JMIR Publications

ABSTRACT

Background:

The transition from high school to college can exacerbate mental health problems in young adults yet barriers prevent seamless mental health care. Existing digital support tools show promise, but are not yet designed to optimize engagement or implementation.

Objective:

Test acceptability and effects of an automated digital Mobile Support Tool for Mental Health (MoST-MH) for young adults transitioning to college

Methods:

Youth aged 18 years with a current mental health diagnosis preparing to transition to college (n=52; 85% female, 91% White race) were recruited from one primary care (n=31) and one mental health clinic (n=21). Participants were randomized 2:1 to either receive MoST-MH (n=34) or enhanced Usual Care (eUC; n=18). MoST-MH included periodic text-message and web-based check-ins of emotional health, stressors, negative impacts, and self-efficacy, which informed tailored self-care support messages. Both eUC and MoST-MH participants received links to a library of psycho-educational videos and were asked to complete web-based versions of the Mental Health Self-Efficacy Scale (MHSES), College Counseling Center Assessment of Psychological Symptoms (CCAPS), and Client Service Receipt Inventory for Mental Health (C-SRI) monthly for 3 months and Post-Study System Usability Scale (PSSUQ) at 3-months.

Results:

MoST-MH participants were sent a median of 5 (range 3 to 10) text-message check-in prompts over the 3-month study period and 100% were completed and participants were sent a median of 2 (range 1 to 8) web-based check-in prompts among which 78% were completed. PSSUQ scores indicate high usability (mean score 2.0). Results from the completer analysis demonstrated reductions in mental health symptoms over time and significant between-group effects of MoST-MH compared to eUC on depressive symptom severity (d = 0.36; 95% CI: 0.08-0.64). No significant differences in mental health self-efficacy or MH healthcare utilization were observed.

Conclusions:

In this pilot trial we found preliminary evidence that MoST-MH was engaged with at high rates, was found to be highly usable, and reduced depression symptoms relative to enhanced usual care among youth with mental health disorders transitioning to college. Findings were measured during the COVID-19 pandemic and study was not powered to detect differences in outcomes between groups, therefore further testing is needed.