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Beyond silence: protocol for a randomized parallel-group trial comparing two approaches to workplace mental health education for healthcare employees.

Moll S, Patten SB, Stuart H, Kirsh B, MacDermid JC - BMC Med Educ (2015)

Bottom Line: Little is known, however, about what approach is most effective, particularly in the context of healthcare work.This is one of the first experimental studies to compare outcomes of standard mental health literacy training to an intervention with an added anti-stigma component (using best-practices of contact-based education).Study findings will inform recommendations for designing workplace mental health education to promote early intervention for employees with mental health issues in the context of healthcare work.

View Article: PubMed Central - PubMed

Affiliation: Institute for Applied Health Science, School of Rehabilitation Science, McMaster University, 4th Floor 1400 Main St.W., Hamilton, ON, L8S 1C7, Canada. molls@mcmaster.ca.

ABSTRACT

Background: Mental illness is a significant and growing problem in Canadian healthcare organizations, leading to tremendous personal, social and financial costs for individuals, their colleagues, their employers and their patients. Early and appropriate intervention is needed, but unfortunately, few workers get the help that they need in a timely way due to barriers related to poor mental health literacy, stigma, and inadequate access to mental health services. Workplace education and training is one promising approach to early identification and support for workers who are struggling. Little is known, however, about what approach is most effective, particularly in the context of healthcare work. The purpose of this study is to compare the impact of a customized, contact-based education approach with standard mental health literacy training on the mental health knowledge, stigmatized beliefs and help-seeking/help-outreach behaviors of healthcare employees.

Methods/design: A multi-centre, randomized, two-group parallel group trial design will be adopted. Two hundred healthcare employees will be randomly assigned to one of two educational interventions: Beyond Silence, a peer-led program customized to the healthcare workplace, and Mental Health First Aid, a standardized literacy based training program. Pre, post and 3-month follow-up surveys will track changes in knowledge (mental health literacy), attitudes towards mental illness, and help-seeking/help-outreach behavior. An intent-to-treat, repeated measures analysis will be conducted to compare changes in the two groups over time in terms of the primary outcome of behavior change. Linear regression modeling will be used to explore the extent to which knowledge, and attitudes predict behavior change. Qualitative interviews with participants and leaders will also be conducted to examine process and implementation of the programs.

Discussion: This is one of the first experimental studies to compare outcomes of standard mental health literacy training to an intervention with an added anti-stigma component (using best-practices of contact-based education). Study findings will inform recommendations for designing workplace mental health education to promote early intervention for employees with mental health issues in the context of healthcare work.

Trial registration: May 2014 - ClinicalTrials.gov: NCT02158871.

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Related in: MedlinePlus

Conceptual Model of Early Intervention.
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Related In: Results  -  Collection

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Fig1: Conceptual Model of Early Intervention.

Mentions: Early intervention, as defined in this study, is facilitated by knowledge, attitudes and behaviors that facilitate timely, effective and appropriate support for workers with emerging signs and symptoms of mental health problems or disorders [17]. Support may involve a range of options, from counseling and/or medication from a healthcare provider to connection with an Employee Assistance program or a self-help group. The conceptual model of early intervention guiding the project is outlined in FigureĀ 1. Earlier intervention can be accomplished by augmenting two key health access behaviors; a) workers seeking help when they are struggling with their own mental health issues, and b) workers facilitating appropriate outreach to colleagues who are struggling in order to facilitate their help seeking behavior. Appropriate help seeking and outreach behaviors are considered together because they are the two primary mechanisms by which a worker receives the help that he/she needs, and they share common pathways [6]. Further, actions taken to facilitate early identification and intervention are mediated through reduction of stigma, improved mental health literacy and better attitudes towards professional treatment. This can have a dual effect on both help seeking and appropriate outreach to colleagues. Although the primary outcome of interest in this study is help seeking and outreach behavior, it should be noted that early intervention leads to more appropriate utilization of mental health services and faster recovery from mental health issues. The overall impact of greater efficiency, reduced absenteeism and sick leave, and increased productivity at work should provide economic advantages to both the worker and the employer [13]. Evaluation of these long-term outcomes is beyond the scope of this project, but will be the focus of subsequent research.Figure 1


Beyond silence: protocol for a randomized parallel-group trial comparing two approaches to workplace mental health education for healthcare employees.

