Let’s Talk About Voices: randomised controlled crossover study of a resource to support mental health workers in supporting voice-hearers

Abstract

Background Easily accessible, impactful, evidence-based resources are needed to assist mental health workers to best support voice-hearers in managing and living well with voices. Let's Talk About Voices (LTAV) is an innovative suite of resources designed for mental health workers to use in supporting voice-hearers. Aim This study aimed to assess the impact of LTAV on mental health workers' self-reported capacity to work with voice-hearers. Method A randomised, controlled crossover design was used, with assessment at three time points. The assessment measure was co-developed by researchers, clinicians, peer workers and voice-hearers based on the aims of LTAV and the Theory of Planned Behaviour. Participants were randomised into two groups. The immediate group received access to LTAV following the first assessment; the delayed group received access following the second assessment. In total, 256 mental health workers commenced the study, with 120 completing all assessments. Results Between-group comparisons for change between times 1 and 2 found a significant difference with a large effect size (F = 40.2, P < 0.001, etap2 = 0.19). Significance remained on intention-to-treat analysis (F = 22.9, P < 0.001, etap2 = 0.08). Pairwise repeated-measures comparisons found a significant increase in scores for both groups following access to LTAV, which was sustained at follow-up. Fourteen of 24 individual items showed significant change. Changes were consistent across professions, work settings and experience working with voice-hearers, but those with less confidence in working with voice-hearers on intake showed significantly stronger improvements. Conclusions This research indicates that LTAV has the potential to substantially improve mental health workers' attitudes and confidence in supporting voice-hearers.Copyright © The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists.