We are thrilled to share progress and output as work commences across all six Atlantic Futures Research Streams. In today's update we hear from PhD student, Alba Madrid Cagigal, (Research Stream 4 – Digital Mental Health Support for Young People), who has recently conducted a systematic review and meta-analysis of the literature examining effectiveness of digital mental health interventions for university students with ongoing mental health difficulties.
These findings have recently been published in the “Early Intervention in Psychology Journal”.
Alba explains:
Recent studies show that one-third of first-year undergraduate students present with clinically significant depressive and anxiety symptoms at entry to university. Therefore, counselling services at universities are under great pressure, which translates into a number of challenges such as heavy workload, and consequently long waiting lists.
In response to this demand there has been a growing interest in digital mental health interventions, as these provide an accessible and cost-effective solution to alleviate this burden. However, engagement with these interventions is often challenging and rather low.
My first PhD study aimed to examine the literature on the effectiveness of these novel interventions for university students with mental health difficulties. We were also interested in investigating the influence of human guidance on their effectiveness.
We first conducted a systematic review of the literature to gain a comprehensive overview of the available evidence of the topic. Overall, our results showed that most of the studies conducted to date were randomised controlled trials that used a waitlist control and were based on cognitive-behavioural therapy.
As we were also interested in finding out what factors were related to the effectiveness of these interventions, we conducted two meta-analyses of two-armed randomidsed controlled trials that reported anxiety and/or depression outcomes. Results from these meta-analyses showed that digital mental health interventions are effective to reduce symptoms of both anxiety and depression.
We conducted two sub-group analyses that allowed us to compare the effects of different types of psychological treatments and intervention type on the effectiveness of these digital interventions. These analyses showed that CBT-based interventions were the most effective for reducing symptoms of both depression and anxiety. As these results might not be surprising, it is important to note that other psychological interventions such as mindfulness or acceptance and commitment therapy are often under-evaluated, and more research is needed to determine the real effect of CBT.
In terms of intervention type, sub-group analyses revealed that the presence of human guidance is needed for the effectiveness of these digital interventions in terms of depressive symptom severity. However, when considering symptom severity for anxiety, we observed that interventions that do not provide any type of guidance might be more effective.
There are major implications for these findings that need to be considered, as this study demonstrates that digital mental health interventions are effective to improve the mental health of university students with mental health difficulties. Moreover, when designing these interventions for students experiencing anxiety, the absence of clinical guidance can increase the accessibility and cost efficiency of these interventions. Furthermore, these results support the integration of guidance in digital interventions aimed at reducing depressive symptoms.
This study highlighted that digital mental health interventions have the potential to alleviate the mental health difficulties of university students, but suggest that depending on the difficulties presented, a certain degree of human guidance is needed for their effectiveness.
This study highlighted that digital mental health interventions have the potential to alleviate the mental health difficulties of university students, but suggest that depending on the difficulties presented, a certain degree of human guidance is needed for their effectiveness.
I would like to thank everyone involved in the Atlantic Futures Stream 4 project for their help and support throughout this first year of my PhD including Dr. Carmen Kealy, Courtney Potts, Prof. Maurice D. Mulvenna, Molly Byrne, Prof Margaret M. Barry & Prof. Gary Donohoe. I am really excited to continue this important work in the years to come.
These findings have recently been published in the “Early Intervention in Psychology Journal”. A link to my paper can be found here.
By Alba Madrid Cagigal
PhD Student, University of Galway
Atlantic Futures Research Stream 4 - Digital Mental Health Support for Young People