The yshareit project aims to increase awareness of and access to reputable e-mental health resources among young people. Small group workshops were conducted using a triage website to explore youth-relevant e-mental health websites. Participants completed a range of activities aimed at enhancing

communication skills and developing ideas for promoting e-mental health resources. The results revealed a significant increase in awareness, usage and promotion to others of e-mental health websites. They indicate that small-group workshops are an effective means of educating young people about reputable e-mental health resources, and that an associated triage website is a useful adjunct for promoting these resources.

**********

The mortality and disability burden associated with mental disorders in Australia is notably high for young people. Mental disorders account for 55% of the total disease and injury burden for young adults aged 15 to 24 years (Mathers, Vos & Stevenson 1999). Given that only one in four young people in Australia experiencing mental health problems will receive professional help, research has highlighted the need to implement cost-effective programs aimed at promoting mental health and wellbeing and preventing/treating mental health problems in young people (Sawyer et al. 2000). A cost-effective medium to deliver these programs is the internet, which offers advantages in terms of affordability and accessibility, provision of additional services to support traditional service delivery, a means of implementing innovative services, and increased consumer choice with regards to health care options (Christensen, Griffiths & Evans 2002).

The internet is a particularly useful way for young people to access mental health information. In Australia, the age group with the highest use of the internet, at 60%, is the 15 to 24 age bracket (Australian Bureau of Statistics (ABS) 2001). Young people aged 15 to 24 years also report the most frequent use of the internet with 54% of 15- to 17-year-olds and 52% of 18- to 24-year-olds reporting that they use the internet on a daily basis (ABS 2006). In addition, the internet is readily accessible to young people in Australia. Those aged 15 to 24 report higher use of the internet from multiple sites, including home (17.6%), other person's house (48.7%), public library (17.7%), TAFE or tertiary institution (30.3%) and other unspecified locations (22.4%) (ABS 2006). (1)

There has been a growth in recent times of reputable Australian e-mental health websites relevant to young people, such as Reach Out!, MoodGYM, Ybblue, BluePages and Kids Help Line. These websites address issues such as substance use, managing relationships, and coping with pressures associated with school and university, as well as providing help for symptoms and treatment for common mental health disorders such as depression and anxiety. The coverage and presentation of information contained within each of these websites differs; consequently, websites may vary in their relevance to an individual's mental health concerns. For instance, whereas the majority of the abovementioned websites are primarily information-based, online interactive training programs, such as MoodGYM, teach cognitive behaviour techniques for symptoms of anxiety and depression.

Despite these recent advances in health-based internet resources, there has been little systematic effort to encourage the uptake of these resources. Strategies are required that familiarise young people with the best available help appropriate to their own or their peers' particular mental health concerns. Peer-educative models are one such strategy, based on social learning theory. Social learning theory, also referred to as social cognitive theory, proposes that new and existing behaviours can be modified through a process of vicarious exposure or modelling (Bandura 1973, 1977). Peer-educative models can provide an effective means of educating young people as peer groups often dictate the types of behaviours that individuals observe and, hence, learn (Bandura 1973, 1977). However, the effectiveness of peer education will be affected by the characteristics of the peer educator. For example, in order to encourage attention to, and learning of, the information presented, peer educators must be credible, present as positive role models and demonstrate confidence and self-efficacy when delivering information (Turner & Shepherd 1999).

Capitalising on the strengths of peer networking, peer-educative models have been used in both school-based (for reviews see Mellanby, Rees & Tripp 2000) and community service-based health education programs (e.g. Brindis et al. 2005). The efficacy of peer-educative models has been highlighted by a number of studies indicating that learning of health information and behaviours can be just as effective, if not more effective, when the information is delivered by peers compared to delivery by adults (Tevyaw et al. 2007; Mellanby et al. 2000). One notable example of a peer-educative model is the Canadian-based Youth Educating About Health (YEAH) program, which is designed and led by young people. The YEAH program delivers youth-driven education and increases awareness of sexual health and associated risk factors for drug-taking for people aged 12 to 25 years (Hampton et al. 2005). Although peer-educative models have been widely employed in the context of health education, there appear to be few examples of peer-educative models used to promote mental health. The use of peer-educative strategies has not been evaluated with respect to the promotion of e-mental health resources.

