issue 1, October 2011 ADVANCES IN MENTAL HEALTH
of such online mental health services to support
the help-seeking process, particularly for young
people experiencing high psychological distress.
REACHOUT.COM
ReachOut.com is an online mental health
promotion, prevention and early intervention
service that provides young people aged 14–25
with the information, tools, skills and connec-
tions they need to make positive decisions about
their mental health and wellbeing. Launched in
1998 by the Inspire Foundation, the service aims
to increase mental health literacy, help-seeking
behaviour, social connectedness and resilience.
The ReachOut.com model uses many of the
interactive features of the internet (Burns et al.,
2007). The six core components are: research-
supported information created by young people
and professionals delivered through over 250
factsheets; an online community forum and blog;
an online game based on cognitive behavioural
therapy1; digital and social media including pod-
casts, digital stories and video; and use of social
networking services to deliver content and build
community. In addition, ReachOut.com aims to
promote help-seeking by maintaining a mental
health brand position that young people trust and
see as relevant, providing credible information on
help options and by offering skill building tools
and opportunities, both on and offl ine. Table 1
outlines the service offerings at each stage of the
help-seeking process.
Websites for health professionals2 and educa-
tors3 support the delivery of ReachOut.com in
clinical and school settings. The service has been
designed and delivered using an action research
model, directly involving over 600 young people.
These participants are referred to here as ‘Youth
Ambassadors’ and are distinct from general site
visitors as they are typically highly engaged service
users due to their role as strategists, content pro-
ducers and community advocates for the service
(Collin, 2007; Oliver, Collin, Burns, & Nicholas,
2006; Swanton, Collin, Burns, & Sorenson, 2007).
1 ReachOutCentral.com.au
2 www.reachoutpro.com.au
3 teachers.reachoutpro.com.au
evidence that technology-based interventions
can be effective (Griffi ths, Farrer, & Christensen,
2010; Spek, Cuijpers, Riper, Keyzer, & Pop,
2007) and, particularly, attractive and engaging
for young people (Burns et al., 2010; Ryan,
Shochet, & Stallman, 2010).
This has been confi rmed by recent Australian
data demonstrating the importance of online ser-
vices for engaging with young people, particularly
those experiencing mental health diffi culties.
Twenty per cent of those aged 12–25 surveyed
(n = 2000) in the 2008 headspace National Youth
and Parent Community Survey reported that they
had personally experienced a mental health diffi -
culty, alcohol or other substance misuse problem
in the previous fi ve years (Burns et al., 2010).
Twenty one per cent of 12–17-year-olds and 34%
of 18–25-year-olds reported that they had specifi -
cally searched the internet for information to help
themselves. Of these, 78% of young people aged
12–25 years felt that the internet had helped a
little or a lot with a mental health, alcohol or sub-
stance misuse problem; 85% would recommend it
to a friend or family member; and 94% felt some-
what or very satisfi ed with the information they
received. Additionally, 55% of 12–17-year-olds
and 45% of 18–25-year-olds felt the internet pro-
vided the kind of information they needed. The
authors identify the need for a range of research
methods to be used to capture the complexity of
young people’s experiences of help-seeking and
technology use (Burns et al., 2010).
This paper responds to calls to examine
whether online services engage those young peo-
ple most likely to need help and how they sup-
port the help-seeking process. It examines the role
of popular Australian online service, ReachOut.
com, by presenting fi ndings from the ReachOut.
com Program Evaluation (2010), supplemented
by interviews and focus groups with a sub-sample
of young people who contribute directly to the
design and delivery of the service. The qualitative
data was part of the Youth Participation Evaluation
(2009) which examined, amongst other things,
young people’s involvement in the service as a way
to promote help-seeking. Drawing on this data
specifi cally we examine the profi le and experience
of ReachOut.com users to consider the potential
Philippa J Collin et al.
42 ADVANCES IN MENTAL HEALTH Volume 10, Issue 1, October 2011 © eContent Management Pty Ltd
METHODS
The Program Evaluation assessed who uses
ReachOut.com, how they utilise it and the extent to
which it improved mental health literacy, social con-
nectedness and help-seeking, and reduced stigma
(Metcalf, Stephens-Reicher, & Collin, 2010). For
this paper, data were drawn from three sources
detailed below: website statistics, cross-sectional
survey of young people who access the ReachOut
website and user-generated site content analysis.
Website statistics
Data were collected from general visits to the site.
Website statistics are captured for all site visitors
via the ReachOut.com content management sys-
tem and Google Analytics, a free software package
which can measure site visits and visitor numbers,
geographical origin of visitors, pages viewed, time
spent on specifi c pages and on the whole site.
Website statistics reported here are for the period
1 July 2009–30 November 2010 and user-gener-
ated content was analysed for the same time period.
User profi ling survey
The cross-sectional user profi ling survey was
open to all visitors to the ReachOut.com web-
site. Of the total 2,291 survey respondents, 1,552
(67.8%) met the ReachOut.com target audience
age range of 14–25 years and did not identify as
visiting for professional reasons. Of these, 23%
identifi ed as male, 76% female and 1% as trans-
gender, intersex or other. In terms of geographical
location the user base broadly refl ects the national
youth sample (Table 2).
The survey was based on the beyondblue com-
munity awareness survey (Highet, Luscombe,
Davenport, Burns, & Hickie, 2006) and headspace
Youth and Community Survey (Hickie, Davenport,
Luscombe, & Fogarty, 2009). In addition to stan-
dard demographics used by the Australian Bureau
of Statistics the following measures were included
and are reported in this paper:
(a) Psychiatric morbidity: The Kessler psycholog-
ical distress scale (K-10) is a 10-item screening
scale for mental disorders (Kessler et al.,
TABLE 1: REACHOUT.COM SERVICE OFFERINGS AT EACH STAGE OF HELP-SEEKING PROCESS (ADAPTED FROM RICKWOOD
ET AL., 2005)
Key stages in
help-seeking
Awareness and
appraisal of problem
Expression of
symptoms and need
for support
Availability of
sources of help
Willingness to seek out
and disclose to sources
ReachOut.com Online delivery: anonymous, peer-based and embedded in everyday life
Participant involvement in service design and delivery building service relevance and brand
Gateway to online tools and services via links and partnerships
Resources (fact
sheets, personal
stories and online
peer-based forums)
that aim to increase
mental health
literacy to assist with
recognising signs and
symptoms of mental
health problems, as
well as understanding
different sources of
help available.
