Online Mental Health Interventions Research Articles

Pilot implementation of an evidence-based online cognitive behavioural therapy for perfectionism in university students: Lessons learnt.

Higher Education Institutes (HEIs) have been met with an unprecedented demand on their student counselling and wellbeing services in recent years with the impacts of COVID-19 and high rates of mental health concerns amongst student populations. Online mental health programs offer one solution by providing students with quick and easy access to effective therapeutic content. The Focused Minds Program is an evidence-based eight-module online self-guided cognitive behavioural intervention that targets the transdiagnostic risk factor of perfectionism and has been shown to decrease depression, anxiety, and disordered eating. The program was implemented at a UK university between 2021 and 2023. Recruitment occurred via departmental emails, academic staff, and the university's counselling staff and website. Participants were provided with access to the intervention for 6-weeks and completed weekly surveys of psychosocial measures. The trial's implementation was assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework: reach (uptake via the recruitment channels), effectiveness (outcomes on psychometric measures of mental wellbeing), adoption (staff and organisational support), implementation (intervention engagement and attrition), and maintenance (continued implementation across the trial period). Key barriers to successful implementation, as well as proposed solutions, are discussed to guide future online mental health interventions provided in HEIs.

Assessing the experiences of teenage mothers in accessing healthcare in Rwanda

Teen mothers are more susceptible to the negative consequences of pregnancy, due to system-wide and socio-cultural barriers to accessing needed services, posing higher pregnancy complications and health risks to the babies and mothers. Understanding their lived experience can inform context-specific health programs and interventions that address their needs and improve the health outcomes. Twenty-three women who had delivered her first child before the age of 18 years were interviewed using semi-structured interview guide. The transcripts were coded, categorized and summarized into four major themes: 1) Many pregnant teen girls were disadvantaged by the system from accessing the healthcare services, 2) Although being judged, many found the health care services positive and important, 3) Faced financial difficulty in accessing health services, despite most medical services are covered by community based health insurance, 4) Health care services focuses mostly on the medical health of pregnancy, the social and psychological needs were mostly not available. The study highlighted the gap in providing mental health services, financial support to the teen mothers as part of a comprehensive health services. Some of them consulted health services for the first time with and did not return for follow up if perceived the services was bad. More sensitive and targeted materials and ANC services can be offered to this unique group of clients. More acceptance training to the health care providers and the public is needed. For health facilities, there is a need to also check their psychological wellbeing when seeking ANC services. Online or mobile phone-based mental health interventions may provide some solutions to the issue. Government should re-evaluate the health insurance system to avoid unintentional exclusion of this group of population. Policy to facilitate men to take responsibilities on teen pregnancy issue is needed.

Online Interventions to Improve Mental Health of K-12 Teachers: A Scoping Review

Purpose: To explore mental health interventions using online technologies for school teachers and identify characteristics and effects on teachers’ mental health improvement.Methods: The method of Arksey and O’Malley was referenced. Two researchers independently searched seven electronic databases. Eleven experimental studies of online mental health interventions for K-12 teachers were analyzed for publication information, intervention characteristics, and summaries of outcome evaluations.Results: Publication years ranged from 2014 to 2023. Most studies were conducted in Europe. Teleconferencing was the most frequently used. Virtual reality has seen recent development. Cognitive factors were frequently evaluated to ensure the program’s effectiveness, including mental health awareness and coping skills. Thus, cognitive behavior therapy was the most significant component of interventions to improve teachers’ health.Conclusion: Our scoping review illustrates recent trends of online interventions to improve teachers’ mental health. Due to very limited information on Korean teachers, it is necessary to adopt available online interventions considering educational systems and teachers’ characteristics. Highly accessible modality, person-centered contents of mental health concern, and careful protection of teachers’ privacy are recommended for promoting mental health of teachers.

The Effectiveness of EduMind for Mental Health Promotion Among Youths.

