Evaluation of the Conversations About Play Course Mental Health First Aid: Effects on Knowledge, Stigmatizing Attitudes, Confidence and Helping Behaviors | BMC Psychology

This assessment of the Game conversations the course used a pre-course, post-course and 6-month follow-up design to measure the course’s effects on participants’ knowledge of gambling and problem gambling, desire for social distancing, trust in support of a person with a gambling problem and the use of the skills taught in the course. It also explored participant satisfaction with the course. This study found that the course increased knowledge and confidence, decreased stigma, and improved the quality of intentions to help someone with gambling problems. These results are similar to other PSSM course evaluations [18, 19, 27, 28]. Participants were also very satisfied with all elements of the course.

The proof that the Game conversations of course positively influences actual helping behavior is less clear. This was also the case in a recent evaluation of the Mental Health First Aid for the Suicidal Person course, and like this study, this may be partly due to a low response rate, leading to insufficient statistical power to assess this item during the course. monitoring. [28]. It is also possible that the Game conversations course does not lead to substantial changes in the behavior of the participants. Future research could aim to determine which explanation is most likely to explain these results. This could be achieved by basing power calculations on the numbers needed to assess changes in behavioral outcomes and using study designs that can capture more instances of first aid provision, for example, methods of momentary ecological assessments.

Prior to the course, participants showed reasonable knowledge about gambling and gambling problems, and improvements were still significant both immediately after the course and six months later. Participants also had a reasonably high quality of their intentions to help before the course, which improved after the course. However, unlike the sustained improvements in participants’ knowledge, these improvements in helping intentions were not maintained at follow-up. Future revisions to the course curriculum could address this issue, perhaps by increasing the amount of practice each participant is involved in during the course, for example through additional role-playing or scenario-based learning. . Refresher courses designed to maintain knowledge and skills should also be considered. Four hour refresher courses for Youth, Standard (Adult) and Aboriginal and Torres Strait Islander MHFA are currently offered every 3 years. the Game conversations can also benefit from the development of short refresher courses which can be delivered a few months after the main course.

The most common non-recommended action before the course was “Tell Patricia what to do to change her game”, and this action showed limited improvement after the training. Given the many negative consequences that can be observed in relation to compulsive gambling [4], this answer to someone is understandable. However, telling the person what they need to do to change their game goes against the best available evidence. the Game conversations recommends making suggestions about what the person could do using a non-judgmental approach, rather than telling them what to do [20]. In a framework of reactance theory [29], how to approach this discussion about changing gambling behaviors is important because resistance to change can be activated if the person perceives that a freedom is being threatened. This can then reduce the person’s motivation to change their game or seek needed treatment. Of note, although telling the person what to do to change their game was the most common non-recommended action and the one that showed the least improvement, less than a quarter of participants expressed the intention to perform this action. Additionally, and perhaps most importantly, very few participants reported using this action with someone they knew at follow-up. Nevertheless, given the serious consequences of problem gambling and its strong link to mental health problems [4, 5], delays in receiving professional treatment should be avoided. It is therefore important to ensure that the Game conversations is as effective as possible in enhancing understanding for all participants and helping intentions regarding how best to discuss a person’s problem gambling with them. Future iterations of the course could explicitly address how to frame such conversations or options for changing behavior, incorporating examples of different terms and how people might react to them (e.g., comparing “telling” with “suggesting”). or “should” with “could”). ”).

Helping someone they knew who was showing signs of problem gambling was a common experience for course participants before the course and at follow-up. The types of assistance given at both times were similar, especially for the actions recommended by the course. However, after taking the course, very few participants reported doing any non-recommended actions. There was also a noticeable increase in discussion of behaviors of concern among participants. Other actions more frequently taken by participants after the course included talking with the person about things they valued in their relationship, involving them in activities that did not include gambling, providing information about support services gambling and encourage the person to learn about the strategies that gambling providers used. It seems that after the course the participants were more confident to talk proactively with the person about their behavior and offer support, and maybe in some cases it was instead of telling the person outright to stop playing and how she should change her behaviors (actions not recommended in the course which were used less by the participants between the course and the follow-up).

Actions that saw virtually no change from pre-course to follow-up included encouraging the person to seek professional help or support from others not involved in gambling and encouraging self-help. -exclude gambling venues. These recommended actions may be considered unnecessary or inappropriate in some cases or may not always be the first stop where other actions suffice (for example, self-exclusion from a venue does not is not applicable if the person is playing online). It is also possible that despite the teachings of the course, there are known barriers to help-seeking that impact the provision of help here, for example shame, embarrassment or stigma. [13, 30]. However, since the encouragement of professional help from family and friends is one of the strongest motivations for seeking treatment [11]more emphasis may be needed on these areas in future updates to the Game conversations Classes. To inform these updates, future research could investigate why course participants who helped someone with gambling problems chose or avoided taking specific actions during their interaction.

The finding that improvements in mastery of intentions to help after the course were not fully maintained at follow-up, and improvements in mastery of actual actions taken were limited, suggests that future updates of the Game conversations The course should provide more opportunities for course participants to practice their skills in order to maintain fluency over time. A randomized controlled trial would also provide a clearer picture on whether the course effectively promotes useful and recommended actions.

This research responds to calls in the literature for community training in gambling and problem gambling. [11, 15]with findings suggesting that such training benefits community members by increasing knowledge, reducing stigmatizing attitudes, and improving aspects of support for someone with a gambling problem. Courses such as Game conversations can be a way to raise awareness of the social cost of gambling [31]its widespread effects on people other than the player [4, 32]and the availability of effective treatments for problem gambling and comorbid mental health conditions [33]. Future research could explore the social and economic impacts of implementing and scaling up community training programs, assessing whether they can increase help-seeking rates for people with problem gambling or reduce injury rates such as financial hardship, spousal and family violence, and legal difficulties.

Limits

This research is not without limits. There was no control group, so changes may be attributable to factors that were not assessed in this evaluation. It is not known whether gambling behavior was changed in the person who received help. A low response rate at follow-up made it difficult to draw clear conclusions about whether the course improved the actual first aid measures taken to support someone with a gambling problem. women, reasonably well-educated, generally did not speak a language other than English at home and took the course in a professional capacity, so it is not clear to what extent these results would generalize to groups of participants with different backgrounds. different demographics. Finally, it is not clear whether the implementation and evaluation of Game conversations course in a different country would produce similar results. Although the course curriculum was developed for the Australian context, the original Delphi expert consensus study involved panelists from several high-income countries whose populations can also benefit from this course. Although evaluation results for longer, more general PSSM courses are similar across countries [20]future research should assess whether this holds true for shorter specialist courses, and therefore whether the results of this research are generalizable.