'READY' an online decision aid tool; from lived experience consumer led, to RCT, to NSW Government use

Abstract

Background: Making decisions about disclosing a mental illness is complicated. Decision aid tools are designed to help an individual make a specific choice. In conjunction with consumers and those with lived experience of mental ill-health we developed a web-based decision aid (called READY) to help inform decisions about disclosure for employees. 

Aims: Examine the efficacy of this tool in an RCT comparing it with online information from beyondblue’s resources on mental ill-health disclosure.

Methods: We conducted a randomised controlled trial with recruitment, randomisation and data collection all online. Participants had access to the intervention for 2 weeks. Assessments occurred at baseline, postintervention and 6 weeks’ follow-up. the primary outcome was decisional conflict. Secondary outcomes were stage and satisfaction of decision-making and mental health symptoms.

Results: 107 adult employees were randomised to READY (n=53) or the control (n=54). Participants using READY showed greater reduction in decisional conflict at postintervention (F(1,104)=16.8, p<0.001) (d=0.49, 95% ci 0.1 to 0.9) and follow-up (F(1,104)=23.6, p<0.001) (d=0.61, 95% ci 0.1 to 0.9). at postintervention the READY group were at a later stage of decision-making (F(1,104)=6.9, p=0.010) which was sustained, and showed a greater reduction in depressive symptoms (F(1,104)=6.5, p=0.013). 28% of READY users disclosed and reported a greater improvement in mental health.

Conclusions: READY provides a confidential, flexible, and effective tool to enhance decision-making about disclosure. Its use led to a comparative improvement in depressive symptoms. READY seems worth evaluating in other settings and, if these results are replicated, scaling for wider use.