Digital interventions to address mental health needs in colleges: Perspectives of student stakeholders

OBJECTIVE: The need for clinical services in U.S. colleges exceeds the supply. Digital Mental health Interventions (DMHIs) are a potential solution, but successful implementation depends on stakeholder acceptance. This study investigated the relevance of DMHIs from students\u27 perspectives. METHODS: In 2020-2021, an online cross-sectional survey using mixed methods was conducted with 479 students at 23 colleges and universities. Respondents reported views and use of standard mental health services and DMHIs and rated the priority of various DMHIs to be offered through campus services. Qualitative data included open-ended responses. FINDINGS: Among respondents, 91% reported having experienced mental health problems, of which 91% reported barriers to receiving mental health services. Students highlighted therapy and counseling as desired and saw flexible access to services as important. With respect to DMHIs, respondents had the most experience with physical health apps (46%), mental health questionnaires (41%), and mental well-being apps (39%). Most were unaware of or had not used apps or self-help programs for mental health problems. Students were most likely to report the following DMHIs as high priorities: a crisis text line (76%), telehealth (66%), websites for connecting to services (62%), and text/messaging with counselors (62%). They considered a self-help program with coach support to be convenient but some also perceived such services to be possibly less effective than in-person therapy. CONCLUSIONS: Students welcome DMHIs on campus and indicate preference for mental health services that include human support. The findings, with particular focus on characteristics of the DMHIs prioritized, and students\u27 awareness and perceptions of scalable DMHIs emphasized by policymakers, should inform schools looking to implement DMHIs

Do You See What I See? Investigating the Efficacy of a Novel Body-scaled Action Intervention in Reducing Body Size Overestimation in Anorexia Nervosa

Perceptual body image disturbances, or the misalignment between the ways in which people perceive their body and objective reality, are a pervasive problem in anorexia nervosa. People with anorexia nervosa will often perceive their body to be significantly larger than it actually is. Despite the prevalence of this body size disturbance in individuals with anorexia nervosa, little effort has been made to specifically reduce the body size overestimation that occurs in this illness. Therefore, the premise of this proposed study is to address this research gap through the introduction of a novel intervention that employs verbal, visual, and physical body size feedback to reduce body size overestimation in individuals with anorexia nervosa. The experimental design of this study will include three conditions (anorexia nervosa intervention participants, anorexia nervosa control intervention participants, and healthy control participants), and body size estimation at three time points (zero weeks, eight weeks, and one year) to determine the efficacy of the intervention. In addition, this study will investigate the strength of the relationship between body size overestimation and lack of motivation to recover in individuals with anorexia nervosa. Considering the high rate of relapse and mortality in anorexia nervosa, body size overestimation may be a factor inhibiting long-term recovery, and thus imperative to reduce to improve illness outcomes

The Challenges in Designing a Prevention Chatbot for Eating Disorders : Observational Study

Background: Chatbots have the potential to provide cost-effective mental health prevention programs at scale and increase interactivity, ease of use, and accessibility of intervention programs. Objective: The development of chatbot prevention for eating disorders (EDs) is still in its infancy. Our aim is to present examples of and solutions to challenges in designing and refining a rule-based prevention chatbot program for EDs, targeted at adult women at risk for developing an ED. Methods: Participants were 2409 individuals who at least began to use an EDs prevention chatbot in response to social media advertising. Over 6 months, the research team reviewed up to 52,129 comments from these users to identify inappropriate responses that negatively impacted users experience and technical glitches. Problems identified by reviewers were then presented to the entire research team, who then generated possible solutions and implemented new responses. Results: The most common problem with the chatbot was a general limitation in understanding and responding appropriately to unanticipated user responses. We developed several workarounds to limit these problems while retaining some interactivity. Conclusions: Rule-based chatbots have the potential to reach large populations at low cost but are limited in understanding and responding appropriately to unanticipated user responses. They can be most effective in providing information and simple conversations. Workarounds can reduce conversation errors.Funding Agencies|National Eating Disorders Association through the Feeding Hope Fund; National Institute of Mental Health [R01 MH123482, K08 MH120341, R01 MH115128]; National Heart, Lung, and Blood Institute [T32 HL130357]; Swedish Research Council [2018-06585]; National Health and Medical Research Council [APP1170937]</p