CBT-based single
player online game,
forums and blog,
fact sheets and
stories to help build
young people’s
interpersonal and
social skills to assist
them in articulating
their experience and
need for help.
Resources on how
to fi nd the most
relevant help and
treatment available
for different
problems and
scenarios.
Targets young people
experiencing mental
health issues AND whole
population to promote
cultural beliefs and
attitudes to (a) affi rm
the message that help is
effective, (b) combat stigma
surrounding mental health
and help-seeking and (c)
give information, promote
skills, provide informal
support and referral.
Facilitated and
informal discussion via
feedback, forum and
blog facilities and via
partner websites such
as Habbo Hotel.
Facilitated and
informal discussion
via feedback, forum
and blog facilities
and via partner
websites such as
Habbo Hotel.
Proximity to service:
awareness and sense of
relevancy and connection
to the service.
ReachOut.com: The role of an online service for promoting help-seeking in young people
43
© eContent Management Pty Ltd Volume 10, Issue 1, October 2011 ADVANCES IN MENTAL HEALTH
2002). Participants were categorised into four
groups based on their score: low (<16), mod-
erate (16–21), high (22–29) and very high
(> = 30) (Australian Bureau of Statistics, 2009;
Department of Human Services, 2008).
(b) Website usage: Respondents were asked to
indicate their primary reason for visiting on the
day of completing the survey using a multiple
choice question with the option to type in an
alternative response. New or return user status
was determined using a multiple choice ques-
tion asking participants when they fi rst visited
ReachOut.com. Using a multiple choice ques-
tion, participants were asked to indicate the
main type of information they were looking
for when visiting ReachOut.com.
(c) Perceived program impact on mental health
literacy and help-seeking: Respondents were
asked to rate how much ReachOut.com had
helped them: ask a professional for help; ask
a friend for help; have more of an under-
standing about mental health issues; learn
more about other people’s experience of a
mental health issue; and, learn skills, knowl-
edge and confi dence to seek help if needed.
This was done using a four-point scale rang-
ing from ‘not at all,’ ‘a little bit’ ‘quite a bit’
and ‘a lot’.
Participation in the cross-sectional user pro-
ling survey was voluntary, self-selected and
anonymous. Participants were recruited via the
ReachOut.com website and affi liated social
networking pages on facebook, Twitter and
MySpace between June and August 2010. Pop-up
windows and cookie technology minimised the
likelihood of visitors seeing and undertaking the
survey more than once. Participants were offered
the chance to win one of ten vouchers valued at
$30 each. The survey was conducted on a secure
online platform and took approximately 20 min-
utes to complete. SPSS 17.0 for Windows (SPSS
Inc, Chicago, IL) was used for statistical data
analyses. Descriptive analyses were undertaken
and independent samples t-tests were executed
to determine any differences in perceived impact
for new versus repeat visitors in the high and very
high levels of psychological distress.
User-generated content
Content can be posted on ReachOut.com forums,
blog and factsheet pages by website members.
Comments on popular factsheets and forums
were thematically analysed for content relating to
help-seeking, namely need, advice and change in
view.
Ethics approval for these activities was obtained
from the Human Research Ethics Committee
at the University of Sydney (reference number:
10685).
In 2009, a sub-study was conducted look-
ing specifi cally at the role of youth participation
for promoting mental health and wellbeing and
the impact of youth participation on individual
participants, the service and the organisation. At the
individual level this evaluation examined, amongst
other things, how engagement in program devel-
opment and delivery impacted on the help-seeking
intentions of participants. Methods included
cross-sectional surveys of youth participants and
Inspire Foundation staff, in-depth interviews and
focus groups. This paper draws on the interviews
and focus groups with young people to expand our
understanding of help-seeking.
Interview and focus groups
Interview and focus group participants in the study
were drawn from a possible pool of 500 young
people who had been involved in service delivery
since 1998. All were invited to participate in focus
groups. Focus groups were conducted in Brisbane
TABLE 2: REACHOUT.COM USERS COMPARED WITH
NATIONAL POPULATION DISTRIBUTION BY GEOGRAPHICAL
LOCATION
Geographical
location
ReachOut.com
users1
National2
NSW 42.6 32.1
VIC 16.1 25.0
QLD 16.4 20.1
SA 6.9 7.2
WA 9.6 10.5
TAS 3.1 2.1
NT 0.3 1.2
1All non-professional users. 2Aged 15–24 years (Australian
Bureau of Statistics, 2010).
Philippa J Collin et al.
44 ADVANCES IN MENTAL HEALTH Volume 10, Issue 1, October 2011 © eContent Management Pty Ltd
(N = 9), Perth (N = 6) and Melbourne (N = 6) and
involved six males and 17 females aged between
18 and 27 years. A further seven young people
were purposively invited to take part in in-depth
interviews due to their particular involvement in
aspects of the service. Two focus group participants
were also interviewed. Participants were asked
to discuss their involvement and the benefi ts of
participation for themselves, the ReachOut.com
program and the Inspire Foundation. Thematic
analysis considered the relationship between par-
ticipation and personal development, social inclu-
sion, mental health and wellbeing.
In-depth interviews were conducted during
June and July 2009 and focus groups in September
and October 2009.
Ethics approval for the focus groups and
interviews was obtained from the University of
Melbourne: 0825247.2.
RESULTS
Website statistics
ReachOut.com is a popular youth mental health
website averaging 96,508 unique visitors per month.
At November 2010 it had strong site membership
(6,446 registered users) and following on social net-
working sites (4,011 fans of the ReachOut.com page
on social networking site, www.facebook.com).
