JMIR Publications

ABSTRACT

Background:

University students, going through the life stage of emerging adulthood, struggle with a number of mental health problems around the world, mostly due to various difficulties related to their studies and their social relations. While most students are aware of their problems, health-seeking behavior tends to lag behind.

Objective:

The COVID-19 pandemic aggravated mental health problems among students as well, and in response to this challenge, the University of Debrecen developed an integrated, four-level model system aimed at the screening, prevention, and treatment of students’ mental health problems.

Methods:

The new system relies on a data collection feature and an intervention/service function with two levels of exclusively digital, and two with partly digital, partly personal service modalities. Students access the system through a dedicated smartphone application (UDSV) with a host of university-related functions requiring personal login. One function of the app involves a mood report with three categories (awful, acceptable, good) of which one per day can be submitted by students. Based on this report, further services are offered. According to the weekly patterns of the mood report, the student may be directed to the second level at which screening for depression or willingness to participate in peer groups is assessed. Depending on the responses, students are referred to personal (face-to-face) services at level three for intervention. Aggregated reporting for management on the use of elements in levels one and two also occurs at level three. Level four allows for system-wide reporting based on which decisions can be made regarding the expansion of services or creating new ones.

Results:

The model was launched in September 2020 and was tested for 45 months. After an initial increase in use, approximately 29% of all students used the application, of which 11% provided mood reports. The percentage of students reporting a bad mood varied between 8.9 and 12.2% in the test period, while around 50% of students reported being in a good mood. There was a marked pattern of increased use of mood reporting during the study periods (fall and spring semesters) while usage prominently decreased during the examination period and summer recess.

Conclusions:

The four-year trial period demonstrated that the mood report embedded in the mobile app can identify students with a potentially increased risk of mental health problems in need of support without stigmatization. The unique feature of our model seems to be its hierarchy integrating digital and personal services, and its app-based screening at the first level. The system provides an easy-to-follow path from digital to personal services along with time-specific data on the mental health of students for institutional management which helps develop and test appropriate, evidence-base action plans.