User Engagement Clusters of an 8-Week Digital Mental Health Intervention Guided by a Relational Agent (Woebot): Exploratory Study.

BackgroundHealthcare workers face burnout from high job demands and prolonged working conditions. While mental health services are available, barriers to access persist. Evidence suggests digital platforms can enhance accessibility. However, there is a lack of systematic reviews on the effectiveness of digital mental health interventions (DMHIs) for healthcare professionals. This review aims to synthesize evidence on DMHIs’ effectiveness in reducing burnout, their acceptability by users, and implementation lessons learned.MethodThis Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA)-guided review included 12 RCTs on DMHIs for healthcare professionals, published before 31 May 2024. The primary focus was on burnout, with secondary outcomes related to mental health and occupation. Quality appraisal used Cochrane risk of bias tools. A narrative synthesis explored DMHIs’ effectiveness, acceptability, utilization, and implementation lessons.ResultsSignificant improvements in mental health outcomes were observed in 10 out of 16 RCTs. Burnout and its constructs showed significant improvement in five RCTs. Studies that measured the acceptability of the interventions reported good acceptability. Factors such as attrition, intervention design and duration, cultural sensitivities, flexibility and ease of use, and support availability were identified as key implementation considerations.ConclusionsWeb-based DMHIs positively impact burnout, mental health, and occupational outcomes among healthcare professionals, as shown in most RCTs. Future research should enhance DMHIs’ effectiveness and acceptability by addressing identified factors. Increasing awareness of DMHIs’ benefits will foster acceptance and positive attitudes. Lessons indicate that improving user engagement and effectiveness requires a multifaceted approach.

The degree of learning engagement is a criterion for measuring whether the learning process of college students is effective and an important indicator for evaluating the quality of higher education. Currently, there is a lack of survey research focusing on the current situation of English learning engagement among non-English major college students. This study aims to explore the English learning engagement of non-English major college students by using the method of questionnaire survey. A questionnaire survey was conducted among 157 non-English major undergraduates in a certain university, including 59 male students and 98 female students. The survey results are as follows: (1) The levels of behavioral engagement, emotional engagement, and cognitive engagement in English learning among non-English major undergraduates are at a medium level. (2) The levels of behavioral and emotional engagement of female students are significantly higher than those of male students. (3) The levels of emotional and cognitive engagement of sophomores are significantly higher than those of freshmen. (4) The levels of behavioral, emotional, and cognitive engagement of liberal arts students are significantly higher than those of science students. These findings provide valuable insights into the English learning engagement of non - English major college students. And some useful implications are provided for teachers, universities, and students themselves to improve the overall quality of English learning engagement among this group of students. Future research could further explore the underlying reasons for these differences and seek more effective ways to enhance the English learning engagement and outcomes of non - English major college students.

BackgroundPregnancy and the postnatal period can be a time of increased psychological distress, which can be detrimental to both the mother and the developing child. Digital interventions are cost-effective and accessible tools to support positive mental health in women during the perinatal period. Although studies report efficacy, a key concern regarding web-based interventions is the lack of engagement leading to drop out, lack of participation, or reduced potential intervention benefits.ObjectiveThis systematic review aimed to understand the reporting and levels of engagement in studies of digital psychological mental health or well-being interventions administered during the perinatal period. Specific objectives were to understand how studies report engagement across 4 domains specified in the Connect, Attend, Participate, and Enact (CAPE) model, make recommendations on best practices to report engagement in digital mental health interventions (DMHIs), and understand levels of engagement in intervention studies in this area. To maximize the utility of this systematic review, we intended to develop practical tools for public health use: to develop a logic model to reference the theory of change, evaluate the studies using the CAPE framework, and develop a guide for future data collection to enable consistent reporting in digital interventions.MethodsThis systematic review used the Cochrane Synthesis Without Meta-analysis reporting guidelines. This study aimed to identify studies reporting DMHIs delivered during the perinatal period in women with subclinical mood symptoms. A systematic database search was used to identify relevant papers using the Ovid Platform for MEDLINE, PsycINFO, EMBASE, Scopus, Web of Science, and Medical Subject Headings on Demand for all English-language articles published in the past 10 years.ResultsSearches generated a database of 3473 potentially eligible studies, with a final selection of 16 (0.46%) studies grouped by study design. Participant engagement was evaluated using the CAPE framework and comparable variables were described. All studies reported at least one engagement metric. However, the measures used were inconsistent, which may have contributed to the wide-ranging results. There was insufficient reporting for enactment (ie, participants’ real-world use of intervention skills), with only 38% (6/16) of studies clearly recording longer-term practice through postintervention interviews. The logic model proposes ways of conceptualizing and reporting engagement details in DMHIs more consistently in the future.ConclusionsThe perinatal period is the optimal time to intervene with strength-based digital tools to build positive mental health. Despite the growing number of studies on digital interventions, few robustly explore engagement, and there is limited evidence of long-term skill use beyond the intervention period. Our results indicate variability in the reporting of both short- and long-term participant engagement behaviors, and we recommend the adoption of standardized reporting metrics in future digital interventions.Trial RegistrationPROSPERO CRD42020162283; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162283