Present study

The present study explores the efficacy of the yshareit project as a model to educate young people about mental health. The yshareit project aims to increase awareness of, and access to, reputable e-mental health resources among young people aged 15 to 25 years. The project combines internet technology and peer education to inform young people about reputable e-mental health resources. A "triage" mental health website was developed which can be accessed online at <http://www. yshareit.com>. It provides links to five reputable Australian websites for mental health that are of relevance to young people (Reach Out!, MoodGYM, Ybblue, BluePages and Kids Help Line). In addition to the website, a workshop was conducted with small groups of young people to provide education about reputable e-mental health resources. These workshops capitalised on the strengths of peer education by encouraging workshop attendees to take on an ambassador role and to educate their peers about the high quality e-mental health resources discussed in the workshops.

The primary aim of the present study is to assess the efficacy of the yshareit e-mental health workshops for increasing awareness, usage, and promotion to others of e-mental health resources among young people. It is hypothesised that there will be a significant increase in the proportion of participants who report being aware of, using and promoting e-mental health resources from baseline to six-month follow-up. Visits to the study website are reported, including click-throughs to the five triaged websites, and it is hypothesised that regions where small-group workshops are delivered will show increased use of the yshareit.com website.

Method

Participants

The workshop sample consisted of 135 young people aged 15 to 25 years (M age = 18.6 years, SD = 2.3) comprising high school/college students aged 15 to 17 years (n = 51), and young people from the general community aged 18 to 25 years (n = 84) recruited by advertisement. The sample was predominately female (79.3%) and participants were recruited from three regional areas of Tasmania: Hobart (58.5%), Launceston (27.4%) and Burnie (14.1%). Complete pre-workshop and follow-up data sets were available for 53 of the 135 participants. Of these 53 participants, the majority were female (77.4%), with a mean age of 19.15 years (SD = 2.66). The majority of these participants were recruited from Hobart (71.7%), followed by Launceston (24.5%) and Burnie (3.8%). Table 1 provides an outline of the pre- and post-sample demographics. Participants received an accreditation certificate for participating in the e-mental health workshops. Ethical approval was granted by the Human Research Ethics Committee (University of Tasmania) and approval was granted from the Department of Education (Tasmania) to conduct the e-mental health workshop in Tasmanian government schools.

Materials

A "triage" website, providing links to five reputable e-mental health websites of relevance to young people (Reach Out!, MoodGYM, Ybblue, Blue Pages and Kids Help Line), was used in the current study and can be accessed online at <http://www.yshareit.com>.

e-mental health questionnaire

This comprises eight questions, developed to assess participants' awareness, usage and promotion of e-mental health resources:

Awareness: whether they had heard of the triaged website and a number of other mental health websites.

Use: whether they had visited websites to source information regarding physical health, mental health, spiritual health or relationships, and, if so, how often they had visited websites to source information relating to the abovementioned issues. Also, whether they had used websites, chatting or email to source information relating to physical health, mental health, spiritual health or relationships.

Promotion to others: whether they would recommend sources of help (e.g. GP, mental health professional, counsellor, websites) to someone with a mental health issue, and, if so, whether they had actually recommended sources of help to someone with a mental health issue.

In addition, general internet usage was assessed via a question regarding how often they used the internet and a question regarding the reasons they used the internet (e.g. games, chatting, shopping, email).

Items regarding frequency were rated on a multinominal scale with response categories: less than once a month, at least once a month, at least once a week, and most days. All other questionnaire items were rated on a binary scale with Yes / No responses.

Participants also received a workshop folder which included activity sheets and information regarding emergency contacts.

Data regarding visits to the yshareit.com website were collected using Statcounter software <http://www.statcounter.com>.