Website statistics show the most popular pages
visited are Depression: types, causes and symptoms,
Mental health diffi culties, and Mood disorders.
Young people are actively engaging with this con-
tent as demonstrated by high numbers of visitor
comments and discussion on these factsheets. For
example, the Depression factsheet has received over
20,968 unique visits and attracted 90 comments
from 35 visitors since it was created in June 2009.
User profi ling survey
The 2010 User Profi ling Survey found that 66%
of visitors are aged 14–25 years and most likely
to be between 16 and 18-years-old (Figure 1),
female (76%) and undertaking either full or part-
time study (64%).
Analyses were based on the sample of 14–25-year-
olds (N = 1552) who responded to each item.
Around half the sample (52%) was visiting for the
rst time, a signifi cant proportion were long-term
repeat visitors and nearly a quarter reported fi rst
visiting ReachOut.com over a year ago. Of return
visitors, approximately one third reported that they
have visited the site between two and fi ve times, in
total, whilst 25% reported visiting over 20 times.
Psychological distress
Using the K-10 (Kessler et al., 2002), a major-
ity of non-professional survey respondents aged
14–25 years scored in the high (22–29; 19.4%) or
very high (30–50; 51.8%) range of psychological
distress (Australian Bureau of Statistics, 2009;
Department of Human Services, 2008), with no
marked difference between new or repeat users.
Mental health literacy and stigma
Although the website offers information on a
wide variety of topics, when visiting ReachOut.
FIGURE 1: AGE OF REACHOUT.COM USERS (YEARS)
5%
21%
26%
9%
6% 6% 7% 6%
14%
0%
5%
10%
15%
20%
25%
30%
Under 14 14-15 16-18 19-20 21-22 23-25 26-30 31-35 36 &
older
ReachOut.com: The role of an online service for promoting help-seeking in young people
45
© eContent Management Pty Ltd Volume 10, Issue 1, October 2011 ADVANCES IN MENTAL HEALTH
com young people reported mainly seeking infor-
mation about mental health issues (Figures 2
and 3).
Respondents self-reported that ReachOut.
com has contributed to their knowledge of men-
tal health problems, feelings and help options
(Table 3).
Overall, 81% of visitors report that they have
‘learnt more about other people’s experience of a
mental health issue’ and ‘have more understand-
ing about mental health issues’ (84%). However,
fewer (especially if distressed) felt ReachOut.com
has helped them to ‘worry less about what people
think about the problems associated with mental
health issues’.
ReachOut.com visitors say they probably
or defi nitely would make friends (85.6%) or
spend an evening socialising (82.6%) with some-
one who had a mental health, alcohol or other
substance use problem. Over two-thirds would
go up to them at a party (70.8%) or have that
person start working closely with them on a job
(68.8%).
Seeking help
There is a range of reasons why young people
engage with ReachOut.com. Predominately
they are looking for information and support for
themselves or someone else (Figure 3).
Only 53% of users who scored in the two
highest ranges of psychological distress reported
visiting the site because they were going through
a tough time and looking for help.
Importantly, the majority of visitors view
ReachOut.com as relevant, credible and agree that
the site is ‘trustworthy’ (74.3%) and ‘there when
they need it’ (67.3%). Similarly, if a friend was
going through a tough time they would tell them
about ReachOut.com (66%). This is particularly
true for young people who are highly distressed
and who rate more highly that [after controlling
for gender (p < .05)]: ‘ReachOut.com is a service
for someone like me’; ‘ReachOut.com is a site I
trust’; ‘ReachOut.com is there when I need it’.
When asked if ReachOut.com had helped
them ask a professional for help, 35.2% responded
‘quite a bit’ or ‘a lot’. Importantly, 60.3% of
respondents say that they have visited ReachOut.
com when they were going through a tough time.
Further, 43.3% of respondents said ReachOut.
com helped them ‘quite a bit’ or ‘a lot’ learn skills,
knowledge and confi dence to seek help if they
needed it. Repeat visitors report ReachOut.com
to have helped them more than fi rst time users.
FIGURE 2: MAIN INFORMATION SOUGHT FROM REACHOUT.COM
Philippa J Collin et al.
46 ADVANCES IN MENTAL HEALTH Volume 10, Issue 1, October 2011 © eContent Management Pty Ltd
Despite overall increased mental health liter-
acy and intentions to seek help, ReachOut.com
visitors remain reluctant to seek help from tradi-
tional and face-to-face sources. When asked how
likely they were to engage in particular activities
if they were going through a tough time, a sig-
nifi cant proportion indicated they were likely or
very likely to seek help via informal sources such
as friends (62.4%) and online sources (66.7%),
but were unlikely or very unlikely to seek help
from formal sources such as a mental health ser-
vice (72.9%), email or web counselling (57.7%)
or a teacher (69.9%). As levels of psychological
distress increased for young people, they were
less likely to report talking to a friend, parent,
relative, family friend or teacher if they were
going through a tough time (p < .05). These
results are consistent with fi ndings from studies
on help-seeking behaviour, which suggest that as
feelings of distress increase, anonymous sources
of help are preferred over known informal sup-
ports (such as friends; Rickwood et al., 2005;
Ryan et al., 2010).
Content analysis
The comment threads on many factsheets have
developed a Q&A-style format where visitors ask
questions or talk about how they are feeling and
other members or staff respond with empathy and
advice about where to go for more information
or help:
Tash13 (11 months ago): a lot of the symp-
toms that are on here sound similar to how ive
acted but im only 18 can i have bipolar at my
age? N also can it go away?