BackgroundDigital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (ie, psychologists and physicians) into digital mental health interventions has become common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other nonclinicians) can help reduce costs and increase accessibility.ObjectiveThis systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of nonclinician-guided digital mental health interventions.MethodsFour databases (MEDLINE, Embase, CINAHL, and PsycINFO) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals that focus on digital intervention were hand searched; gray literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane risk-of-bias tool version 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Nonclinician-guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions.ResultsThirteen studies qualified for inclusion. Nonclinician-guided interventions yielded higher posttreatment effectiveness outcomes when compared to conditions involving control programs (eg, online psychoeducation and monitored attention control) or wait-list controls (k=7, Hedges g=–0.73; 95% CI –1.08 to –0.38). There were also significant differences between nonclinician-guided interventions and unguided interventions (k=6, Hedges g=–0.17; 95% CI –0.23 to –0.11). In addition, nonclinician-guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08; 95% CI –0.01 to 0.17). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualifications of the individual performing the intervention, and that the presence of a nonclinician guide improves effectiveness outcomes compared to having no guide. Nonclinician-guided interventions did not yield significantly different adherence outcomes when compared with unguided interventions (k=3, odds ratio 1.58; 95% CI 0.51 to 4.92), although a general trend of improved adherence was observed within nonclinician-guided interventions.ConclusionsIntegrating paraprofessionals and nonclinicians appears to improve the outcomes of digital mental health interventions, and may also enhance adherence outcomes (though this trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (ie, psychosocial support, therapeutic alliance, and technical augmentation) and their associated outcomes.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42020191226; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=191226

Digital mental health interventions for young people offer a promising avenue for promoting mental well-being and addressing mental health issues in this population. This scoping review aims to explore the range of digital mental health interventions available for young people aged 16-25 years, with a particular focus on digital tool types, modalities, delivery formats, target populations, and study retention rates. The scoping review was conducted in 6 databases (PubMed, Web of Science, Scopus, MEDLINE, Cochrane Library, and PsychInfo). Studies were included if they were published from 2019 to 2024 in English, reported on a population of young people aged 16-25 years, and included validated mental health or well-being outcome measures. All types of digital interventions from promotion and prevention to treatment of mental health were included. After screening 13,306 articles, 145 articles were included in the final review. The findings reveal a diverse landscape of studies, equally focusing on the prevention and promotion of mental health and the treatment of mental ill health, most commonly using cognitive behavioral therapy (63/145, 43.4%). The most common digital tools were apps (51/135, 37.8%), web-based resources (45/135, 33.3%), and websites (19/135, 14.1%). The results highlight the over emphasis on convenience sampling (140/145, 96.6%), with participants mainly recruited from universities or colleges, and a lack of representation from marginalized groups, including lesbian, gay, bisexual, transgender, and queer youth; those from socioeconomically deprived backgrounds; and those who are neurodivergent. Moreover, the focus on anxiety and depression leaves other mental health conditions underrepresented. Retention rates ranged from 16% to 100% and averaged 66% across all studies. There is a need for more research on mental health promotion and prevention measures among those aged younger than 25 years as young people are at increased risk of mental health issues. This includes exploring different intervention approaches and modalities beyond cognitive behavioral therapy and ensuring inclusivity in study populations. Standardizing intervention durations and incorporating long-term follow-up data could provide valuable insights into the efficacy and effectiveness of digital interventions. Future studies should aim for greater inclusivity, ensuring representation from marginalized groups to address the diverse mental health needs of young people effectively. By adopting these approaches, digital mental health interventions can become more accessible, engaging, and impactful for young people worldwide.

