Aligning students and counseling centers on student mental health needs and treatment resources

A pilot randomized controlled trial of a brief intervention targeting positive valence systems function to prevent internalizing symptoms in college students

OBJECTIVE

Depression and anxiety are major mental health concerns for college students, and accessible, low-cost interventions are urgently needed. Although traditional treatments focus on negative emotions, there is growing support for the efficacy of positive emotion-focused interventions. We extended this prior work by developing a peer-delivered brief promoting positive emotion (BPPE) intervention that aims to enhance positive valence systems processes and reduce internalizing risk in college students. The goal of this study was to examine the feasibility, acceptability, and initial mental health outcomes of BPPE.

METHOD

In this pilot randomized controlled trial, 92 unselected college students (Mage = 19.44, SD = 1.15) completed measures of depressive and social anxiety symptoms, perceived stress, well-being, and positive and negative affect before being randomized to the BPPE intervention (n = 47) or a comparison study skills instruction (n = 45). Participants repeated the affect measure immediately after the intervention and repeated the rest of the measures 1 month later (n = 66). Intention-to-treat linear mixed-effect models were used to examine group differences.

RESULTS

We found that BPPE can be delivered with high fidelity by peer-trained skills coaches and was rated as highly satisfactory by participants. Positive affect increased pre- to immediately postintervention in the BPPE group. Significant group by time interactions were observed for depression, social anxiety, and perceived stress across the 1-month follow-up, such that BPPE appeared to buffer against worsening symptoms across time.

CONCLUSION

Our findings provide preliminary support for a brief, scalable, preventive intervention targeting positive valence systems functions among college students. Future studies warrant a fully powered randomized controlled trial to test the efficacy of the intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Starting well, staying well: randomised controlled trial of "Whitu - seven ways in seven days," a well-being app for university students

OBJECTIVES

Digitally native university students face challenges to their well-being and up to a third develop mental health problems. "Whitu: seven ways in seven days" is an app based on positive psychology, cognitive behaviour therapy (CBT) and psychoeducation principles.

METHODS

Ninety-first year university students (45 per arm) participated in a randomised controlled trial of Whitu against a university self-help website ("Be Well"). Primary outcomes were changes in well-being on the World Health Organisation 5-item well-being index (WHO-5) and the short Warwick-Edinburgh mental well-being scale (SWEMWBS). Secondary outcomes were changes in depression, anxiety, self-compassion, stress, sleep and self-reported acceptability of the app.

RESULTS

At 4 weeks (primary endpoint), participants in the intervention group experienced significantly higher mental well-being (mean difference: 2.53 (95%CI: 0.53, 4.52); p = 0.013) and significantly lower depression (-4.23 (-8.32, -0.15); p = 0.042), compared to controls. Emotional well-being was greater in the intervention group at 3 months (12.23 (3.93, 20.54; p = 0.004). Other outcomes were similar between groups. User feedback was positive, with 88% saying they would recommend the app to a friend.

CONCLUSIONS

Whitu is an acceptable, effective, scalable and multi-modal means of improving some aspects of well-being and mental health among university students.

TRIAL REGISTRATION

This study was registered with the Australian New Zealand Clinical Trials Network Registry: ACTRN12622000053729.

Mental healthcare on college campuses during COVID-19: Comparing telehealth, in-person, and hybrid modes of delivery

Objective: During COVID-19, many colleges offered mental health services to their students through telehealth or through a combination of telehealth and in-person (hereby hybrid) services. This study examines the experiences and perceptions among students who received telehealth, hybrid, or in-person services. Participants: Data was collected from the Healthy Minds Survey, a national survey of college students, during Fall 2020 and Spring/Winter 2021 (n = 13,976). Methods: Chi-square and Kruskal-Wallis H tests were conducted to examine how students who received campus mental health services through different modes of delivery differed in reported barriers to care, satisfaction with care, and perceived support. Results: Students receiving in-person services differed from students receiving telehealth or hybrid services on multiple metrics. For example, they were less likely to be satisfied with the quality of therapists or the ability to schedule appointments without long delays. However, effect sizes were small. Conclusion: There may be unique strengths to telehealth and hybrid services.