FIGURE 3: REASON FOR VISITING REACHOUT.COM BY DISTRESS LEVEL
ReachOut.com: The role of an online service for promoting help-seeking in young people
47
© eContent Management Pty Ltd Volume 10, Issue 1, October 2011 ADVANCES IN MENTAL HEALTH
Porcelain (11 months ago): Hi Tash13, welcome
to ROtreat :) If you believe all these symptoms
you have are there, perhaps, its best to get a pro-
fessional diagnosis from a psychologist as they’re
more professional in diagnosing people
Rosin – RO Crew (11 months ago): Hi and
welcome to ReachOut Tash 13. I think Ophelia
has given you some excellent advice. Thanks
Ollie. If you think you may have Bipolar
Disorder, please don’t hesitate to go and see a
counsellor or psychologist. Your GP should be
able to direct you towards your local services. If
you are looking for info on seeking help please
check out this link: http://au/reachout.com/
nd/getting-help/who-can-help-you.
Bubbly phsyco (9 months ago): this one is to
tash, bipolar can affect anyone at any age. I was
fteen when i got on medication for bipolar,
i was going up and down and up and down
all day everyday. one minute i was the happi-
est bubbliest girl and then next minute i was a
rude objocious devil. Bipolar will not just go
away if you havent already go see a doctor
(Feedback comments on http://au.reachout.
com/fi nd/articles/bipolar-disorder)
ReachOut.com visitors themselves become
advocates of help-seeking as evidenced in
comments on site content and on ReachOut.com
profi le pages on social networking services:
Spud (about 1 year ago): how often do I con-
sider this bliss to be haedes domain? Often
enough to know that even I need help It is
getting worse, the light at the end of the tun-
nel has been smashed If there is a soul on
this site who know who I should seek, you are
a god among mere mortals.
Porcelain (about 1 year ago): @Spud life is
tough, am not going to disagree with you, but
there are people out there who can help you.
Have you considered speaking to your doctor
who can perhaps allow you to seek face to face
counselling? Or Kids Help too can help you,
since they are trained counsellors. The no#
is 1800.55.1800. Also, have you checked out
the sort of things you can do to help you get
through your day to day routine? Head over to
Zen Den on Forum if you like and try having
a go at the positive stuff. There are lots of great
ideas [includes links to forums and related
content on ReachOut.com.]
Spud (about 1 year ago): thinks the doc
idea is a nogo cos I cant stand face2face but
the helpline might b cool woudl it wrk on
a mobile?
Porcelain (about 1 year ago): @Spud – It
works on mobiles. Yes. If you are with Optus,
it’s free call, other services you have to pay
depending on how much it costs you to make
a call. Give it a go and see how you go :)
(Comments on http://au.reachout.com/fi nd/
articles/depression)
This exchange highlights how the peer-based
and user-led nature of ReachOut.com can pro-
mote help-seeking. This is refl ected in many
examples of unsolicited content posted by visitors
discussing the role ReachOut.com played in their
own help-seeking journeys:
I was diagnosed with Bipolar II a few months
ago. I never would have gone to the psychia-
trist if it werent for this fact sheet. So THANK
YOU. (Comment posted on the Bipolar
factsheet.)
TABLE 3: REPORTED IMPROVEMENTS IN MENTAL HEALTH1
How much has ReachOut.com
helped you to ?
‘Quite a
bit’ (%)
‘A lot’
(%)
Total
(%)
Understand how the way you
think about things can affect
how you feel and behave
29 17 46
Learn skills, knowledge and
confi dence to seek help if I
need it
28 15 43
Understand how I can help
others going through a tough
time
28 18 46
Learn more about other
people’s experience of a
mental health issue
31 21 52
Have more understanding
about mental health issues
33 24 57
1A four point rating scale was used: not at all; a little bit;
quite a bit and a lot.
Philippa J Collin et al.
48 ADVANCES IN MENTAL HEALTH Volume 10, Issue 1, October 2011 © eContent Management Pty Ltd
Interviews and focus groups
Two key insights emerge from interviews and
focus groups with young people involved in
designing and delivering the service. Firstly, there
is a diverse range of often complex reasons that
may combine to bring young people initially to
the site, and to return over time:
Well, I started using the Reach Out program
about 6 years ago and that was due to my own
tough experiences. Then I got involved with
Inspire about a year and a-half ago and that
was because I had a fi eldwork placement I had
to do for my degree and I had to choose an
organisation that I wanted to work in. Yeah,
I chose Inspire because I’d already like used
Inspire as my own and I sort of wanted to give
back to it. (Amelia, 21, interview, Sydney)
In addition to seeking information and sup-
port for a tough time, young people come to
ReachOut.com while looking for opportunities to
volunteer or get workplace experience or because
they are interested in advocacy. Their experiences
suggest a complex interplay between activities
associated with ‘everyday life’ and help-seeking.
Secondly, in focus groups Youth Ambassadors
associated increased knowledge, skills and pro-
pensity to seek help with involvement with
ReachOut.com:
I fi nd the way I live my life now is more – I’ve
got a really good understanding of where my
limits are. I know when to ask for help if I need
it. I know how to better understand people
when they are going through things to com-
municate with them in a more sort of under-
standing way. (Female, 26, focus group, Perth).
Having a sense of ownership over the service –
not just being a ‘client’ – and feeling valued by the
service were linked to an appreciation for the role
of help-seeking for mental health.
DISCUSSION
Among other people ReachOut.com is being
used by large numbers of young people who are
experiencing levels of psychological distress that
are signifi cantly higher than observed in the gen-
eral youth population. The majority of young
people (71.2%) who participated in the 2010
User Profi ling survey scored in the two highest
categories for psychological distress. This indi-
cates that ReachOut.com is engaging young peo-
ple who are likely to be experiencing moderate to
severe mental health diffi culties.
Young people are using ReachOut.com for its
intended purpose of obtaining information and
support to help them through tough times. Site
users reported they had learnt more about mental
health issues, and said that ReachOut.com helped
them to develop a better understanding of other
people’s experiences of mental health diffi culties.
Furthermore, a signifi cant proportion of young
people reported that ReachOut.com had helped
them to seek help by talking to someone if they
were going through a tough time, and more than
a third indicated ReachOut.com had helped them
to access professional services. However, only
53% of those scoring in the top two categories for
psychological distress reported visiting because
they were going through a tough time, suggest-
ing ReachOut.com may be reaching and engag-
ing young people who may not yet recognise that
they need support. It is therefore important that
ReachOut.com continues to provide a safe and
supportive environment that offers tools that sup-
port young people to get help and enable clear
pathways to care.
