A novel multi-component online intervention to improve the mental health of university students: Randomised controlled trial of the Uni Virtual Clinic

Abstract

BackgroundOf the millions of students enrolled in university, up to 50% will experience a mental disorder. Many of these students do not seek help, and for those who do, university-based services are often over-burdened. Anonymous, evidence-based, online interventions can improve students’ access to mental health support. The Uni Virtual Clinic (UVC) is a transdiagnostic online mental health program designed specifically for university students. This paper reports on a randomised controlled trial examining the effectiveness of the UVC in a sample of Australian university students.MethodsUniversity students with elevated psychological distress (K10>15; n = 200) were randomised to the UVC intervention or a waitlist control condition for a period of 6 weeks. Baseline, post-intervention, and 3-month follow-up surveys assessed depression, anxiety, self-efficacy, quality of life, adherence, and satisfaction with the UVC intervention.ResultsMixed models analysis demonstrated that use of the UVC was associated with small significant reductions in social anxiety and small improvements in academic self-efficacy. The program was not effective in reducing symptoms of depression, anxiety, or psychological distress compared to a control group. The majority of participants in the intervention condition who were retained at follow-up engaged with the program, and most of these participants reported satisfaction with the UVC.DiscussionThe results suggest that multi-component online interventions such as the UVC have utility in a university environment. Future trials of the UVC should examine the impact of guidance and/or tailoring on treatment efficacy, and the potential role of the UVC in a stepped care model incorporating on-campus services.

Digital Interventions for Screening and Treating Common Mental Disorders or Symptoms of Common Mental Illness in Adults: Systematic Review and Meta-analysis

“…Overall, the included studies covered 6223 participants in intervention conditions and 5797 participants in comparison conditions. Nearly half of the studies (8/19, 42%) including a cost-effectiveness study[ 37 - 39 , 44 - 46 , 49 , 52 ] were conducted in Australia. Four (4/19, 21%) studies were conducted in the United States [ 5 , 40 , 42 , 48 ].…”

“…Studies recruited adults with subclinical or mild symptoms of CMDs among the general population in the community through social media (Facebook and Twitter) advertisements [ 5 , 37 , 38 ]. Nearly half of the studies aimed at promoting positive well-being and targeted users with some indication of clinical symptoms, including university students [ 42 , 44 - 46 , 48 , 49 ] and the general public who were interested in self-care to promote well-being [ 5 , 38 , 39 , 43 , 47 , 54 ]. The remaining studies targeted populations with an increased risk of mental health morbidities either because of work-related stress or health conditions.…”

“…In Australia, a trial reported that about half (53%) of the participants were Whites, 15% were Asians, 3% were Africans, 0.8% were Aboriginal or Torres Strait Islanders, and a further 17% preferred not to provide ethnicity details [ 44 ]. Finally, in an Australian study of a university student virtual clinic, 65% of the participants were Whites, 28% were Asians, 1% were Africans, and 1% were Aboriginal, Torres Strait, and Pacific Islanders [ 49 ].…”

“…The mode of delivery and design features of the interventions are summarized in Table 2 . Most were delivered through a web-based portal allowing users to access it through any device with a web browser [ 37 - 39 , 44 , 49 , 50 , 53 , 54 ]. Some were specifically developed and trialed as mobile apps [ 5 , 43 , 46 , 47 ].…”

“…An explicit theoretical basis underpinning the design and delivery integrating algorithm and web-based behavioral change techniques was generally lacking. Across studies, only a few web-based behavioral change techniques were explicitly adopted by the interventions, including provision of feedback on performance [ 39 , 51 ], goal setting [ 46 ], and prompts for self-monitoring of behavior and progress [ 37 , 43 , 49 ]. Intervention duration and intensity varied widely across studies, with most interventions lasting 4 weeks [ 43 , 44 , 46 ], a few lasting 3 months [ 38 , 39 , 41 ], and the longest lasting 11 months [ 53 ].…”