The impact of a mindfulness-based stress reduction program on university students' mental health: A mixed-methods evaluation

Objective: To evaluate an eight-week Mindfulness-Based Stress Reduction (MBSR) program's impact on university students' mental health. Participants: Undergraduate and graduate students. Methods: Ninety participants completed pre-, mid-, and post-program surveys. Mindfulness, Satisfaction with Life, Psychological Distress, and Perceived Stress scores were analyzed using repeated measures ANOVA and pairwise comparisons. Additionally, 115 participants completed post-survey open-ended responses addressing their subjective experiences, which were thematically examined. Results: Participants showed significant improvements in all outcome measures from pre- to post- [p < 0.001] and mid- to post-program [p < 0.05]. All measures, except Satisfaction with Life, showed significant improvement from pre- to mid-program. Participants reported high program satisfaction. Facilitators of the participants' practice included program structure, perception of outcomes, and group setting; however, busy schedules posed a prominent barrier. Conclusion: This evaluation supports MBSR as a public health, group-based approach to improving students' mental health and building a more positive campus community.

The initiation or continuation of mental health services in the transition to college

Objective: To examine what factors impact college students in the United States who are deciding to initiate or continue mental health services. Participants: Spring 2021 undergraduate students (N = 453) at a large urban university. Methods: Online, cross-sectional survey with mental health service experience as the independent variable and social support, accessibility, attitudes toward mental health, mental health literacy, and trust of mental health professionals as the dependent variables, as well as thematic analysis of reasons to discontinue services. Results: Individuals with lower levels of social support and higher levels of mental health literacy were more likely to have received therapy. Participants tended to discontinue services because of negative experiences, accessibility problems, negative attitudes toward services, or they felt better. Conclusions: Mental health literacy, social support, and accessibility are significant predictors of college student service use and should be taken into consideration by university administration.

Best Practices for Depression Screening Among College Students: A Literature Review

Rates of depression among the college-aged population are alarming, particularly in light of the coronavirus disease 2019 pandemic. It is important for providers who care for this population to have proper screening and referral processes to meet growing student needs. The purpose of this literature review was to examine current best practices for depression screening among college students. Comprehensive searches of PubMed, CINAHL, Embase, and Cochrane databases were completed with the assistance of a medical librarian. A total of 775 studies were screened, and 17 articles were included in the review. Evidence supports universal-based depression screenings; use of screening methods to include brief and online screenings; use of validated screening tools, including the Patient Health Questionnaire (PHQ) -2 and PHQ-9; and the importance of a proper referral process and adequate access to treatment measures. An appropriate depression screening and referral process within campus health centers is critical to meet the needs of college students. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 13-17.].

Implementation of a computerized tool to address barriers to academic success among college students

OBJECTIVE

Academic assistance professionals work with college students to address barriers to academic success, although few assessment tools exist. This feasibility study examined the results of implementing a computerized tool for academic assistance professionals to help students. The Measure of Obstacles to Succeeding Academically in College (MOSAIC) is a 31-item risk assessment tool used to characterize academic barriers. It utilizes a tailored computer algorithm on a mobile device to match students with resources to address academic barriers.

METHODS

The MOSAIC was customized and administered at seven universities around the United States. Student responses were analyzed in Microsoft Excel. Academic assistance professionals were asked about implementation in unstructured interviews.

RESULTS

Stress and study skill concerns were the most reported barriers. The MOSAIC was well received, especially among students experiencing academic difficulties, but integration into routine workflow was an obstacle to sustained implementation.

CONCLUSIONS

The MOSAIC holds promise in addressing issues impeding academic success.

Depression, anxiety, and suicidal behaviors in a large-scale national survey of student athletes versus non-athlete college students: risk and protective factors

OBJECTIVE

This study investigates the prevalence and risk factors of internalizing disorders and suicidal behaviors in student-athletes and their non-athlete peers.

PARTICIPANTS

The sample consisted of 223,226 college students (69,404 student-athletes [31.09%]) who participated in the NCHA-ACHA II survey (Fall 2015-2018).

METHODS

Items from the NCHA-ACHA II were used to assess severity of depression, anxiety, and suicidal behaviors. Chi-squared Test of Independence and multinomial logistic regressions were used to examine self-reported internalizing symptoms, previous diagnosis, previous use of mental health resources, and suicidal behaviors within student-athletes and non-athletes.

RESULTS

Findings indicated high rates of internalizing symptoms. Student-athletes, both varsity and intramural/club, displayed decreased odds of internalizing symptoms, self-reported mental health diagnosis, and suicidal behaviors.