Introduction The global surge in mental health issues, particularly among the youth, is evident. Despite the proliferation of digital mental health services, their adoption remains limited, hindered by various barriers. To address this issue, an evidence-based, validated digital mental health intervention is necessary. Although much research has explored the effectiveness of such interventions, there was limited evidence supporting those within the youth population. The objective of this research is to assess the effects of aninterventional module on depression, anxiety, and stress symptoms among youths. Methods The EduMind online mental health intervention contents were developed from a needs assessment and a scoping review of effective psychotherapies, achieving a high content validation index (CVI) of 0.96. The contents were integrated into a web application to assess its effectiveness among the target population which consisted of university students of a local institution. A quasi-experimental study compared the intervention group (n=264) to a waitlist-control group (n=200), evaluating changes in mental health status with the Depression, Anxiety and Stress Scale 21 (DASS-21) questionnaire using analysis of covariance (ANCOVA) to analyse mean differences. Results Participants in the intervention group indicated a significant decrease (p< 0.001) in depression, anxiety, and stress. The pre-test and post-test mean scores in the intervention group were 15.81 and 8.97 for depression, 11.46 and 7.02 for anxiety and 14.64 and 6.33 for stress, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for depression. However, there was a slight significant reduction for anxiety with pre- and post-test scores of13.31 and 12.95. Stress mean scores exhibited a slight increase, rising from 13.55 to 14.24. The final phase revealed significant improvements in mental health status between groups, with significant effect sizes for stress (ƞp2= 0.57, p < 0.001), depression (ƞp2= 0.71, p < 0.001), and anxiety (ƞp2= 0.27, p < 0.001). Conclusion The findings contribute to the advancement of technology-assisted health services, facilitating greater uptake among the population.This study utilized a comprehensive module development framework and demonstrated the effectiveness of the expert-guided mental health intervention module.Furthermore, the study suggests potential integration with the National Strategic Plan for Mental Health 2020-2025 and the National Mental Health Policy, proposing the web application as a potential compulsory student screening tool administered by universities. The information gathered by this application could inform future research directions, propelling technological-assisted mental health services to new heights.

Implementing a group-based online mental well-being program for women living with and beyond breast cancer - A mixed methods study.

There is a gap in available mental well-being services in Australia for women diagnosed with breast cancer. This pilot mixed-methods uncontrolled study aimed to assess the feasibility of an online mental health and well-being intervention, the Be Well Plan (BWP), which enables participants to create a personalized, flexible well-being strategy. Women diagnosed with stages I-IV breast cancer were recruited into 4 asynchronous groups to participate in the BWP, a 5-week facilitator-led group-based mental health and well-being program. Psychological measures used at baseline and post-intervention included: the Warwick Edinburgh Mental Well-Being Scale, Brief Resilience Scale, Self-compassion Scale, 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder scale, and EORC QLQ-C30. Multivariate analysis of variance and effect sizes were calculated on pre- and post-psychological measures, followed by qualitative content analysis on post-completion interviews with participants. Nineteen women (mean age 45.7, standard deviation=7.74) were included in the study. Large effect sizes were reported for mental well-being, depressive symptoms, and anxiety (partial ω2=0.28, 0.21, and 0.20, respectively). Self-compassion, resilience, and quality of life results were not statistically significant. Qualitative content analysis provided insight into experiences with Program Delivery Experience, Application of the BWP, Mental Health Improvements, Supporter Involvement, Adopted Interventions, and Recruitment. Participants reported benefits in mindfulness, grounding techniques, and physical activities. The BWP has the potential to be an effective intervention to support the mental health and well-being of breast cancer survivors. This study highlights flexible interventions that accommodate the diverse needs of breast cancer survivors to improve mental well-being and alleviate psychological distress.

