A Randomised Controlled Trial of the Effectiveness of a Media-based Intervention on Intentions to Seek Help for Mental Health Difficulties among Australian Men

INTERVENTION: The intervention is a music video developed for this study of approximately four minutes' duration. The video takes a well‐known song and adapts the lyrics with the intention to encourage men to seek support from others when they are experiencing mental health difficulties. The lyrics focus on how men are typically encouraged to remain stoic, to keep their difficulties to themselves, and to never cry, but encourages them to express their feelings and seek support when they are not coping well. The video focuses on a group of diverse men who meet in a large community hall; it has the appearance of a support group. The video begins with a single man beginning to sing the lyrics to the adapted song; he is gradually joined by others until all men have stood and are taking part in this spontaneous 'choir'. The video ends with the call to action printed on the screen 'When the going gets tough. Get Talking' and a link to a website, which will house information for gaining various types of mental health support. Participation in this RCT is open to all men living in Australia, given the trial will be conducted completely online. Potential participants will register their interest online and be sent a Plain Language Statement detailing the study. All participants will attend an online orientation session in which the researchers and a study psychologist will further discuss the trial protocol, and participants will sign an online consent form and complete the T1 questionnaire. They will then be randomised. A psychologist will contact any participant who scores 2 or above on the suicide risk screening questionnaire, the Depression Symptom Inventory ‐ Suicidality Subscale. Participants will be excluded if they are at imminent suicide risk or likely to experi CONDITION: Mental Health ‐ Depression Mental Health ‐ Studies of normal psychology, cognitive function and behaviour Mental Health;Wellbeing; ; Mental Health ; Wellbeing Public Health ‐ Health promotion/education PRIMARY OUTCOME: A change in intentions to seek help as measured by the General Help Seeking Questionnaire ‐ Self (GHSQ‐Self) (Wilson et al. 2005. Measuring help seeking intentions: Properties of the General Help Seeking Questionnaire. Canadian Journal of Counselling, Vol. 39(1), 15‐28.).; ; This questionnaire asks: If you were having a personal or emotional problem, how likely is it that you would seek help from the following people or services? Ten responses are provided: intimate partner, friend, parent, other family member, mental health professional, phone helpline, doctor, minister or religious leader, I would not seek help from anyone, I would seek help from another not listed above. We modified this scale by providing an additional three responses: online health chat rooms, online searches for health information, and social media. Respondents rate the likelihood on a seven‐point scale (1 = Extremely unlikely to 7 = Extremely likely); scores are summed and a higher total score indicates greater intentions to seek help. [Baseline (T1) to post‐intervention (T2 = one week from baseline).] SECONDARY OUTCOME: A change in intentions to encourage other males to seek help as measured by an adapted version of the General Help Seeking Questionnaire (GHSQ ‐ Other male) (as outlined for the primary outcome). ; ; ; ; The format is as appears for the primary outcome, with the variation that the question prompt asks: 'If a male friend or family member of yours was having a personal or emotional problem, how likely is it that you would recommend to that person to seek help from the following people?'[Baseline (T1) to post‐intervention (T2 = one week from T1).] A change in intentions to encourage other males to seek help as measured by the General Help Seeking Questionnaire ‐ Other male (GHSQ‐Other male), as in secondary outcome [1], but measured at four‐week follow‐up (T3).[Baseline (T1) to four weeks post‐intervention (T3 = four weeks from T2).] A change in intentions to seek help as measured by the General Help Seeking Questionnaire ‐ Self (GHSQ‐Self), as in the primary outcome, but measured at four‐week follow‐up (T3).[Baseline (T1) to four weeks post‐intervention (T3 = four weeks from T2).] A change in scores on the Conformity to Masculine Norms Inventory‐30 Self‐Reliance (CMNI‐30:SR) subscale (Levant, R. F., McDermott, R., Parent, M. C., Alshabani, N., Mahalik, J. R., & Hammer, J. H. (2020, February 3). Development and Evaluation of a New Short Form of the Conformity to Masculine Norms Inventory (CMNI‐30). Journal of Counseling Psychology. Advance online publication. http://dx.doi.org/10.1037/cou0000414). ; The MDRS‐7 is a 7‐item scale measuring male‐specific depression symptoms. It assesses symptoms in six domains: emotion suppression, drug use, alcohol use, anger and aggression, somatic symptoms, and risk‐taking. Each item is rated for how much the symptoms has applied to the respondent over the last month from 0 = None of the time to 3 = All of the time.[Baseline (T1) to four weeks post‐intervention (T3 = four weeks from T2).] INCLUSION CRITERIA: Identifies as male. Aged 18 years or over at the time of consenting to participate in the trial. Lives in Australia. Can read and understand English to a level sufficient to complete the trial participant tasks. ; This is a self‐report measure that assesses conformity to traditional masculine norms, across 11 norms, including self‐reliance. We are using only the three‐item self‐reliance subscale, as is relates to willingness to ask for help when needed. Participants rate their agreement (Strongly disagree to Strongly agree) with three items, such as 'It bothers me when I have to ask for help'. Subscale scores are a sum of responses, with higher scores indicating higher conformity to masculine norms.[Baseline (T1) to post‐intervention (T2 = one week from T1).] A change in scores on the Conformity to Masculine Norms Inventory‐30 Self‐Reliance (CMNI‐30:SR) subscale, as in secondary outcome [2], at four‐week follow‐up (T3).[Baseline (T1) to four weeks post‐intervention (T3 = four weeks from T2).] Change in past four‐week health service use as measured by the Health Service Use Questionnaire (HSUQ). The HSUQ is a modified version of the Resource Use Questionnaire (Le LK‐D, Sanci L, Chatterton ML, Kauer S, Buhagiar K, Mihalopoulos C. The Cost‐Effectiveness of an Internet Intervention to Facilitate Mental Health Help‐Seeking by Young Adults: Randomized Controlled Trial. J Med Internet Res. 2019;21(7):e13065), developed for use in this study. It assesses participants' use of a range of health services for mental health difficulties over the past four weeks. Use of a range of services is measured, including primary health services such as consultations with a general practitioner or psychologist; psychotropic medications (e.g., sleeping tablets, antidepressants); inpatient admissions (e.g. hospital, community care unit); internet‐based services (e.g., information pages, online support group); and phone counselling. The HSUQ also contains questions related to the effects of mental health difficulties on functioning at work/in education.[Baseline (T1) to four weeks post‐intervention (T3 = four weeks from T2).] Change in scores on the Male Depression Risk Scale‐7 (MDRS‐7). (Herreen D, Rice SM, Zajac I. Brief assessment of male depression in clinical care: Validation of the Male Depression Risk Scale Short Form in a mixed cross‐sectional cohort study of Australian men. Submitted to BMJ Open.) from baseline (T1) to four‐week follow‐up (T3).