Digital phenotyping for mental health of college students: a clinical review

Experiencing continued growth in demand for mental health services among students, colleges are seeking digital solutions to increase access to care as classes shift to remote virtual learning during the COVID-19 pandemic. Using smartphones to capture real-time symptoms and behaviours related to mental illnesses, digital phenotyping offers a practical tool to help colleges remotely monitor and assess mental health and provide more customised and responsive care. This narrative review of 25 digital phenotyping studies with college students explored how this method has been deployed, studied and has impacted mental health outcomes. We found the average duration of studies to be 42 days and the average enrolled to be 81 participants. The most common sensor-based streams collected included location, accelerometer and social information and these were used to inform behaviours such as sleep, exercise and social interactions. 52% of the studies included also collected smartphone survey in some form and these were used to assess mood, anxiety and stress among many other outcomes. The collective focus on data that construct features related to sleep, activity and social interactions indicate that this field is already appropriately attentive to the primary drivers of mental health problems among college students. While the heterogeneity of the methods of these studies presents no reliable target for mobile devices to offer automated help—the feasibility across studies suggests the potential to use these data today towards personalising care. As more unified digital phenotyping research evolves and scales to larger sample sizes, student mental health centres may consider integrating these data into their clinical practice for college students.

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The Investigation of Mental Health Problems and Social Phobia Status of College Students

International Online Journal of Educational Sciences ◽

10.15345/iojes.2015.04.016 ◽

2015 ◽

Cited By ~ 1

Author(s):

Pakize Özyürek ◽

İbrahim Kılıç

Keyword(s):

Mental Health ◽

College Students ◽

Social Phobia ◽

Mental Health Problems ◽

Health Problems

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African American Women and Depression: Promoting the Need for Culturally Competent Treatment

10.35455/brk123456 ◽

2018 ◽

Author(s):

Bernice Kennedy ◽

Chalice Jenkins ◽

Keyword(s):

Mental Health ◽

African American ◽

Depressive Symptoms ◽

African American Women ◽

Mental Health Problems ◽

American Woman ◽

Stressful Events ◽

Mental Illnesses ◽

Diagnostic Process ◽

American Women

Abstract Depression is gradually increasing in African American women. These women are experiencing role changes and additional life stressors. Depressed African American women may perceive themselves as being devalued by society with fewer support systems to buffer stressful events. Depressive symptoms may develop into clinical depression and a further decrease in the quality of life for the African American woman. The assumption that all women share similar experiences does not allow for differences to emerge regarding the diagnostic process, measuring tools, and successful treatment strategies for various cultures. The authors developed a Multifaceted Model of Depression in African American Women for improving treatment of African American women with depression and future research needs. Cultural background plays a vital role in how the symptoms of mental illnesses are developed, reported, interpreted, and how women are treated. African Americans who subscribed to the Strong Black Women Archetype (SBWA) are naturally strong, resilient, self-contained, and self-sacrificing. This self-reliance prevents them from reaching out for social support. This, in turn, can contribute to depressive symptoms with negative health outcomes. The African American women are more apt to have less access to routine medical care where early diagnosis and interventions can be done, so their mental health problems (e.g., depression, stress, etc.) are often more developed, complicated, and their social supports more depleted when they do access treatment. When African American women do have access to mental health care, they receive poor quality care compared to Whites.

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“Take care of yourself”: a psychoeducational tool for adolescents for the mental health promotion (MHP) in the pediatric primary care (PPC)

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1246 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Passalacqua ◽

A Crameri ◽

A Zysset ◽

F Wieber ◽

A Wyl

Keyword(s):

Mental Health ◽

Focus Groups ◽

Mental Health Problems ◽

Mental Illnesses ◽

Pediatric Primary Care ◽

Online Addiction ◽

Health Strategy ◽

Helping Others ◽

Centered Care ◽

Resilience Framework

Abstract Background Worldwide 10-20% of children and adolescents experience mental disorders (MD). Half of all mental illnesses begin by the age of 14 and three-quarters by mid-20s. As adolescents move from child to adult-centered care, they should be encouraged to implement a proactive mental health strategy. Pediatrician have the potential to be an important gateway to MHP. The healthcare coordination may be affected by contextual constraints such as lack of time and the reluctance of the adolescents to seek help for MD. Adopting a resilience framework, we aimed to develop a psychoeducational toolkit to optimize the contact between the adolescents and their pediatrician. Methods We first collected pediatricians needs in a focus group and systematically searched in the literature for components of interventions that are effective in the MHP. We selected a previously developed toolkit, that we aimed to optimize and adapt culturally. The adapted toolkit was then evaluated by adolescents in two focus groups. We took their feedback into account when finalizing the toolkit. Results The psychoeducational toolkit “Take care of yourself” is a resource for adolescents to recognize risks for MD. It comprises ten topics that are central to MHP: myths and facts about MD, dealing with stress, love and loss, unhealthy relationships, separation, grief, online addiction, drugs, helping others, confidentiality, rights and obligations and useful websites. Analyses of the focus groups showed that adolescents and pediatricians evaluated the toolkit as appealing and helpful. Conclusions This toolkit provides a resource for adolescents to address mental health problems. It aims to increase MHP in PPC and to contribute to the destigmatization of MD. In a next step, we plan to test the effectiveness of this psychoeducational tool.