Anxiety Disorders among Left-Behind Children in Rural China: A Comprehensive Literature Review

With rapid urbanization leading to mass adult migration from rural to urban areas in China, a consequential demographic group called left-behind children has emerged. Often left in the care of relatives or on their own, these children experience extended periods of parental absence associated with various mental health implications, notably anxiety disorders. This paper explores anxiety disorders of left-behind Children including depressive symptoms, the effect of COVID-19 and bullying victimization among left-behind children in rural China through literature review. Further, it examines potential interventions from the implementation of online mental health interventions, strengthening community support systems, and policy and financial interventions. Additionally, the paper points towards the potential efficacy of community-based interventions, emphasizing the importance of a multi-pronged approach. The analysis promotes a more thorough investigation into the viability and effectiveness of these interventions, opening the door to better mental health outcomes for underprivileged kids in rural China.

Acceptability, feasibility and perceived effectiveness of online and remote mental health and wellbeing interventions during the COVID-19 pandemic: A qualitative study with care-experienced young people, carers and professionals

The COVID-19 pandemic, and associated lockdowns, saw numerous services move to online and remote delivery. This included mental health and wellbeing interventions for care-experienced young people. To date there has been limited consideration of how different stakeholders experienced the receipt or delivery of remote provision during this period. We conducted online one-to-one and small group interviews with: young people with experience of care (n = 3); a young person whose biological parents were foster carers (n = 1); foster and kinship carers (n = 10); and social care and affiliated professionals (n = 9). We further engaged with relevant stakeholder consultation groups to refine and confirm study findings. Five central themes were generated, that reflected participants’ experience of a range of services, while also serving as recommendations for the future development and optimisation of provision: 1) Awareness: there is a lack of general awareness of mental health provision and understanding of what is available to support care-experienced young people, and a specific lack of knowledge regarding online support; 2) Choice and tailoring: young people need choice and flexibility in identifying provision that best suits their needs, and this includes the decision to receive online, blended or in-person services; 3) Training: carers and professionals need training on how to foster relationships with young people online and how to ensure safety and child protection; 4) Safety, protection and risk: young people need to have safe and private spaces when accessing online services; and 5) Access and resources: care-experienced young people don’t always have access to online support, and need appropriate technological devices that don’t have prohibitive restrictions. Taken together, the study findings offer insight into how interventions and services may be developed and optimised moving forward to ensure that they are meeting the needs of young people in care, and maximize likely effectiveness.

Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial

BackgroundUntreated perinatal mood and anxiety disorders (PMAD) have short- and long-term health and social consequences; online cognitive behavioral therapy (CBT) interventions can reduce symptoms. Despite partner support being protective online interventions rarely target couples. This study builds on research on an existing CBT-based intervention, the Mothers and Babies Online Course (eMB), by testing its feasibility with prenatal couples.MethodsWe conducted a pilot, randomized, controlled feasibility trial using a 1:1 parallel design. To be eligible, participant dyads were pregnant people (between 13–30 weeks gestation and with a score of 10 or greater on either the GAD-7 or PHQ-9 scale indicating elevated symptoms of anxiety or depression) and their cohabitating partners, living in Missouri, with access to the internet; both in the dyad consented to participate. Recruitment occurred via Facebook ads, flyers, and a snowball approach. The intervention group received eMB, and the control group received a list of community resources. We examined retention and adherence data extracted from eMB analytics and study databases. All participants were given depression and anxiety scales at baseline, 4 and 8 weeks to test preliminary efficacy; satisfaction and acceptability were measured at trial end (i.e., eight weeks) and via interview.ResultsThere were 441 people who responded to recruitment materials, 74 pregnant people were screened; 19 partners did not complete enrolment, and 25 dyads were ineligible. There were 15 dyads per group (N = 30) who enrolled; all completed the study. The survey response rate was 90% but partners required nearly twice the number of reminders. No participant completed all lessons. Mean depression and anxiety scores dropped over time for dyads in control (M = -1.99, -1.53) and intervention (M = -4.80, -1.99). Intervention pregnant people’s anxiety significantly decreased (M = -4.05; 95% CI [0.82, 7.27]) at time two compared to control. Twelve pregnant people and four partners participated in post-intervention interviews and suggested improvements for eMB.ConclusionOnline dyadic interventions can potentially reduce PMAD symptoms. However, to feasibly study eMB with couples, strategies to increase program adherence are necessary. Tailoring interventions to overtly include partners may be advantageous.Trial registrationClinicalTrials.gov NCT05867680, 19/05/2023.

