J. Med. Internet Res. - Internet-based interventions to promote mental health help-seeking in elite athletes: an exploratory randomized controlled trial.


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CKGROUND: Mental disorders are more common in young adults than at any other life stage. Despite this, young people have low rates of seeking professional help for mental health problems. Young elite athletes have less positive attitudes toward seeking help than nonathletes and thus may be particularly unlikely to seek help. Interventions aimed at increasing help-seeking in young elite athletes are warranted.OBJECTIVE: To test the feasibility and efficacy of three Internet-based interventions designed to increase mental health help-seeking attitudes, intentions, and behavior in young elite athletes compared with a control condition.METHODS: We conducted a randomized controlled trial (RCT) of three brief fully automated Internet-based mental health help-seeking interventions with 59 young elite athletes recruited online in a closed trial in Australia. The interventions consisted of a mental health literacy and destigmatization condition, a feedback condition providing symptom levels, and a minimal content condition comprising a list of help-seeking resources, compared with a control condition (no intervention). We measured help-seeking attitudes, intentions and behavior using self-assessed surveys. Participation was open to elite athletes regardless of their mental health status or risk of mental illness.RESULTS: Of 120 athletes initially agreeing to participate, 59 (49%) submitted a preintervention or postintervention survey, or both, and were included in the present study. Adherence was satisfactory, with 48 (81%) participants visiting both weeks of assigned intervention material. None of the interventions yielded a significant increase in help-seeking attitudes, intentions, or behavior relative to control. However, at postintervention, there was a trend toward a greater increase in help-seeking behavior from formal sources for the mental health literacy/destigmatization condition compared with control (P = .06). This intervention was also associated with increased depression literacy (P = .003, P = .005) and anxiety literacy (P = .002, P = .001) relative to control at postintervention and 3-month follow-up, respectively, and a reduction in depression stigma relative to control at postintervention (P = .01, P = .12) and anxiety stigma at 3-month follow-up (P = .18, P = .02). The feedback and help-seeking list interventions did not improve depression or anxiety literacy or decrease stigmatizing attitudes to these conditions. However, the study findings should be treated with caution. Due to recruitment challenges, the achieved sample size fell significantly short of the target size and the study was underpowered. Accordingly, the results should be considered as providing preliminary pilot data only.CONCLUSIONS: This is the first RCT of an Internet-based mental health help-seeking intervention for young elite athletes. The results suggest that brief mental health literacy and destigmatization improves knowledge and may decrease stigma but does not increase help-seeking. However, since the trial was underpowered, a larger trial is warranted.TRIAL REGISTRATION: 2009/373 (www.clinicaltrials.gov ID: NCT00940732), cited at http://www.webcitation.org/5ymsRLy9r.

Resumo Limpo

ckground mental disord common young adult life stage despit young peopl low rate seek profession help mental health problem young elit athlet less posit attitud toward seek help nonathlet thus may particular unlik seek help intervent aim increas helpseek young elit athlet warrantedobject test feasibl efficaci three internetbas intervent design increas mental health helpseek attitud intent behavior young elit athlet compar control conditionmethod conduct random control trial rct three brief fulli autom internetbas mental health helpseek intervent young elit athlet recruit onlin close trial australia intervent consist mental health literaci destigmat condit feedback condit provid symptom level minim content condit compris list helpseek resourc compar control condit intervent measur helpseek attitud intent behavior use selfassess survey particip open elit athlet regardless mental health status risk mental illnessresult athlet initi agre particip submit preintervent postintervent survey includ present studi adher satisfactori particip visit week assign intervent materi none intervent yield signific increas helpseek attitud intent behavior relat control howev postintervent trend toward greater increas helpseek behavior formal sourc mental health literacydestigmat condit compar control p intervent also associ increas depress literaci p p anxieti literaci p p relat control postintervent month followup respect reduct depress stigma relat control postintervent p p anxieti stigma month followup p p feedback helpseek list intervent improv depress anxieti literaci decreas stigmat attitud condit howev studi find treat caution due recruit challeng achiev sampl size fell signific short target size studi underpow accord result consid provid preliminari pilot data onlyconclus first rct internetbas mental health helpseek intervent young elit athlet result suggest brief mental health literaci destigmat improv knowledg may decreas stigma increas helpseek howev sinc trial underpow larger trial warrantedtri registr wwwclinicaltrialsgov id nct cite httpwwwwebcitationorgymsrlyr

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