Recent Developments in Digital Mental Health Interventions for College and University Students

  • Timothy D. BeckerEmail author
  • John B. Torous
Technology and its Impact on Mental Health Care (J Torous and T Becker, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Technology and its Impact on Mental Health Care



Mental health problems are prevalent among university students. Insufficient resources at student health centers and other barriers to treatment result in low rates of students receiving treatment, potentially impacting academic performance and long-term health. Digital mental health interventions have been proposed as a means of reducing the treatment gap, given their potential for flexibility, cost-effectiveness, and stigma reduction.

Recent Findings

Randomized controlled trials (RCTs) of short-term online interventions based on cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness have had promising short-term effects on measurements of anxiety, depression, and sleep when compared to waitlist controls in small to medium size non-clinical samples of predominantly women university students in high-income countries. Most interventions suffer from low adherence and completion rates, sometimes partially offset by personal support. The impact of these interventions on long-term mental health and academic outcomes remains uncertain.


Although studies of Internet-based interventions have shown promising results, the effectiveness of current interventions is limited by low adherence and questionable long-term efficacy in real-world settings.


University students College mental health Digital mental health eHealth Internet CBT 


Compliance with Ethical Standards

Conflict of Interest

John Torous reports grants from Ostuka, outside the submitted work. Timothy Becker reports personal fees from Buoy Health, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, et al. Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychol Med. 2016;46:2955–70.CrossRefPubMedGoogle Scholar
  2. 2.
    Eisenberg D, Golberstein E, Hunt JB. Mental health and academic success in college. BE J Econ Anal Policy. 2009;9.Google Scholar
  3. 3.
    Xiao H, Carney D, Youn S, Janis R, Castonguay L, Hayes J, et al. Are we in crisis? National mental health and treatment trends in college counseling centers. Psychol Serv [Internet. 2017;14:407–15 Available from:
  4. 4.
    Lipson SK, Lattie EG, Eisenberg D. Increased rates of mental health service utilization by U.S. college students: 10-year population-level trends (2007–2017). Psychiatr Serv [Internet]. 2018; Available from:;70:60–3. Scholar
  5. 5.
    Eisenberg D, Hunt J, Speer N, Zivin K. Mental health service utilization among college students in the United States. J Nerv Ment Dis. 2011;199:301–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Conley CS, Durlak JA, Shapiro JB, Kirsch AC, Zahniser E. A meta-analysis of the impact of universal and indicated preventive technology-delivered interventions for higher education students. Prev Sci [Internet] Prevention Science. 2016;17:659–78. Available from.
  7. 7.
    Dunbar MS, Sontag-Padilla L, Kase CA, Seelam R, Stein BD. Unmet mental health treatment need and attitudes toward online mental health services among community college students. Psychiatr Serv [Internet]. 2018; Available from:;69:597–600. Scholar
  8. 8.
    Ryan ML, Shochet IM, Stallman HM. Universal online interventions might engage psychologically distressed university students who are unlikely to seek formal help. Adv Ment Heal. 2010;9:73–83.CrossRefGoogle Scholar
  9. 9.
    Davies EB, Morriss R, Glazebrook C. Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis. J Med Internet Res. 2014;16:e130.CrossRefPubMedGoogle Scholar
  10. 10.•
    Harrer M, Adam SH, Baumeister H, Cuijpers P, Karyotaki E, Auerbach RP, et al. Internet Interventions for Mental Health in University Students: A Systematic Review and Meta-Analysis. Int J Methods Psychiatr Res. 2018; Recent systematic review of 48 studies on online mental health interventions for college students with meta-analyses for a range of outcomes.Google Scholar