'I probably wouldn't want to talk about anything too personal': A qualitative exploration of how issues of privacy, confidentiality and surveillance in the home impact on access and engagement with online services and spaces for care-experienced young people.

This paper draws on a qualitative interview-based study that explored online mental health and wellbeing interventions and services for care-experienced young people. The study involved young people (n = 4), foster carers (n = 8), kinship carers (n = 2) and social care professionals (n = 9) in Wales, UK. The paper reflects on the complexities of online communication in the space of 'the home'. It documents the ways in which care-experienced young people's living arrangements can restrict access to services and complicate confidentiality within portals to the virtual world, creating an environment where young people and their carers 'wouldn't want to talk about anything too personal'. Drawing on data generated in a study focused on services and interventions to support the mental health and wellbeing of care-experienced children and young people, the paper considers privacy, confidentiality and surveillance in the home and reflects on how associated relational practices impact on care-experienced young people. While the data discussed in this paper was generated during the Covid-19 pandemic, its findings have implications for how care-experienced young people and their carers can be supported to engage with the digital world in the future.

What consumers, general practitioners and mental health professionals want: the co-design and prototype testing of a transdiagnostic, acceptance and commitment therapy-based online intervention to reduce distress and promote wellbeing among Australian adults

BackgroundMany Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists. Additional strategies to prevent or help people de-escalate distress at an early stage are needed. Web-based mental health interventions are becoming increasingly acceptable to consumers and referring General Practitioners (GPs), but most are designed for specific disorders/populations. This study explores consumers’ and health professionals’ preferences and recommendations for the design of a transdiagnostic, Acceptance and Commitment Therapy (ACT)-based, online intervention for Australian adults.MethodsThirty-five people (consumers, carers, GPs, mental health professionals) participated in one or more co-design stages. Stage 1: semi-structured interviews to establish what is wanted from such websites (n = 22). Stage 2: feedback emailed on branding options (n = 20). Stage 3: feedback provided via Zoom or an online survey after testing a website prototype (n = 19). Data were analysed using Thematic Framework Analysis and descriptive statistics.ResultsStage 1 highlighted nine key design principles (plus 25 subthemes) that participants emphasised as important to ensure the website would have broad appeal and meet their needs: (1) user choice is valued highly; (2) ACT-based content is acceptable as it is focused on helping people be proactive and ‘get unstuck’; (3) non-pathologising, direct, empowering, lay language is endorsed; (4) a positive look and feel is appreciated; (5) images and videos are important to break up text and maintain engagement; (6) short text messages to aid engagement are valued; (7) provision of tailored psychoeducation for highly distressed and suicidal users is endorsed; (8) personal and proactive brand name is preferred (icanactnow); (9) diverse marketing and training activities are recommended. In Stage 2, icanactnow branding preferences were elicited (simplicity, colours to represent growth and a call to action). Stage 3 resulted in the inclusion of a safety plan template and a tailored entry portal for people referred to icanactnow by health professionals. High levels of satisfaction with the prototype were reported.ConclusionsThese findings informed icanactnow and provide insights for the development of other online mental health interventions, in ways that appeal to both consumers and professionals recommending them.

Exploration of global users' experiences of participating in the “Talk to Me” Mass Open Online Course mental health program

AbstractYoung adults are particularly vulnerable to experiencing poor mental health. To improve mental health outcomes, there has been a rise in online mental health interventions. The “Talk to Me” Mass Open Online Course (MOOC) was designed to increase levels of mental health literacy among young adults and those close to them. Although online interventions are readily available to young adults, studies continue to report high attrition rates, indicating an unsatisfactory participant experience. This study explored the experiences of over 1600 global users engaging in the “Talk to Me” MOOC. A cross‐sectional survey design using quantitative and qualitative methods was used to explore user experiences of engaging in the online MOOC. Quantitative results found that 96% of participants found the “Talk to Me” MOOC to be “engaging” or “very engaging.” While 98.2% of participants agreed that their knowledge and skills had increased. Qualitative results found four dominant themes: integration and use of roleplay videos; skills, knowledge, and outcomes; accessibility; and technical references. These results add to the evidence base regarding online mental health interventions and indicate the perceived benefits of the “Talk to Me” MOOC. Participants reported an overall positive experience when engaging in the “Talk to Me” MOOC.

