The role of digital mental health support tools and the importance of the student co-production model in supporting their development

This project led by University of Lincoln successfully implemented digital interventions to support students in their transition from school or college into university. It embedded a student co-production model to allow student ownership of the design of digital resources and tools, as well as in their evaluation.

The use of digital tools to support wellbeing has become increasingly common in recent years, with 43,000 wellness and medical apps now available for smartphone use and an estimated 500 million people around the world using apps to support their health (Imison et al., 2016).

Given that the vast majority of the student-aged population are already highly engaged with all types of technology (The Lancet, 2018), and particularly in the light of COVID-19 restrictions limiting opportunities for face-to-face connection, it seems a natural step to offer students the digital means to support their own wellbeing.

However, there are a number of factors that can have a significant impact on the effectiveness of digital interventions. In particular, the ability of students to choose and control how they use digital tools, as well as having a role in influencing their design, is important in encouraging self-efficacy which can be vital for both prevention and recovery.

The transition into university can be a particularly challenging time for students in terms of the impact upon mental wellbeing, and access to a community that offers support is vital. This is made more difficult as students, whether with mental health issues or not, may risk losing their previous support community if moving away to university.

In addition, anxiety around being in an unfamiliar environment and not knowing peers during transition may act as barriers in both help-seeking and forming new support networks.

The challenge is to find new and innovative ways to allow students to connect with like-minded peers and build their own support communities. These should be done in ways which minimise anxiety around forming new social contacts and maximise opportunities to develop productive, meaningful relationships.

As many students are already engaged with online communities, often through social media channels or smartphone apps, digital interventions can help facilitate formal and informal opportunities for peer connection and community building.

The reduction of activities which can be done face to face throughout the pandemic has only emphasised the use of online tools as a means of support and communication.

For students seeking to develop new support networks, offering the digital means to do so can take away the awkward first steps in seeking out others with similar lived experience.

The University of Lincoln therefore offers students the opportunity to connect with other students through its Student Life community, both pre-entry and once students have started at university.

Resources include podcasts, filmed content which is shared via social media channels and an app which targets content to specific cohorts of students. All resources and interventions offer opportunities to connect through discussion on social media, and within the app through challenges, mood trackers, journaling and a news feed.

A natural step up from the Student Life community building is offering students the chance to shape and influence project activities. The student co-production model allows students to help steer the direction of the project through a range of student-led initiatives.

This includes creating content, influencing the design of the app and evaluating the content created, giving them direct ownership of the support community created through digital peer interactions.

Opportunities to co-produce are highlighted through the Student Life social media channels and through the news feed of the app to target those students who are already engaged with the community. On top of this, paid work to co-produce is offered as part of the project which gives students both additional income and the opportunity to build employability and life skills.

Taking the ‘designed for students, by students’ approach has resulted in a high uptake of digital support by students.

The most recent data provided by the project’s digital partners, and used to evaluate the impact of the project, demonstrates that active users for Lincoln’s mental health support app is double that of other universities using a comparable app.

In addition, each time students access the app they are using an average of 13 different elements of the app – providing evidence that they are not just ‘clicking in, clicking out’ but are actively engaging with the range of support on offer.

Qualitative data also demonstrates that students value the student-created approach:

• ‘I…. loved the podcast as it was by students and covered a range of topics…’
• ‘Good knowing people’s personal experiences and advice.’
• ‘It’s interesting to hear about their experiences…’
• ‘I particularly like the challenges section of the app; I feel like this could help more people feel involved with other students.’

Students are also taking up the opportunities offered to co-produce for the project, creating content that they know would be of the most benefit to themselves and their peers and using the community they have created to share it.

Doing so furthers one of the main aims of the project: to normalise emotional development and the use of digital tools to support this as a natural part of the university experience.

Using student co-production to highlight the need for students to both self- and peer-manage by embedding coping strategies both personally and within the support community can foster good habits which may aid in a lifelong ability to cope with change.

Harnessing this ability is particularly pertinent now in the wake of the global pandemic. It is hoped that the skills that students have acquired through the project will help them manage change, foster resilience and self-manage their emotions throughout the transitional period, throughout university and potentially post-university during students’ next transition into employment or further study.