JMIR Publications

ABSTRACT

Background:

In the United States, millions of adolescents report poor mental health, where one in five teenagers consider suicide. Reducing stigma and fostering peer support remain critical for positive mental health interventions and programs. Increasingly, digital mental health tools have emerged with great promise, leveraging social networks. Despite the potential, limited understanding of such comprehensive programs and their implementation exist.

Objective:

The objective of this study investigates a piloted digital mental health training program (Be Present) for youth, specifically describing the impact on youth behavioral outcomes, user engagement, and identifying high-risk youth in the early phases on prevention

Methods:

Eligibility included Ohio residents (14-22y) to be enrolled as either a “Friend” or a “Peer Advocate”. From May – June 2019, participants completed the Advocate Training course, taking pre-post surveys. Single-arm descriptive analyses measured youth outcomes (self-efficacy, intentions, behaviors, social support, knowledge, and sources of strength), engagement, and assess risk based on survey responses.

Results:

A total of 65 adolescents participated, with 54 completing both pre-post surveys. The majority of participants included non-Hispanic White females. Findings illustrated a significant increase in self-report of referrals for mental health services as well as in perceptions that youth had of experiencing social support, however no significant differences were found for measures self-efficacy, knowledge, and sources of strength between pre-post surveys. Roughly two-thirds of the participants completed all of the Advocate training modules, observing a gradual decline in engagement. Most respondents who received escalated high-risk response messages identified as female.

Conclusions:

The pilot presented promise for implementing a digital mental health program focused on peer support, specifically observing reported youth behavioral outcomes, user engagement, and identifying high-risk youth. Various limitations exist given the small nonrepresentative sample and lack of control group. All findings should be considered preliminary to a larger trial and underscore the feasibility of delivering online training programs to bolster adolescent mental health. Such formative evaluation proved critical for future implementation and research, offering opportunity for substantial improvements for real world digital mental health programs.