(PS7-A11) A Qualitative Study of College Students Using Mobile Applications to Improve Self-care During the Pandemic

Background

In 2019, over 87% of college counseling centers reported growth in demand for mental health services (Gorman et al., 2019) but the increase is rarely matched with more resources, forcing counselors to triage based on urgency, limit outreach, and reduce visit frequency. These issues have been exacerbated by the increase in mental health symptoms during the pandemic (Charles et al., 2021). Evidence-based, digital mental health tools like mobile applications (apps) are one possible solution for reducing pressure on counselors and enhancing care access for students. Studies have shown success in implementing digital mental health at campuses that tailor these programs to students’ typical routines and communication patterns. This qualitative project examines the question: What are the main benefits and drawbacks of using a mobile app to address mental health in college students?

Methods

To assess the effects of integrating digital mental health into a typical routine, we collected qualitative data from students at a large urban university who were enrolled in Psychopathology and Abnormal Psychology classes (online-only; N=265) throughout Fall 2020 and Spring 2021 semesters—a time when most classes were fully virtual. Students were assigned a three-week self-care project during which they chose a self-care goal and picked one app from a list of five to work on it. It was explicitly stated that success in meeting self-care goals would not be graded. The apps used scientifically supported principles (e.g., behavioral activation, mindfulness) and were free to use. Students answered 14 questions throughout the project, including, “What app did you choose, and why?,” “How did you get around obstacles (or not?),” and “What progress (if any) did you see?.” Using a five-step thematic analysis procedure (Braun & Clarke, 2006), we coded responses with NVivo and Microsoft Suite, then collaborated to extract key themes.

Results

We identified three main themes and eight sub-themes. Students reported: 1) Using a mobile mental health app was beneficial and helped them more than expected by improving productivity and confidence in school and work settings (a), enhancing sleep (b), and bettering various facets of mental health, including mood, focus, and coping skills (c). 2) Challenges using the app, including slow/no progress on goals (a), loss of interest (b), negative effects – specifically spending more time on a screen (c), and difficulty integrating the app into daily life (d). 3) The pandemic was a major source of stress and a reason to use a mental health app, specifically that the app was helpful amid the challenge of online learning (a).

Conclusions

Students reported that using a mobile app for self-care was helpful, which is intriguing given the difficulties they also noted with virtual education and socialization. The challenges students experienced were consistent with pre-pandemic empirical evidence showing that sustained engagement with digital mental health interventions is poor. Incorporating digital mental health tools into students’ typical routines is one way to improve access to mental health support, but further research is needed to discover how to drive prolonged interest and engagement.