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Ojeda VD, Parker T, Lyles M, Edwards TM, Jimenez C, Hiller-Venegas S, Berliant E, Lister Z. Access to Healthcare Among Young Adult Probationers Participating in a Pilot Health-Focused Reentry Program. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024:306624X241240700. [PMID: 38528472 DOI: 10.1177/0306624x241240700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Justice-involved adults experience disparities in healthcare access. This pilot study examines healthcare access among young adult probationers (n = 66) receiving 6-months of Service Navigation and Health Coaching support implemented between 2017 and 2021. Data are from baseline, 6-month follow-up and satisfaction surveys. Between baseline and follow-up, the proportion of insured young adult participants (66%-88%; p < .001) and those using healthcare services (36%-71%; p < .001) increased significantly; report of unmet physical healthcare needs decreased significantly (44%-26%; p = .003). Satisfaction data revealed increased self-efficacy, motivation, focus, and improved organizational, goal setting, and communication skills. The program improved healthcare access by increasing health insurance and recent use of healthcare services. Longitudinal studies are needed to assess maintenance of these outcomes and potential impacts on disparities in health status and access to care indicators. Integrating navigation and coaching supports to advance the well-being of justice-involved young adults is a promising mechanism to facilitate healthcare access.
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Affiliation(s)
- Victoria D Ojeda
- University of California, San Diego, La Jolla, USA
- University of California, San Diego School of Medicine, La Jolla, USA
| | - Tamara Parker
- University of California, San Diego School of Medicine, La Jolla, USA
| | - Maurice Lyles
- University of California, San Diego School of Medicine, La Jolla, USA
| | - Todd M Edwards
- University of California, San Diego School of Medicine, La Jolla, USA
| | - Cielo Jimenez
- University of California, San Diego School of Medicine, La Jolla, USA
| | | | - Emily Berliant
- University of California, San Diego School of Medicine, La Jolla, USA
| | - Zephon Lister
- University of California, San Diego School of Medicine, La Jolla, USA
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Peyton D, Wadley G, Hackworth N, Grobler A, Hiscock H. A co-designed website (FindWays) to improve mental health literacy of parents of children with mental health problems: Protocol for a pilot randomised controlled trial. PLoS One 2023; 18:e0273755. [PMID: 36943835 PMCID: PMC10030009 DOI: 10.1371/journal.pone.0273755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Mental health problems, such as behavioural and emotional problems, are prevalent in children. These problems can have long lasting, detrimental effects on the child, their parents and society. Most children with a mental health problem do not receive professional help. Those that do get help can face long wait times. While waiting, parents want to learn how they can help their child. To address this need, we co-designed a new website to help parents find ways of helping their child's mental health problem while waiting to get specialist help. OBJECTIVES To assess the acceptability and feasibility of a new co-designed website, FindWays, through a pilot randomised controlled trial. The protocol is registered with ISRCTN (ISRCTN64605513). METHODS This study will recruit up to 60 parents of children aged two-twelve years old referred to a paediatrician for behavioural and/or emotional problems. Participants will be randomly allocated by computer generated number sequence to either the intervention or control group. Intervention group participants will receive access to the FindWays website to help them manage their child's mental health problem while they wait to see the paediatrician. Acceptability and feasibility will be assessed over the 4-month intervention through mixed methods including: recruitment, adherence, retention, net promoter score (quantitative measures) and semi-structured interviews to gain an in-depth understanding of parents' experience and potential adverse effects (qualitative measure). Secondary outcomes measured by parent survey at 4-months post randomisation include child mental health, parent mental health, impact of the child's mental health problem on their functioning and family, and health service use and associated costs. RESULTS Recruitment commenced June 2022 with publication expected in October 2023. CONCLUSION This study will provide novel data on the acceptability and feasibility of a new website co-designed with parents to help them find ways of managing their child's behaviour and emotions.