Purpose Brands are investing heavily in content marketing within digital communication channels, yet there is limited understanding of the effectiveness of this content on consumer engagement. This paper aims to examine how consumer engagement with branded content is created through consumer-initiated online brand communities (OBCs) and brand-initiated digital content marketing (DCM) communications. Self-brand connections are examined as an important antecedent to the cognitive, affective, behavioural and social dimensions of consumer engagement and the subsequent impact of engagement on loyalty is explored across these two channels. Design/methodology/approach A survey approach was used with two consumer samples for one focal retail brand, namely, a consumer-initiated OBC (Facebook) and email subscribers of the retail brand’s DCM communications. A multi-group analysis of structural invariance procedure was used to comparatively examine the formation of engagement for consumers within the OBC and DCM channels. Findings This study demonstrates the different ways in which engagement forms across different digital communication channels. Self-brand connection (SBC) was found to strongly drive behavioural, cognitive, affective and social engagement. The cognitive, affective and behavioural engagement was found to mediate the self-brand connection and consumer loyalty relationship. Overall, this relationship was most strongly and significantly mediated by affective and cognitive engagement within the OBC channel when compared to the DCM channel. Research limitations/implications The findings of this study should be interpreted with several limitations in mind. First, the research was conducted within the confines of one OBC, within one social networking site platform characterised by self-selected membership based on a passion and immersion with the brand. This means that consumers within the OBC were highly connected to one another and the retail brand and highly socialised in-group norms and mores. This type and intensity of connection may not be the case for all forms of OBCs. Second, this study was limited to one retail brand, from one brand category. Future research should examine OBCs across a range of utilitarian and hedonic brands to comprehensively contextualise the dimensions of engagement. Third, the data for this study was cross-sectional. The use of netnographic analysis and qualitative interviews across a range of OBCs would support the triangulation of the findings of this research, especially with regard to the narrative that consumers’ express when discussing how their SBC manifests through the dimensions of engagement. Fourth, this study explored a single antecedent of engagement, namely, self-brand connections. Future research may consider how SBC operates in conjunction with other complementary factors to enhance consumers’ affective, cognitive, social and behavioural engagement such as brand awareness, satisfaction and participation/interactivity. In addition, future research could examine an expanded array of engagement outcomes such as purchase intention, the share of wallet and reputation. Finally, future research should examine the operationalisation and validation of the dimensions of engagement using multiple competing scales to assess the suitability of these engagement scales across multiple brand categories and contexts. Practical implications Given the increasing investment in branding within social media and the fragmentation of brand communications across multiple communications platforms, the management of effective brand communications remains a significant challenge. This study found that the relationship between self-brand connections, affective, social, behavioural and cognitive engagement and loyalty was context-specific and moderated by a digital communication channel (OBC vs DCM email marketing), thus providing insights as to the effectiveness of OBCs and DCMs as two tools for enhancing consumer loyalty. Originality/value This study makes a novel contribution to the engagement literature by examining the antecedent role of self-brand connections in predicting consumers’ engagement; the moderating role of digital communication platforms (OBC vs DCM) on the formation of cognitive, affective, behavioural and social engagement; and the mediating effect of these dimensions on loyalty.

