Increasing intentions to use mental health services among university students. Results of a pilot randomized controlled trial within the World Health Organization's World Mental Health International College Student Initiative

被引:39
作者
Ebert, David Daniel [1 ]
Franke, Marvin [1 ,19 ]
Kaehlke, Fanny [1 ,19 ]
Kuechler, Ann-Marie [2 ,20 ]
Bruffaerts, Ronny [3 ,4 ,16 ]
Mortier, Philippe [5 ,16 ]
Karyotaki, Eirini [6 ,7 ,28 ]
Alonso, Jordi [8 ,9 ,10 ,34 ]
Cuijpers, Pim [6 ,7 ,28 ]
Berking, Matthias [1 ,19 ]
Auerbach, Randy P. [11 ,12 ,40 ]
Kessler, Ronald C. [13 ,41 ]
Baumeister, Harald [2 ,20 ]
Hasking, Penelope [14 ]
Boyes, Mark [14 ]
Kiekens, Glenn [14 ,15 ]
Demyttenaere, Koen [16 ]
Bootsma, Erik [16 ]
Husky, Mathilde [17 ]
Kovess-Masfety, Viviane [18 ]
Ebert, David D. [19 ]
Mak, Arthur [21 ]
Benjet, Corina [22 ]
Borges, Guilherme [22 ]
Elena Medina-Mora, Maria [22 ]
Abrego Ramirez, Adrian [23 ]
Covarrubias Diaz, Anabell [24 ]
Socorro Duran, Ma. [25 ]
Perez Tarango, Gustavo [25 ]
Zavala Berbena, Maria Alicia [25 ]
Gonzalez Gonzalez, Rogaciano [25 ]
Gutierrez-Garcia, Raul A. [25 ]
Edith Hermosillo de la Torre, Alicia [26 ]
Martinez Martinez, Kalina Isela [26 ]
Martinez Ruiz, Sinead [27 ]
O'Neill, Siobhan [29 ]
Bjourson, Tony [30 ]
Murray, Elaine [30 ]
Stein, Dan J. [31 ]
Lochner, Christine [32 ]
Roos, Janine [32 ]
Taljaard, Lian [32 ]
Bantjes, Jason [33 ]
Saal, Wylene [33 ]
Vilagut, Gemma [34 ]
Alayo, Itxaso [35 ]
Ballester, Laura [35 ]
Jesus Blasco, Gabriela Barbaglia Maria [35 ]
Castellvi, Pere [35 ]
Isabel Cebria, Ana [35 ]
机构
[1] Univ Erlangen Nurnberg, Dept Clin Psychol & Psychotherapy, Erlangen, Germany
[2] Univ Ulm, Dept Clin Psychol & Psychotherapy, Ulm, Germany
[3] Katholieke Univ Leuven, Publ Hlth Psychiat, Leuven, Belgium
[4] Katholieke Univ Leuven, Univ Psychiat Ctr, Leuven, Belgium
[5] KU Leuven Univ, Dept Neurosci, Res Grp Psychiat, Leuven, Belgium
[6] Vrije Univ Amsterdam, Dept Clin Psychol, Amsterdam, Netherlands
[7] Amsterdam Publ Hlth Inst, Amsterdam, Netherlands
[8] IMIM Hosp del Mar Med Res Inst, Hlth Serv Res Unit, Barcelona, Spain
[9] Pompeu Fabra Univ UPF, Barcelona, Spain
[10] CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
[11] Columbia Univ, Dept Psychiat, New York, NY USA
[12] Sackler Inst, Div Clin Dev Neurosci, New York, NY USA
[13] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA
[14] Curtin Univ, Sch Psychol, Perth, WA, Australia
[15] Katholieke Univ Leuven, RG Adult Psychiat, Leuven, Belgium
[16] Katholieke Univ Leuven, Leuven, Belgium
[17] Univ Bordeaux, Bordeaux, France
[18] Ecole Hautes Etud Sante Publ, Rennes, France
[19] Friedrich Alexander Univ Erlangen Nuremberg, Erlangen, Germany
[20] Univ Ulm, Ulm, Germany
[21] Chinese Univ Hong Kong, Hong Kong, Peoples R China
[22] Inst Nacl Psiquiatria Ramon de la Fuente, Mexico City, DF, Mexico
[23] Univ Politecn Aguascalientes, Aguascalientes, Mexico
[24] Univ La Salle Noroeste, Obregon, Mexico
[25] Univ De La Salle Bajio, Campus Salamanca, Leon, Spain
[26] Univ Autonoma Aguascalientes, Aguascalientes, Mexico
[27] Univ La Salle Pachuca, Pachuca, Mexico
[28] Vrije Univ Amsterdam, Amsterdam, Netherlands
[29] Ulster Univ, Psychol Res Inst, Coleraine, Londonderry, North Ireland
[30] Ulster Univ, Sch Biomed Sci, Coleraine, Londonderry, North Ireland
[31] Univ Cape Town, Dept Psychiat & Mental Hlth, Unit Risk & Resilience Mental Disorders, MRC, Rondebosch, South Africa
[32] Stellenbosch Univ, Dept Psychiat, Unit Risk & Resilience Mental Disorders, MRC, Stellenbosch, South Africa
[33] Stellenbosch Univ, Dept Psychol, Stellenbosch, South Africa
[34] IMIM Hosp del Mar Med Res Inst, CIBERESP, Barcelona, Spain
[35] Pompeu Fabra Univ, Barcelona, Spain
[36] Cadiz Univ, Cadiz, Spain
[37] Univ Basque Country, Leioa, Spain