  11. 11.
    Ellis LA, Campbell AJ, Sethi S, Resources W, Groups OS. Comparative randomized trial of an online cognitive-behavioral therapy program and an online support group for depression and anxiety. J CyberTherapy Rehabil. 2011.Google Scholar
  12. 12.
    Harrer M, Adam SH, Fleischmann RJ, Baumeister H, Auerbach R, Bruffaerts R, et al. Effectiveness of an internet- and app-based intervention for college students with elevated stress: randomized controlled trial. J Med Internet Res. 2018;20:1–16.CrossRefGoogle Scholar
  13. 13.
    Melnyk BM, Amaya M, Szalacha LA, Hoying J, Taylor T, Bowersox K. Feasibility, acceptability, and preliminary effects of the COPE online cognitive-behavioral skill-building program on mental health outcomes and academic performance in freshmen college students: a randomized controlled pilot study. J Child Adolesc Psychiatr Nurs. 2015;28:147–54.CrossRefPubMedGoogle Scholar
  14. 14.
    Mullin A, Dear BF, Karin E, Wootton BM, Staples LG, Johnston L, et al. The UniWellbeing course: a randomised controlled trial of a transdiagnostic internet-delivered cognitive behavioural therapy (CBT) programme for university students with symptoms of anxiety and depression. Internet Interv [Internet] Elsevier BV. 2015;2:128–36. Available from.
  15. 15.
    Musiat P, Conrod P, Treasure J, Tylee A, Williams C, Schmidt U. Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention. PLoS One. 2014;9:e93621.CrossRefPubMedGoogle Scholar
  16. 16.
    Sethi S, Campbell AJ, Ellis LA. The use of computerized self-help packages to treat adolescent depression and anxiety. J Technol Hum Serv. 2010;28:144–60.CrossRefGoogle Scholar
  17. 17.
    Stallman HM, Kavanagh DJ, Arklay AR, Bennett-Levy J. Randomised control trial of a low-intensity cognitive-behaviour therapy intervention to improve mental health in university students. Aust Psychol. 2016;51:145–53.CrossRefGoogle Scholar
  18. 18.
    Day V, McGrath PJ, Wojtowicz M. Internet-based guided self-help for university students with anxiety, depression and stress: a randomized controlled clinical trial. Behav Res Ther. 2013;51:344–51.CrossRefPubMedGoogle Scholar
  19. 19.
    Morris J, Firkins A, Millings A, Mohr C, Redford P, Rowe A. Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context. Anxiety, Stress Coping. 2015.Google Scholar
  20. 20.•
    McCall HC, Richardson CG, Helgadottir FD, Chen FS. Evaluating a web-based social anxiety intervention among university students: randomized controlled trial. J Med Internet Res. 2018;20:1–12 Intervention presented to highlight how the authors specifically sought to address previously identified limitations of online interventions.Google Scholar
  21. 21.
    Botella C, Gallego MJ, Garcia-Palacios A, Guillen V, Baños RM, Quero S, et al. An internet-based self-help treatment for fear of public speaking: a controlled trial. Cyberpsychology, Behav Soc Netw. 2010;13:407–21.CrossRefGoogle Scholar
  22. 22.
    Kahlke F, Berger T, Schulz A, Baumeister H, Berking M, Auerbach R, et al. Efficacy of an unguided internet-based self-help intervention for social anxiety disorder in university students: a randomized controlled trial. Int J Methods Psychiatr Res. 2019;e1766.Google Scholar
  23. 23.
    Levin ME, Haeger JA, Pierce BG, Twohig MP. Web-based acceptance and commitment therapy for mental health problems in college students: a randomized controlled trial. Behav Modif. 2017;41:141–62.CrossRefPubMedGoogle Scholar
  24. 24.
    Levin ME, Pistorello J, Seeley JR, Hayes SC. Feasibility of a prototype web-based acceptance and commitment therapy prevention program for college students. J Am Coll Heal. 2014;62:20–30.CrossRefGoogle Scholar
  25. 25.
    Levin ME, Hayes SC, Pistorello J, Seeley JR. Web-based self-help for preventing mental health problems in universities: comparing acceptance and commitment training to mental health education. J Clin Psychol. 2016;72:207–25.CrossRefPubMedGoogle Scholar
  26. 26.
    Lee RA, Jung ME. Evaluation of an mhealth app (destressify) on university students’ mental health: pilot trial. J Med Internet Res. 2018.Google Scholar