ReachOut.com as a gateway service
ReachOut.com takes on and extends the role of
the individual who fi rst identifi es a problem and
sends a young person to treatment (Stiffman,
Pescosolido, & Cabassa, 2004). It appears to
be acting as a gateway service by assisting a
young person to identify that they have a prob-
lem that warrants help and then supporting the
young person to access appropriate treatment
in a timely manner. A key action in this process
is supporting the young person to address their
concerns regarding help-seeking. Furthermore,
the predominately online delivery of ReachOut.
com enables the service to tailor its offering to be
relevant regardless of young people’s stage in the
help-seeking process.
The data presented here indicate three unique
operational features of ReachOut.com which
ReachOut.com: The role of an online service for promoting help-seeking in young people
49
© eContent Management Pty Ltd Volume 10, Issue 1, October 2011 ADVANCES IN MENTAL HEALTH
enhance the help-seeking process (Table 1):
Online delivery, participant involvement and
embedding linkages to professional services may
encourage help-seeking, particularly because they
promote proximity and brand. The combination
of proximity and brand is important because it
refers not only to availability and awareness of
services, but also a sense of relevance and being
connected to these services regardless of mental
health status. These elements may be critical char-
acteristics of an online gateway service that sup-
ports the help-seeking process for young people.
Repeat users of ReachOut.com are more likely
than fi rst time users to report that using the site
increased their knowledge of mental health issues
and likelihood of seeking help, thus it is important
to continue investing in strategies that increase
young people’s exposure to and engagement with
ReachOut.com in order to promote high levels of
program retention. Furthermore, this may suggest
a ‘dose-response’ relationship exists between the
number of times a young person uses ReachOut.
com and its effectiveness in relation to improving
mental health literacy and help-seeking. Further
investigation, to understand which aspects of
the program used in what ways and with which
frequency are most effective in promoting mental
health literacy and help-seeking, should be
undertaken.
Future research should also incorporate lon-
gitudinal tracking of users’ engagement with
ReachOut.com and the long-term outcomes for
their mental health and wellbeing. This, alongside
continued use of qualitative methods, is necessary
to understand the relative importance of distinct
elements of the service for different audiences,
along with frequency of use and duration and
nature of interaction with the service. These ques-
tions are central to the development of effective
engagement and retention strategies needed to
maximise the service’s positive impact. They will
also guide the development of new online tools
that can be provided either within or external to
the ReachOut.com platform.
CONCLUSIONS
With the internet already featuring strongly in
the help-seeking pathways of young people,
particularly those experiencing mental health
diffi culties (Burns et al., 2010; Rickwood, 2011),
there is a clear need to understand the role of
online services such as ReachOut.com. Since its
establishment as a unique service 15 years ago,
ReachOut.com has been positioned as a ser-
vice for all young Australians aged 14–25 years.
As part of this broad role, ReachOut.com has
unique and relevant service offerings at each stage
of the help-seeking process. The online delivery,
participant involvement and embedding links
to professional services appear to be unique and
important characteristics which encourage help-
seeking, particularly because they promote prox-
imity and brand. ReachOut.com may have an
important role to play in early intervention as
a gateway service – helping those young people
who have become unwell to identify that they
have a problem and support them to access clini-
cal tools, applications and services. Building on
strong brand awareness and alignment to deliver
these tools and services in partnership with men-
tal health professionals, creating stronger path-
ways to offl ine care, will further enhance the
impact of ReachOut.com on the help-seeking
behaviour of young Australians.
ACKNOWLEDGEMENTS
ReachOut.com staff, Brain & Mind Research
Institute and Leading Edge. The Youth
Participation Evaluation was supported by
Australian Rotary Health and Ehon Chan, Kris
Gesling, Belinda Eslick, Zenna Baxter and Tanya
Pretila, peer researchers in that project.
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Received 14 December 2010 Accepted 30 May 2011
CALL FOR PAPERS
Government intervention in rural and regional Australia and beyond
DEADLINE FOR PAPERS: 1ST DECEMBER 2011
A special issue of Rural Society – Volume 21 Issue 3 – ISBN 978-1-921729-43-0 – ii+110 pages – June 2012
Editor: Troy Whitford (Charles Sturt University, Wagga Wagga NSW, Australia)
There is ongoing debate surrounding the level of
government intervention required to assist rural and
regional communities. Prior to the Global Financial
Crisis, neo-liberal economic ideology dominated not
only business but also government spending decisions.
A rationale developed that markets could best decide
what areas would economically grow. The view was
that government intervention was only propping-up
communities which would otherwise have to adjust its
expectations and accept limited social and economic
opportunities. While the Global Financial Crisis heralded
a new Keynesian approach to government spending,
the funding approaches were more akin to stimulating
the economy than setting long term planning to improve
rural and regional economies. Consequently, while
there have been increases in government spending it
still has not been reconciled to what level and length
government intervention should be applied to rural and
regional communities.
We invite submissions to a special edition of Rural Society
that will explore these issues. The special edition will
feature an international cast of authors along with nation-
ally recognised scholars in the fi elds of rural and regional
policy making.
