Development and evaluation of an online intervention for the treatment of depression in university students

University of Nottingham and Mental Health Research UK Joint Award

Mark Robinson PhD Scholarship 2011, University of Nottingham, 
School of Community Health Sciences & Institute of Mental Health

Supervisors: Professor Cris Glazebrook & Professor Richard Morriss

Research Student: Bethan Davies

Start date: September 2011

Description

There are many factors associated with university life which can affect the mental health of students, including leaving the family home and supportive school environments, loneliness, sleep disturbance, drug and alcohol use, economic hardship and exam stress. 

Research suggests that University students have high rates of depression compared to the general population and the Royal College of Psychiatrists has argued that more needs to be done to identify and treat mental health problems in this vulnerable group.

Online self-help interventions for the management of depression have been shown to be effective and computer-based health education has lots of advantages for a student population including easy access and an engaging and interactive format. 

Computer-based education can use film to model behaviours and strategies which have been shown to improve mental health and can provide feedback by recording progress.

This project aims to use what we know about computer-based health education and therapy to develop an online programme specifically for university students with symptoms of depression. 


We want to see if those students using the programme have fewer symptoms of depression, make better use of available help and have a greater understanding of depression and its treatment compared to students without access. 

The PhD student will also talk to students offered the programme to find out how they felt about it and if anything made it difficult to use. If effective, the computer program will be a cost-effective intervention which be offered to students experiencing symptoms of anxiety and depression at an early stage.

Final Report

Young adulthood is a vulnerable period for the onset and development of depression, and is a common mental health problem experienced by university students. Depression can significantly impact and impair students’ academic performance, social relationships, and general well-being. However students often do not seek professional help for their mental health for many reasons, including stigma about mental health and help-seeking and preferences for self-reliance. Students are highly connected to internet-enabled technologies, and online interventions present a useful strategy for helping managing depression and can address many reasons why they do not seek professional help. Mental health literacy is an umbrella term reflecting an individual’s beliefs, knowledge and attitudes relating to mental health, which assist in recognition, management and prevention of mental health problems. The aim of this PhD was to develop an evidenced-based psycho-educational online intervention for promoting mental health literacy for depression (“depression literacy”) and management of depression in Nottingham-based university students.

This online intervention was informed by evidence from several research projects and through literature review of depression in university students, help-seeking theory for mental health problems, and the role of mental health literacy in helping improve management and help-seeking for depression.Study One involved a systematic review and meta-analysis of evidence for computer- and web based interventions to improve common mental health problems in university student populations. Study Two involved identifying the mental health needs of the intervention’s target population through a survey which profiled depressive and anxiety symptoms and related help-seeking behaviours with 758 local university students. Expanding on this, Study Three used involved interviews with students to explore their perceptions of changes in their mental well-being since entering university, factors affecting their mental well-being, and how they coped and managed their mental health within education. Findings from these two studies suggested friends were an important source of help. This led to Study Four, which involved a survey exploring students’ helping actions to support a hypothetical friend experiencing depressive symptoms. Findings from these four studies contributed into the development of the online intervention, based on Rickwood et al.’s (2005) four-step process model of help-seeking. Study Five describes the development and brief testing of the online intervention - a website named “Managing Your Mood Online” (MYMO). This website consisted of ten sections reflecting different aspects of mental health literacy. This thesis demonstrates the first stage of a process to design an appropriate and relevant resource for Nottingham-based university students.

After completing the PhD, my first appointment was as a Research Fellow in the NIHR MindTech Health Technology Co-Operative, based at the University of Nottingham. This group is a national centre focussing on the development, adoption and evaluation of new technologies for mental healthcare and dementia (www.mindtech.org.uk), and I am working within its Children and Young People’s Theme that focuses on the development and evaluation of digital technologies for children and young people’s mental health and well-being. I am also a member of the advisory board for Students Against Depression (www.studentsagainstdepression.org), a website developed and maintained by the Charlie Waller Memorial Trust (www.cwmt.org.uk).

Year 1 Progress Report from Bethan Davies

I’m Bethan Davies and I am a PhD student at the University of Nottingham who has been awarded funding from Mental Health Research UK to fund my studies. My PhD is focusing on the mental health of university students and will involve developing and evaluating an online intervention for depression in this population
. ...Read more ...

Bethan Davies wins Cascade Grant

The Cascade Grants Programme is a funding programme at the University of Nottingham that uses alumni donations to current students’ projects. The funding is awarded to projects that directly enhance the experience of students. Bethan submitted an application discussing the development of an online intervention central to her PhD, and how this can help support students’ mental health. She requested a small grant to support the hiring of a software developer once the intervention has been drafted. She was awarded £500, and will use this to support the development of materials and design of the intervention.

Moving onwards

Well I am now a second year PhD student – and the work is definitely on! Others have said to me it tends to be much busier in the second year, and after some delays with my ethics application in my first year I have now begun collecting some data. ... Read more ...

November 2012 - Events

This month I attended a workshop run by the British Psychological Society at their London offices. The workshop was based around using LifeGuide – which is a freely available piece of software that allows researchers to create, modify and trial online interventions.
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Blog March 2013

The New Year has brought on many new challenges for me – I have now collected data from my online survey, have cleaned it up and need to start statistical analysis. Initial findings seem to show that about half the students surveyed reported some degree of depressive or anxiety symptomology. I will be analysing this in the upcoming weeks to further explore the data. ...Read more ...

Blog August 2013

In mid-May I was very fortunate to be able to travel to Chicago to attend International Society for Research on Internet Interventions (ISRII) annual conference. A combination of financial support from the university’s graduate school and my school meant I could afford to go on this trip. 
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Blog December 2013

I have completed my systematic review and meta-analysis, and after reviewing and editing it many times have now submitted it for review to the Journal of Medical Internet Research. Hopefully when this review is published, I will be able to share more of this with you all. 
...Read more ... ...