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

Sandra Moll, Scott Burton Patten, Heather Stuart, Bonnie Kirsh, Joy Christine MacDermid, Sandra Moll, Scott Burton Patten, Heather Stuart, Bonnie Kirsh, Joy Christine MacDermid

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.

Figures

Figure 1
Figure 1
Conceptual Model of Early Intervention.

References

    1. Conference Board of Canada. Mental health issues in the labour force: Reducing the economic impact on Canada. 2012. . Accessed Feb 2014.
    1. Dewa CS, Chau N, Dermer S. Examining the comparative incidence and costs of physical and mental health-related disabilities in an employed population. J Occup Environ Med. 2010;52:758–62. doi: 10.1097/JOM.0b013e3181e8cfb5.
    1. Statistics Canada . 2005 national survey of the work and health of nurses (CIHI share file) Ottawa: Statistics Canada and Canadian Institute for Health Information; 2006.
    1. Wieclaw J, Agerbo E, Mortensen PB, Bonde JP. Risk of affective and stress related disorders among employees in human service professions. Occup Environ Med. 2006;63:314–9. doi: 10.1136/oem.2004.019398.
    1. Canadian Institute for Health Information (CIHI) Canada’s healthcare providers: 2005 Chartbook. Ottawa: Author; 2005.
    1. Gärtner FR, Nieuwenhuijsen K, van Dijk FJ, Sluiter JK. The impact of common mental disorders on the work functioning of nurses and allied health professionals: a systematic review. Int J Nurs Stud. 2010;47:1047–61. doi: 10.1016/j.ijnurstu.2010.03.013.
    1. Attridge M. A quiet crisis: the business case for managing employee mental health. Vancouver, BC: Wilson Banwell PROACT Human Solutions; 2008.
    1. Silas L. From promise to practice: getting healthy work environments in health workplaces. Healthcare Papers. 2007;7:46–51. doi: 10.12927/hcpap..18672.
    1. Moll S. Doctoral thesis. Toronto: University of Toronto; 2010. Mental health issues and work: Institutional practices of silence in a mental healthcare organization.
    1. Crout LA, Chang E, Cioffi J. Why do registered nurses work when ill? J Nurs Adm. 2005;35:23–8. doi: 10.1097/00005110-200501000-00010.
    1. Kessler RC, Frank RG. The impact of psychiatric disorder on work loss days. Psychol Med. 1997;27:861–73. doi: 10.1017/S0033291797004807.
    1. Lesage A, Dewa CS, Kirsh B. The momentum for research on mental health in the workplace in Canada. Can J Comm Mental Health. 2006;25:1–4. doi: 10.7870/cjcmh-2006-0008.
    1. Bender A, Kennedy S. Mental health and mental illness in the workplace: diagnostic and treatment issues. Healthcare Papers. 2004;5:54–67. doi: 10.12927/hcpap..16824.
    1. Krupa T, Kirsh B, Cockburn L, Gewurtz R. Understanding the stigma of mental illness in employment. Work. 2009;33:413–25.
    1. Rosvold EO, Bjertness E. Physicians who do not take sick leave: hazardous heroes? Scand J Publ Health. 2001;29:71–5. doi: 10.1177/14034948010290010101.
    1. Pomaki G, Franche R-L, Murray E, Khushrushahi N, Lampinen TM. Workplace-based work disability prevention interventions for workers with common mental health conditions: a review of the literature. J Occup Rehab. 2012;22:182–95. doi: 10.1007/s10926-011-9338-9.
    1. Commonwealth Department of Health and Aged Care. Promotion, Prevention and Early Intervention for Mental Health—A Monograph. Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care, Canberra; 2000. . Accessed Jan 2014.
    1. Schomerus G, Matschinger H. Angermeyer MC attitudes that determine willingness to seek psychiatric help for depression: a representative population survey in applying the theory of planned behavior. Psychol Med. 2009;39:1855–65. doi: 10.1017/S0033291709005832.
    1. Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166:182–6.
    1. Kelly CM, Jorm AF, Wright A. Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Med J Aust. 2007;187(Suppl 7):26–30.
