Recent Developments in Digital Mental Health Interventions for College and University Students
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.
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.
KeywordsUniversity 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
- 2.Eisenberg D, Golberstein E, Hunt JB. Mental health and academic success in college. BE J Econ Anal Policy. 2009;9.Google Scholar
- 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: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emexa&NEWS=N&AN=622853666.
- 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;appi.ps.2018003. Available from:;70:60–3. https://doi.org/10.1176/appi.ps.201800332.CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1007/s11121-016-0662-3.
- 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;appi.ps.2017004. Available from:;69:597–600. https://doi.org/10.1176/appi.ps.201700402.CrossRefGoogle Scholar
- 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.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
- 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.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. https://doi.org/10.1016/j.invent.2015.02.002.
- 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.•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
- 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
- 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
- 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
- 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.Hershner S, O’Brien LM. The impact of a randomized sleep education intervention for college students. J Clin Sleep Med. 2018.Google Scholar
- 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
- 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