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Affiliation(s)
- Daniel Peyton
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Greg Wadley
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
| | - Naomi Hackworth
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
- Parenting Research Centre, East Melbourne, Australia
- Murdoch Children's Research Institute, Parkville, Australia
| | - Anneke Grobler
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Australia
| | - Harriet Hiscock
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Health Services Research Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia
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Johnson JA, Sanghvi P, Mehrotra S. Technology-Based Interventions to Improve Help-Seeking for Mental Health Concerns: A Systematic Review. Indian J Psychol Med 2022; 44:332-340. [PMID: 35949632 PMCID: PMC9301737 DOI: 10.1177/02537176211034578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Despite the high prevalence of mental health disorders worldwide, a significant proportion of distressed individuals do not seek professional help. Digital technology can be a potential bridge to reduce the treatment gap for mental disorders. A systematic review was undertaken to examine the technology-based interventions aimed at improving help-seeking attitude, intention, or behavior for mental health concerns. METHODS The literature search was conducted in January-February 2020 through various e-databases using relevant keywords that targeted help-seeking interventions for mental health disorders via different technology modes. RESULTS 21 studies (15 randomized controlled trials and six non-randomized studies) were reviewed. The included studies were published between April 2006 to February 2020. Majority of the interventions led to an increase in the help-seeking variables. The crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking is highlighted. The review emphasizes the need for understanding utility of multicomponent interventions with personalized elements targeting help-seeking behavior, particularly in low-middle-income countries, and studies involving longer duration follow-ups. CONCLUSION This systematic review is the first of its kind to examine technology-based interventions to improve help-seeking for mental health and suggests that such interventions play a crucial role in positively impacting help-seeking. The complex interplay between the relevant variables such as mental health literacy, stigma, help-seeking attitude, intention and behavior, and the intervention components that may have a differential bearing on these variables are issues that merit urgent attention in further research.
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Affiliation(s)
- Jemimah A Johnson
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Prachi Sanghvi
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Seema Mehrotra
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Cohen DA, Londoño T, Klodnick VV, Emerson KR, Stevens L. “There wasn’t any build up to it, it was just like, now you have to go over.” Disengagement during the Child to Adult Community Mental Health Service Transition. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221102914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study explored the personal, real-time experience of accessing adult mental health services after aging out of child mental health services. Mean age of the 19 participants at enrollment was 18. Eleven identified as women, five as men, and two as gender non-conforming. Over half of the sample identified as Hispanic or Latinx. This study employed a longitudinal, qualitative design with three interviews over 12-months (e.g., baseline, 6-months, 12-months), and monthly check-ins to prevent study attrition. Interviews explored previous and current mental health service experiences; the transition experience from child-to-adult services, and perceived service barriers and facilitators. Research team members used thematic coding to code each interview individually, focusing on identifying the disengagement timeline, experience, and related factors. Universally, participants saw a benefit in continuing mental health services, but almost all disengaged due to difficulty in navigating care and getting their needs met during the transition from child to adult services. This study provides a young adult perspective on the real gap between child and adult services within one community mental health agency. Improved transition practices and tailoring services to young adult development may prevent mental health disengagement during the transition from child to adult service systems.
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Hoffmann SH, Paldam Folker A, Buskbjerg M, Paldam Folker M, Huber Jezek A, Lyngsø Svarta D, Nielsen Sølvhøj I, Thygesen L. Potential of Online Recruitment Among 15-25-Year Olds: Feasibility Randomized Controlled Trial. JMIR Form Res 2022; 6:e35874. [PMID: 35612877 PMCID: PMC9178448 DOI: 10.2196/35874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 11/20/2022] Open
Abstract
Background Recruiting young people for health and intervention studies by traditional methods has become increasingly challenging. The widespread access to the internet may offer new strategies for online recruitment. Objective This study aims to assess the feasibility of online recruitment for a randomized controlled trial evaluating the effectiveness of Mindhelper, an online national youth mental health promotion service. The target group was young Danes aged 15-25 in need of mental health promotion. Methods Advertisements for recruitment were set up on Facebook and Instagram. Browser history was collected for a subsample of participants. We compared basic characteristics of participants who completed the baseline survey and those who did not, as well as of participants who completed the follow-up survey and those who were lost to follow-up. The significance of these differences was tested with the Pearson chi-square test. Results A total of 560 Danes aged 15-25 