Manuscripts may wish to:
canvass some of the central arguments for government
intervention in rural and regional communities.
apply a national and/or international context using
comparative studies. Particular countries of focus will
be Thailand, Great Britain and the United States.
conduct a comprehensive examination of the Australian
approach to rural and regional policy surveyed in a
historical and contemporary sense.
http://rsj.e-contentmanagement.com/archives/vol/21/issue/3/call/
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eCONTENT MANAGEMENT
Scholarly Research for the Professions
... Looking online for advice was found to appeal to young people for multiple reasons. For example it is more informal (Collin et al., 2011); convenient, easy to access, fast and non-judgmental (st. Jean et al., 2018;Lupton, 2020); free, private, anonymous, confidential and non-stigmatised, which was especially important when searching for mental health advice (Kauer, Mangan and Sanci, 2014;The Mix, 2015;Pretorius, Chambers and Coyle, 2019); provides a wealth of diverse information and opinions (Lupton, 2020); can be experience-based, and individually focused (Cao and Liu, 2017); and is an accidental by-product and extension of young people's increasingly online lives and of the shift to online banking (Common Vision, 2019; MacFarland and Hayes, 2020); is available on demand at any time, night and day (Cao and Liu, 2017;The Mix, 2019;Lupton, 2020); can be accessed anonymously from the safety of one's home, which also helps young people feel safe (The Mix, 2019), and offers young people a sense of control over their helpseeking journey (Pretorius, Chambers and Coyle, 2019). ...
... Many studies report that young people see online advice as supplementing, rather than replacing, faceto-face advice from family, friends and professionals (Collin et al., 2011;Lupton, 2020). Furthermore, selfaccessed online advice can provide a gateway to more specialist services (Kauer, Mangan and Sanci, 2014;The Mix, 2019). ...
... In studies on health-related advice, online services were often found to offer a gateway to further helpseeking, including accessing professional support, and pursuing other sources of information and advice (Collin et al., 2011;Pretorius, Chambers and Coyle, 2019;The Mix, 2019). This is valid to capture. ...
Technical Report
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A rapid literature review on where and how young people seek information and advice on money matters. Possibly contrary to expectations, the internet and social media do not provide the information young people are looking for when it comes to financial matters, and often cause more confuison than enlightenment. Our findings show that young people tend to use generalist search terms and engines, are largely unaware of specialist sites, and find it hard to judge what to trust online: challenges compounded by the commercial interests behind much of the available online ‘advice’. Most turn to friends or families for money advice, signalling the need for trustworthy and individualised guidance. Unfortunately the adults they turn to were reported to often lack confidence or sufficient knowledge on financial matters. Recommendations made included better financial capacity building for families, children, young people and those who work with them (e.g. teachers and youth workers); and free, easily accessible, impartial, high quality, personalised advice – as and when needed. In other words, it can’t be presumed that all financial education can be delivered in one go, at age 12, 16 or 20 (even if feasible). Young people want appropriate advice when they hit key junctures in their lives, especially points of transition, such as starting a job, taking on a tenancy, getting credit/ into debt, becoming a parent, …
... Established in Australia in 1998, Reach-Out is a web-based mental health promotion, early intervention and prevention service for young people aged 12-25 75 . Co-design and youth participation have been central to its development and delivery 76 . ...
... ReachOut aims to improve young people's mental health literacy, resilience, social connectedness, and help-seeking behaviors through self-help information, peer support forums and referral tools 75,77 . It also offers support and resources to parents and schools. ...
... Nearly three-quarters of young people accessing ReachOut are experiencing high or very high levels of psychological distress 75 . A recent evaluation found that the service is accessible and relevant to young people, increases help-seeking behaviors, and significantly reduces depression, anxiety, stress and risk of suicide 78,79 . ...
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Mental ill-health represents the main threat to the health, survival and future potential of young people around the world. There are indications that this is a rising tide of vulnerability and need for care, a trend that has been augmented by the COVID-19 pandemic. It represents a global public health crisis, which not only demands a deep and sophisticated understanding of possible targets for prevention, but also urgent reform and investment in the provision of developmentally appropriate clinical care. Despite having the greatest level of need, and potential to benefit, adolescents and emerging adults have the worst access to timely and quality mental health care. How is this global crisis to be addressed? Since the start of the century, a range of co-designed youth mental health strategies and innovations have emerged. These range from digital platforms, through to new models of primary care to new services for potentially severe mental illness, which must be locally adapted according to the availability of resources, workforce, cultural factors and health financing patterns. The fulcrum of this progress is the advent of broad-spectrum, integrated primary youth mental health care services. They represent a blueprint and beach-head for an overdue global system reform. While resources will vary across settings, the mental health needs of young people are largely universal, and underpin a set of fundamental principles and design features. These include establishing an accessible, “soft entry” youth primary care platform with digital support, where young people are valued and essential partners in the design, operation, management and evaluation of the service. Global progress achieved to date in implementing integrated youth mental health care has highlighted that these services are being accessed by young people with genuine and substantial mental health needs, that they are benefiting from them, and that both these young people and their families are highly satisfied with the services they receive. However, we are still at base camp and these primary care platforms need to be scaled up across the globe, complemented by prevention, digital platforms and, crucially, more specialized care for complex and persistent conditions, aligned to this transitional age range (from approximately 12 to 25 years). The rising tide of mental ill-health in young people globally demands that this focus be elevated to a top priority in global health.
... From the literature, the message is clear that in order to be able to seek help, people need to understand a service; have a positive view of it; have faith in the ability to deliver; and knowledge of what can be offered. With regard to help-seeking, we focused our literature review on seeking assistance through formal avenues of support (Heerde et al., 2015;Collin et al., 2011 highlight the many different elements that have an impact on a person's help-seeking behaviours, including knowledge, skills and social supports. Daro (2019, p. 32) argues 'all families need outside help; the question is how best to direct them to such assistance'. ...
... Clarity of purpose and rationale is essential in a communication strategy (Vineburgh, 2004;Campbell and Manganello, 2006). Specific strategies are needed for creating awareness among young people (Hickie et al., 2007;Wyn et al., 2000;Collin et al., 2011;Wright et al., 2006), and campaigns and awareness activities need to include a specific and deliberate focus on targeted populations (Vineburgh, 2004) which are most likely to be marginalised. As policymakers are made more aware of equity issues and differential access to preventive services, it is all the more important to reach out to marginalised populations to make them aware of the importance of early support and that it is the support all families need, not just them. ...
