Supporting mental health, wellbeing and study skills in Higher Education:an online intervention system

Abstract Background Dealing with psychological and study skill difficulties can present a challenge for both Higher Education (HE) students, who suffer from them, but also for HE Institutions and their support services. Alternative means of support, such as online interventions, have been identified as cost-effective and efficient ways to provide inclusive support to HE students, removing many of the barriers to help-seeking as well as promoting mental health and wellbeing. Case presentation The current case study initially outlines the rigorous approach in the development of one such online intervention system, MePlusMe. It further highlights key features that constitute innovative delivery of evidence-based psychological and educational practice in the areas of mental health, promotion of wellbeing, support of mood and everyday functioning, and study-skills enhancement. Conclusions This case study aims to present the innovative features of MePlusMe in relation to current needs and evidence-basis. Finally, it presents future directions in the evaluation, assessment, and evidence of the fitness-for-purpose process

A review of web-based support systems for students in higher education

Abstract Background Recent evidence suggests that there is an increasing need for accessible and anonymous services to support higher education (HE) students suffering from psychological and/or academic difficulties. Such difficulties can lead to several negative outcomes, including poor academic performance, sub-optimal mental health, reduced study satisfaction, and dropout from study. Currently, universities in the UK lack financial resources and the on-campus mental health services traditionally offered to students are increasingly economically unsustainable. Compounded by the perceived stigma of using such services, mental health providers have been driven to address the escalating needs of students through online services. Methods In this paper, we review online support systems identified through a literature search and a manual search of references in the identified papers. Further systems were identified through web searches, and systems still in development were identified by consultation with researchers in the field. We accessed systems online to extract relevant information, regarding the main difficulties addressed by the systems, the psychological techniques used and any relevant research evidence to support their effectiveness. Conclusion A large number of web-based support systems have been developed to support mental health and wellbeing, although few specifically target HE students. Further research is necessary to establish the effectiveness of such interventions in providing a cost-effective alternative to face-to-face therapy, particularly in certain settings such as HE institutions

The development and evaluation of an online intervention, ‘MePlusMe’, supporting mood, wellbeing, study skills, and everyday functioning in students in higher education

Background Higher education institutions (HEIs) have an obligation to provide support for the mental health and wellbeing of their enrolled students. There is growing concern about the mental health and wellbeing of higher education (HE) students, not least because of associations with academic performance. The proportion of UK HE students failing to complete their studies has risen to more than 16%. Demand for student support services (SSS) is increasing, which is likely to result in increased waiting times. This may increase the likelihood of problems escalating and negative consequences for both the individual and HEIs. HEIs are facing major cuts to their budgets, with cuts of up to 40% over four years announced in the last UK Governmental Spending Review. Recent fee increases add further pressure on UK HEIs to be cost-effective, show quality and value for money, and enhance ‘student experience’ - important influences on the ratings, intake, and income of HEIs. This further challenges the ability of UK HEIs to offer effective SSS. There is a need of HEIs SSS to employ alternative means of supporting students. Aims We aimed to develop and evaluate an online multimedia intervention to meet current demand for a system addressing mild to moderate psychological and/or study skill difficulties of HE students. Methods & Results The development of our system followed the Medical Research Council (MRC) guidelines for developing complex interventions. To date, we have conducted two stages of development: a) HEI student survey We administered an online survey to university students at King’s College London between February and April 2012, comprising seven questions regarding difficulties faced by students at university, their views (acceptability and engagement) about online support systems, and what features make such systems useful to them. Data from open-ended and closed questions were explored using descriptive statistics. Respondents (n=61) identified difficulties they faced, which were grouped into three broad categories: time management/work load, social life, and finances. The majority of respondents stated that they would use an online support system if they faced difficulties at university (75.4%), although most of them (95.1%) had never heard of or accessed any online support systems. Respondents expressed a preference for the system to contain a tool to assess which techniques are relevant to the user and direct them to those resources (75.4%), the ability to track progress (67.2%), and the inclusion of tailor-made workshops (65.6%). Respondents also stated that learning techniques to manage their difficulties either via written (56%) or animated videos (56%) was more important to them than understanding their difficulties. The most desirable capability of a system was to be able to function as a mobile application (68.9%). Using these findings, we outlined our system conception, including several key features: • A screening process identifying students with more significant difficulties and redirecting them to appropriate sources of support. • Access for students with mild to moderate difficulties to the system and its techniques via two routes: i) Questionnaire route, where students identify their symptoms and are presented with a package of techniques relevant to their difficulties ii) Workshop route, where students access up to two ready-made packages of techniques by choosing the title relevant to their difficulties • A personal space (“My Place”) where they can access the packages with techniques presented in animated video format, use a rating system to monitor their progress, and receive reminders to return to the system. • A social network. b) Proof of Concept Study Subsequently, we conducted a proof of concept study between September and October 2012 to investigate the acceptability of the system’s design and its reflection of end users’ needs. Five UK HEIs (King’s College London, University of Edinburgh, University of Roehampton, Bournemouth University, and University of Warwick; n = 873 students) participated. Students were presented with an online demo of the system comprising slides and videos demonstrating the proposed aesthetics, elements, and functions of the system. They completed five surveys consisting of 36 open-ended and forced-choice questions with the option to provide further information. Analysis of the quantitative (descriptive) and qualitative (thematic analysis) data showed a positive impression of the questionnaire. Students suggested that questions could be shorter and graphics could be revised to appeal to older users. Students’ impression of the Workshop route was also positive, but they requested removal of the restriction of just two workshops at a time. In “My Place” students suggested that reminder messages be restricted in number and that certain functionalities be added, such as a “blackout” button. Students suggested altered wordings and graphics in the animated videos to suit older age groups and to offer a variety of characters. About half of the students found the system useful, and the vast majority reported that they would use it frequently or somewhat frequently. Whilst fear of stigma and lack of time were key barriers to using the system, students stressed the advantage of privacy it offered for dealing with difficulties. Further development of our system was informed by these results, with the following amendments incorporated: • Simplification of questions in the questionnaire. • Replacement of the Workshops route with a more liberal option, the Library route in which relevant techniques may be chosen without restriction on the number that can be selected. • Optional reminder emails and reduction in their frequency. • Enriched animated videos with more characters to offer variety. • Amended wording, phrasing and graphic design for the system ensuring that it is appropriate for all student age groups. • Added functionalities, e.g., blackout buttons. • The name MePlusMe. Conclusions Findings from the above studies contributed significantly to the development of a system format which appears to facilitate engagement and meet students’ aesthetics and needs. The next step will be a full-scale feasibility study, which is under way. This study will evaluate potential effects on students’ mood (symptoms of anxiety and depression), mental wellbeing, study skills, and everyday functioning, and their engagement and satisfaction with a full-functioning system. The outcomes of this crucial step will inform a randomised controlled trial (RCT), leading t