Digital interventions to address mental health needs in colleges : Perspectives of student stakeholders

Objective: The need for clinical services in U.S. colleges exceeds the supply. Digital Mental health Interventions (DMHIs) are a potential solution, but successful implementation depends on stakeholder acceptance. This study investigated the relevance of DMHIs from students perspectives. Methods: In 2020-2021, an online cross-sectional survey using mixed methods was conducted with 479 students at 23 colleges and universities. Respondents reported views and use of standard mental health services and DMHIs and rated the priority of various DMHIs to be offered through campus services. Qualitative data included open-ended responses. Findings: Among respondents, 91% reported having experienced mental health problems, of which 91% reported barriers to receiving mental health services. Students highlighted therapy and counseling as desired and saw flexible access to services as important. With respect to DMHIs, respondents had the most experience with physical health apps (46%), mental health questionnaires (41%), and mental well-being apps (39%). Most were unaware of or had not used apps or self-help programs for mental health problems. Students were most likely to report the following DMHIs as high priorities: a crisis text line (76%), telehealth (66%), websites for connecting to services (62%), and text/messaging with counselors (62%). They considered a self-help program with coach support to be convenient but some also perceived such services to be possibly less effective than in-person therapy. Conclusions: Students welcome DMHIs on campus and indicate preference for mental health services that include human support. The findings, with particular focus on characteristics of the DMHIs prioritized, and students awareness and perceptions of scalable DMHIs emphasized by policymakers, should inform schools looking to implement DMHIs.Funding Agencies|National Institute of Mental HealthUnited States Department of Health &amp; Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH) [K08 MH120341]; Swedish Research CouncilSwedish Research CouncilEuropean Commission [2018-06585]; National Heart, Lung, and Blood InstituteUnited States Department of Health &amp; Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung &amp; Blood Institute (NHLBI) [T32 HL130357]</p

Digital Overload among College Students : Implications for Mental Health App Use

Mental health phone applications (apps) provide cost-effective, easily accessible support for college students, yet long-term engagement is often low. Digital overload, defined as information burden from technological devices, may contribute to disengagement from mental health apps. This study aimed to explore the influence of digital overload and phone use preferences on mental health app use among college students, with the goal of informing how notifications could be designed to improve engagement in mental health apps for this population. A semi-structured interview guide was developed to collect quantitative data on phone use and notifications as well as qualitative data on digital overload and preferences for notifications and phone use. Interview transcripts from 12 college students were analyzed using thematic analysis. Participants had high daily phone use and received large quantities of notifications. They employed organization and management strategies to filter information and mitigate the negative effects of digital overload. Digital overload was not cited as a primary barrier to mental health app engagement, but participants ignored notifications for other reasons. Findings suggest that adding notifications to mental health apps may not substantially improve engagement unless additional factors are considered, such as users motivation and preferences.Funding Agencies|National Institute of Mental HealthUnited States Department of Health &amp; Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH) [R01 MH115128]; National Health and Medical Research CouncilNational Health and Medical Research Council of Australia [NHMRC APP1170937]; National Institutes of HealthUnited States Department of Health &amp; Human ServicesNational Institutes of Health (NIH) - USA [K08 MH120341, K01 DK120778]; Na-tional Institutes of HealthUnited States Department of Health &amp; Human ServicesNational Institutes of Health (NIH) - USA [K01 DK116925]; National Heart, Lung, and Blood InstituteUnited States Department of Health &amp; Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung &amp; Blood Institute (NHLBI) [T32 HL130357]; Swedish Research CouncilSwedish Research CouncilEuropean Commission [2018-06585]</p