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Advances in psychiatric treatment in primary care

Advances in Psychiatric Treatment ◽

10.1192/apt.7.1.1 ◽

2001 ◽

Vol 7 (1) ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Christopher Dowrick

Keyword(s):

Mental Health ◽

Primary Care ◽

National Health Service ◽

Health Service ◽

Health Professionals ◽

Depressive Disorders ◽

Mental Health Problems ◽

Psychiatric Treatment ◽

Mental Illnesses ◽

Breaking Work

Following ground-breaking work by Shepherd et al (1966) and, more recently, Goldberg & Huxley (1992), primary care is now recognised as the arena in which most contact occurs between the National Health Service (NHS) and people with mental health problems. General practitioners (GPs) remain the first, and in many cases the only, health professionals involved in the management of a whole range of conditions, from common anxiety and depressive disorders to severe and enduring mental illnesses.

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Pathways to Mental Health Services and Perceptions about the Effectiveness of Treatment

Society and Mental Health ◽

10.1177/2156869318802341 ◽

2018 ◽

Vol 9 (3) ◽

pp. 388-407 ◽

Cited By ~ 3

Author(s):

Sirry M. Alang ◽

Donna D. McAlpine

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Mental Health Problems ◽

Severity Of Illness ◽

Mental Illnesses ◽

Social Characteristics ◽

Treatment Gap ◽

Quality Outcomes ◽

Effectiveness Of Care

The gap between need and effective treatment for mental health problems continues to be a challenge for researchers and policymakers. Much of the attention has been on differences in treatment rates, with insufficient attention to variation in pathways that people take into treatment. Individuals may choose to seek help but may also be substantially influenced by others or coerced into care. The chances of each type of pathway are influenced by social characteristics and may shape perceptions of effectiveness of care. This paper investigates variation in pathways into care and perceived effectiveness of care. We also examine whether choice or coercion into care are associated with whether individuals perceive care as effective and if severity of illness moderates this relationship. We use data from the 2010–2014 National Survey on Drug Use and Health (N = 10,020). Persons who independently sought mental health care were more likely to rate treatment as effective compared to persons ordered into care. Among people with severe mental illnesses, the probability of rating treatment as effective is lowest among those who were ordered into care. Entry into mental health care is not sufficient for closing the treatment gap if coerced care leads to poorer quality outcomes.

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Can digital data diagnose mental health problems? A sociological exploration of ‘digital phenotyping’

Sociology of Health & Illness ◽

10.1111/1467-9566.13175 ◽

2020 ◽

Vol 42 (8) ◽

pp. 1873-1887

Author(s):

Rasmus H. Birk ◽

Gabrielle Samuel

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Health Problems ◽

Digital Data ◽

Digital Phenotyping

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Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

JMIR Mental Health ◽

10.2196/21075 ◽

2020 ◽

Vol 7 (10) ◽

pp. e21075

Author(s):

Emily Lattie ◽

Katherine A Cohen ◽

Nathan Winquist ◽

David C Mohr

Keyword(s):

Mental Health ◽

College Students ◽

Mobile Apps ◽

Care Program ◽

User Feedback ◽

Mental Illnesses ◽

High Rate ◽

Feedback Information ◽

Symptoms Of Depression ◽

Mental Health Programs

Background In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation. Objective This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study. Methods IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill–focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app. Results Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=−2.006; P=.045) and in the frequency with which participants used both cognitive (Z=−2.091; P=.04) and behavioral (Z=−2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time. Conclusions The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students. Trial Registration ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577

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Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study (Preprint)

10.2196/preprints.21075 ◽

2020 ◽

Author(s):

Emily Lattie ◽

Katherine A Cohen ◽

Nathan Winquist ◽

David C Mohr

Keyword(s):

Mental Health ◽

College Students ◽

Mobile Apps ◽

Care Program ◽

User Feedback ◽

Mental Illnesses ◽

High Rate ◽

Feedback Information ◽

Symptoms Of Depression ◽

Mental Health Programs

BACKGROUND In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation. OBJECTIVE This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study. METHODS IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill–focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app. RESULTS Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=−2.006; P=.045) and in the frequency with which participants used both cognitive (Z=−2.091; P=.04) and behavioral (Z=−2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time. CONCLUSIONS The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students. CLINICALTRIAL ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577

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