Fluctuations in mental health in students accessing a university-wide online mental health promotion intervention before and during the COVID-19 pandemic

ABSTRACT Objective Growing evidence shows that online mental health interventions for university students are a cost-effective means for addressing mental health problems among university students. This study presents data on the numbers and characteristics of students who engaged in an online mental health promotion intervention called YOLO in the context of a university-wide rollout of the program before and after the onset of the COVID-19 pandemic. Methods Participants completed a questionnaire assessing socio-demographics and mental health (wellbeing and distress). A total of 240 students accessed the program over a 12-month period and of these, 164 provided reliable data. Results YOLO was accessed by students representing diverse socio-demographics including domestic vs. international student status, degree level, faculty, ethnicity, and age, although there was an over-representation of females (77.2%). Students who accessed YOLO pre-COVID-19 did not substantially differ across most mental health dimensions from those who accessed it during-COVID-19, although more students reported mild-moderate anxiety symptoms during-COVID than pre-COVID-19. The only socio-demographics significantly associated with mental health were age and degree level. Younger age was related to higher anxiety and 3rd and 4th year undergraduate students reported poorer mental health comparative to students in other years. Additionally, a higher proportion of these students accessed YOLO during-COVID-19 than at pre-COVID-19. Conclusion The present data along with findings from other studies that have evaluated YOLO, suggest that online mental health promotion programs that do not require in-person contact are an important and necessary resource for all university students.

Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study

BackgroundPost-secondary students frequently experience high rates of mental health challenges. However, they present meagre rates of treatment-seeking behaviours. This elevated prevalence of mental health problems, particularly after the COVID-19 pandemic, can lead to distress, poor academic performance, and lower job prospects following the completion of education. To address the needs of this population, it is important to understand students' perceptions of mental health and the barriers preventing or limiting their access to care.MethodsA broad-scoping online survey was publicly distributed to post-secondary students, collecting demographic, sociocultural, economic, and educational information while assessing various components of mental health.ResultsIn total, 448 students across post-secondary institutions in Ontario, Canada, responded to the survey. Over a third (n = 170; 38.6%) of respondents reported a formal mental health diagnosis. Depression and generalized anxiety disorder were the most commonly reported diagnoses. Most respondents felt that post-secondary students did not have good mental health (n = 253; 60.5%) and had inadequate coping strategies (n = 261; 62.4%). The most frequently reported barriers to care were financial (n = 214; 50.5%), long wait times (n = 202; 47.6%), insufficient resources (n = 165; 38.9%), time constraints (n = 148; 34.9%), stigma (n = 133; 31.4%), cultural barriers (n = 108; 25.5%), and past negative experiences with mental health care (n = 86; 20.3%). The majority of students felt their post-secondary institution needed to increase awareness (n = 231; 56.5%) and mental health resources (n = 306; 73.2%). Most viewed in-person therapy and online care with a therapist as more helpful than self-guided online care. However, there was uncertainty about the helpfulness and accessibility of different forms of treatment, including online interventions. The qualitative findings highlighted the need for personal strategies, mental health education and awareness, and institutional support and services.ConclusionsVarious barriers to care, perceived lack of resources, and low knowledge of available interventions may contribute to compromised mental health in post-secondary students. The survey findings indicate that upstream approaches such as integrating mental health education for students may address the varying needs of this critical population. Therapist-involved online mental health interventions may be a promising solution to address accessibility issues.

Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan

Ukraine has been embroiled in an increasing war since February 2022. In addition to Ukrainians, the Russo-Ukraine war has affected Poles due to the refugee crisis and the Taiwanese, who are facing a potential crisis with China. We examined the mental health status and associated factors in Ukraine, Poland, and Taiwan. The data will be used for future reference as the war is still ongoing. From March 8 to April 26, 2022, we conducted an online survey using snowball sampling techniques in Ukraine, Poland, and Taiwan. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale; post-traumatic stress symptoms by the Impact of Event Scale-Revised (IES-R) and coping strategies by the Coping Orientation to Problems Experienced Inventory (Brief-COPE). We used multivariate linear regression to identify factors significantly associated with DASS-21 and IES-R scores. There were 1626 participants (Poland: 1053; Ukraine: 385; Taiwan: 188) in this study. Ukrainian participants reported significantly higher DASS-21 (p < 0.001) and IES-R (p < 0.01) scores than Poles and Taiwanese. Although Taiwanese participants were not directly involved in the war, their mean IES-R scores (40.37 ± 16.86) were only slightly lower than Ukrainian participants (41.36 ± 14.94). Taiwanese reported significantly higher avoidance scores (1.60 ± 0.47) than the Polish (0.87 ± 0.53) and Ukrainian (0.91 ± 0.5) participants (p < 0.001). More than half of the Taiwanese (54.3%) and Polish (80.3%) participants were distressed by the war scenes in the media. More than half (52.5%) of the Ukrainian participants would not seek psychological help despite a significantly higher prevalence of psychological distress. Multivariate linear regression analyses found that female gender, Ukrainian and Polish citizenship, household size, self-rating health status, past psychiatric history, and avoidance coping were significantly associated with higher DASS-21 and IES-R scores after adjustment of other variables (p < 0.05). We have identified mental health sequelae in Ukrainian, Poles, and Taiwanese with the ongoing Russo-Ukraine war. Risk factors associated with developing depression, anxiety, stress, and post-traumatic stress symptoms include female gender, self-rating health status, past psychiatric history, and avoidance coping. Early resolution of the conflict, online mental health interventions, delivery of psychotropic medications, and distraction techniques may help to improve the mental health of people who stay inside and outside Ukraine.

Cognitive self-compassion (CSC) online intervention to enhance self-esteem of adolescents exposed to parental intimate partner violence in India

Children and adolescents exposed to parental intimate partner violence are more likely to have low self-esteem, and the adverse effects of low self-esteem have to be addressed. In the context of the global pandemic, there is a lack of online mental health interventions for parental IPV victims. This study examined the efficacy of the Cognitive Self Compassion (CSC) Online Intervention to enhance the self-esteem of adolescents exposed to parental IPV. The present study employed Conklin’s program development model, which involves three phases: (1) planning, (2) design and implementation, and (3) evaluation and program validation. The participants were adolescents (N = 192, 11-17 years of age) from India, Kerala and they were randomly assigned to experimental(n-20) and control group(n = 20). Coopersmith self-esteem scale, Interview, and focus group discussion was used to assess the severity of the problem. The significant change in post-test scores between the experimental and control groups (Ctrl: M = 14.95, SD = 1.73; Exp: M = 37.20, SD = 1.85) and the Pretest and post- test scores of the experimental group (Pretest: M = 15.60, SD = 1.90; Posttest = 37.20, SD = 1.85) indicates that the eight modular programs of CSC online intervention program effectively improve self-esteem in adolescents exposed to IPV and the effect sizes at post treatment were large (d.12.42). The study provided ample indication of the efficacy of the Cognitive Self Compassion online intervention program to enhance the self-esteem of adolescents

Design and evaluation of a mobile-based intervention for Maya adults during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has had a direct impact on mental health. International organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treatment option for common mental health problems. However, the evidence regarding these approaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-assessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous population. Future studies might consider developing similar interventions for other indigenous communities in Latin America.

Feasibility of a secondary school-based mental health intervention: Reprezents' On The Level.

