JMIR Publications

ABSTRACT

Background:

Mental health disorders are the most prevalent health issues among postsecondary students, yet few solutions to this emerging crisis exist. While mobile health technologies are touted as promising solutions for the unmet mental health needs of these students, the efficacy of these tools remains unclear. In response to these gaps, the current study evaluates Thought Spot, a mobile and web application created through participatory design research.

Objective:

Examine the impact of Thought Spot on mental health and wellness help-seeking intentions, behaviors, attitudes, self-stigma and self-efficacy among postsecondary students in Canada.

Methods:

A two-armed, double-blinded randomized controlled trial involving students from three postsecondary institutions was conducted. Students were eligible if they were age 17–29, enrolled in full-time or part-time studies, functionally competent in English, and had access to a compatible digital device. The usual care group received a mental health services information pamphlet. The intervention group received the Thought Spot application on their digital device. Thought Spot is a standalone application that allows users to add, review, and search crowd-sourced information about nearby mental health and wellness services. Users can also track their mood on the app. Outcomes were self-assessed through questionnaires collected at baseline, 3 and 6 months. The primary outcome was change in formal help-seeking intentions from baseline to 6 months, measured by the General Help-Seeking Questionnaire. A mixed-effects model was used to compare the impact of usual care and intervention on the primary outcome (formal help-seeking intentions). Secondary outcomes included changes in informal help-seeking intentions and help-seeking behaviors, help-seeking attitudes, self-stigma and self-efficacy.

Results:

A total of 481 students were randomized into two groups: 240 to usual care, and 241 to the intervention group. There were no significant differences in help-seeking intentions between the usual care and intervention groups over 6 months (F (2,877) = 0.85; P=0.43, f=0.04). Both groups demonstrated similar increases in formal help-seeking intentions at 3 and 6 months (F (2, 877) = 23.52; P<0.001, Cohen’s f=0.21). A decrease in seeking help from informal sources (e.g., family, friends) was observed between 3 and 6 months in the control group but not in the intervention group (Difference = -0.35; 95% confidence interval, -0.70 to 0.004, P=0.05, d=0.20).

Conclusions:

Prompting postsecondary students about mental health and help-seeking appears to increase help-seeking intentions. mHealth interventions may be as effective as information pamphlets in increasing formal help-seeking but may confer a small advantage in driving help-seeking from informal sources. Although there is enthusiasm, developers and health policy experts should exercise caution and thoroughly evaluate these types of digital tools. Future studies should explore the cost-effectiveness of digital interventions and develop strategies for improving their efficacy. Clinical Trial: The trial is registered under the ClinicalTrials.gov number, NCT03412461