The Effects of a Digital, Transdiagnostic, Clinically and Peer-Moderated Treatment Platform for Young People With Emerging Mental Health Complaints: Repeated Measures Within-Subjects Study (Preprint)

Abstract

BACKGROUND To address the growing prevalence of youth mental health problems in the Netherlands, prevention and early intervention is crucial to minimize individual, societal, and economic impacts. Indicative prevention aims to target emerging mental health complaints before the onset of a full-blown disorder. By intervening at this early stage, fewer psychosocial and neurobiological consequences occur, and individuals are more responsive to treatment, resulting in cost-effective outcomes. The Moderated Online Social Therapy (MOST) platform, that was successfully implemented and proven effective in Australia, is a digital peer- and clinically moderated treatment platform designed for young people. The Netherlands is the first country outside Australia to implement this platform, under the name ENgage YOung people earlY (ENYOY) and it has the potential to reduce the likelihood of young people developing serious mental health disorders. OBJECTIVE The objective of our study was to investigate the long-term outcomes in youngsters using the ENYOY-platform in relation to psychological distress, psychosocial functioning, and positive health parameters, such as quality of life. METHODS Dutch-speaking young people with emerging mental health complaints (N = 131) participated on the ENYOY-platform for six months in a longitudinal within-subjects study. Psychological distress, psychosocial functioning and positive health parameters were assessed at baseline, three-, six-, and 12-months. Repeated Measures Analysis of Variance was conducted and adjusted for age, gender, therapy- and community activity. Reliable Change Index (RCI) and Clinically Significant Index (CSI) were computed to compare baseline measurement with six-month and 12-month measurements. The missing data rate was 22.54% and drop-out rate 37%. RESULTS A total of N = 81youngster completed all measurements. Over time, psychological distress reduced, and psychosocial functioning improved with large effect sizes (both p < .001, ηp² =.239 and .318 respectively) independent of age, gender, therapy- and community activity (p > .05). Likewise, secondary analyses showed significant effects of time on positive health parameters quality of life, well-being, and meaningfulness (p < .05 and ηp² = .062, .140, and .121 respectively). Improvements were found between baseline, 3 and 6 months (p < .05) and sustained at 12-months follow-up (p > .05). RCI showed improvements in psychological distress for approximately 38% of cases, no change in 55%, and worsening in 6%. For psychosocial functioning, the percentages were 51%, 43%, and 6% respectively. CSI demonstrated clinically significant change in 76% of cases for distress and 90% for functioning. CONCLUSIONS This trial has demonstrated that the ENYOY-platform holds promise as a transdiagnostic intervention for addressing emerging mental health complaints among young people in the Netherlands and has laid the groundwork for further clinical research. Additionally, it would be of great relevance to expand the population on - and service delivery of the platform. CLINICALTRIAL Trial Register ID NL8966, retrospectively registered. INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12888-021-03315-x