'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. Issue 5 (11th April 2020)

• Record Type: Journal Article
• Authors: Nickerson, Angela; Byrow, Yulisha; Pajak, Rosanna; McMahon, Tadgh; Bryant, Richard A.; Christensen, Helen; Liddell, Belinda J.
• Is Part Of: Psychological medicine. Volume 50:Issue 5(2020)
• Page Start: 781
• Page End: 792
• Publication Date: 2020-04-11
• Subjects: refugees, -- posttraumatic stress disorder, -- stigma, -- trauma, -- help-seeking; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291719000606
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract: Background: Refugees 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. Methods: Participants 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. Results: Intent-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. Conclusions: This 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.