  27. 27.
    Noone C, Hogan MJ. A randomised active-controlled trial to examine the effects of an online mindfulness intervention on executive control, critical thinking and key thinking dispositions in a university student sample. BMC Psychol. 2018;6:13.CrossRefPubMedGoogle Scholar
  28. 28.
    Lintvedt OK, Griffiths KM, Sørensen K, Østvik AR, Wang CEA, Eisemann M, et al. Evaluating the effectiveness and efficacy of unguided internet-based self-help intervention for the prevention of depression: a randomized controlled trial. Clin Psychol Psychother. 2013;20:10–27.CrossRefPubMedGoogle Scholar
  29. 29.
    Taylor CB, Kass AE, Trockel M, Cunning D, Weisman H, Bailey J, et al. Reducing eating disorder onset in a very high risk sample with significant comorbid depression: a randomized controlled trial. J Consult Clin Psychol. 2016;84:402–14.CrossRefPubMedGoogle Scholar
  30. 30.
    Levin ME, Stocke K, Pierce B, Levin C. Do College students use online self-help? A survey of intentions and use of mental health resources. J College Stud Psychother. 2018;32:181–98.CrossRefGoogle Scholar
  31. 31.
    Räsänen P, Lappalainen P, Muotka J, Tolvanen A, Lappalainen R. An online guided ACT intervention for enhancing the psychological wellbeing of university students: a randomized controlled clinical trial. Behav Res Ther. 2016;78:30–42.CrossRefPubMedGoogle Scholar
  32. 32.
    Cavanagh K, Strauss C, Cicconi F, Griffiths N, Wyper A, Jones F. A randomised controlled trial of a brief online mindfulness-based intervention. Behav Res Ther. 2013;51:573–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Kvillemo P, Brandberg Y, Bränström R. Feasibility and outcomes of an internet-based mindfulness training program: a pilot randomized controlled trial. JMIR Ment Heal. 2016;3:e33.CrossRefGoogle Scholar
  34. 34.
    Frazier P, Meredith L, Greer C, Paulsen JA, Howard K, Dietz LR, et al. Randomized controlled trial evaluating the effectiveness of a web-based stress management program among community college students. Anxiety, Stress Coping. 2015;28:576–86.CrossRefGoogle Scholar
  35. 35.
    Hintz S, Frazier PA, Meredith L. Evaluating an online stress management intervention for college students. J Couns Psychol. 2015;62:137–47.CrossRefPubMedGoogle Scholar
  36. 36.
    Geisner IM, Varvil-Weld L, Mittmann AJ, Mallett K, Turrisi R. Brief web-based intervention for college students with comorbid risky alcohol use and depressed mood: does it work and for whom? Addict Behav. 2015;42:36–43.CrossRefPubMedGoogle Scholar
  37. 37.•
    Freeman D, Sheaves B, Goodwin GM, Yu LM, Nickless A, Harrison PJ, et al. The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. The lancet psychiatry. 2017; One of the largest studies to date addressing the impact of an online intervention for mental health among college students.Google Scholar
  38. 38.
    Hershner S, O’Brien LM. The impact of a randomized sleep education intervention for college students. J Clin Sleep Med. 2018.Google Scholar
  39. 39.
    Forsell E, Jernelöv S, Blom K, Kraepelien M, Svanborg C, Andersson G, et al. Proof of concept for an adaptive treatment strategy to prevent failures in internet-delivered CBT: a single-blind randomized clinical trial with insomnia patients. Am J Psychiatry. 2019;176:315–23.CrossRefPubMedGoogle Scholar
  40. 40.
    Nicholas J, Shilton K, Schueller S, Gray E, Kwasny M, Mohr D. The role of data type and recipient in individuals’ perspectives on sharing passively collected smartphone data for mental health: cross-sectional questionnaire study. JMIR mHealth uHealth. 2019;7:e12578.CrossRefPubMedGoogle Scholar
  41. 41.
    Rooksby J, Morrison A, Murray-rust D. Student Perspectives on Digital Phenotyping The Acceptability of Using Smartphone Data to Assess Mental Health. CHI Conf Hum Factors Comput Syst Proc (CHI 2019). Scotland: Glasgow. p. 2019.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Psychiatry, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA

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