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BackgroundAdolescence can be a fertile time for relationship issues, with interpersonal conflict being a risk factor for poor mental health. Mobile app interventions may have a significant appeal to young people in assisting with relationship distress. However, currently available apps have not been formally evaluated. Youths’ perspectives on engaging with mobile technology to assist with relationships are also unknown. ObjectiveThis study aimed to examine adolescents’ attitudes toward the concept of a mobile phone app for relationship help and support, and whether they would be likely to use such an intervention. MethodsA cross-sectional Web survey consisting of 42 questions, including 13 free responses, was delivered. The proposed app, including character vignettes, was presented, and participants were asked to indicate whether they had experienced the same relationship issues, whether their peers would relate to the issues, and how helpful they found the proposed advice. Participants were also asked to provide their own suggestions for help, which were analyzed using thematic analyses. ResultsA total of 150 adolescents (aged 15 to 18) participated. Overall, 60.7% (91/150) were likely to use an app for relationship problems, and this was not associated with demographics or social support (all P values >.05). Likelihood of app usage was found to be influenced by perceived need for help, personal beliefs about app effectiveness, and whether the app is engaging and easy to use. Overall, adolescents were receptive of the proposed content with an average of 99.3% (149/150), rating the strategies provided as somewhat to very helpful. ConclusionsAdolescents were likely to use a mobile phone app for relationship support, and use was not influenced by gender, age, social support, or any other background characteristic. Instead, likely use was influenced by need, personal beliefs, usability, and the appropriateness of app content. App developers must address these factors if the app is to have a wide-scale uptake.

Background Suicidal ideation is a major risk for a suicide attempt in younger people, such that reducing severity of ideation is an important target for suicide prevention. Smartphone applications present a new opportunity for managing ideation in young adults; however, confirmatory evidence for efficacy from randomized trials is lacking. The objective of this study was to assess whether a therapeutic smartphone application ('LifeBuoy') was superior to an attention-matched control application at reducing the severity of suicidal ideation. Methods and findings In this 2-arm parallel, double-blind, randomized controlled trial, 455 young adults from Australia experiencing recent suicidal ideation and aged 18 to 25 years were randomly assigned in a 2:2 ratio to use a smartphone application for 6 weeks in May 2020, with the final follow-up in October 2020. The primary outcome was change in suicidal ideation symptom severity scores from baseline (T0) to postintervention (T1) and 3-month postintervention follow-up (T2), measured using the Suicidal Ideation Attributes Scale (SIDAS). Secondary outcomes were symptom changes in depression (Patient Health Questionnaire-9, PHQ-9), generalized anxiety (Generalized Anxiety Disorder-7, GAD-7), distress (Distress Questionnaire-5, DQ5), and well-being (Short Warwick-Edinburgh Mental Well-Being Scale, SWEMWBS). This trial was conducted online, using a targeted social media recruitment strategy. The intervention groups were provided with a self-guided smartphone application based on dialectical behavior therapy (DBT; 'LifeBuoy') to improve emotion regulation and distress tolerance. The control group were provided a smartphone application that looked like LifeBuoy ('LifeBuoy-C'), but delivered general (nontherapeutic) information on a range of health and lifestyle topics. Among 228 participants randomized to LifeBuoy, 110 did not complete the final survey; among 227 participants randomized to the control condition, 91 did not complete the final survey. All randomized participants were included in the intent-to-treat analysis for the primary and secondary outcomes. There was a significant time x condition effect for suicidal ideation scores in favor of LifeBuoy at T1 (p < 0.001, d = 0.45) and T2 (p = 0.007, d = 0.34). There were no superior intervention effects for LifeBuoy on any secondary mental health outcomes from baseline to T1 or T2 [p-values: 0.069 to 0.896]. No serious adverse events (suicide attempts requiring medical care) were reported. The main limitations of the study are the lack of sample size calculations supporting the study to be powered to detect changes in secondary outcomes and a high attrition rate at T2, which may lead efficacy to be overestimated. Conclusions LifeBuoy was associated with superior improvements in suicidal ideation severity, but not secondary mental health outcomes, compared to the control application, LifeBuoy-C. Digital therapeutics may need to be purposefully designed to target a specific health outcome to have efficacy. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12619001671156, Author(s): Michelle Torok 1,*, Jin Han 1, Lauren McGillivray 1, Quincy Wong 2, Aliza Werner-Seidler 1, Bridianne O'Dea 1, Alison Calear 3, Helen Christensen 1 Introduction Young people have repeatedly [...]

