Improving mental wellbeing among university students via a smartphone application based on Acceptance and Commitment Therapy
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Mental health literacy encompasses an individual’s knowledge and attitudes which influence recognition, treatment and management of a mental health problem. Depression is a common mental health problem experienced by university students, but they often do not seek professional help for their mental health, and prefer more informal sources of help. Online interventions to improve students’ mental health literacy could be a useful and engaging mental health promotion strategy in this population, in order to help improve their recognition and appraisal of depression, their ability to respond to it appropriately (either through seeking professional help or applying self-help), and improve their ability to support others experiencing depression. This thesis describes four studies conducted to inform the development of an online mental health literacy intervention tailored for Nottingham-based university students. These studies describe: 1) a systematic review and meta-analysis of website-based interventions for common mental health problems in university students; 2) a survey-based study investigating the profile of depressive, anxiety and hypomanic/manic symptomology in local students; 3) an interview-based study with students about their mental health and well-being since entering university, and their perspectives about help-seeking and self-management; and 4) an exploratory study investigating students’ mental health first aid skills for a hypothetical friend experiencing depression. This, coupled with literature review of student mental health, mental health help-seeking, and mental health literacy, resulted in the development of the pilot online intervention (“Managing Your Mood Online”), which underwent usability testing with a sample of representative end users. This study found the pilot intervention to be acceptable and usable, but with many potential areas for improvement. This thesis concludes with several considerations for future development of the online intervention.
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Substantial numbers of students in Higher Education (HE) are reporting mental health difficulties, such as mild to moderate symptoms of depression and anxiety. Coupled with academic skills challenges, these difficulties can lead to decreased academic performance, low levels of study satisfaction, and eventually drop out. Student support services are facing budget cuts and can only attend to limited numbers of students, usually the ones who present with more severe mental health problems. Moreover, face-to-face contact may not appeal to those students who feel embarrassed by their problems or are afraid of being stigmatised. To address this important problem, an online psychological wellbeing and study skills support system called MePlusMe, has been developed to provide personalised support to its users. In the present study we investigated the feasibility and acceptability of the contents, design, and functionalities of the system. An offline version of the system was introduced to 13 postgraduate and undergraduate students (mean age = 31.3 years, SD = 10.25 years; 4 males) in a UK HE Institution, who presented with mild or moderate mental health difficulties. The participants evaluated the design of the system, its functionalities, and contents at Baseline and at Weeks 2, 4, and 8. Participants found the system easy to use, professional, and efficient and its contents non-judgemental and informative. Participants stated that engaging with and practicing the techniques targeted at mental health difficulties led to improvements in positive thinking and self-confidence, while the study skills techniques were practical. Suggestions for further improvement included the development of an app and an option for direct engagement with professionals. The findings confirmed the acceptability of the contents, design and functionalities of the system, while providing useful information to inform its further development. Next steps include a feasibility study, which will test and quantify the effects on everyday functioning, mood, mental wellbeing, and academic self-efficacy after using the system, and subsequently a randomized controlled trial, which will evaluate its effectiveness.
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ObjectiveWhile tertiary students commonly experience distress that substantially impacts functioning and performance, few seek help. Innovative strategies are needed to promote wellbeing and address this distress. The current article describes the development, acceptability testing, and use of an Internet intervention to promote student wellbeing and resilience—thedesk. MethodAcceptability and useability of the program were evaluated by user analytics and focus groups.ResultsIn the first 3.5 years, 118,000 individuals accessed the website and had 163,000 sessions averaging 5.3 min and 6.9 accessed pages. Users' wellbeing scores were positively skewed, suggesting that the engaged content has broad relevance. While the percentage of people leaving the site after viewing the homepage was considered acceptable at 50%, there is significant room to improve engagement. Responses from consumer focus groups suggested high acceptability, perceived usability, and likely utility. Concerns included data security and, for international students, the need for greater direction on program use.ConclusionsWhile further research is needed to evaluate the effects of thedesk on wellbeing and distress, the current results suggest that it provides highly accessible support that is well accepted by most tertiary students and has the potential for use as a stand‐alone intervention or, adjunctively, to increase the impact of other student support.