CONCLUSIONS

This study with a national sample expands previous studies showing concerning rates of mental health difficulties, student-athletes demonstrated lower odds. These findings highlight the importance of further research and need for targeted intervention within this population.

Remote-delivered services during COVID-19: A mixed-methods survey of college counseling center clinicians

OBJECTIVE

The COVID-19 pandemic has drastically increased use of remote-delivered mental health services. This study identifies advantages and limitations of remote-delivered services on college campuses to inform mental health delivery post-pandemic. Methods: Clinicians (n = 30) were asked to evaluate COVID-19's impact on their work, environment, and wellness in an online survey. Qualitative data was coded using a thematic analysis approach, while quantitative data was analyzed using descriptive statistics. Results: Many clinicians reported benefits of remote services, including increased accessibility, greater convenience, no change in therapeutic alliance, and decreased stress for clinicians. Clinicians also experienced challenges such as social isolation, technological difficulties, and personal/family concerns. Clinicians envisioned a hybrid service combining online and in-person activities post-pandemic. Conclusions: Overall, remote-delivered mental health services on college campuses have potential in increasing treatment quality while highlighting a necessity for further research in hybrid mental health delivery.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2038178 .

From formative design to service-ready therapeutic: A pragmatic approach to designing digital mental health interventions across domains

As digital mental health interventions (DMHIs) proliferate, there is a growing need to understand the complexities of moving these tools from concept and design to service-ready products. We highlight five case studies from a center that specializes in the design and evaluation of digital mental health interventions to illustrate pragmatic approaches to the development of digital mental health interventions, and to make transparent some of the key decision points researchers encounter along the design-to-product pipeline. Case studies cover different key points in the design process and focus on partnership building, understanding the problem or opportunity, prototyping the product or service, and testing the product or service. We illustrate lessons learned and offer a series of questions researchers can use to navigate key decision points in the digital mental health intervention (DMHI) development process.

Estimated prevalence and sociodemographic correlates of mental disorders in medical students of Hebei Province, China: A cross-sectional study

BACKGROUND

In China, the identification rate and treatment rate of mental disorders are low, and there are few surveys on the prevalence of mental disorders among college students using diagnostic tools such as Mini-International Neuropsychiatric Interview (MINI), so the prevalence and treatment of mental disorders among college students are unclear.

AIM

To estimate prevalence of mental disorders among medical students in Hebei Province, and provide guidance for improving their mental health.

METHODS

This was a cross-sectional study based on an Internet-based survey. Three levels of medical students in Hebei Province were randomly selected (by cluster sampling) for screening. Using the information network assessment system, the subjects scanned the 2D code with their mobile phones, clicked to sign the informed consent, and answered a scale. A self-designed general status questionnaire was used to collect information about age, gender, ethnicity, grade, and origin of students. The MINI 5.0. was used to investigate mental disorders. Data analysis was performed with SPSS software. Statistically significant findings were determined using a two-tailed P value of 0.05.

RESULTS

A total of 7117 subjects completed the survey between October 11 and November 7, 2021. The estimated prevalence of any mental disorders within 12 mo was 7.4%. Mood disorders were the most common category (4.3%), followed by anxiety disorders (3.9%); 15.0% had been to psychological counseling, while only 5.7% had been to a psychiatric consultation, and only 10% had received drug therapy in the past 12 mo.

CONCLUSION

Although the estimated prevalence of mental disorders in medical students is lower than in the general population, the rate of adequate treatment is low. We determined that improving the mental health of medical students is an urgent matter.

Implementation of a Technology-Enhanced Peer Mentor Referral System for First-Year University Students

COVID-19 forced college administrators to reassess how they provide students with the most effective methods of support. This project examined the first year of a novel digital peer mentoring program with the goal of connecting diverse students to campus resources they needed to navigate the transition to and through their first year of college. MentorHub, a referral and supportive accountability mobile application, was implemented with first-year undergraduates at a large, private university in the northeastern region of the USA. MentorHub tracked students' current challenges and connected them with trained peer mentors who provided students with support and referrals to campus resources (e.g., mental health, financial, academic). Analyses were not hypothesis-driven, but instead were exploratory and intended for improving the platform. In the first year of the program (August 2021 to June 2022), 47% (N = 3141) students logged onto the platform at least once. Patterns of self-reported challenges revealed that career concerns were the most challenging at the beginning of the fall semester, and that academic habits were most challenging over the course of the year. Referrals (N = 756) were made by mentors, 13% of which were for health and well-being. First-generation and underrepresented minority students showed distinct patterns in referrals. Findings revealed distinct patterns in self-reported challenges across the academic year. Students' use of MentorHub and responses to in-app questions allowed for a real-time understanding of student challenges and patterns of engagement with peer mentors. Implications for a stepped-care approach to addressing student challenges are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41347-023-00303-8.

