BACKGROUND

University students in Indonesia are exposed to stressors such as high academic task load, financial strains, and relationship problems. Therefore, they are at risk of developing symptoms of common mental disorders, such as depression and anxiety (i.e., psychological distress). However, there is a gap between the number of mental health professionals and the number of students in need of a psychological intervention. Self-Help Plus (SH+), a guided group-based stress management intervention developed by the WHO, was adapted to the population and context to address barriers in accessing mental health care among students in Indonesia. The aim of the APRESIASI study is to assess the effectiveness and cost-effectiveness of SH + in reducing psychological distress among university students in Indonesia.

METHODS

The SH + intervention will be tested in a pragmatic superior randomized controlled trial (RCT) with two parallel arms. SH + will be tested among Indonesian university students with symptoms of psychological distress (Patient Health Questionnaire-9; PHQ-9 ≥ 5.5 < 20). The participants (n = 296) will be randomized into either the intervention group that receives SH + with enhanced care as usual (ECAU), or into the ECAU only with a 1:1 allocation ratio. The primary outcome is the reduction in psychological distress assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) at three-month follow-up. The secondary outcomes are symptoms of depression, anxiety, perceived stress, functioning, resilience, quality of life, identified problems, treatment acceptability, and cost-effectiveness.

DISCUSSION

To our knowledge, SH + is the first a transdiagnostic, face-to-face, and group-based intervention to be tested for its effectiveness in reducing psychological distress in Indonesia. If shown to be effective, SH + has the potential to be scaled up across university settings.

TRIAL REGISTRATION

ISRCTN15761598, 14/07/2023.