There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11-18years) in 36 secondary schools across London and Essex, UK. OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50min). Follow-up data was collected at timepoint 2 (T2) 4-6weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed the feasibility of implementing the OTL intervention in secondary schools. 10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4-6weeks after the OTL show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools. These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health and well-being and give them the necessary tools to support their mental health.

16.2 Youth Voice in Project Youth Empowerment and Support (YES): An Online Anonymous Adolescent Mental Health Single Session Intervention to Decrease Hopelessness

16.2 Youth Voice in Project Youth Empowerment and Support (YES): An Online Anonymous Adolescent Mental Health Single Session Intervention to Decrease Hopelessness

Prolonged grief disorder in Arabic-speaking treatment-seeking populations: Relationship with socio-demographic aspects, loss- and trauma-related characteristics, and mental health support.

IntroductionProlonged grief disorder (PGD) has been included as a new diagnosis in the ICD-11 and is set to be included in the DSM-5-TR. To better identify vulnerable individuals, different factors associated with PGD have to be taken into account, but results regarding these factors remain equivocal. Moreover, few studies on PGD are available from Arabic-speaking populations and from different countries dealing with conflicts and wars. The objective was thus to examine PGD prevalence and associated characteristics in these populations.Materials and methodsA total of N = 1,051 bereaved participants from Arabic-speaking populations completed the PG-13 as part of a screening procedure for an online mental health intervention. Multiple linear regression was conducted to examine associated factors for PGD symptom severity, and multiple logistic regression was applied to investigate associated factors for PGD according to PG-13 diagnostic criteria.ResultsOf the participants, 18.8% (n = 198) met the PGD diagnostic criteria, at an average of about 6 years post-loss. The multiple linear regression yielded eight associated factors for PGD symptom severity (age, gender, number of losses, number of traumatic event types, relationship with the deceased, age at loss, impairment during first year post-loss, perceived social support), which explained 40.2% of the variance [F(17, N=1,033) = 40.82, p < 0.001, R2 = 0.402]. The multiple logistic regression yielded five significant associations with PGD (gender, relationship with the deceased, number of lost persons, impairment during first year post-loss, perceived social support), which explained 33.0% (Nagelkerke R2) of the variance in PGD according to PG-13 diagnostic criteria.DiscussionA substantial proportion of the participants met the PG-13 criteria for PGD, emphasizing that therapeutic services are indispensable in this population. The associated factors for PGD found in our Arab-speaking sample are largely consistent with those found in studies from other regions. The slightly differing numbers of associated factors between the linear and logistic regression underline that a continuous score reflects the continuum between normal and dysfunctional grieving, and therefore also a range of factors associated with PGD.

A Systematic Review on Effectiveness of Online Well-Being Programs for The Physical and Mental Well-Being of University Health-Allied Students

Aim: The study reviewed available literature on the effectiveness of online well-being programs concerning university health-allied students' physical and mental well-being. Methods: Following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines, this study involved searching for intervention articles for health-allied university students in the electronic databases of ProQuest, Herdin, Research Gate, ScienceDirect, Wiley Online Library, ERIC, DOAJ, CORE, PubMed, EBSCOHost, Google Scholar, Taylor &amp; Francis, and Emerald Insights. The Cochrane Intervention Review guidelines became the basis for the results of the studies that met the quality criteria. For the other study designs, specific appraisal tools were used. Participants' characteristics, intervention parameters, and outcomes were extracted and synthesized for analysis. Results: Ten studies were included and reported in the study. All studies focusing on physical well-being (n = 2) reported significant improvements in physical activity with concurrent positive effects on mental well-being. Overall, studies focusing on mental well-being (n = 8) had mixed results on interventions providing statistically significant results. However, most studies either have practical significance ranging from mild to large effects, having a positive directional change for outcomes, or deemed helpful with a high participation rate. Conclusion and Implications: This review found evidence suggesting the effectiveness of online physical and mental health interventions for health allied university students. Interventions that encompass both physical and mental health are deemed the most effective.