Recognising an at Risk Mental State for Psychosis: Australian Lay People and Clinicians’ Ability to Identify a Problem and Recommend Help Across Vignette Types

Abstract

Objective: This study assessed lay people and clinicians' recognition of an at risk mental state (ARMS) for psychosis, their intentions to recommend help, and the equivalence of written and videotaped vignettes when detecting the problem. Methods: In an Australian online survey, 52 lay people and 32 psychologists with provisional or full registration were randomly assigned to either a videotaped or written vignette of someone with an ARMS. Measures assessed detection and labelling of the mental health problem, and lay people's intentions to recommend help. Results: Data were analysed with Chi-Square statistics, Fisher's Exact tests, and Multinomial Logistic Regression. Lay people frequently detected that a mental health problem existed but labelled it incorrectly. All clinicians detected that a mental health problem existed and most labelled it correctly. Lay people's detection that a mental health problem existed was not associated with vignette type but videotaped vignettes produced significantly more correct labelling. Clinicians had poorer labelling when the vignette was videotaped. Correct labelling was associated with intentions to recommend help to a doctor, psychiatrist, and psychologist/counsellor but not with other help sources or with "no help." Conclusions: Results indicated that if lay people received further education about ARMS, they may be more likely to recommend help to certain mental health professionals. They further highlight the need to use multiple vignette methods in mental health literacy research and the importance of simulated learning about ARMS in professional training environments. Replication of these results in larger samples is required.What this paper adds 1 Given the increased emphasis on preventative treatment at early stages of psychosis, further research is warranted into whether lay people and clinicans can detect and label an ARMS and whether correct labelling facilitates intentions to recommend help. People with ARMS cannot access targeted treatment without first being correctly identified and referred. Thus, this study addresses this gap in our knowledge. 2 Recognition rates for psychosis and early psychosis have beenpreviously based upon open-ended responding. This provides complex and detailed conceptualisations of how problems are perceived and highlights how people tend to use general terms such as "mental illness." However, this does not allow us to detect peoples' perception of the primary presenting problem or their literacy using professional terminology.Requiring that participants use professional terminology gives researchers an indication of whether they understand the underlying psychotic nature of the problem in ARMS. The current research captures people's detection of a general mental health problem and the perceived nature of the primary problem, using broad psychiatric labels. 3 The outcomes of Marshall and Dunstan (2013) research into the impact of vignette methodology may have been influenced by order effects and unequal content across videotaped vignett...

Australian Psychologist

“…Given the pilot case-series, the authors make recommendations for the importance of further research using the CMAP intervention. Finally, the article by Greenhalgh and Shanley (2016) report on a vignette design in which they assessed 52 lay people and 32 provisional and fully registered psychologists' recognition of an "at risk mental state" (ARMS) for psychosis. Participants were randomised to either a written or videotaped vignette.…”