Leveraging Campus Landscapes for Public Health: A Pilot Study to Understand the Psychological Effects of Urban Sheep Grazing on College Campuses

Since the 1980s, college students in the U.S. have self-reported a decline in their physical and emotional health. With these conditions compounded by the COVID-19 pandemic and its physical distancing restrictions, higher education institutions have an increased responsibility to establish strategic interventions and health-promoting programs for their students. Research collaborations between public health professionals and environmental designers have highlighted the benefits of environmental factors, such as wildlife, street trees, and public parks, on mental health. This pilot project aims to build upon the transdisciplinary dialogue between ecology, design, and public health by examining the social benefits of grazing lawnscape management, which is the practice of using herbivorous livestock to manage turfgrass areas. Through the design of an accessible central campus grazing space for a flock of 25 sheep and use of online questionnaires, a smartphone-based single-item survey, and open-ended feedback given via social media, the UC Davis Sheepmower Project addresses three primary questions: (1) Are there differences in self-reported stress levels and well-being between people who did not watch grazing sheep (no sheepmower group) compared with those who did watch grazing sheep (sheepmower group)? (2) Does holding sheep grazing events create opportunities for education about well-being and engagement with the campus community? (3) Can this type of urban grazing installation ultimately contribute to the overall identity of a college campus? Web-based questionnaire results indicate there is no significant difference in self-reported stress levels between the two groups; however, the moment-in-time smartphone-based single item question suggests that the presence of sheep provides temporary, noticeable relief and enhanced mood for those who observe the animals. Reflections posted on social media suggested that participants found the sheep grazing events fostered feelings of community and placemaking within the campus identity. However, the questionnaire sample indicated the grazing events did not have a significant effect on participants' sense of place or overall campus identity. This transdisciplinary effort breaks down traditionally siloed approaches to human and environmental health and is an example of a whole-systems approach to developing innovative solutions and encouraging applied collective action.

Intention to use digital mental health solutions: A cross-sectional survey of university students attitudes and perceptions toward online therapy, mental health apps, and chatbots

Background

Globally, the high prevalence of mental disorders among university students is a growing public health problem, yet a small minority of students with mental health problems receive treatment. Digital mental health solutions could bridge treatment gaps and overcome many barriers students face accessing treatment. However, there is scant evidence, especially in South Africa (SA), relating to university students' use of and intention to use digital mental health solutions or their attitudes towards these technologies. We aim to explore university 2students attitudes towards and perceptions of digital mental health solutions, and the factors associated with their intention to use them.

Methods

University students from four SA universities (n = 17 838) completed an online survey to assess experience with, attitudes and perceptions of, and intentions to use, digital mental health solutions. We conducted an exploratory factor analysis to identify factors underlying attitudes and perceptions, and then used multivariate ordinal regression analysis was used to investigate the factors' association with students' intention to use digital mental health solutions.

Results

Intention to use digital mental health solutions was high, and attitudes towards and perceptions of digital mental health solutions were largely positive. Importantly, our analysis also shows that 12.6% of users were willing to utilise some form of digital mental health solutions but were unwilling to utilise traditional face-to-face therapies. The greatest proportion of variance was explained by the factor 'Attitudes towards digital technologies' utility to improve student counselling services, provided they are safe'.

Conclusion

SA university students are already engaging with digital mental health solutions, and their intention to do so is high. Certain attitudes and perceptions, particularly concerning the utility, effectiveness, and safety, underlie willingness to engage with these solutions, providing potential targets for interventions to increase uptake.

Effectiveness of digital mental health interventions for university students: an umbrella review

Background

Poor mental health among university students remains a pressing public health issue. Over the past few years, digital health interventions have been developed and considered promising in increasing psychological wellbeing among university students. Therefore, this umbrella review aims to synthesize evidence on digital health interventions targeting university students and to evaluate their effectiveness.

Methods

A systematic literature search was performed in April 2021 searching PubMed, Psychology and Behavioural Science Collection, Web of Science, ERIC, and Scopus for systematic reviews and meta-analyses on digital mental health interventions targeting university students. The review protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO [CRD42021234773].