<p>The phenomenon of school engagement, considered as a stable, directed and active participation of students in educational activities and in the school life in general, is of considerable interest to researchers in the field of educational psychology. According to modern scientific concepts, engagement can be assessed through behavioral, cognitive, emotional and social manifestations. The research had its purpose to study the dynamics of school engagement in adolescents, as well as to reveal the relationship of conscious self-regulation with behavioral and cognitive components of engagement based on the longitudinal data obtained on the sample of 6-8 grade students (N=80). A separate task was to find an answer to the question of whether the conscious self-regulation can be considered as a significant predictor of changes in the behavioral and cognitive engagement of students during their study in the secondary school. Methods: "Multidimensional Scale of School Engagement"(Wang et al., 2019; Fomina, Morosanova, 2020); "The Self-Regulation Profile of Learning Activity Questionnaire — SRPLAQ" (Morosanova, Bondarenko, 2017). Statistical processing of longitudinal data (including the latent growth curve modeling) made it possible to reveal the negative dynamics of the students’ behavioral and cognitive engagement during their study in the secondary school. The data analysis allowed to describe the effects of relationship between behavioral and cognitive engagement: a higher level of cognitive engagement contributes to a less pronounced decrease in behavioral engagement. The study established positive correlations of conscious self-regulation with both cognitive and behavioral engagement. The decrease in engagement is less pronounced in adolescents with a higher level of development of conscious self-regulation.</p>

Children's mental health issues are widespread in the United Kingdom, yet access to traditional services remains limited. Digital mental health interventions (DMHIs) offer a scalable alternative by reducing barriers such as cost, stigma, and location. However, most DMHIs target either children or parents individually, overlooking the potential of combined approaches. This review assessed the effectiveness of DMHIs that include both parent- and child-delivered components for children aged 12 and under. The review also examined user experiences and compared DMHIs with traditional mental health support services. A systematic review was conducted following PRISMA guidelines, searching six electronic databases. Studies were included if they evaluated DMHIs involving both children and parents/guardians, focused on mental health outcomes, and were peer-reviewed. Data extraction and risk-of-bias assessments were performed independently by reviewers. Of 3703 screened studies, three randomised controlled trials (n = 630) met inclusion criteria. These showed improvements in child anxiety, social competence, and parental nurturing behaviours. Parents reported positive engagement, citing flexibility and ease of use. However, therapists raised concerns about long-term implementation. Due to study heterogeneity and small sample sizes, a meta-analysis was not feasible; a narrative synthesis was conducted. DMHIs that incorporate both parent and child components are comparatively rare but show promise as a valid means of enhancing child and parent well-being. However, further research is needed to refine these interventions, address barriers to engagement, and optimise their broader application, particularly in community settings, to help reduce the pressure on clinical services.

Young people (YP) (between 10 and 24 years) are disproportionally vulnerable to developing and being affected by mental health conditions due to physical, social and emotional risk factors. YP in low-and middle-income countries (LMICs) have poorer access to, and quality of, mental health services compared to those in high-income countries. Digital mental health interventions (DMHIs) have been proposed as tools to address this burden of disease and reduce the global treatment gap in youth mental health outcomes. This study aimed to examine the evidence for DMHIs for treating mental disorders in YP based in LMICs. To do this, the author searched academic databases (MEDLINE, PsycINFO, Embase and Web of Science) for primary studies on DMHIs targeting YP in LMICs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed. The quality of the studies was assessed using the Critical Appraisal Skills Programme) framework. A narrative synthesis methodology was used to summarise and explain the findings. The authors identified 287 studies of which 7 were eligible in the final review. The authors found evidence of the effectiveness of multiple forms of DMHI (especially internet-based cognitive behavioural therapy) on anxiety and depression outcomes. Studies reported a lack of long-term benefits of treatment, high dropout rates, and did not include key geographical settings or data on cost-effectiveness. No studies were judged to be of high quality. This review highlights the available evidence showing that DMHIs can improve mental health outcomes for YP in LMICs, but due to the limited number of studies and lack of high-quality data, increased adoption and scaling up of digital interventions require more rigorous studies showing clinical effectiveness and ability to provide return on investment.

