JMIR Publications

ABSTRACT

Background:

Barriers to accessing mental health support are common experiences reported by university students. Digital tools can improve equitable access to the indicated level of support and provide actionable insight and recommendations.

Objective:

This study aimed to evaluate the acceptability and effectiveness of a web-based self-guided mental health and well-being support platform (U-Flourish Platform) that was tailored specifically for university students.

Methods:

The i-spero® platform was adapted in partnership with students to provide evidence-based well-being plans, mental health symptom tracking, and automated alerts and recommendations based on self-report data from students. After providing informed consent, students registered to access the platform and completed baseline demographic information and weekly validated screening measures of anxiety (GAD), depression (PHQ), and well-being (SWEMWEBS) over 8 weeks. At 6 weeks, students completed a user-experience survey. Paired t-tests were used to compared symptom scores and chi-squared tests assessed changes in symptom screening status over the 8-week period. Unadjusted logistic regression was used to assess whether baseline demographic factors and symptom screening status were associated with user-experience outcomes.

Results:

The analyses included data from 404 consenting students. At 6-weeks, most students (75%) expressed satisfaction with the platform, felt it was easy to use and understand (85%), and found the platform helpful for supporting their mental health (58%). Adherence was relatively high (76%) and attrition was relatively low (26%) after 6 weeks but reduced substantively thereafter; associated with timing of the end of incentivized use and end of term examinations and assignments. Mean anxiety (1.55 vs. 2.19, p<.0001; Cohen’s d=0.36), depression (0.94 vs. 1.36, P=.0001; Cohen’s d=0.33), and well-being (24.87 vs. 22.28, P<.0001, Cohen’s d=0.34) scores were improved at 8-Weeks vs baseline, with the greatest positive effects for students who screened positive for anxiety (Cohen’s d=1.16) and depression (Cohen’s d=2.22) at baseline. There was no evidence of differences in user-experience across demographic factors (i.e. gender, international student status, and lifetime history of a mental disorder) or baseline screening status, except for males who had lower odds (OR=0.40, 95% CI: 0.18-0.90) of finding the platform easy to use compared to female students. Of the 404 student-users, 142 created at least one well-being plan, with 75% and 57% of them being endorsed as helpful and being satisfactory in the support they provided, respectively. Most students reported satisfaction with the Platform (75%), it being easy to use (85%), and it having a positive impact on their mental health (58%).

Conclusions:

Evidence supports that a self-guided digital well-being and mental health support platform is an acceptable and useful resource for university students. Therefore, student-tailored digital tools should be considered as part of an integrated and comprehensive whole-university approach for student well-being and mental health support.