Improving support for people with mental health problems in China: a cluster randomised controlled trial of culturally adapted Mental Health First Aid training

IF 8.1 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Nicola Reavley , Amy J. Morgan , Anthony F. Jorm , Betty Kitchener , Yan Wang , Shurong Lu , Wenjing Li , Claire Kelly , Brian Oldenburg , Min Zhao , Yanling He
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引用次数: 0

Abstract

Background

Culturally appropriate interventions that teach members of the public to provide early help towards a person developing a mental health problem or in a mental health crisis may improve access to services, social support, and mental health outcomes. This is the first study to evaluate the effectiveness of culturally adapted Mental Health First Aid (MHFA) Training for China.

Methods

A two-arm wait-list pilot cluster randomised controlled trial (cRCT) was conducted in 3 settings in Shanghai (health services, workplaces and community settings). Intervention settings were paired according to type and one of each pair was randomly allocated to the intervention (MHFA Training for China) or the wait-list control group, with a 1:1 allocation. Participants were invited by the trial coordinators in each setting. They were asked to complete questionnaires at baseline (T1) and 1 month (T2) and 7 months after training (T3). Control group participants were asked to complete questionnaires at corresponding times. The primary outcome was participant intended actions (recommended or not recommended) towards a person experiencing a mental health problem or in a mental health crisis. Secondary outcomes included recognition of depression in a vignette; beliefs about the helpfulness of health professionals and interventions; helping actions; confidence in providing mental health first aid; and stigmatising attitudes.

Findings

Between April and May 2024, 6 clusters were recruited and randomised, with 3 in each of the intervention and control arms. Following exclusion of participants who did not provide data, 146 participants were included at baseline: 67 in the intervention group and 79 in the control group. For the primary outcome (recommended actions subscale), the intervention group showed a significantly larger improvement than the control group at T2 (8.19 [95% CI 4.05–12.34]; p < 0.001) and T3 (3.08 [95% CI −1.02 to 7.18]; p = 0.034). Differences in changes in non-recommended actions were non-significant. At T2, significant differences favouring the intervention group were observed in confidence to provide support, perceiving the person as dangerous or unpredictable and in recognition of depression in a vignette. There were no significant differences in secondary outcomes at T3.

Interpretation

Delivering culturally adapted MHFA Training for China more widely could improve support for people experiencing mental health problems in the community.

Funding

This trial was supported the National Health and Medical Research Council under a Global Alliance for Chronic Diseases grant (GNT1142395).
改善对中国精神健康问题患者的支持:一项文化适应精神健康急救培训的随机对照试验
背景:在文化上适当的干预措施,教导公众对出现精神健康问题或处于精神健康危机中的人提供早期帮助,可能会改善获得服务、社会支持和精神健康结果的机会。这是第一个评估中国文化适应性心理健康急救(MHFA)培训有效性的研究。方法在上海市卫生服务机构、工作场所和社区3个环境中进行两臂等待名单试验随机对照试验(cRCT)。将干预设置按类型进行配对,每对中随机分配1个干预组(MHFA中国培训组)或等候名单对照组,按1:1的比例分配。参与者是由试验协调员在每种情况下邀请的。在基线(T1)、训练后1个月(T2)和7个月(T3)完成问卷调查。对照组参与者被要求在相应的时间完成问卷调查。主要结果是参与者对经历精神健康问题或处于精神健康危机的人有意采取的行动(建议或不建议)。次要结局包括在小插曲中识别抑郁症;对卫生专业人员的帮助和干预措施的信念;帮助行为;对提供精神卫生急救的信心;以及污名化的态度。在2024年4月至5月期间,招募并随机分组了6组,干预组和对照组各3组。在排除了没有提供数据的参与者后,146名参与者在基线时被纳入:干预组67名,对照组79名。对于主要结局(推荐行动分量表),干预组在T2 (8.19 [95% CI 4.05-12.34]; p < 0.001)和T3 (3.08 [95% CI - 1.02至7.18];p = 0.034)时的改善显著大于对照组。非推荐行动的变化差异不显著。在T2时,观察到干预组在提供支持的信心,感知该人危险或不可预测以及在小插曲中识别抑郁症方面存在显著差异。T3时的次要结局无显著差异。在中国更广泛地开展与文化相适应的MHFA培训可以改善对社区中遇到精神健康问题的人的支持。该试验由国家卫生和医学研究委员会在全球慢性疾病联盟资助下(GNT1142395)支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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