Young people (YP) (between 10 and 24 years) are disproportionally vulnerable to developing and being affected by mental health conditions due to physical, social and emotional risk factors. YP in low-and middle-income countries (LMICs) have poorer access to, and quality of, mental health services compared to those in high-income countries. Digital mental health interventions (DMHIs) have been proposed as tools to address this burden of disease and reduce the global treatment gap in youth mental health outcomes. This study aimed to examine the evidence for DMHIs for treating mental disorders in YP based in LMICs. To do this, the author searched academic databases (MEDLINE, PsycINFO, Embase and Web of Science) for primary studies on DMHIs targeting YP in LMICs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed. The quality of the studies was assessed using the Critical Appraisal Skills Programme) framework. A narrative synthesis methodology was used to summarise and explain the findings. The authors identified 287 studies of which 7 were eligible in the final review. The authors found evidence of the effectiveness of multiple forms of DMHI (especially internet-based cognitive behavioural therapy) on anxiety and depression outcomes. Studies reported a lack of long-term benefits of treatment, high dropout rates, and did not include key geographical settings or data on cost-effectiveness. No studies were judged to be of high quality. This review highlights the available evidence showing that DMHIs can improve mental health outcomes for YP in LMICs, but due to the limited number of studies and lack of high-quality data, increased adoption and scaling up of digital interventions require more rigorous studies showing clinical effectiveness and ability to provide return on investment.

Young people (YP) (between 10 and 24years) are disproportionally vulnerable to developing and being affected by mental health conditions due to physical, social and emotional risk factors. YP in low-and middle-income countries (LMICs) have poorer access to, and quality of, mental health services compared to those in high-income countries. Digital mental health interventions (DMHIs) have been proposed as tools to address this burden of disease and reduce the global treatment gap in youth mental health outcomes. This study aimed to examine the evidence for DMHIs for treating mental disorders in YP based in LMICs. To do this, the author searched academic databases (MEDLINE, PsycINFO, Embase and Web of Science) for primary studies on DMHIs targeting YP in LMICs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed. The quality of the studies was assessed using the Critical Appraisal Skills Programme) framework. A narrative synthesis methodology was used to summarise and explain the findings. The authors identified 287 studies of which 7 were eligible in the final review. The authors found evidence of the effectiveness of multiple forms of DMHI (especially internet-based cognitive behavioural therapy) on anxiety and depression outcomes. Studies reported a lack of long-term benefits of treatment, high dropout rates, and did not include key geographical settings or data on cost-effectiveness. No studies were judged to be of high quality. This review highlights the available evidence showing that DMHIs can improve mental health outcomes for YP in LMICs, but due to the limited number of studies and lack of high-quality data, increased adoption and scaling up of digital interventions require more rigorous studies showing clinical effectiveness and ability to provide return on investment.

Young people (YP) (between 10 and 24 years) are disproportionally vulnerable to developing and being affected by mental health conditions due to physical, social and emotional risk factors. YP in low-and middle-income countries (LMICs) have poorer access to, and quality of, mental health services compared to those in high-income countries. Digital mental health interventions (DMHIs) have been proposed as tools to address this burden of disease and reduce the global treatment gap in youth mental health outcomes. This study aimed to examine the evidence for DMHIs for treating mental disorders in YP based in LMICs. To do this, the author searched academic databases (MEDLINE, PsycINFO, Embase and Web of Science) for primary studies on DMHIs targeting YP in LMICs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed. The quality of the studies was assessed using the Critical Appraisal Skills Programme) framework. A narrative synthesis methodology was used to summarise and explain the findings. The authors identified 287 studies of which 7 were eligible in the final review. The authors found evidence of the effectiveness of multiple forms of DMHI (especially internet-based cognitive behavioural therapy) on anxiety and depression outcomes. Studies reported a lack of long-term benefits of treatment, high dropout rates, and did not include key geographical settings or data on cost-effectiveness. No studies were judged to be of high quality. This review highlights the available evidence showing that DMHIs can improve mental health outcomes for YP in LMICs, but due to the limited number of studies and lack of high-quality data, increased adoption and scaling up of digital interventions require more rigorous studies showing clinical effectiveness and ability to provide return on investment.

