title: An experimental study exploring the impact of vignette gender on the quality of university students' mental health first aid for peers with symptoms of depression.
abstract: BACKGROUND
  University students have high rates of depression, and friends are often the most commonly-used source of support for emotional distress in this population. This study aimed to explore students' ability to provide effective support for their peers with depressive symptoms and the factors influencing the quality of their mental health first aid (MHFA) skills, including students' gender, course of study, and gender of student experiencing depression.
  
  
  METHODS
  Via an online survey, students at two British universities (N = 483) were quasi-randomly allocated to view a video vignette of either a male or female student depicting symptoms of depression. An open-ended question probed MHFA actions they would take to help the vignette character, which were rated using a standardised scoring scheme based on MHFA guidelines.
  
  
  RESULTS
  Students reported low MHFA scores (mean 2.89, out of possible 12). The most commonly reported action was provision of support and information, but only eight (1.6%) students stated an intention to assess risk of harm. Those studying clinically non-relevant degrees with limited mental health content reported poorer MHFA (p = <0.001) and were less confident about their ability to support a friend with depression (p = 0.04). There was no main effect of vignette gender, but within the group of students on non-relevant courses the male vignette received significantly poorer MHFA than the female vignette (p = 0.02). A significant three-way interaction found that male participants studying non-relevant degrees who viewed a male vignette had poorer MHFA compared to females studying non-relevant degrees who viewed the female vignette (p = 0.005).
  
  
  CONCLUSIONS
  Most students lack the necessary MHFA skills to support friends suffering from symptoms of depression, or to help them get appropriate support and prevent risk of harm. Students on courses which do not include mental health related content are particularly ill-equipped to support male students, with male students receiving the poorest quality MHFA from fellow male students on these courses. MHFA training has the potential to improve outcomes for students with depression, and could have a valuable role in reducing the excess risk of harm seen in male students.
authors.affiliation: Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, The University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK. bethan.davies@nottingham.ac.uk.|NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, The University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK. bethan.davies@nottingham.ac.uk.
authors.forename: E Bethan
authors.initials: EB
authors.lastname: Davies
authors.affiliation: School of Medicine, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. mzyjw@nottingham.ac.uk.
authors.forename: John
authors.initials: J
authors.lastname: Wardlaw
authors.affiliation: Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, The University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK. richard.morriss@nottingham.ac.uk.|NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, The University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK. richard.morriss@nottingham.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Morriss
authors.affiliation: Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, The University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK. cris.glazebrook@nottingham.ac.uk.|NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, The University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK. cris.glazebrook@nottingham.ac.uk.
authors.forename: Cris
authors.initials: C
authors.lastname: Glazebrook
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D005392:First Aid; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D010379:Peer Group; D012944:Social Support; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014495:Universities; D014743:Videotape Recording; D055815:Young Adult