Health e-cards as a means of encouraging help seeking for depression among young adults: randomized controlled trial.
BACKGROUND
There is a need to identify interventions that increase help seeking for depression among young adults.


OBJECTIVE
The aim was to evaluate a brief depression information intervention employing health e-cards (personalized emails containing links to health information presented on a Web page).


METHODS
A randomized controlled trial was carried out with 348 19- to 24-year-olds drawn from the community. Participants were randomized to receive one of three conditions, all of which delivered a short series of health e-cards. Two active conditions involved the delivery of depression information designed to increase help-seeking behavior and intentions and to improve beliefs and knowledge associated with help seeking. A control arm delivered information about general health issues unrelated to depression. The primary outcome was help-seeking behavior. Secondary outcomes were help-seeking intentions; beliefs about the efficacy of depression treatments and help sources; ability to recognize depression; knowledge of the help-seeking process; and depressive symptoms. The study's primary focus was outcomes relating to formal help seeking (consultation with a general practitioner or mental health professional) but also targeted behaviors, intentions, and beliefs relating to informal help seeking.


RESULTS
Relative to the control condition, depression health e-cards were not associated with an increase in formal help-seeking behavior, nor were they associated with improved beliefs about depression treatments; ability to recognize depression; knowledge of the help-seeking process; or depressive symptoms. Depression e-cards were associated with improved beliefs about the overall efficacy of formal help sources (z = 2.4, P = .02). At post-intervention, participants in all conditions, relative to pre-intervention, were more likely to have higher intentions of seeking help for depression from a formal help source (t(641) = 5.8, P < .001) and were more likely to rate interpersonal psychotherapy as being helpful (z = 2.0, P = .047). Depression e-cards were not associated with any significant changes in informal help-seeking behavior, intentions, or beliefs.


CONCLUSIONS
The study found no evidence that providing depression information in the form of brief e-cards encourages help seeking for depression among young adults. Involvement in the study may have been associated with increased help-seeking intentions among participants in all conditions, suggesting that mechanisms other than depression information may increase help seeking.
Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia.
Daniel L
DL
Costin
Andrew J
AJ
Mackinnon
Kathleen M
KM
Griffiths
Philip J
PJ
Batterham
Anthony J
AJ
Bennett
Kylie
K
Bennett
Helen
H
Christensen
D000293:Adolescent; D001294:Attitude to Health; D017281:Cost of Illness; D003376:Counseling; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D018450:Disease Progression; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010342:Patient Acceptance of Health Care; D011570:Psychiatry; D011586:Psychology, Clinical; D011613:Psychotherapy; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult