title: Beyond silence: protocol for a randomized parallel-group trial comparing two approaches to workplace mental health education for healthcare employees.
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
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  May 2014 - ClinicalTrials.gov: NCT02158871.
authors.affiliation: Institute for Applied Health Science, School of Rehabilitation Science, McMaster University, 4th Floor 1400 Main St.W., Hamilton, ON, L8S 1C7, Canada. molls@mcmaster.ca.
authors.forename: Sandra
authors.initials: S
authors.lastname: Moll
authors.affiliation: Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, AB, T2N 4Z6, Canada. patten@ucalgary.ca.
authors.forename: Scott Burton
authors.initials: SB
authors.lastname: Patten
authors.affiliation: Public Health Sciences, Abramsky Hall, 3rd Floor, Queen's University, Kingston, ON, K7L 3 N6, Canada. heather.stuart@queensu.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Stuart
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Ave, Unit 160, Toronto, ON, M5G 1 V7, Canada. bonnie.kirsh@utoronto.ca.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Kirsh
authors.affiliation: School of Rehabilitation Science, McMaster University, Institute for Applied Health Science, 4th Floor, 1400 Main St. W, Hamilton, ON, L8S 1C7, Canada. macderj@mcmaster.ca.
authors.forename: Joy Christine
authors.initials: JC
authors.lastname: MacDermid
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education* / Q000523:psychology; D006801:Humans; D008603:Mental Health / Q000193:education*; D008605:Mental Health Services; D028642:Persons with Psychiatric Disorders / Q000523:psychology; D009786:Occupational Health Services / Q000379:methods*; D009864:Ontario; D057545:Social Stigma; D017132:Workplace