    1. Joyce T, Hazelton M, McMillan M. Nurses with mental illness: their workplace experiences. Int J Mental Health Nurs. 2007;16:373–80. doi: 10.1111/j.1447-0349.2007.00492.x.
    1. Schomerus G, Angermeyer MC. Stigma and its impact on help-seeking for mental disorders: what do we know? Epidemiol Psichiatr Soc. 2008;17:31–7. doi: 10.1017/S1121189X00002669.
    1. Stuart H, Arboleda-Florez J, Sartorius N. Paradigms lost: fighting stigma and the lessons learned. New York: Oxford; 2012.
    1. Kitchener B, Jorm AF. Mental health first aid training in a workplace setting: a randomized controlled trial. BMC Psychiat. 2004;4:23. doi: 10.1186/1471-244X-4-23.
    1. Kitchener B, Jorm AF. Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior. BMC Psychiat. 2002;2:10. doi: 10.1186/1471-244X-2-10.
    1. Hugo M. Mental health professionals’ attitudes towards people who have experienced a mental health disorder. J Psychiatr Ment Health Nurs. 2001;8:419–25. doi: 10.1046/j.1351-0126.2001.00430.x.
    1. Corrigan PW, River L, Lundin RK, Penn DL, Uphoff-Wasowski K, Campion J. Three strategies for changing attributions about severe mental illness. Schizophr Bull. 2001;27(2):187–95. doi: 10.1093/oxfordjournals.schbul.a006865.
    1. Couture SM, Penn DL. Interpersonal contact and the stigma of mental illness: a review of the literature. J Ment Health. 2003;12:291–305. doi: 10.1080/09638231000118276.
    1. Wallach HS. Changes in attitudes towards mental illness following exposure. Comm Ment Health J. 2004;40:235–48. doi: 10.1023/B:COMH.0000026997.92083.4d.
    1. Stuart H, Koller M, Christie R, Pietrus M. Reducing mental health stigma: a case study. Healthcare Q. 2011;14(Supplement 2):40–9. doi: 10.12927/hcq.2011.22362.
    1. Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, et al. Lost in knowledge translation: time for a map? J Cont Ed Health Prof. 2006;26:13–36. doi: 10.1002/chp.47.
    1. Kitchener B, Jorm AF. Mental health first aid training: review of evaluation studies. Aust N Z J Psychiat. 2006;40:6–8. doi: 10.1080/j.1440-1614.2006.01735.x.
    1. Moll S. The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health. BMC Public Health. 2014;14:138. doi: 10.1186/1471-2458-14-138.
    1. Jorm AF, Kitchener BA, Fischer J-A, Cvetkovski S. Mental health first aid training by e-learning: a randomized controlled trial. Aust N Z J Psychiat. 2010;44:1072–81. doi: 10.3109/00048674.2010.516426.
    1. Jorm AF, Kitchener BA, O’Kearney R, Dear KBG. Mental health first aid training of the public in a rural area: a cluster randomized trial. BMC Psychiat. 2004;4:33. doi: 10.1186/1471-244X-4-33.
    1. Statistics Canada. The 2011/2012 Canadian Community Health Survey. 2012. . Accessed Aug 2013.
    1. Elhai JD, Schweinle W, Anderson SM. Reliability and validity of the attitudes toward seeking professional psychological help scale-short form. Psychiatry Res. 2008;159:320–9. doi: 10.1016/j.psychres.2007.04.020.
    1. Kassam A, Papish A, Modgill G, Patten S. The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: the opening minds scale for health care providers (OMS-HC) BMC Psychiat. 2012;12:62. doi: 10.1186/1471-244X-12-62.
    1. Schomerus G, Matschinger H, Angermeyer MC. Continuum beliefs and stigmatizing attitudes towards persons with schizophrenia, depression and alcohol dependence. Psychiatry Res. 2013;209:665–9. doi: 10.1016/j.psychres.2013.02.006.
    1. Swami V. Mental health literacy of depression: gender differences and attitudinal antecedents in a representative British sample. PLoS One. 2012;7:e49779. doi: 10.1371/journal.pone.0049779.
    1. Diggle PJ, Heagerty P, Liang K, Zeger SL. Analysis of Longitudinal Data. 2. Oxford, UK: Oxford University Press; 2002.
    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. J Pers Soc Psychol. 1986;51:1173–82. doi: 10.1037/0022-3514.51.6.1173.
    1. Thorne S, Kirkham S, O’Flynn Magee K. The analytic challenge in interpretive description. Int J Qual Methods. 2004;3:1–11.

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