were recruited within 1 month (ie, had completed the baseline survey). Among these participants, 356 (63.6%) were at risk of developing depression or stress. The average advertisement price per participant completing the baseline questionnaire was 31 DKK (approximately €4 [US $4.2]). The follow-up survey was sent to 545 participants, of whom 318 (58.3%) completed the survey. No statistically significant differences were observed in baseline characteristics of participants who completed the follow-up and those who were lost to follow-up in terms of gender (P=.45), age (P=.35), occupation (P=.17), cohabitation (P=.90), mental well-being (P=.26), mental illness (P=.44; impact of the illness, P=.05), or use of the internet when having a hard time (P=.92). Conclusions We conclude that it is feasible to recruit young Danes online for a large-scale randomized controlled trial assessing the effectiveness of Mindhelper. Trial Registration ClinicalTrials.gov NCT04650906; https://clinicaltrials.gov/ct2/show/NCT04650906
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Affiliation(s)
- Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mark Buskbjerg
- Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Marie Paldam Folker
- Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Andrea Huber Jezek
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Durita Lyngsø Svarta
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ida Nielsen Sølvhøj
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review. Curr Opin Psychiatry 2022; 35:207-218. [PMID: 35579875 DOI: 10.1097/yco.0000000000000788] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Interventions that facilitate help-seeking could help individuals to get care earlier on which could also help avert some mental health crises. Delivering interventions via a digital format could mitigate some key barriers to mental healthcare. We reviewed the literature for digital interventions which facilitate formal or informal help-seeking for mental health problems. We examined the impact of identified interventions on actual and intended help-seeking and attitudes towards help-seeking. RECENT FINDINGS We identified 35 interventions. About half (51%) of studies showed an improvement in at least one help-seeking outcome with the greatest number showing an improvement in help-seeking intentions and the fewest studies showing an improvement in actual behaviour (29%). Findings suggest that interventions that promote active participation and personal involvement through sharing one's own narrative seem to be promising practices to facilitate help-seeking. SUMMARY Our findings suggest digital interventions can improve help-seeking for mental health problems among a range of populations. Given speciality mental health resources are scarce, further research needs to consider how these interventions could best target the most vulnerable groups to link them with mental healthcare and how these interventions might facilitate earlier intervention in a way that might reduce need for crisis care and support.
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van Doorn M, Nijhuis LA, Egeler MD, Daams JG, Popma A, van Amelsvoort T, McEnery C, Gleeson JF, Öry FG, Avis KA, Ruigt E, Jaspers MWM, Alvarez-Jimenez M, Nieman DH. Online Indicated Preventive Mental Health Interventions for Youth: A Scoping Review. Front Psychiatry 2021; 12:580843. [PMID: 33995136 PMCID: PMC8116558 DOI: 10.3389/fpsyt.2021.580843] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/30/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: Between the ages of 12 and 25 the onset of mental disorders typically occurs, and the burden of mental health problems is greatest for this group. Indicated preventive interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders have gained considerable traction. However, the threshold to seek help appears to be high even when help is needed. Online interventions could offer a solution, especially during the COVID-19 pandemic. This scoping review will present an overview of the recent research of indicated online preventive interventions for youth (12-25 years) experiencing the early stages of mental health complaints with the aim of identifying the nature and extent of the research evidence. Methods: The 5-stage framework by Arksey and O'Malley was used. Academic literature published from 2013 onwards in printed or electronic format was included from Scopus, PsychINFO, and Ovid MEDLINE(R) ALL. Results: The search yielded 11,122 results, with the final selection resulting in inclusion of 30 articles for this review. In total, the articles included 4,950 participants. 26.7% of the selected articles focused on youth between 12 and 25 years. Of the articles 60% did not screen for, nor exclude participants with clinical levels of symptoms. Most studies used a common evidence-based therapy for the disorder-category targeted. More than half of the online interventions included some form of human support. Adherence levels ranged between 27.9 and 98%. The results indicate general effectiveness, usability and acceptability of online indicated preventive interventions. The most commonly used approach was CBT (n = 12 studies). Studies varied in their size, rigor of study, effectiveness and outcome measures. Online interventions with a combination of clinical and peer moderation (n = 3 studies) appear to result in the most stable and highest effect sizes. Conclusion: Online indicated preventive mental health interventions for youth with emerging mental health issues show promise in reducing various mental health complaints, and increasing positive mental health indicators such as well-being and resilience. Additionally, high levels of usability and acceptability were found. However, the included studies show important methodological shortcomings. Also, the research has mainly focused on specific diagnostic categories, meaning there is a lack of transdiagnostic approaches. Finally, clear definitions of- as well as instruments to measure- emerging or subclinical mental health symptoms in youth remain are missing.
