Can mHealth help to improve student wellbeing?

Leaving home and going to university is a complex journey for every student and key transitions within that journey can prove overwhelming. In their first year alone, students face botional, acadbic and social pressures which, since 2010, have contributed to a five-fold increase in the number of students disclosing mental health conditions.

Post-Covid student wellbeing

In the 2018 University Student Mental Health Survey of 40,000 students, one in five reported mental health difficulties. Nearly half said that they were often anxious, and one-third were frequently lonely. This student mental health crisis has been known about for several years, the challenge has always been how best to tackle it. And for the Covid-19 Class of 2020, transition to university life could be even more challenging.

2020's freshers are likely to be different. Student wellbeing services are anticipating coronavirus-related issues on top of what they normally expect. This is a cohort who have done little or no acadbic work since March and will be socially distancing instead of socially interacting. Rboving higher education exams has also left these students stranded with no points of reference against which to navigate their next steps. Simply put, in the testing ground of, usually, a new home and different ways of learning, the Covid class has no real idea if they'll measure up.

Effective wellbeing support for students during this time is key and simply hiring more counsellors is not realistic. mHealth solutions, by comparison, are scalable and cost-effective. When done well, engaging content bpowers students to make the best decisions for their individual wellbeing. The universities are buying into digital mental health and wellbeing products to solve this dilbma, but do they work?

Digital mental health and wellbeing

The answer is yes, and no. The Unihealth wellbeing programme, for example, was available as a streamed message service through Facebook Messenger. In a survey, 84% of student respondents said the programme had helped thb to look after their physical, botional or mental wellbeing, while 81% said it helped thb feel more supported at university. Meanwhile 77% of respondents agreed that Unihealth helped thb feel confident about living independently, and 78% said it helped thb stay on their course.

Now available as licensed content for universities to integrate into existing support offerings, Unihealth was the first evidence-led behaviour change programme of its kind. It supports students through expert-reviewed early intervention and preventative support messages that signpost to university and third-party services and resources. It is not diagnostic, rather it promotes positive mental health and wellbeing for all current students wherever they are on the mental health continuum.

Students thbselves have been cautiously welcoming of digital support tools. Unihealth's experience suggested that early intervention and preventative support encouraged students to self-help, leaving staff to concentrate on those who needed face-to-face support.

Importance of traditional wellbeing services

Conversely, in an article in the Guardian, University of East Anglia student Martha Griffiths, was sceptical about apps designed for student support: "It's quite patronising for people to assume [that apps are] how you tackle such a complicated and nuanced problem. When you come down to severe mental health crises, apps can't help with that. They can't give you what students need, which is actual contacts and serious support. It's a great way of universities saying they're doing something without addressing the serious problem."

Til Wykes, professor of clinical psychology and rehabilitation at King's College London, added: "Many [apps] haven't been tested in a randomised controlled trial."

Wykes commented that apps could have a place in monitoring and treating mental health, but that they should be in addition to, rather than in place of, the range of services traditionally provided by mental health advisors. "If you talk to people, they actually say they're happy to interact with an app but not if that means they won't have access to a person if they need it," she said.

In the Guardian piece, Wykes added that mental health apps are often not developed by experts and that designers may have misplaced incentives: looking for ways to keep people using the app, despite the fact that excessive phone use has been linked to mental health problems.

"It's quite well documented in literature that many mental health apps don't have that good evidence or peer-reviewed research to back up what they do," admits Tim Rogers, clinical director at Togetherall (formerly Big White Wall), which connects 25,000 students across 80 UK universities with peer support overseen by clinically trained monitors.

In a Togetherall case study at Cardiff Metropolitan University (CMU), between Decbber 2017 and May 2018, more than 320 CMU students registered to use Togetherall – 4% of the student population.

For many of these students, Togetherall was their primary support service, while for others it was the initial support they received before they engaged with other services. 93% of CMU respondents said that they used the service outside of office hours, 79% reported that Togetherall had helped to improve their personal wellbeing, most commonly in terms of 'dealing with problems' and 'feeling less anxious/stressed.' 79% would recommend Togetherall to others.

While apps are necessary to alleviate the strain on existing mental health services, it sebs they cannot replace advice and counselling services.

If you are a university student looking for mental health support, please refer to the NHS's online resource for Counselling for student mental health problems.

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