Predictors of Adolescent Engagement and Outcomes – a cross-sectional study using the Togetherall (formerly Big White Wall) digital mental health platform

Abstract

Online mental health platforms can improve access to, and use of, mental health support for young people who may find it difficult to engage with face-to-face delivery.We modelled engagement and change in anxiety and depression symptoms in adolescent users of the Togetherall (formerly “Big White Wall”) anonymous digital mental health peer-support platform.A cross-sectional study assessed online activity data from members of Togetherall in UK adolescents referred from mental health services (N=606). Baseline demographics, depression, anxiety, and usage statistics were assessed. Symptom levels among participants who chose to take validated anxiety and depression measures were measured. And participant characteristics were used to predict engagement.Mean number of logins for adolescent members was higher for older adolescents, and for a longer duration than younger adolescents. Mean number of logins and usage time was higher in female adolescents than males. For the total sample, 47.9% of users accessed more than one course, and 27% accessed at least one self-help resource. Gender and age predicted number of joined courses. Greater accessed self-help materials predicted reduced anxiety symptoms. Members’ mean baseline symptom levels were: GAD-7 between 13.63 and 14.79; PHQ-9 between 16.8 and 18.58.Data were derived from a naturalistic design and modelling of multiple symptom scores should be interpreted with caution.Findings show that adolescents readily engage with an anonymous online platform for common mental disorder, with scope for tailored pathways for different symptom profiles. Members benefit from engagement with Togetherall materials and courses.