Table 28GRADE Summary of Findings for Help-Seeking

Outcome, follow-up, no. participants (trials) Findings Certainty of the evidence (GRADE) What happens?
Help-seeking

Post-intervention: 84 (1 RCT 50 )

Longest follow-up: 62 (1 RCT 50 )

One RCT50 with high risk of bias (unclear direction) reported on participants’ help-seeking behaviour. This RCT compared the effectiveness of HOP program to treatment as usual among adolescent psychiatric patients, who were mostly were female (69.3%), born in Germany (94.8%) and were around 22 months since the first psychiatric diagnosis.

The outcome was assessed by the General Help-Seeking Questionnaire.59 In the RCT, an average of scores from items related to family/friends and professionals were reported. Higher scores indicate an increased likelihood for seeking help.50 A mean score was calculated from the scores of the subscales (range 1 to 4), with higher scores indicating more empowerment.

For seeking help from family/friends, at post-intervention, participants in the HOP group reported significantly increased help-seeking behaviour compared to those in the TAU group (mean between-group difference for change from baseline = 0.77 [95% CI 0.36 to 1.17]). At 6-week follow-up, however, there was no significant difference between the groups.

As for seeking help from professionals, participants in HOP group reported significantly higher improvement compared to those in the TAU group at post-intervention (mean between-group difference for change from baseline = 0.60 [95% CI 0.15 to 1.05]) and at 6-week follow-up (mean between-group difference for change from baseline = 0.82 [95% CI 0.32 to 1.32]). Overall, we conclude that that peer support may be favoured compared to no peer support in improving help-seeking behaviour among youth.

 Very low

due to serious concerns for risk of bias, concerns for inconsistency, serious concerns for indirectness and imprecision.a

HOP may be favoured vs. TAU with respects to social withdrawal at post-intervention, but the evidence is very uncertain.

HOP may be favoured vs. TAU with respects to help-seeking at 6 weeks follow-up, but the evidence is very uncertain.

HOP= Honest, Open, Proud; HOP-C = Honest, Open, Proud–College; RCT = randomized controlled trial; TAU = treatment as usual

a

At post-intervention and at follow-up: rated down once for risk of bias due to serious concerns about the potential for bias arising from missing outcome data and bias in measurement of the outcomes (participant reported subjective outcomes); rated down once due to serious concerns for inconsistency because of limited of evidence of consistency as only 1 trial was available that reported on the outcome at all time points; rated down once due to serious concerns for indirectness because only 1 program (HOP/HOP-C) was identified and the population seemed relatively homogenous, thereby lowering the generalizability of findings to peer support programs in general; rated down once due to serious concerns about imprecision because of the relatively lower sample size in each comparison; publication bias was not detected.

From: Peer Support Programs for Youth Mental Health

Cover of Peer Support Programs for Youth Mental Health
Peer Support Programs for Youth Mental Health: Health Technology Assessment [Internet].
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