The progress of artificial intelligence (AI) has sparked significant research interest in its application in education and students’ perceptions of and response to this technology. This multiple-case study explores three Chinese university students’ (representing high-, intermediate-, and low-level English proficiency) engagement with AI-guided chatbot feedback in English writing learning. Data sources include chat records, written drafts and semi-structured interviews. The study identifies two sub-dimensions, interaction and revision, to characterize students’ behavioral, cognitive, and emotional engagement with AI-guided chatbot feedback. The findings demonstrate that all students exhibited high levels of behavioral engagement during interactions, while only intermediate- and high-level students demonstrated significant cognitive engagement during interaction. Besides, the high-level student displayed higher levels of behavioral and cognitive engagement in the revision process compared to her counterparts. Finally, students’ emotional engagement was intricate in both interaction and revision process, exhibiting various approbations and concerns towards the application of AI-guided chatbot in writing learning. These insights can inform the effective implementation of AI-guided chatbot in providing feedback for second language writing instruction.

BackgroundWhile many digital mental health interventions (DMHIs) have been shown to be effective, such interventions also have been criticized for poor engagement and retention rates. However, several questions remain about how users engage with DMHIs, how to define engagement, and what factors might help improve DMHI engagement.Main abstractIn this narrative review, we show that although DMHIs are criticized for poor engagement, research suggests engagement rates are quite variable across studies and DMHIs. In some instances, engagement rates are high, even in real-world settings where there is evidence of a subset of users who could be considered ‘superusers’. We then review research on the barriers and facilitators to DMHI engagement, highlighting that qualitative research of users’ perceptions does not always align with quantitative research assessing relationships between these barriers/facilitators and actual engagement with DMHIs. We also introduce several potential issues in conceptualizations of DMHI engagement that may explain the mixed findings, including inconsistent definitions of engagement and assumptions about linear relationships between engagement and outcomes. Finally, we outline evidence suggesting that engagement with DMHIs is comparable to mobile application use broadly as well as engagement with more traditional forms of mental health care (i.e., pharmacological, psychotherapy).ConclusionsIn order to increase the number of people who can benefit from DMHIs, additional research on engagement and retention is necessary. Importantly, we believe it is critical that this research move away from several existing misconceptions about DMHI engagement. We make three recommendations for research on DMHI engagement that we believe, if addressed, are likely to substantially improve the impact of DMHIs: (1) the need to adopt a clearly defined, common definition of engagement, (2) the importance of exploring patterns of optimal engagement rather than taking a ‘one size fits all’ approach, and (3) the importance of defining success within DMHIs based on outcomes rather than the frequency or duration of a user’s engagement with that DMHI.

This study aimed to provide a critical analysis of the current literature on the use of digital mental health interventions (DMHIs) for the management and treatment of mental health disorders among refugees and asylum seekers. These groups are among the most disadvantaged compared to the general population in terms of health and socio-economic status, due to conflicts and wars. The number of refugees fleeing their home countries is growing exponentially, and refugees experience trauma, torture, persecution and human right abuses, which have a profound effect on their mental health and overall well-being. The researchers conducted an integrative literature review from electronic databases Medline, CINAHL and Google Scholar, selecting articles published in English from 2010 to 2023. The thematic analysis of the 10 articles identified in the review revealed four main themes and two sub-themes: (1) types of digital health intervention/apps used; (2) barriers encountered in digital health intervention; (3) user experience of the digital health intervention and (4) mapping gaps. Two sub-themes were identified located in Theme 2: (2.1) Language and demographic barriers and (2.2) Structural barriers. The study showed that the use of DMHIs was associated with positive experiences among refugees and asylum seekers. Limited mental health care is offered to refugees and asylum seekers due to a range of logistical, political, economic, geographical, language, cultural and social barriers. DMHIs have the potential to overcome and/or moderate these barriers. The study concludes that the scaled implementation of effective DMHIs holds the possibility to improve the wider distribution of mental health care among refugees and asylum seekers. However, further research is needed to confirm the effectiveness of DMHIs and to scale up studies for their utilisation among this group. In summary, this study highlights the potential of DMHIs in improving the mental health care of refugees and asylum seekers. The results of this study have important implications for mental health service providers, policymakers and researchers to address the mental health needs of this vulnerable/priority group.