Online intervention, 'MePlusMe', supporting mood, wellbeing, study skills, and everyday functioning in students in higher education: A protocol for a feasibility study

Background: Psychological and study skill difficulties faced by students in higher education can lead to poor academic performance, sub-optimal mental health, reduced study satisfaction, and drop out from study. At the same time, higher education institutions' support services are costly, oversubscribed, and struggle to meet demand whilst facing budget reductions. The purpose of the proposed study is to evaluate the acceptability of a new online intervention, MePlusMe, aimed at students in higher education facing mild to moderate psychological and/or study skill difficulties. The study will also assess the feasibility of proposed recruitment and outcome assessment protocols for a future trial of effectiveness. The system supports self-management strategies alongside ongoing monitoring facilitated by a messaging service, as well as featuring a built-in community of student users. It is based on current clinical guidelines for the management of common mental health problems, together with best practice from the educational field. Methods/design: Two hundred and forty two students will be recruited to a within-subjects, repeated measures study conducted over 8 weeks. Self-report measures of depression and anxiety symptoms, mental wellbeing, academic self-efficacy, and everyday functioning will be collected at baseline, and then at 2, 4, and 8 weeks. During this period, students will have access to the intervention system. UK higher education institutions Bournemouth University and University of Warwick will participate in the study. Data on student satisfaction and engagement will also be collected. Study findings will help to determine the most appropriate primary outcome and the required sample size for a future trial. Discussion: This study will evaluate the acceptability of an online intervention system for students facing psychological and/or study skill difficulties and will test recruitment procedures and outcome measures for a future trial of effectiveness. The system is designed to be implemented as a stand-alone service or a service complementary to student support services, which is accessible to the majority of students and effective in improving student experience at higher education institutions. © 2015 Papadatou-Pastou et al

Investigating the feasibility of MePlusMe, an online intervention to support mental health, wellbeing, and study skills in higher education students

Introduction: While there are several web-based mental health interventions, few target higher education (HE) students. Importantly, more research is needed to establish their effectiveness. Here, we provide a pragmatic evaluation of an online intervention (MePlusMe) specifically designed to improve the mental health, well-being, and study skills of HE students. Methods: In accordance with the published protocol for a feasibility study, we recruited a convenience sample of 137 HE students to participate in an eight-week intervention, with 26 participants retained at week 8. Validated measures of mood (depression and anxiety), well-being, and self-efficacy were collected at baseline, 2, 4, and 8weeks, alongside two feedback forms assessing design and functionality (baseline) and engagement (week 4 and 8). Results: We observed significant reductions in levels of anxiety and depression as well as increases in well-being, but no changes in self-efficacy. Participants rated the system design and functionality positively and qualitative findings indicated high levels of satisfaction with MePlusMe. Discussion: Findings support both the acceptability and the effectiveness of MePlusMe. Nonetheless, modest retention rates limit the precision and generalisability of these findings. Further investigation should ascertain optimal duration of engagement, most acceptable means of outcome assessment, and further detail about obstacles to utilisation