O'Dea Bridianne, Subotic-Kerry Mirjana, King Catherine, Mackinnon Andrew J, Achilles Melinda R, Anderson Melissa, Parker Belinda, Werner-Seidler Aliza, Torok Michelle, Cockayne Nicole, Baker Simon T E, Christensen Helen
Black Dog Institute, Hospital Road, Randwick, NSW, Australia, 2031.
Faculty of Medicine, University of New South Wales, High Street, Kensington, NSW, Australia 2052.
Lancet Reg Health West Pac. 2021 Jun 12;12:100178. doi: 10.1016/j.lanwpc.2021.100178. eCollection 2021 Jul.
Secondary schools have attempted to address gaps in help-seeking for mental health problems with little success. This trial evaluated the effectiveness of a universal web-based service (Smooth Sailing) for improving help-seeking intentions for mental health problems and other related outcomes among students.
A cluster randomised controlled trial was conducted to evaluate the 12-week outcomes of the Smooth Sailing service among 1841 students from 22 secondary schools in New South Wales, Australia. Assignment was conducted at the school level. The control condition received school-as-usual. The primary outcome was help-seeking intentions for general mental health problems at 12-weeks post-baseline. Secondary outcomes included help-seeking behaviour, anxiety and depressive symptoms, psychological distress, psychological barriers to help-seeking, and mental health literacy. Data were analysed using mixed linear models. This trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224).
At 12-weeks post-baseline, there was a marginal statistical difference in the relative means of help-seeking intentions (effect size0•10, 95%CI: -0•02-0•21) that favoured the intervention condition. Help-seeking from adults declined in both conditions. There was a greater reduction in the number of students who "needed support for their mental health but were not seeking help" in the intervention condition (OR: 2•08, 95%CI: 1•72-2.27, P<•0001). No other universal effects were found. Participants found the service easy to use and understand; However, low motivation, time, forgetfulness, and lack of perceived need were barriers to use.
Smooth Sailing led to small improvements in help-seeking intentions. Refinements are needed to improve its effectiveness on other mental health outcomes and to increase student uptake and engagement.
HSBC and Graf Foundation.
中学一直在努力解决心理健康问题求助方面的差距，但成效甚微。本试验评估了一项基于网络的通用服务（“一帆风顺”）在提高学生心理健康问题求助意愿及其他相关结果方面的有效性。
开展了一项整群随机对照试验，以评估“一帆风顺”服务对澳大利亚新南威尔士州22所中学的1841名学生的12周效果。随机分组在学校层面进行。对照组接受常规学校服务。主要结局是基线后12周时一般心理健康问题的求助意愿。次要结局包括求助行为、焦虑和抑郁症状、心理困扰、求助的心理障碍以及心理健康素养。数据采用混合线性模型进行分析。本试验已在澳大利亚和新西兰临床试验注册中心注册（注册号：ACTRN12618001539224）。
在基线后12周时，求助意愿的相对均值存在微小统计学差异（效应量0.10，95%置信区间：-0.02至0.21），干预组更具优势。在两种情况下，向成年人求助的情况都有所减少。在干预组中，“需要心理健康支持但未寻求帮助”的学生人数减少得更多（比值比：2.08，95%置信区间：1.72至2.27，P<0.0001）。未发现其他普遍效果。参与者认为该服务易于使用和理解；然而，动机不足、时间问题、遗忘以及缺乏感知需求是使用的障碍。
“一帆风顺”服务在求助意愿方面有小幅改善。需要进行改进，以提高其对其他心理健康结果的有效性，并增加学生的接受度和参与度。
汇丰银行和格拉夫基金会。
