Conversations about Suicide in Australian Men's Sheds

INTERVENTION: The Mental Health First Aid Conversations about Suicide (MHFA‐CaS) course is a specialised four‐hour course that teaches community members to recognise when someone is experiencing suicidal thoughts and provide them with appropriate support. Participants will learn how to identify warning signs for suicide, support a person in crisis, help a person at risk of suicide stay safe and connect someone to appropriate professional help. The curriculum has been developed by MHFA and is based on guidelines developed through the expert consensus of people with lived experience of mental health problems and professionals. The course will include the use of a handbook, PowerPoint slides, videos and offers role‐play to practice help giving. The course will be delivered in Men’s Sheds by instructors who are trained and accredited by MHFA Australia. It will be offered to approximately 15 participants per course group by online videoconferencing or face to face, depending on the preference of the local Men’s Shed coordinator and Shed members. The face to face courses will be delivered at a suitable location within the local community, e.g. the Men’s Shed or neighbourhood house. Each Men’s Shed cluster will be offered one or two MHFA‐CaS courses depending on the number of enrolments. The intervention group will receive the course between July 2021 and June 2022. The waitlist control group will receive the course between February 2022 and January 2023. There will be minor adaptations to the course to make it more suitable for older men. This will include tailoring of scenarios and the artwork to include male peers. CONDITION: Mental Health ‐ Suicide Suicide; ; Suicide PRIMARY OUTCOME: Change in intentions to assist a person who is at risk of suicide in response to a vignette used in previous studies (Jorm et al, 2018; Nicholas et al, 2020). Participants will be asked to indicate their likelihood of undertaking 15 helping actions.; ; Jorm, A.F., et al., Associations of training to assist a suicidal person with subsequent quality of support: results from a national survey of the Australian public. BMC psychiatry, 2018. 18(1): p. 1‐7.; Nicholas, A., et al., Confidence and intentions to help a person at risk of suicide. Suicide Life‐Threatening Behavior, 2020. 50(1): p. 138‐150.[Baseline (pre‐intervention) and 1 month (post‐intervention) and 7 months after baseline (follow‐up, primary endpoint) ] SECONDARY OUTCOME: Changes in confidence to assist a person who is at risk of suicide. Participants will be asked to rate how confident they would feel supporting the person depicted in a vignette (Nicholas at al, 2020). ; ; Nicholas, A., et al., Confidence and intentions to help a person at risk of suicide. Suicide Life‐Threatening Behavior, 2020. 50(1): p. 138‐150.[Baseline (pre‐intervention) and 1 month (post‐intervention) and 7 months after baseline (follow‐up)] Changes in disclosure norms about suicide. Participants will be asked to what extent they agree with four statements adopted from other studies (LaMontagne et al, 2016; Martin, 2010). ; ; LaMontagne, A.D., et al., An integrated workplace mental health intervention in a policing context: Protocol for a cluster randomised control trial. BMC psychiatry, 2016. 16(1): p. 1‐13. ; Martin, A., Individual and contextual correlates of managers' attitudes toward depressed employees. Human Resource Management, 2010. 49(4): p. 647‐668. ; ; ; ; ; ; ; ; Participants: Male, member of a participating Men's Shed and agrees to participate in the study. ; [Baseline (pre‐intervention) and 1 month (post‐intervention) and 7 months after baseline (follow‐up)] Changes in health related quality of life. Participants’ health related quality of life will be measured using the brief version of the assessment of quality of life instrument (AQoL‐4D; Hawthorne, Richardson & Osborne, 1999). ; Hawthorne, G., J. Richardson, and R. Osborne, The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health‐related quality of life. Quality of life research, 1999. 8(3): p. 209‐224.[Baseline (pre‐intervention) and 7 months after baseline (follow‐up)] Changes in helping actions received in response to suicide risk (based on Nicholas et al., 2019). Participants will be asked to indicate whether they received any of 15 helping actions in response to suicide risk in the last 6 months. ; Nicholas, A., et al., Helping actions given and received in response to suicide risk: Findings from an Australian nationally representative telephone survey. SSM‐population health, 2019. 9: p. 100483.[Baseline (pre‐intervention) and 7 months after baseline (follow‐up)] Changes in helping actions taken to assist a person who is at risk of suicide (based on Jorm et al, 2018; Nicholas et al, 2019). Participants will be asked to indicate whether they performed any of 15 helping actions to support someone in the last 6 months. ; Jorm, A.F., et al., Associations of training to assist a suicidal person with subsequent quality of support: results from a national survey of the Australian public. BMC psychiatry, 2018. 18(1): p. 1‐7. ; Nicholas, A., et al., Helping actions given and received in response to suicide risk: Findings from an Australian nationally representative telephone survey. SSM‐population health, 2019. 9: p. 100483.[Baseline (pre‐intervention) and 7 months after baseline (follow‐up)] Changes in mental health resource usage. Health care utilisation will be measured using adjusted items from the resource use questionnaire (RUQ; Chatterton, et al, 2018). ; Chatterton, M.L., et al., Economic evaluation of a dietary intervention for adults with major depression (the “SMILES” trial). BMC Public Health, 2018. 18(1): p. 1‐11.[Baseline (pre‐intervention) and 7 months after baseline (follow‐up)] Changes in stigmatising attitudes about suicide, Participants will be asked to what extent they agree with statements designed to measure stigmatising attitudes. The stigma items will be based on the Depression Stigma Scale (Griffiths et al, 2004). ; Griffiths, K.M., et al., Effect of web‐based depression literacy and cognitive–behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial. The British Journal of Psychiatry, 2004. 185(4): p. 342‐349.[Baseline (pre‐intervention) and 1 month (post‐intervention) and 7 months after baseline (follow‐up)] Changes in the desire for social distance measured by the Social Distance Scale (Link et al, 1999). ; Link, B.G., et al., Public conceptions of mental illness: labels, causes, dangerousness, and social distance. American journal of public health, 1999. 89(9): p. 1328‐1333.[Baseline (pre‐intervention) and 1 month (post‐intervention) and 7 months after baseline (follow‐up)] Changes in the endorsement of suicide prevention myths. Participants will be asked to indicate their agreement with items representing common suicide myths, the items will be based on previous research (Nicholas et al, 2020) ; Nicholas, A., et al., Belief in suicide prevention myths and its effect on helping: a nationally representative survey of Australian adults. BMC psychiatry, 2020. 20(1): p. 1‐12.[Baseline (pre‐intervention) and 1 month (post‐intervention) and 7 months after baseline (follow‐up)] Course quality and satisfaction. Five items will be used asking participants how new the information in the course was to them, how much of the information in the program they understood, how well the program was presented, how relevant the content was to them and how much they liked the different parts of the program (ie, handbook, PowerPoint slides, videos and activities). Additionally, two open‐ended questions will ask participants what aspects of the course they find most helpful and if there is anything in the course that could be improved. This questionnaire was used in a previous MHFA study (Bond et al, 2021). ; Bond, K.S., et al., Effects of the Mental Health First Aid for the suicidal person course on beliefs about suicide, stigmatising attitudes, confidence to help, and intended and actual helping actions: an evaluation. International Journal of Mental Health Systems, 2021. 15(1): p. 1‐12.[One month after baseline (post‐intervention) ] INCLUSION CRITERIA: Cluster: The local Men's Shed coordinator agrees to offer the MHFA Conversations about Suicide course to Shed members in their area and agrees to randomisation to the intervention or wait list group.