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Affiliation(s)
| | | | - Mees D. Egeler
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Joost G. Daams
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Carla McEnery
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - John F. Gleeson
- Orygen, Parkville, VIC, Australia
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Ferko G. Öry
- Erasmus University College, Rotterdam, Netherlands
| | - Kate A. Avis
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Emma Ruigt
- Amsterdam University Medical Centers, Amsterdam, Netherlands
- Minddistrict, Amsterdam, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
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Penfold RB, Thompson EE, Hilt RJ, Kelleher KJ, Schwartz N, Beck A, Clarke GN, Ralston JD, Hartzler AL, Coley RY, Akosile M, Vitiello B, Simon GE. Safer use of antipsychotics in youth (SUAY) pragmatic trial protocol. Contemp Clin Trials 2020; 99:106184. [PMID: 33091587 PMCID: PMC7726008 DOI: 10.1016/j.cct.2020.106184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/18/2020] [Accepted: 10/15/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Programs such as the Pediatric Access Line in Washington state have shown decreases in antipsychotic medication use by youth with non-psychotic disorders. Program outcomes have been studied with observational designs. This manuscript describes the protocol for Targeted and Safer Use of Antipsychotics in Youth (SUAY), a randomized controlled trial of psychiatrist review of prescriptions and facilitated access to psychosocial care. The aim of the intervention is to reduce the number of person-days of antipsychotic use among participants. METHODS Recruitment occurs at 4 health systems. Targeted enrollment is 800 youth aged 3-17 years. Clinicians are block randomized to intervention versus usual care prior to the study. Youth are nested within the arm of the prescribing clinician. Clinicians in the intervention group receive an EHR-based best practice alert with options to expedite access to psychosocial care and all medication orders are reviewed by a child and adolescent psychiatrist with feedback provided to the prescriber. The primary outcome is person-days of antipsychotic medication use in the 6 months following the initial order. All randomized individuals contribute data regardless of their level of participation (including declining all services). DISCUSSION The trial has been approved by the institutional review boards at each of the 4 sites. The intervention has 4 novel design features including automated recruitment using a best practice alert, psychiatrist medication order review and consultation, telephone navigation to psychosocial care, and telemental health visits. Recruitment began in March of 2018 and will be completed in June 2020. Follow-up will be completed December 31, 2020. TRIAL REGISTRATION Clinicaltrials.gov, NCT03448575.
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Affiliation(s)
- Robert B Penfold
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
| | - Ella E Thompson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Kelly J Kelleher
- Nationwide Children's Hospital, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Nadine Schwartz
- Nationwide Children's Hospital, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Arne Beck
- Kaiser Permanente Colorado, Institute for Health Research, Denver, CO, USA
| | - Gregory N Clarke
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | - James D Ralston
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Andrea L Hartzler
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | - R Yates Coley
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Mary Akosile
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Benedetto Vitiello
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, University of Turin, Turin, Italy
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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Kahl BL, Miller HM, Cairns K, Giniunas H, Nicholas M. Evaluation of ReachOut.com, an Unstructured Digital Youth Mental Health Intervention: Prospective Cohort Study. JMIR Ment Health 2020; 7:e21280. [PMID: 33055066 PMCID: PMC7596653 DOI: 10.2196/21280] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/06/2020] [Accepted: 09/09/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Young people experience a disproportionate burden associated with mental illness that Australia's mental health care system is ill-equipped to handle. Despite improvements in the provision of mental health services, the rates of service utilization among young people remain suboptimal, and there are still considerable barriers to seeking help. Digital mental health services can overcome a number of barriers and connect young people requiring support; however, the evidence base of digital interventions is limited. OBJECTIVE The aim of this study is to examine the effectiveness of a brief, self-directed, unstructured digital intervention, ReachOut.com (hereafter ReachOut), in reducing depression, anxiety, stress, and risk of suicide. METHODS A cohort of 1982 ReachOut users participated in a 12-week longitudinal study, with a retention rate of 81.18% (1609/1982) across the duration of the study. Participants completed web-based surveys, with outcome measures of mental health status and suicide risk assessed at 3 time points across the study period. RESULTS The results demonstrated that over the 12-week study period, young people using ReachOut experienced modest yet significant reductions in symptoms of depression, anxiety, and stress. Significant, albeit modest, reductions in the proportion of participants at high risk of suicide were also observed. CONCLUSIONS The findings of this research provide preliminary evidence of the promise of an unstructured digital mental health intervention, ReachOut, in alleviating symptoms of mental ill-health and promoting well-being in young people. These findings are particularly important given that digital services are not only acceptable and accessible but also have the potential to cater to the diverse mental health needs of young people at scale, in a way that other services cannot.
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