Monday, December 12, 2011

Study about Beliefs: Parents & Young People on Effective Interventions

"One surprising finding was that young people (particularly young adults) were more likely to see close family as a source of help than were parents, suggesting that parents may be underestimating their own potential role."

"Ideally, the public endorsement of recommended interventions should be close to 100%. The biggest gap is for psychiatric medications, where <50% rated recommended interventions as likely to be helpful."

"Psychological therapies, such as cognitive behaviour therapy, are recommended for all the disorders covered in the survey. Cognitive behaviour therapy was rated as likely to be helpful by less than half of adolescents, young adults and parents, and this held irrespective of the vignette presented. However, this low rating was largely because of ignorance of this treatment (which may be related to its limited availability). Unlike medication, respondents did not often see it as harmful. By contrast, the non-specific psychological intervention of counselling was overwhelmingly rated as likely to be helpful by all groups for all vignettes."

"Previous surveys of adults have shown relatively positive views of complementary and self-help therapies. In the present survey we asked about a range of interventions not covered in the earlier surveys. The complementary and self-help therapies included were those known to have some evidence for effectiveness in treating depression or anxiety disorders in adults, although the amount of evidence on these therapies with adolescents is much poorer, making comparison with young people’s preferences more difficult. Many of these therapies were frequently rated as likely to be helpful (physical activity, relaxation training, meditation, massages, morning light exposure, self-help books). St John’s wort did not rate so highly, but this appeared to be largely due to ignorance of what it was rather than a concern about possible harms."

"These findings have implications for areas on which campaigns to improve mental health literacy need to focus in the future. The first is in attitudes towards medication. Although there is evidence that attitudes of adults in Australia have become more favourable in recent years, there is still a considerable gap with clinical practice guidelines. The second is with the preference for generic psychological interventions (counselling) compared to specific interventions known to be effective (e.g. cognitive behaviour therapy). A similar gap exists with the professions providing psychological therapies (psychologists and psychiatrists vs counsellors). There is evidence that knowledge and attitudes of young people and adults can be changed by community campaigns so these are feasible goals. Recent changes in funding provided under Australia’s national health insurance scheme, Medicare, have made psychological services more readily available, but young people need to know about the availability and usefulness of these services."

"Another possible approach to improving evidence based care for young people would be to use terms to describe services that would make them more appealing to this age group and their parents. For example, services might be more acceptable if psychological therapies were labeled as ‘counselling’ and mental health professionals as ‘counsellors’. To some extent, this approach runs counter to the aim of improving mental health literacy and requires cautious exploration."

"The present results highlight the need for further evidence on complementary and self-help interventions. We face a situation in which some therapies that have a strong evidence base are perceived less favourably than others that have weaker supporting evidence. As well as trying to improve the mental health literacy of the public about what is known to work, we need to do further evaluation of interventions that already have wide acceptance and use. Interestingly, a recent study found that people who had experienced depression also rate many of these types of interventions as having helped them."

"Because of their more limited life experience, adolescents require assistance from others in their social network to seek appropriate professional help. In this regard, both family and close friends are viewed favourably as sources of help. However, parents tended to underrate their importance compared to their children. Parents need to be a target for first aid knowledge and skills to assist young people who develop mental disorders. Although it is perhaps too much to expect young people to provide a high level of peer support, there is certainly room for some basic skills. For example, adolescents often do not respond to a friend in a way that could facilitate appropriate help, such as engaging a parent, teacher or school counsellor to help. Even with a suicidal peer, many young people would not tell an adult."

"In conclusion, this is the first national survey of young people’s treatment beliefs in any country. As in previous surveys of adults, it found some gaps between public perceptions and current clinical practice. These gaps can be the target of community mental health literacy campaigns and training of key supporters in first aid skills. However, consideration can also be given to describing some interventions using terminology that may make them more acceptable to young people. Furthermore, the evidence base needs to be extended to more fully evaluate those complementary and self-help interventions that are already widely accepted by young people."

TITLE: Young people's beliefs about preventive strategies for mental disorders: findings from two Australian national surveys of youth
AUTHOR: Yap, Marie Bee Hui; Reavley, Nicola; Jorm, Anthony Francis
AFFILIATION: Orygen Youth Health Research Centre, Centre for Youth Mental Health,
University of Melbourne, Parkville VIC, Australia
SOURCE: Journal of Affective Disorders, 2007 Published online 3 October 2011

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