Procedure

The e-mental health workshops were conducted with small groups of participants; a typical size for workshops was 10 to 15 participants. Workshops were conducted in school computer labs for participants recruited from local high schools/colleges, and in a university computer lab for participants recruited from the general community. Each of the workshops was either facilitated by two psychology graduates or one psychology graduate and one medical student. Workshops ran for approximately three hours at sites where all participants had access to online computers. In the first part of the workshop, participants completed the e-mental health questionnaire and were introduced to the study's triaged websites via links from the yshareit. com website (ReachOut!, Ybblue, BluePages, MoodGYM, Kids Help Line). Participants then worked through case scenarios depicting common mental health issues for young people (depression, stress, substance use), using the resources available from the triaged sites to develop their responses. Participants also engaged in a brainstorming activity to identify strategies to improve communication skills with regards to discussing mental health issues and strategies for the broader sharing of the information obtained in the workshop with their friends, peers, family and the wider community.

Approximately six months after completion of the initial workshop, participants were invited to attend a follow-up workshop where they were asked to complete the e-mental health questionnaire. The 26 attendees were presented with the results obtained for the project to date and were involved in a discussion forum concerning issues such as barriers to accessing sources of help and the future direction of the project. Participants unable to attend a follow-up workshop were invited to complete an electronic version of the e-mental health questionnaire and submit their completed questionnaire via email. Twenty-seven participants completed follow-up questionnaires via email.

Design and data analysis

The current study involved a repeated measures design with an independent variable of time (pre-workshop, follow-up). The dependent measures were counts for each response category for questions regarding general internet usage, and awareness, use and promotion to others of e-mental health resources and sources of help. (2)

Results

E-mental health workshop data

Awareness of e-mental health resources

With regards to awareness of e-mental health resources, the e-mental workshops were effective at increasing awareness of a range of mental health websites as shown in Table 2. In particular, significant increases were shown in the proportion of participants who reported having heard of MoodGYM, Kids Help Line, ReachOut!, Lifeline's Just Ask, and BluePages. With respect to beyondblue (including Ybblue, beyondblue's website for youth), 100% of participants reported being aware of beyondblue's website at follow-up (23% more than pre-workshop).

Internet use for general and personal reasons

Changes in the overall use of the internet for general purposes and to source information relating to personal issues (physical health, spiritual health, mental health and relationships), and frequency of internet use for general and personal reasons were assessed by comparing pre-workshop and follow-up questionnaire responses. As shown in Table 3.1 there was no significant change in the frequency of general internet use or frequency of internet use to source information relating to physical health, mental health, spiritual health or relationships. There was also no significant change in the overall use of the internet for general or personal purposes (see Table 3.2). In terms of the ways in which the internet was used to source information relating to the abovementioned personal issues, there was a significant increase only in the proportion of participants who reported using websites to source information on mental health and relationships. There was no significant change from pre-workshop to follow-up in the proportion of participants who reported having used email or chatting to source information regarding their own health or relationships issues (see Table 3.3). There was a significant increase from pre-workshop to follow-up in the proportion of participants who reported having visited the triaged and other websites (see Table 3.4).

Promotion to others of e-mental health resources

Changes in the recommendation to others of e-mental health resources were assessed by comparing participant responses from pre-workshop to follow-up. With regards to the promotion of sources of help available for mental health issues, there was a significant increase only in recommendation of mental health websites (see Table 4).

Website statistics

In the period 29 September 2005 to 3 December 2007, there were 3,392 visits to the yshareit.com website, with 1,995 visitors clicking through to a triaged website. Of the unique visitors to the site, 1,366 were first-time visitors, 264 had revisited the site 1-5 times, 35 revisited 5-10 times, and 16 revisited more than 10 times. With regards to click-throughs from the yshareit.com home page to the five triaged sites, 595 visitors clicked through to ReachOut!, 446 to Ybblue, 411 to MoodGYM, 264 to BluePages, and 243 to Kids Help Line.