... Similarly, Deane, Wilson and Ciarrochi (2001) found that young people with suicidal thoughts were more likely to seek help from professionals or telephone helplines. In addition, Collin et al. (2011) state that young people feel empowered online, can access feedback immediately and can talk openly about sensitive topics. It is essential that all vessels of support services available for children to utilise are adept and equipped to assist young people with whatever problems they decide to disclose. ...
... Parental consent is not required in order for children to use a phone helpline in addition to being able to maintain their anonymity (Potter and Hepburn, 2003). In addition, Collin et al. (2011) state that young people feel empowered online, can access feedback immediately and can talk openly about sensitive topics. ...
Thesis
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Mixed method critical realist researcher into the experiences and understanding of Sexual Harassment among Irish Adolescents over a 12 month period.
... (continued) Carretier et al., 2021;Collin et al., 2011;Communio, 2009;Garrett et al., 2020;Gleeson et al., 2014Gleeson et al., , 2017Gleeson et al., , 2021Hetrick et al., 2017;Kahl et al., 2020;Kim et al., 2021;Leijdesdorff et al., 2022;Malla et al., 2019;McEnery et al., 2021;McGorry, 2007McGorry, , 2022Rice et al., 2020;Rickwood et al., 2015Rickwood et al., , 2019Rodriguez-Villa et al., 2020;Torous et al., 2019a;van Doorn et al., 2021;Vusio et al., 2021). ...
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Since the traditional mental health system showed significant limitations in the early identification, diagnosis and treatment of the current new youth psychopathological trajectories, by substantially failing in targeting the needs of the current young generation, there is the demand to redesign and digitally adapt youth mental health care and systems. Indeed, the level of digital literacy and the level of digital competency and knowledge in the field of digital psychiatry is still under-investigated among mental health professionals, particularly in youth mental health. Therefore, we aimed at: (a) carrying out a post-hoc analysis of an international multi-centre study, to investigate the opinions of mental health professionals regarding the feasibility, efficacy and clinical experience in delivering digital mental health interventions (DMHIs) in youths; (b) providing a comprehensive overview on the integrated digitally-based youth mental health care models and innovations. Mental health professionals declared the lack of a formal training in digital psychiatry, particularly in youth mental health. Subjects who received a formal theoretical/practical training on DMHIs displayed a statistical trend towards a positive feasibility of digital psychiatry in youth mental health (p = 0.053) and a perceived increased efficacy of digital psychiatry in youths (p = 0.051). Respondents with higher Digital Psychiatry Opinion (DPO) scores reported a positive perceived feasibility of DMHIs in youths (p < 0.041) and are more prone to deliver DMHIs to young people (p < 0.001). Respondents with higher knowledge scores (KS) declared that DMHIs are more effective in youth mental health (p < 0.001). Overall, the digitalisation indeed allowed young people to keep in touch with a mental health professional, facilitating a more dynamic and fluid mental health care access and monitoring, generally preferred and considered more feasible by post-Millennial youngsters. Accordingly, our findings demonstrated that mental health professionals are more prone to offer DMHIs in youth mental health, particularly whether previously trained and knowledgeable on the topic.
... Adolescents are particularly likely to use the Internet for health-related information concerning sensitive issues due to the anonymity provided online (Barak & Fisher, 2009). Evidence also suggests some of the most at-risk young people in Australia disclose mental health problems online, when they are less likely to do so in offline settings (Collin et al., 2011). ...
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Objective: Exposure to trauma is common in childhood and adolescence and is associated with significant psychopathology. Despite being amenable to treatment, many young people suffering trauma-related distress do not disclose or seek help. Multiple barriers to young people help seeking for mental health concerns have been identified, but very little research has focused on help seeking after trauma exposure. We undertook a qualitative analysis of Internet forums in which young people discuss trauma, aiming to understand the barriers preventing them from disclosing and seeking help offline. Method: Posts about trauma written in 2016 from five Internet forums targeting young people were analyzed by thematic analysis. Results: Barriers to offline help-seeking for trauma aligned with five key themes: questioning the validity of the trauma response; negative emotions and beliefs about the self; fear of a negative response; difficulties trusting others; and not thinking or talking about the trauma. Conclusions: Young people conceptualized many barriers as consequences of the trauma, such as avoidance of the trauma memory, and difficulties trusting others, indicating there are trauma-specific barriers to help-seeking. Understanding of, and attempts to minimize, these barriers may facilitate provision of services to vulnerable young people. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... InsightTimer, Headspace)) can reduce stress, depression, anxiety and improve psychological well-being (Firth et al., 2017a(Firth et al., , 2017bGál, Ștefan, & Cristea, 2021;Rathbone, Clarry, & Prescott, 2017). In an Australian study, it was found that among young men with MH issues, talking online helped (81%), and these men were also satisfied or very satisfied with the online help they received (83%) (Collin et al., 2011). Similarly, crisis phone-lines have been assessed as cost-effective and easy to access compared to faceto-face services (Bradford & Rickwood, 2014) and are effective in relation to several MH-related outcomes including enhanced mood and prevention of self-directed violence (Hoffberg, Stearns-Yoder, & Brenner, 2020). ...
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... 28,38 Reupert et al. 39 utilized a competence enhancement model, whereas Griffiths et al. 40 employed the social anxiety help-seeking behavior framework. A few others incorporated cognitive-behavior principles [41][42][43] and the cognitive bias modification paradigm 27 to develop the intervention. King et al. 38 used the motivational interviewing approach, whereas Suka et al. 34 based their intervention on theories of persuasion, decision-making, and attitude-behavior relations. ...
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Resumo A promoção da literacia saúde mental em adolescentes tem recebido particular atenção na saúde pública, dado a adolescência ser vista como um período crítico para prevenção de problemas de saúde mental na idade adulta. Apesar da consistência empírica sobre a eficácia dos programas face a face de literacia da saúde mental para adolescentes, pouco se sabe sobre as características e o efeito de intervenções mediadas pela tecnologia para este objetivo. A presente revisão sistemática teve como finalidade sistematizar conhecimento empírico sobre os efeitos de programas mediados pela tecnologia de promoção da literacia em saúde mental em adolescentes. Procedeu-se a um levantamento sistemático da literatura até dezembro de 2019, tendo sido selecionados quatro estudos empíricos que avaliaram os efeitos deste tipo de programas em diferentes indicadores de saúde mental. Os resultados revelaram que os programas mediados pela tecnologia apresentaram efeitos positivos no aumento da literacia em saúde mental, sendo o sexo e a idade moderadores destas associações. No entanto, o seu efeito na redução do estigma e nos comportamentos de procura de ajuda profissional foi inconsistente. As limitações dos estudos incluídos na revisão são discutidas.