Results

The initital literature search resulted in 806 records of which seven remained after duplicates were removed and evaluated against the inclusion criteria. Effectiveness was reported and categorized into the following six delivery types: (a) web-based, online/computer-delivered interventions (b) computer-based Cognitive Behavior Therapy (CBT), (c) mobile applications and short message service (d) virtual reality interventions (e) skills training (f) relaxation and exposure-based therapy. Results indicated web-based online/computer delivered-interventions were effective or at least partially effective at decressing depression, anxiety, stress and eating disorder symptoms. This was similar for skills-training interventions, CBT-based intervention and mobile applications. However, digital mental health interventions using virtual reality and relaxation, exposure-based therapy was inconclusive. Due to the variation in study settings and inconsistencies in reporting, effectiveness was greatly dependent on the delivery format, targeted mental health problem and targeted purpose group.

Conclusion

The findings provide evidence for the beneficial effect of digital mental health interventions for university students. However, this review calls for a more systematic approach in testing and reporting the effectiveness of digital mental health interventions.

Effect of COVID-19 outbreak on anxiety among students of higher education; A review of literature

BACKGROUND AND PURPOSE

The Covid-19 pandemic has impacted the mental health of students and exacerbated the prevalence of anxiety among them. The purpose of the literature review was to consolidate evidence for the prevalence of anxiety among students of higher education during the COVID-19 pandemic and to underscore the effect of various pandemic-related factors on this anxiety.

METHODS

A comprehensive literature search was conducted utilizing various databases such as MEDLINE, PsycInfo Google Scholar, ScienceDirect, Scopus, and Embase to identify relevant studies. To be incorporated in this review, studies had to include students of higher education, measure the prevalence of anxiety, and assess anxiety during Covid-19 pandemic.

RESULTS

37 studies met the inclusion criteria and assessed the prevalence of anxiety among students during confinement. Studies showed that more than one-third of the students suffered from anxiety during the early stages of the pandemic. Moreover, being a female, living in rural areas, facing financial hardship, working full-time, spending the quarantine in isolation, worrying about infection for themselves and others, having the uncertainty of the future, having reduced sleep quality, and transitioning to online learning, were factors associated with increased anxiety during the pandemic.

CONCLUSION

Anxiety was shown to be highly prevalent among the student population during the Covid-19 pandemic. Higher education institutions and governments should take action to ensure the safety and the physical, social, and mental wellbeing of the students.

Uptake and effectiveness of a self-guided mobile app platform for college student mental health

BACKGROUND

College students endorse high rates of mental health problems. While many colleges offer on-campus services, many students who could benefit from mental health services do not receive care. Indeed, nearly half of students who screen positive for depression, for example, do not receive treatment. Digital mental health programs, such as those delivered via mobile apps, may help expand access to mental health care and resources. This mixed-methods study aims to examine the uptake and effectiveness of an implementation of IntelliCare for College Students, a self-guided app-based mental health platform, on two university campuses.

METHODS

Data on counseling center utilization was collected prior to the implementation of the app (pre-implementation phase) and while the app was available on campus (implementation phase). Data on app usage was collected throughout the implementation phase. A subset of participants (n = 20), along with counseling center staff members (n = 10), completed feedback interviews.

RESULTS

Overall, uptake of the app platform was low. A total of 117 participants downloaded the app and registered their study ID during the implementation phase. Approximately 24% (28/117) of participants used the app only once. The number of days between the first and last day of app use ranged from 0 to 299, with a mean of 35.01 days and a median of 14 days. A relatively small portion of the sample (26.5%; 31/117) downloaded one or more of the IntelliCare interactive apps. In examining counseling center utilization, there were no significant changes in intake appointments, individual therapy sessions, or crisis appointments observed from the pre-implementation phase to the implementation phase of the study. Feedback interviews highlighted the significant level of disruption caused by the COVID-19 pandemic and shift to remote learning, including challenges disseminating information to students and a preference to spend less time with digital devices outside of class time.

CONCLUSIONS

Findings from this study indicate that there is an ongoing need to identify ways to reach college students and support student mental health and wellness for the remainder of the COVID-19 pandemic and beyond.

Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice

BACKGROUND

Machine-learning algorithms and big data analytics, popularly known as 'artificial intelligence' (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI-assisted health care is essential for design justice based on diverse patient needs.

