Psychological Medicine
2019

'Tell Your Story': a randomized controlled trial of an online intervention to reduce mental health stigma and increase help-seeking in refugee men with posttraumatic stress (Article) (Open Access)

Nickerson A.* , Byrow Y. , Pajak R. , Mcmahon T. , Bryant R.A. , Christensen H. , Liddell B.J.
  • a School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
  • b School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
  • c School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
  • d Settlement Services International, Sydney, NSW, Australia, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
  • e School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
  • f Black Dog Institute, School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
  • g School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia

Abstract

BackgroundRefugees report elevated rates of posttraumatic stress disorder (PTSD), but are relatively unlikely to seek help for their symptoms. Mental health stigma is a key barrier to help-seeking amongst refugees. We evaluated the efficacy of an online intervention in reducing self-stigma and increasing help-seeking in refugee men.MethodsParticipants were 103 refugee men with PTSD symptoms from Arabic, Farsi or Tamil-speaking backgrounds who were randomly assigned to either receive an 11-module online stigma reduction intervention specifically designed for refugees ('Tell Your Story', TYS) or to a wait-list control (WLC) group. Participants completed online assessments of self-stigma for PTSD and help-seeking, and help-seeking intentions and behaviors at baseline, post-intervention, and at a 1 month follow-up.ResultsIntent-to-treat analyses indicated that, compared to the WLC, TYS resulted in significantly smaller increases in self-stigma for seeking help from post-treatment to follow-up (d = 0.42, p = 0.008). Further, participants in the TYS conditions showed greater help-seeking behavior from new sources at follow-up (B = 0.69, 95% CI 0.19-1.18, p = 0.007) than those in the WLC. The WLC showed significantly greater increases in help-seeking intentions from post-intervention to follow-up (d = 0.27, p = 0.027), relative to the TYS group.ConclusionsThis is the first investigation of a mental health stigma reduction program specifically designed for refugees. Findings suggest that evidence-based stigma reduction strategies are beneficial in targeting self-stigma related to help-seeking and increasing help-seeking amongst refugees. These results indicate that online interventions focusing on social contact may be a promising avenue for removing barriers to accessing help for mental health symptoms in traumatized refugees. Copyright © Cambridge University Press 2019.

Author Keywords

Help-seeking Stigma posttraumatic stress disorder Refugees trauma

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064939552&doi=10.1017%2fS0033291719000606&partnerID=40&md5=09fc47e8d90761468d20abd87b0fa47f
DOI: 10.1017/S0033291719000606
ISSN: 00332917
Cited by: 3
Original Language: English