Moll S, Patten SB, Stuart H, Kirsh B, MacDermid JC - BMC Med Educ (2015)

Conceptual Model of Early Intervention.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4440553&req=5

Fig1: Conceptual Model of Early Intervention.
Mentions: Early intervention, as defined in this study, is facilitated by knowledge, attitudes and behaviors that facilitate timely, effective and appropriate support for workers with emerging signs and symptoms of mental health problems or disorders [17]. Support may involve a range of options, from counseling and/or medication from a healthcare provider to connection with an Employee Assistance program or a self-help group. The conceptual model of early intervention guiding the project is outlined in FigureĀ 1. Earlier intervention can be accomplished by augmenting two key health access behaviors; a) workers seeking help when they are struggling with their own mental health issues, and b) workers facilitating appropriate outreach to colleagues who are struggling in order to facilitate their help seeking behavior. Appropriate help seeking and outreach behaviors are considered together because they are the two primary mechanisms by which a worker receives the help that he/she needs, and they share common pathways [6]. Further, actions taken to facilitate early identification and intervention are mediated through reduction of stigma, improved mental health literacy and better attitudes towards professional treatment. This can have a dual effect on both help seeking and appropriate outreach to colleagues. Although the primary outcome of interest in this study is help seeking and outreach behavior, it should be noted that early intervention leads to more appropriate utilization of mental health services and faster recovery from mental health issues. The overall impact of greater efficiency, reduced absenteeism and sick leave, and increased productivity at work should provide economic advantages to both the worker and the employer [13]. Evaluation of these long-term outcomes is beyond the scope of this project, but will be the focus of subsequent research.Figure 1

Bottom Line: Little is known, however, about what approach is most effective, particularly in the context of healthcare work.This is one of the first experimental studies to compare outcomes of standard mental health literacy training to an intervention with an added anti-stigma component (using best-practices of contact-based education).Study findings will inform recommendations for designing workplace mental health education to promote early intervention for employees with mental health issues in the context of healthcare work.

View Article: PubMed Central - PubMed

Affiliation: Institute for Applied Health Science, School of Rehabilitation Science, McMaster University, 4th Floor 1400 Main St.W., Hamilton, ON, L8S 1C7, Canada. molls@mcmaster.ca.

ABSTRACT

Background: Mental illness is a significant and growing problem in Canadian healthcare organizations, leading to tremendous personal, social and financial costs for individuals, their colleagues, their employers and their patients. Early and appropriate intervention is needed, but unfortunately, few workers get the help that they need in a timely way due to barriers related to poor mental health literacy, stigma, and inadequate access to mental health services. Workplace education and training is one promising approach to early identification and support for workers who are struggling. Little is known, however, about what approach is most effective, particularly in the context of healthcare work. The purpose of this study is to compare the impact of a customized, contact-based education approach with standard mental health literacy training on the mental health knowledge, stigmatized beliefs and help-seeking/help-outreach behaviors of healthcare employees.

Methods/design: A multi-centre, randomized, two-group parallel group trial design will be adopted. Two hundred healthcare employees will be randomly assigned to one of two educational interventions: Beyond Silence, a peer-led program customized to the healthcare workplace, and Mental Health First Aid, a standardized literacy based training program. Pre, post and 3-month follow-up surveys will track changes in knowledge (mental health literacy), attitudes towards mental illness, and help-seeking/help-outreach behavior. An intent-to-treat, repeated measures analysis will be conducted to compare changes in the two groups over time in terms of the primary outcome of behavior change. Linear regression modeling will be used to explore the extent to which knowledge, and attitudes predict behavior change. Qualitative interviews with participants and leaders will also be conducted to examine process and implementation of the programs.

Discussion: This is one of the first experimental studies to compare outcomes of standard mental health literacy training to an intervention with an added anti-stigma component (using best-practices of contact-based education). Study findings will inform recommendations for designing workplace mental health education to promote early intervention for employees with mental health issues in the context of healthcare work.

Trial registration: May 2014 - ClinicalTrials.gov: NCT02158871.

Show MeSH
Related in: MedlinePlus