A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service (Preprint)

Abstract

BACKGROUND Mental ill-health is the leading cause of disability worldwide. 75% of mental health conditions emerge between the ages of 12 and 25. Unfortunately, due to lack of resources as well as limited engagement with services the majority of young people affected by mental-ill health do not successfully access evidence-based support. In addressing this gap, our team has developed a multimodal, scalable online mental health service (MOST+) merging: real-time, clinician-delivered web chat counselling, interactive user-directed online therapy, expert and peer moderation, and secure peer-to-peer social networking. OBJECTIVE The primary objective of this study was to ascertain the feasibility, acceptability, and safety of MOST+. Secondary aims were to assess pre-post changes in clinical, psychosocial and wellbeing outcomes and to explore the correlations between system usage, perceived helpfulness, and secondary outcome variables. METHODS 157 help-seeking young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive user-directed online therapy and integrated web chat counselling. Additional access to peer-to-peer social networking was granted to 73 participants (46%) whose age could be confirmed and for whom it was deemed safe. The intervention was evaluated via an uncontrolled single-group study. RESULTS Ninety-three participants completed the follow-up assessment. Baseline measures indicated that most participants suffered from moderate (33%) to severe (61%) mental health conditions. All a priori feasibility, acceptability and safety criteria were met. Participants provided mean scores of 3.5 (out of 5) on ease of use (M=3.7, SD=1.1), relevancy (M=3.9, SD=1.0), helpfulness (M=3.5, SD=0.9) and overall experience (M= 3.9, SD=0.8). 98% reported a positive experience using MOST+, 86% considered it helpful, 82% reported that using MOST+ helped them feel better, 86% felt more socially connected using it and 92% would recommend it to others. No serious adverse events or inappropriate use were detected during the study and 97% participants reported feeling safe. There were statistically significant improvements in eight of 11 secondary outcomes assessed: psychological distress (d=-0.39, p< 0.001), perceived stress (d=-0.44, p<0.001), psychological wellbeing (d=0.51, p<0.001), depression (d=-0.29, p=0.008), loneliness (d=-0.23, p=0.04), social support (d=0.30, p=0.004), autonomy (d=0.36, p=0.001) and self-competence (d=0.30, p=0.005). There were significant correlations between indicators of system usage, perceived helpfulness as well as a number of secondary outcome variables. CONCLUSIONS MOST+ is a feasible, acceptable and safe online clinical service for young people suffering from mental ill-health. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system usage and outcomes variables, provide initial support for the therapeutic potential of MOST+. MOST+ stands as a promising and scalable platform to deliver stand-alone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services. CLINICALTRIAL Actrn12617000370303

ENgage YOung people earlY (ENYOY): a mixed-method study design for a digital transdiagnostic clinical – and peer- moderated treatment platform for youth with beginning mental health complaints in the Netherlands

“…However, several studies show only a third of young people seek help for their mental health problems [33,34], and most individuals receive mental health care at a much later stage [35][36][37]. Since the step to seek help remains relatively large, within a national youth emental health service (eHeadspace Generation Next), Australia successfully implemented the Moderated Online Social Therapy (MOST+); an evidence based digital interactive peer and clinical moderated treatment platform for youth with beginning mental health problems [38]. Inspired by the Australian Headspace approach, Headspace centres have been implemented in e.g.…”

“…For the Dutch version of the platform, we use the name ENgage YOung people earlY (ENYOY). Research shows that the MOST+ site leads to minimal drop out and enhances continuation of treatment effects [32,38]. This model has the potential to realise the goal of specialized treatment by providing cost-effective, non-stigmatising, constantly available support to young people suffering from mental health problems.…”