JMIR Publications

ABSTRACT

Background:

An estimated one in five adolescents experience a mental health disorder each year, yet due to barriers of accessing and seeking care, most remain undiagnosed and untreated. With increasing digital connectivity, including in low-and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including over 2 million mental health online applications, have been developed to address a range of mental health issues.

Objective:

The objective of this review was to synthesize the current evidence on the digital mental health interventions targeting adolescents and young people, with a focus on effectiveness, cost-effectiveness, and generalizability to low- and middle-income countries.

Methods:

We searched MEDLINE/PubMed, PsychInfo, and Cochrane databases between January 2011 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged 10-24. Two authors independently screened studies, extracted data, and assessed the quality of the reviews.

Results:

We included 18 systematic reviews and meta-analyses in this systematic overview. Overall, the digital mental health interventions evaluated to date have not shown to be effective with regard to clinical outcomes. We found some evidence on effectiveness for anxiety, depression, and stress compared to no intervention. Interventions with an in-person element with a professional, peer, or parent was associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. We found no studies on cost-effectiveness. Also, none of the studies reported on the socio-economic background or other characteristics of the target population nor focused exclusively on low- and middle-income countries, and thus, the potential for generalizability to these populations or settings remains weak.

Conclusions:

Despite a growing number of applications and an increasing body of research, there is very little evidence demonstrating effectiveness or cost-effectiveness of digital mental health interventions. Further, where there is evidence, potential for generalizability is limited. Widespread adoption and scale-up of digital mental health interventions will require demonstration of effectiveness and cost-effectiveness vis-à-vis type of service provided, target population, and the current standard of care.