Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 2, 2025
Open Peer Review Period: Jan 2, 2025 - Feb 27, 2025
Date Accepted: Oct 16, 2025
(closed for review but you can still tweet)
Understanding Youth Goal-Setting and Achievement in a Free Digital Mental Health Platform: The Impact of User-Set and Practitioner-Set Goals on Engagement and Psychological Distress
ABSTRACT
Background:
Youth and young adult mental health concerns are rising globally, with digital mental health platforms offering a promising solution for accessible support. Among the various features these platforms provide, goal-setting and achievement have been shown to positively influence behavior change and mental health outcomes. However, there is limited understanding of how user-set goals compare to those set collaboratively with a practitioner regarding their impact on user engagement and mental health outcomes in digital mental health platforms.
Objective:
The purpose of this study was to examine the relationship between various goal-related variables (e.g., the number of goals created, progress in user-set and practitioner-set goals) and user engagement, as well as mental health (i.e., psychological distress), within a free digital mental health platform. A secondary exploratory aim was to assess how different user presenting issues were associated with platform engagement.
Methods:
We leveraged secondary data from a free, web-based mental health platform for youth aged 10-26 in the UK that offers goal-setting features, emotional journaling, peer support, asynchronous chat with practitioners, and various self-guided wellbeing activities. Data included in the analyses were from youth and young adults (average age = 15.84; 75.5% female) who engaged with the goal-setting feature and completed both pre- and post-engagement psychological distress measures (N=691) between January 2020 to December 2023. We examined the relationship between user-set goals and practitioner-set goals on user engagement and psychological distress via linear regressions. The impact of different user presenting issues on engagement was also explored via linear regression.
Results:
The number of goals and goal progress, whether user-set or practitioner-set, were not significantly associated with platform engagement. Regarding goal progress, greater goal progress in practitioner-set goals was significantly associated with reduced psychological distress (β=-0.27, P<.001), while user-set goal progress showed no significant association (P=.16). School-related and physical health presenting issues were the two strongest predictors of increased platform engagement (β=.23, P<.001 and β=.20, P<.001, respectively).
Conclusions:
These findings underscore the importance of collaborative goal-setting in improving mental health outcomes for youth and young adults in digital mental health platforms. By highlighting the role of guided support and goal progression, this paper enhances our understanding of how digital mental health platforms can better support young people’s mental health and well-being. This paper also highlights how digital mental health platforms can serve as a valuable resource for addressing a wide range of mental health needs. Clinical Trial: n/a
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.