Objectives: The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods: The FPS is an Australian school‐based prospective cohort study with an embedded cluster‐randomized controlled trial examining the effects of digital prevention programs on mental health. Data sources include self‐report questionnaires, cognitive functioning, linkage to health and education records, and smartphone sensor data. Participants are assessed annually for 5 years. Results: The baseline cohort (N = 6388, M = 13.9 years) is broadly representative of the Australian adolescent population. The clinical profile of participants is comparable to other population estimates. Overall, 15.1% of the cohort met the clinical threshold for depression, 18.6% for anxiety, 31.6% for psychological distress, and 4.9% for suicidal ideation. These rates were significantly higher in adolescents who identified as female, gender diverse, sexuality diverse, or Aboriginal and/or Torres Strait Islander (all ps < 0.05). Conclusions: This paper provides current and comprehensive data about the status of adolescent mental health in Australia. The FPS cohort is expected to provide significant insights into the risk, protective, and mediating factors associated with development of mental health conditions during adolescence. [ABSTRACT FROM AUTHOR]

Data generated within social media platforms may present a new way to identify individuals who are experiencing mental illness. This study aimed to investigate the associations between linguistic features in individuals' blog data and their symptoms of depression, generalised anxiety, and suicidal ideation. Individuals who blogged were invited to participate in a longitudinal study in which they completed fortnightly symptom scales for depression and anxiety (PHQ-9, GAD-7) for a period of 36 weeks. Blog data published in the same period was also collected, and linguistic features were analysed using the LIWC tool. Bivariate and multivariate analyses were performed to investigate the correlations between the linguistic features and symptoms between subjects. Multivariate regression models were used to predict longitudinal changes in symptoms within subjects. A total of 153 participants consented to the study. The final sample consisted of the 38 participants who completed the required number of symptom scales and generated blog data during the study period. Between-subject analysis revealed that the linguistic features "tentativeness" and "non-fluencies" were significantly correlated with symptoms of depression and anxiety, but not suicidal thoughts. Within-subject analysis showed no robust correlations between linguistic features and changes in symptoms. The findings may provide evidence of a relationship between some linguistic features in social media data and mental health; however, the study was limited by missing data and other important considerations. The findings also suggest that linguistic features observed at the group level may not generalise to, or be useful for, detecting individual symptom change over time. [ABSTRACT FROM AUTHOR]

This study examined school counsellors' and parents' experiences of a school-based digital mental health service (Smooth Sailing) that screened students' mental health and provided automated psychological care. The Smooth Sailing service was offered to 4 secondary schools in New South Wales, Australia, for a 6-week trial period with 59 students taking part. The participating school counsellors (n = 4) completed a semi-structured interview to explore their experiences. Parents of students who had consented to being contacted (n = 37/59) were invited to complete an anonymous online survey about their child's participation. Six parents completed the survey. The school counsellors expressed overall support for the service and cited the ease of service use, its ability to identify students at-risk, and the provision of psychoeducation to students as clear benefits. They identified some barriers to the service, such as parental consent and suggested strategies to improve uptake and engagement, such as incentives, more frequent screening and use with older students. Parents also reported positive experiences with the service, expressing appreciation for mental health screening in schools and a new system to connect them and their child to school counselling services. Taken together, these findings provide initial support for delivering the Smooth Sailing service in secondary schools. Trial registration: This trial was registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12617000977370). [ABSTRACT FROM AUTHOR]

Background : Schools play an important role in supporting young people's mental health, but face challenges identifying and responding to students in need of care. To assist secondary schools, the Black Dog Institute has developed an online, school-based, mental health service (Smooth Sailing). Delivered in the classroom, Smooth Sailing uses a website to screen, assess, allocate, and deliver care for depression and anxiety. The service is based on the principles of stepped care, offering treatments with varied intensity and follow-up by a school counselor when necessary. The current study aimed to evaluate the feasibility, acceptability, and safety of this new type of service among secondary school students. Methods : Between February and June 2017, a single-arm, pre-post, pilot study was conducted among students from four NSW secondary schools. Schools were given access to the service for 6 weeks. Feasibility measures (consent rates and step allocations), acceptability measures (service use and satisfaction) and safety measures (deterioration in help-seeking intention scores and mental health symptoms) were assessed at baseline and completion of the 6-week trial period. Results : A total of 59 students took part in the service pilot (mean age, 14.57 years; SD, 0.89 years; range, 13-16 years). At baseline, 18.64% of students were found to require follow-up from the school counselor, and 80% of these were new cases. Although completion of the online modules was low, service satisfaction was high. At 6 weeks, the mean scores for help-seeking, depression, and anxiety remained relatively stable or improved. Conclusions : The current study presents important findings for the development and implementation of an online mental health service that screens students' mental health and allocates care accordingly, all within the school setting. Although the findings provide some support for the feasibility, acceptability, and safety, service improvements are needed. The modifications outlined are likely to improve the quality of the service and its effectiveness. Trial Registration : Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12617000977370 [ABSTRACT FROM AUTHOR]

Background The Australian Government's Fifth National Mental Health and Suicide Prevention Plan recommends a stepped care model of mental healthcare that focuses on matching the intensity of care to the severity of illness. General practitioners (GPs) need to learn more about low-intensity online interventions to better meet the needs of patients of lower severity. Objective This article provides GPs with information about low-intensity, evidence-based online resources developed in Australia and available for integration into the care of patients with mild-to-moderate mental health conditions. This article has an emphasis on new developments since 2015. Discussion The internet provides an opportunity to deliver effective mental health treatment to people who would otherwise not seek, or be able to reach, skilled help for their mental health conditions. High-quality, evidence-based cognitive behavioural therapy treatment programs are available to all Australians, at no or low cost. These options can be integrated into a stepped care model of mental healthcare, and provide GPs with an opportunity to help patients access treatment that suits their needs. [ABSTRACT FROM AUTHOR]