Most visitors to the yshareit.com website resided within Australia (2,437), the majority from Tasmania (1,319), followed by Victoria (452), New South Wales (255), Australian Capital Territory (207), South Australia (85), Queensland (71), Western Australia (46) and the Northern Territory (2). The website received limited use from sites outside of Australia including China (42), USA (31), New Zealand (9), Malaysia (6), Canada (4), UK (3), Singapore (2), Germany (2), and one visitor each from five other countries.

General discussion

Despite the recent growth of youth-relevant e-mental health resources, there has been little systematic effort to promote and encourage the uptake of these resources among young people. The current study utilised both internet technology and peer education in order to increase awareness, usage and promotion to others of reputable e-mental health resources among young people. The current study involved the use of a triage website which provides links to five youth-relevant sites (Reach Out!, MoodGYM, Ybblue, Blue Pages and Kids Help Line) and also involved an educational e-mental health workshop which was conducted with small groups of young people. Hypotheses concerning significant increases in the proportion of workshop participants who reported being aware of, using and promoting e-mental health resources from baseline to six-month follow-up were supported.

The results suggest that the e-mental health workshop was a useful strategy for increasing levels of both awareness and use of triaged and non-triaged sites (Lifeline's Just Ask and Youth Network of Tasmania: YNOT). Increases in awareness and use of the non-triaged sites is particularly noteworthy as this finding may suggest that as a result of undertaking the e-mental health workshop and exploring the triaged resources, participants were made aware of other equally reputable e-mental health resources via links from the triaged sites and were motivated to explore these websites. However, as the e-mental health questionnaire explicitly asked whether participants were aware of a specific list of websites, including the triaged sites, it is possible that the current results regarding awareness of e-mental health websites represent a priming effect, and the increased awareness and use of the non-triaged sites may result from false recognition. Future research aimed at evaluating the efficacy of the yshareit e-mental health workshop should include additional questionnaire items aimed at assessing potential priming effects. In addition, it is recommended that future evaluation studies use magnitude ratings of awareness, use and promotion to others of e-mental health resources.

In terms of the ways in which the internet was used to source information relating to personal health and relationship issues, there was a significant change from pre-workshop to follow-up in the proportion of participants who reported using websites to source information relating to mental health and relationships only. This finding, in conjunction with the increased use of the triaged websites, suggests that the e-mental health workshop is a useful medium for encouraging the uptake of reputable e-mental health resources among young people.

The current study also aimed to assess the efficacy of the e-mental health workshop for increasing the promotion of sources of help for mental health care, such as GPs, mental health professionals and websites. Workshop participants explored the triaged websites and were encouraged to investigate types of help available for someone with a mental health or personal issue as part of working through hypothetical scenarios. The proportion of participants who reported that they would recommend, and had recommended, websites to someone with a mental health issue increased. There was no reported increase in recommendation of other sources of help such as GPs and mental health professionals. It is speculated that the recommendations of helpful professionals and services remained unchanged because the workshop was conducted with a focus on reputable e-mental health resources. Further attention could be paid in future research to highlighting the benefits of referral to health professionals.

Support was provided for the hypothesis that there will be increased use of the yshareit. com website in regions where the e-mental health workshop was delivered--as demonstrated by the higher number of website hits from sites within Tasmania compared to all other Australian states and territories. The higher number from Tasmania is notable, particularly given that the population of Tasmania is small--only 476,481, or 2.4% of the Australian population of 19,855,288 (ABS 2007). There were 1,319 hits on the yshareit.com website from users within Tasmania, and while a number of these are assumed to be from participants attending the e-mental health workshop, it is unlikely that the total number of website hits can be accounted for solely by workshop participants. The higher number of hits from Tasmania reflects the promotional activities occurring within the state. The yshareit.com website has also been accessed by users from other Australian states and territories; however, there have been few visits from sites overseas. This suggests that there are active networks promoting e-mental health resources and mental health care within Australia that do not extend to overseas. Given that the yshareit project has not been actively promoted outside of Tasmania, evidence that the website is being used by individuals in other Australian states and territories is a promising sign and suggests that a triage website is a useful means of promoting reputable e-mental health resources.