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This article has been double-blind peer reviewedIn this article…Insights into acceptance and commitment therapyHow improving mindfulness and values-based behaviour can help nursesA staff training programme based on acceptance and commitment therapyAbstractAcceptance and commitment therapy (ACT) is a
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One in three university students experiences mental health problems during their study. A similar percentage leaves higher education without obtaining the degree for which they enrolled. Research suggests that both mental health problems and academic underperformance could be caused by students lacking control and purpose while they are adjusting to tertiary education. Currently, universities are not designed to cater to all the personal needs and mental health problems of large numbers of students at the start of their studies. Within the literature aimed at preventing mental health problems among students (e.g., anxiety or depression), digital forms of therapy recently have been suggested as potentially scalable solutions to address these problems. Integrative psychological artificial intelligence (AI) in the form of a chatbot, for example, shows great potential as an evidence-based solution. At the same time, within the literature aimed at improving academic success, the online life-crafting intervention in which students write about values and passions, goals, and goal-attainment plans has shown to improve the academic performance and retention rates of students. Because the life-crafting intervention is delivered through the curriculum and doesn’t bear the stigma that is associated with therapy, it can reach larger populations of students. But life-crafting lacks the means for follow-up or the interactiveness that online AI-guided therapy can offer. In this paper, we propose to integrate the current literature on chatbot interventions aimed at the mental health of students with research about a life-crafting intervention that uses an inclusive curriculum-wide approach. When a chatbot asks students to prioritize both academic as well as social and health-related goals and provides personalized follow-up coaching, this can prevent -often interrelated- academic and mental health problems. Right on-time delivery, and personalized follow-up questions enhance the effects of both -originally separated- intervention types. Research on this new combination of interventions should use design principles that increase user-friendliness and monitor the technology acceptance of its participants.
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This paper examines the effectiveness of a three week mindfulness group program as a tool for improving academic performance, managing study stress and improving overall well-being. A mindfulness based approach was chosen due to its effectiveness in reducing stress as well as improving psychological wellbeing and working memory in various groups of university students. Evaluations from students over a three year period have consistently reported improved life and study skills across a number of areas, including capacity to manage stress and to stay more present. They also reported increased focus and improved sleep. The outcomes demonstrate an effective and innovative way to support student learning and wellbeing as well as providing students with a non-threatening way to engage with the counselling service.
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Peer support programs offer a promising approach to addressing the high levels of stress and psychological distress reported by university students. However, few studies have considered the impact of implemented programs on the wellbeing and skill development of student facilitators. This study examines the experiences of student facilitators of a guided peer support program for reducing and preventing stress and low mood in student participants. Benefits to student facilitators, anticipated and actual, include the development of skills and experience in group facilitation, and a greater sense of community and belonging. While challenges exist in establishing initiatives, peer support and mentoring programs can offer valuable benefits by increasing wellbeing and fostering skill development for both participants and student facilitators. It is important that university-based peer support programs consider the student facilitator experience in both program development and evaluation and ensure training addresses facilitator concerns, prepares students adequately for the role, and considers the benefits for individual professional development.
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Purpose Recovery Colleges are education-based mental health resources, utilising practitioner and lived experience expertise, promoting skills to enhance student independence. The purpose of this paper is to evaluate the impact of engagement with a Recovery College in Northern England on student wellbeing. Design/methodology/approach Feedback questionnaires were analysed from 89 students attending the Recovery College. Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMBS) and “Empower Flower” (a measure of personal resources) data for 56 students were compared pre- and post-attendance at courses. Findings The SWEMBS and Empower Flower indicated improvements in wellbeing and personal resources pre- to post-attendance at Recovery College courses. Satisfaction with the service was high. Students saw the service as unique, accepting and enabling. Students noted they developed a sense of hope, confidence and aspirations. They related this to practical changes, e.g. increasing work-related activity and decreasing service use. Research limitations/implications This research suggests that there is a need for further evaluation of the unique contribution that Recovery Colleges can make to mental wellbeing, and the mechanisms involved in promoting the process of recovery. Practical implications The Recovery College may be a cost-effective way to provide a supportive recovery-orientated environment which promotes students’ ability to build self-confidence and skills, enabling them to connect with others and progress towards independence and valued goals. This complements more traditional mental health services. Originality/value This paper reports on an area of mental health development where there is very limited research, adding valuable data to the literature.
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