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University students are a high risk population for mental health problems, yet few seek professional help when experiencing problems. This study explored the potential role of an online intervention for promoting wellbeing in university students, by investigating students’ help-seeking behaviour, intention to use online interventions and student content preference for such interventionss; 254 university students responded to an online survey designed for this study. As predicted, students were less likely to seek help as levels of psychological distress increased. Conversely, intention to use an online intervention increased at higher levels of distress, with 39.1%, 49.4% and 57.7% of low, moderate and severely distressed students respectively indicating they would use an online program supporting student well-being. Results suggest that online interventions may be a useful way to provide help to students in need who otherwise may not seek formal help.
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This paper presents findings from a study which investigated young people's ICT use and the capacity of service providers to utilise these technologies in their practice. The results suggest that ICT may be an important resource for mental health promotion, particularly in relation to engaging young people. It was found that young people who experience marginalisation access and engage with ICT although the quality of the access available to them is often limited. The findings also suggest that there is a pressing need to provide training for service providers to increase their capacity to use ICT.
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Building resilience in young people is an important goal if we are to strengthen capacity and promote skills that help to reduce mental health problems. One way to foster resilience in young people is through meaningful youth participation; that is, decision-making by young people that involves meaning, control, and connectedness. Whilst youth participation may occur in recognition of young people's rights to be involved in all decisions that affect them, meaningful participation can itself enhance a young person's sense of connectedness, belonging and valued participation, and thereby impact on mental health and well being. Based on its extensive experience working collaboratively with young people, the Inspire Foundation, in partnership with young people, has developed a flexible and diverse approach to youth participation. This paper outlines the theoretical and conceptual underpinnings of the model, and discusses the operationalisation of program goals, atmosphere and activities that seek to build resilience through meaningful youth participation.
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Effective mental illness prevention programs are important for the safety of youth and adolescents. Research suggests that programs should facilitate appropriate help seeking by lowering help-seeking barriers. This study used focus groups to obtain high school student opinions about actual help-seeking behaviors, reducing adolescent help-seeking barriers, raising sensitive issues with adolescents, and increasing appropriate help-source engagement. Transcript analysis revealed several themes. Relationship and trust were key approach factors for current help seeking. Memories of successful prior helping episodes were also important. Education about appropriate help seeking, presented in ways consistent with those currently used by adolescents (e.g., through peer networks), might reduce help-seeking barriers. Education should include key adults who act as gatekeepers within adolescent networks (e.g., parents and teachers). Assertive outreach and follow-up might be important factors for continued help-source engagement. Themes provide a basis for suggestions about ways to facilitate adolescent help seeking and maintain appropriate help-source engagement.
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Background:The Global Burden of Disease study has suggested that mental disorders are the leading cause of disability burden in the world. This study takes the leading cause of mental disorder burden, depression, and trials an approach for defining the present and optimal efficiency of treatment in an Australian setting.Aims of the Study:To examine epidemiological and service use data for depression to trial an approach for modelling (i) the burden that is currently averted from current care, (ii) the burden that is potentially avertable from a hypothetical regime of optimal care, (iii) the efficiency or cost-effectiveness of both current and optimal services for depression and (iv) the potential of current knowledge for reducing burden due to depression, by applying the WHO five-step method for priorities for investment in health research and development.Methods:Effectiveness and efficiency were calculated in disability adjusted life years (DALYs) averted by adjusting the disability weight for people who received efficacious treatment. Data on service use and treatment outcome were obtained from a variety of secondary sources, including the Australian National Survey of Mental Health and Wellbeing, and efficacy of individual treatments from published meta-analyses expressed in effect sizes. Direct costs were estimated from published sources.Results:Fifty-five percent of people with depression had had some contact with either primary care or specialist services. Effective coverage of depression was low, with only 32% of cases receiving efficacious treatment that could have lessened their severity (averted disability). In contrast, a proposed model of optimal care for the population management of depression provided increased treatment contacts and a better outcome. In terms of efficiency, optimal care dominated current care, with more health gain for less expenditure (28 632 DALYs were averted at a cost of AUD295 million with optimal care, versus 19 297 DALYs averted at a cost of AUD720 million with current care). However, despite the existence of efficacious technologies for treating depression, only 13% of the burden was averted from present active treatment, primarily because of the low effective coverage. Potentially avertable burden is nearly three times this, if effective treatments can be delivered in appropriate amounts to all those who need it.Discussion:This paper reports a method to calculate the burden currently averted from cross-sectional survey data, and to calculate the burden likely to be averted from an optimal programme estimated from randomized controlled trial data. The approach taken here makes a number of assumptions: that people are accurate in reporting their service use, that effect sizes are a suitable basis for modelling improvements in disability and that the method used to translate effect sizes to disability weight change is valid. The robustness of these assumptions is discussed. Nonetheless it would appear that while optimal care could do more than present services to reduce the burden of depression, current technologies for treating depression are insufficient.Implications for Health Care Provision and Use:There is an urgent need to educate both clinicians (primary and specialist) and the general public in the effective treatments that are available for depression.Implications for Health Policies:Over and above implementing treatments of known efficacy, more powerful technologies are needed for the prevention and treatment of depression.Implications for Further Research:Modelling burden averted from a variety of secondary sources can introduce bias at many levels. Future research should examine the validity of approaches that model reductions in disability burden. A powerful treatment to relieve depression and prevent relapse is needed. Copyright © 2000 John Wiley & Sons, Ltd.