OBJECTIVE

To inform the future development of PPI in AI-assisted health care by exploring public engagement in the conceptualization, design, development, testing, implementation, use and evaluation of AI technologies for mental health.

METHODS

Systematic scoping review drawing on design justice principles, and (i) structured searches of Web of Science (all databases) and Ovid (MEDLINE, PsycINFO, Global Health and Embase); (ii) handsearching (reference and citation tracking); (iii) grey literature; and (iv) inductive thematic analysis, tested at a workshop with health researchers.

RESULTS

The review identified 144 articles that met inclusion criteria. Three main themes reflect the challenges and opportunities associated with PPI in AI-assisted mental health care: (a) applications of AI technologies in mental health care; (b) ethics of public engagement in AI-assisted care; and (c) public engagement in the planning, development, implementation, evaluation and diffusion of AI technologies.

CONCLUSION

The new data-rich health landscape creates multiple ethical issues and opportunities for the development of PPI in relation to AI technologies. Further research is needed to understand effective modes of public engagement in the context of AI technologies, to examine pressing ethical and safety issues and to develop new methods of PPI at every stage, from concept design to the final review of technology in practice. Principles of design justice can guide this agenda.

Digital Overload among College Students: Implications for Mental Health App Use

Mental health phone applications (apps) provide cost-effective, easily accessible support for college students, yet long-term engagement is often low. Digital overload, defined as information burden from technological devices, may contribute to disengagement from mental health apps. This study aimed to explore the influence of digital overload and phone use preferences on mental health app use among college students, with the goal of informing how notifications could be designed to improve engagement in mental health apps for this population. A semi-structured interview guide was developed to collect quantitative data on phone use and notifications as well as qualitative data on digital overload and preferences for notifications and phone use. Interview transcripts from 12 college students were analyzed using thematic analysis. Participants had high daily phone use and received large quantities of notifications. They employed organization and management strategies to filter information and mitigate the negative effects of digital overload. Digital overload was not cited as a primary barrier to mental health app engagement, but participants ignored notifications for other reasons. Findings suggest that adding notifications to mental health apps may not substantially improve engagement unless additional factors are considered, such as users’ motivation and preferences.

College Student Perspectives of Telemental Health: a Review of the Recent Literature

PURPOSE OF REVIEW

We review the recent literature regarding college student experiences with and attitudes toward telemental health (TMH). We examine their perspectives of the advantages and drawbacks to this form of mental healthcare and their willingness to engage in TMH.

RECENT FINDINGS

College students view TMH as convenient, accessible, easy to use, and helpful. TMH helps to overcome the barrier of stigma associated with seeking mental health treatment. Despite positive reviews, many students find a lack of customization or connection to the provider to be drawbacks to some forms of TMH. Willingness to engage in TMH varies based on prior experience with mental health treatment, ethnicity, and severity of symptoms. The recent literature highlights the potential for TMH to play a key role in mental health services for college students. It also highlights some of its shortcomings, which are indicative of the continued need for in-person services. Future studies should continue to track college student perspectives toward and utilization of TMH.

Mental Health Disturbances and Related Problems in Italian University Medical Students from 2000 to 2020: An Integrative Review of Qualitative and Quantitative Studies

Background and objectives: The presence of mental health problems in the population of medical students in Italy has been evaluated in several cross-sectional studies, which have used different methodologies and study designs. However, a global overview of the prevalence of mental health problems in Italian medical students is not available, although this would be essential for promoting preventive strategies and supportive treatments. Materials and Methods: An integrative review aiming to describe the prevalence of mental health problems in Italian medical students has been performed. Results: The most relevant findings are the high prevalence of substance use, in particular alcohol and nicotine, and of depressive and anxiety disorders in Italian medical students. In particular, substance use ranges from 13 to 86%, which is higher compared to Italian students coming from other faculties. Italian medical students show a high rate of smoking and of depressive symptoms of about 20%. Conclusions: Our findings highlight the need to develop appropriate supportive interventions for the medical student population, which are rarely provided and implemented among the routine activities of Italian medical universities. A relevant aspect to be considered is the stigma and anticipated discrimination attached to mental disorders, which reduce the help-seeking process in medical students.

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

BACKGROUND

In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation.

OBJECTIVE

This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study.

METHODS

IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill-focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app.

RESULTS

Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=-2.006; P=.045) and in the frequency with which participants used both cognitive (Z=-2.091; P=.04) and behavioral (Z=-2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time.

CONCLUSIONS

The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577.