The results of the current study have implications for the ways in which young people can be educated about mental health. Teaching young people about reputable e-mental health resources in small groups appears to be a suitable educational model, as participants did increase their awareness and use of e-mental health resources. The young people who participated in the yshareit e-mental health workshop were also encouraged to take on a youth ambassador role and to share the information that they obtained from the workshop with their friends, family and wider community. Although the workshop appeared to be successful in increasing the promotion to others of e-mental health resources among workshop participants, further research is needed to assess the extent to which peer education occurred outside the e-mental health workshops. Current research is exploring less resource-intensive methods of training youth ambassadors and increasing access. For example, our research staff are currently developing an online interactive program that is based on the materials and activities outlined in the yshareit e-mental health workshop, which was evaluated as part of this study.

The young people who volunteered to participate in the current study did so based on a self-identified interest in mental health. It is, therefore, noteworthy that the majority of participants in the current study were female. According to Fox and Rainie (2000), females are more interested in health topics, demonstrate greater health-seeking behaviours and are more likely to seek online health information compared to males. Hence, the predominance of female participants in the current study reflects a self-selection bias or "volunteer effect" which has implications for further research, in terms of engaging males. Eysenbach and Wyatt (2002) state that the self-selection bias or "volunteer effect" originates from the fact that people are more likely to volunteer to participate in research that is of interest and relevance to them, and the current study supports claims that females are more interested in health-based research. The current study has, therefore, identified a need to develop strategies to engage males in mental health education programs.

In summary, the current study indicated that conducting an e-mental health workshop is a suitable way of educating young people about reputable e-mental health resources, as participants demonstrated increased awareness, usage and promotion to others of e-mental health resources six months after completing the workshop. Given that the majority of participants were female, the current study also highlighted the need to engage males in mental health education programs such as the yshareit e-mental health workshop. The yshareit.com website statistics indicated that the yshareit project is achieving its aims of promoting e-mental health resources within Tasmania, as demonstrated by the high number of website visits from sites within Tasmania compared to all other Australian states and territories.

Acknowledgments

The yshareit project has been supported by research grants provided by Australian Rotary Health.

References

Australian Bureau of Statistics 2001, Census of population and housing: Australia's youth--2001 (Cat. No. 2059.0), viewed 4 May 2007, <www.ausstats.abs.gov.au>.

--2006, Household use of information technology--Australia, (Cat. no. 8146.0), viewed 4 May 2007, <www.ausstats.abs.gov.au>.

--2007, 2006 Census QuickStats: Tasmania, Commonwealth of Australia, viewed 3 December 2007, <www.censusdata.abs.gov.au>.

Bandura, A. 1973, Aggression: A social learning analysis, Prentice-Hall, Englewood Cliffs, New Jersey.

--1977, Social learning theory, Prentice-Hall, Englewood Cliffs, New Jersey.

Brindis, C.D., Geierstanger, S.P., Wilcox, N., McCarter, V. & Hubbard, A. 2005, 'Evaluation of a peer provider reproductive health service model for adolescents' [Electronic version], Perspectives on Sexual and Reproductive Health, n.37, pp.85-92.

Christensen, H., Griffiths, K.M. & Evans, K. 2002, E-mental health in Australia: Implications of the internet and related technologies for policy, ISC Discussion Paper No. 3, Commonwealth Department of Health and Ageing, Canberra.

Eysenbach, G. & Wyatt, J. 2002, 'Using the internet for surveys and health research' [Electronic version], Journal of Medical Internet Research, n.4, e-13.

Fox, S. & Rainie, L. 2000, The online health care revolution: How the web helps Americans take better care of themselves, viewed 17 December 2007, <http://www.pewinternet.org/reports/toc.asp?Report=26>.

