Abstract
BackgroundDuring COVID-19, the psychological distress and well-being of the general population has been precarious, increasing the need to determine the impact of complementary internet-based psychological interventions on both positive mental health as well as distress states. Psychological distress and mental well-being represent distinct dimensions of our mental health, and congruent changes in outcomes of distress and well-being do not necessarily co-occur within individuals. When testing intervention impact, it is therefore important to assess change in both outcomes at the individual level, rather than solely testing group differences in average scores at the group level.ObjectiveThis study set out to investigate the differential impact of an internet-based group mental health intervention on outcomes of positive mental health (ie, well-being, life satisfaction, resilience) and indicators of psychological distress (ie, depression, anxiety, stress).MethodsA 5-week mental health intervention was delivered to 89 participants using the Zoom platform during 2020. Impact on outcomes of distress, well-being, and resilience was assessed at the start and end of the program with multiple analysis of variance (MANOVA) and reliable change indices (RCIs) being used to determine program impact at the group and individual levels, respectively.ResultsThe intervention significantly improved all mental health outcomes measured, (F6,83=5.60, P<.001; Wilks Λ=.71; partial η2=.29) showing small to moderate effect sizes on individual outcomes. The largest effect sizes were observed for life satisfaction and overall well-being (η2=.22 and η2=.2, respectively). Larger effect sizes were noted for those with problematic mental health scores at baseline. A total of 92% (82/89) of participants demonstrated reliable change in at least one mental health outcome. Differential response patterns using RCI revealed that more than one-half of the participants showed improvement in both mental well-being and psychological distress, over one-quarter in outcomes of well-being only, and almost one-fifth in distress only.ConclusionsThe results provide evidence for the significant impact of an internet-based mental health intervention during COVID-19 and indicate the importance of assessing dimensions of both well-being and distress when determining mental health intervention effectiveness.
Highlights
Mental Well-being and Psychological Distress as Dual Dimensions of Mental HealthA commonly cited definition of mental health is the one postulated by the World Health Organization: “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” [1]
The same applies for mental health intervention research, where historically, efforts have centered around treating or intervening in mental disorders, invariably focusing on “mental health conditions” or “mental illnesses” that significantly affect cognition, emotion, and behavior that may lead to dysfunction or disability [3,4]
Research into mental health has focused on the related outcome of psychological distress [5], a state of emotional suffering that is typically characterized by symptoms of depression and anxiety [6]
Summary
A commonly cited definition of mental health is the one postulated by the World Health Organization: “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” [1] Despite this definition — and numerous other readily used mental health definitions — incorporating positive facets of mental health, mental health care, and the research that underpins it is overwhelmingly focused on understanding and solving problems related to mental disorders [2]. It is important to assess change in both outcomes at the individual level, rather than solely testing group differences in average scores at the group level
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