[38] Miguel Hernandez Univ, Elche, Spain
[39] Illes Balears Univ, Palma de Mallorca, Spain
[40] Columbia Univ, New York, NY 10027 USA
[41] Harvard Med Sch, Boston, MA 02115 USA
[42] Boston Univ, Boston, MA 02215 USA
[43] Harvard Univ, Cambridge, MA 02138 USA
[44] McLean Hosp, 115 Mill St, Belmont, MA 02178 USA
基金
英国医学研究理事会;
关键词
health behavior; psychoeducation; public mental health; risk factors; ACCEPTANCE FACILITATING INTERVENTION; INTERVIEW SCREENING SCALES; IDENTIFICATION TEST AUDIT; HELP-SEEKING; ASSESS RISK; DISORDERS; DEPRESSION; BEHAVIOR; ATTITUDES; FEEDBACK;
D O I
10.1002/mpr.1754
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background The majority of university students with mental health problems are untreated. Only a small empirical literature exists on strategies to increase mental health service use. Aims To investigate the effects and moderators of a brief acceptance-facilitating intervention on intention to use mental health services among university students. Method Within the German site of the World Health Organization's World Mental Health International College Student (WMH-ICS) initiative, 1,374 university students were randomized to an intervention condition (IC; n = 664) or a control condition (CC; n = 710) that was implemented in the survey itself. Both conditions received the questions assessing mental disorders and suicidality that were included in other WMH-ICS surveys. The IC group then additionally received: Internet-based personalized feedback based on subject symptom severity in the domains of depression, anxiety, substance use, suicidal thoughts and behaviors, and nonsuicidal self-injury; psychoeducation tailored to the personal symptom profile; and information about available university and community mental health services. The primary outcome was reported intention to use psychological interventions in the next semester, which was the last question in the survey. A broad range of potential moderating factors was explored. Results There was a significant main effect of the intervention with students randomized to IC, reporting significantly higher intentions to seek help in the next semester than students in the CC condition (d = 0.12, 95% CI: 0.02 to 0.23). Moderator analyses indicated that the intervention was more effective among students that fulfilled the criteria for lifetime (d = 0.34; 95% CI: -0.08 to 0.7) and 12-month panic-disorder (d = 0.32; 95% CI: -0.10 to 0.74) compared with those without lifetime (d = 0.11; 95% CI: 0.00 to 0.22) or 12-month panic disorder (d = 0.11; 95% CI: 0.00 to 0.22), students with lower (d = 0.37; 95% CI: -0.77 to 1.51) than higher (d = -0.01; 95% CI: -0.36 to 0.34) self-reported physical health, and students with nonheterosexual (d = 0.38; 95% CI: 0.08 to 0.67) compared with heterosexual (d = 0.06; 95% CI: -0.06 to 0.17) sexual orientation. The intervention had no effects among students who reported that they recognized that they had an emotional problem and "are already working actively to change it" (Stage 4 "stages of change"). Conclusions A simple acceptance-facilitating intervention can increase intention to use mental health services, although effects, are on average, small. Future studies should investigate more personalized approaches with interventions tailored to barriers and clinical characteristics of students. In order to optimize intervention effects, the development and evaluation should be realized in designs that are powered to allow incremental value of different intervention components and tailoring strategies to be evaluated, such as in multiphase optimization designs.
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页数:12
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