Hampton, M., Fahlamn, S.A., Goertzen, J.R. & Jeffery, B.L. 2005, 'A process evaluation of the Youth Educating About Health (YEAH) program: A peer-designed and peer-led sexual health education program' [Electronic version], The Canadian Journal of Human Sexuality, n.14, pp.129-41.

Mathers, C., Vos, T. & Stevenson, C. 1999, The burden of disease and injury in Australia, Australian Institute of Health and Welfare (cat. no. PHE 17), Canberra, viewed 19 March 2007, <http://www.aihw.gov.au>.

Mellanby, A.R., Rees, J.B. & Tripp, J.H. 2000, 'Peer-led and adult-led school health education: A critical review of available comparative research', Health Education Research, n.15, pp.533-45.

Sawyer, M.G., Arney, F.M., Baghurst, P.A., Clark, J.J., Graetz, B.W., Kosky, R.J. et al. 2000, The mental health of young people in Australia, Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care, Canberra, viewed 4 May 2007, <http://.www.mentalhealth.gov.au>.

Tevyaw, T.O., Borsari, B., Colby, S.M. & Monti, P.M. 2007, "Peer enhancement of a brief motivational intervention with mandated college students', Psychology of Addictive Behaviors, n.21, pp.114-19.

Turner, G. & Shepherd, J. 1999, 'A method in search of a theory: Peer education and health promotion', Health Education Research, n.14, pp.235-47.

Notes

(1) The data pertaining to the 15- to 24-year-olds was obtained by calculating the combined total percentages for 15- to 17-year-olds and 18- to 24-year-olds, using data provided by the ABS (2006).

(2) Details of analyses performed are available from the corresponding author, Professor Kenneth Kirkby, via email ken.kirkby@utas.edu.au

Caroline Spiranovic is a junior post-doctoral researcher in the Discipline of Psychiatry, University of Tasmania.

Kate Briggs is a junior post-doctoral researcher in the Discipline of Psychiatry, University of Tasmania.

Kenneth Kirkby is Professor and Head of the Discipline of Psychiatry, University of Tasmania.

Caroline Mobsby is a recent MBBS (Bachelor of Medicine and Bachelor of Surgery) graduate with interests in diverse fields, including youth and mental health.

Brett Daniels is an honorary research associate with the School of Medicine, University of Tasmania.

TABLE 1 Age and sex of participants comprising pre- and post-workshop
samples and participants followed-up via focus group or online
questionnaire.

                   Pre- (%)       Post- (%)
Demographic

Age   15-17      51    (37.8)   16    (30.2)
      18-25      84    (62.2)   37    (69.8)
      Totals    135   (100.0)   53   (100.0)
Sex   Male       28    (20.7)   12    (22.6)
      Female    107    (79.3)   41    (77.4)
      Totals    135   (100.0)   53   (100.0)

                     Follow-up method (%)
Demographic      Focus group        Online
                                questionnaire

Age   15-17       5    (19.2)    11    (40.7)
      18-25      21    (80.8)    16    (59.3)
      Totals     26   (100.0)    27   (100.0)
Sex   Male        4    (15.4)     8    (29.6)
      Female     22    (84.6)    19    (70.4)
      Totals     26   (100.0)    27   (100.0)

TABLE 2 Proportional changes in awareness of mental
health websites from pre-workshop to follow-up
assessments.

Website name          N    Pre   Post      P
                           (%)   (%)

beyondblue            53   77.4  100.0
(Incl.Ybblue) *
MoodGYM               53   11.3  81.1   <.001
Kids Help Line        53   71.7  88.7    .04
ReachOut!             53   73.6  92.5   <.01
Youth Network of      53   24.5  37.7     ns
Tasmania (YNOT)
Lifeline's Just Ask   52   32.7  65.4   <.001
BluePages             52   17.3  80.8   <.001

Notes:  * McNemar statistic could not be computed due
to zero values for one or more cells

TABLE 3.1 Proportional changes in general internet use and internet
use to source personal issues information--pre-workshop to
follow-up assessments.

                         Frequency of                Pre-    Post-
Type of internet use     internet use           N     (%)     (%)    p

General internet use     Once a month or less   53     1.9     0.0   ns
                         Once a week or more          98.1   100.0
Physical health          Once a month or less   53    94.3    92.5   ns
                         Once a week or more           5.7    75.0
Mental health            Once a month or less   53    98.1    94.3   ns
                         Once a week or more           1.9     5.7
Spiritual health         Once a month or less   52    96.2    96.2   ns
                         Once a week or more           3.8     3.8
Relationships            Once a month or less   53    92.5    90.6   ns
                         Once a week or more           7.5     9.4

TABLE 3.2 Proportional changes in use of the internet for general and
personal purposes from pre-workshop to follow-up assessments.

                         Purpose of                   Pre-   Post-
Type of internet use     internet use           N      (%)     (%)    p

Internet use: general    Games                  53    52.8    41.5   ns
                         Chatting               53    64.2    54.7   ns
                         Email                  53    96.2    94.3   ns
                         Shopping               53    50.9   472.0   ns
                         School or work         53    96.2    98.1   ns
                         Hobbies and interests  53   774.0    71.7   ns
Internet use: personal   Physical Health        53    60.4   679.0   ns
                         Mental Health          53    41.5    50.9   ns
                         Spiritual Health       53    24.5    24.5   ns
                         Relationships          53    32.1    35.8   ns

TABLE 3.3 Proportional changes in the use of email, chatting, and
websites to source personal issues information.

                         Type of                  Pre-    Post-
Type of information      internet use        N     (%)     (%)    p

Physical Health          Use email          52     5.8     3.8   ns
                         Use chatting       52     3.8     9.6   ns
                         Use websites       52    69.2    84.6   ns
Mental Health            Use email          52     9.6    15.4   ns
                         Use chatting       52    11.5   173.0   ns
                         Use websites       52    57.7    76.9   .04
Spiritual Health         Use email          52    11.5    11.5   ns
                         Use chatting       52    11.5    13.5   ns
                         Use websites       52    46.2    65.4   ns
Relationships            Use email          52    21.2    25.0   ns
                         Use chatting       52    25.0    30.8   ns
                         Use websites       52    32.7    53.8   .03

TABLE 3.4 Proportional changes in the use of the
triaged and non-triaged websites from pre-workshop to
follow-up assessments.

Website name            N    Pre    Post     P
                             (%)    (%)

beyondblue              53   30.2   94.3   <.001
MoodGYM                 53   11.3   81.1   <.001
Kids Help Line          53   17.0   66.0   <.001
BluePages               53    5.7   58.5   <.001
Youth Network of        52    3.8   23.1   <.01
Tasmania (YNOT) *
Lifeline's Just Ask *   53    1.9   35.8   <.001

* non-triaged sites

TABLE 4 Proportional changes in the recommendation of sources of
help for mental health issues from pre-workshop to follow-up
assessments.

Recommendation     Source of help         N    Pre (%)   Post (%)    p

Have recommended   Friend                 53    75.5       77.4     ns
                   Family                 53    58.5       62.3     ns
                   Parent                 53    45.3       45.3     ns
                   Teacher                53    18.9       13.2     ns
                   General Practitioner   53    45.3       37.7     ns
                   Counsellor             53    67.9       71.7     ns
                   Website                53    41.5       67.9     .01
                   Email                  53    11.3       9.4      ns
                   Library                53     5.7       11.3     ns
Would recommend    Friend                 53    86.8       81.1     ns
                   Family                 53    66.0       81.1     .06
                   Parent                 53    64.2       62.3     ns
                   Teacher                53    30.2       30.2     ns
                   General Practitioner   53    67.9       58.5     ns
                   Counsellor             53    90.6       92.5     ns
                   Website                53    67.9       90.6     .01
                   Email                  53    30.2       30.2     ns
                   Library                53    24.5       35.8     ns