{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T07:43:01Z","timestamp":1794037381012,"version":"4.8.0"},"reference-count":117,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While third\u2010level educational institutions have long provided counselling, a sharp rise in demand has led to limited access to mental health supports for many students, including those with ongoing difficulties. Digital mental health interventions represent one response to this unmet need, given the potential low cost and scalability associated with no\u2010to\u2010low human resources involved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to conduct a systematic review and meta\u2010analysis of the literature examining effectiveness of digital mental health interventions for university students with ongoing mental health difficulties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The following databases were searched: PubMed, EBSCOhost (CINHAHL\/PsycINFO\/PsycArticles) and Web of Science. Two\u2010armed randomised\u2010control trials were included in the meta\u2010analysis. A random\u2010effects meta\u2010analysis was conducted and standardised mean differences were calculated. Effect sizes were then compared in terms of therapeutic approach, and whether interventions were fully automated or guided interventions. This study was registered with PROSPERO, CRD42024504265.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty four eligible studies were included in this narrative synthesis, of which 21 randomised\u2010controlled trials were included in the meta\u2010analysis. Random\u2010effects meta\u2010analysis indicated an overall medium effect size in favour of digital interventions for both depression (Cohen's <jats:italic>d<\/jats:italic>\u2009=\u20090.55), and anxiety (Cohen's <jats:italic>d<\/jats:italic>\u2009=\u20090. 46). Of note, for anxiety outcomes, fully automated interventions appeared more effective (<jats:italic>d<\/jats:italic>\u2009=\u20090.55) than guided interventions (<jats:italic>d<\/jats:italic>\u2009=\u20090.35).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Digital mental health interventions are associated with beneficial effects for college students when measured in terms of anxiety and depression symptom severity. For anxiety, fully automated interventions may be more effective than guided interventions to reduce symptom severity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eip.70017","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T06:22:07Z","timestamp":1741587727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Digital Mental Health Interventions for University Students With Mental Health Difficulties: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4824-8307","authenticated-orcid":false,"given":"Alba","family":"Madrid\u2010Cagigal","sequence":"first","affiliation":[{"name":"School of Psychology University of Galway  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Kealy","sequence":"additional","affiliation":[{"name":"Health Promotion Research Centre University of Galway  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Potts","sequence":"additional","affiliation":[{"name":"School of Psychology Ulster University  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice D.","family":"Mulvenna","sequence":"additional","affiliation":[{"name":"School of Computing Ulster University  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Byrne","sequence":"additional","affiliation":[{"name":"School of Psychology University of Galway  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Barry","sequence":"additional","affiliation":[{"name":"Health Promotion Research Centre University of Galway  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Donohoe","sequence":"additional","affiliation":[{"name":"School of Psychology University of Galway  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12571"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20083"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2011.00270"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2196\/17712"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000362"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20010362"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/23311908.2022.2040160"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1961.01710120031004"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.56.6.893"},{"key":"e_1_2_8_11_1","volume-title":"BDI\u2010II, Beck Depression Inventory: Manual","author":"Beck A.","year":"1996"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2023.115082"},{"key":"e_1_2_8_13_1","volume-title":"Comprehensive Meta\u2010Analysis Version 3","author":"Borenstein M.","year":"2013"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470743386"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/24387"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2196\/14318"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2196\/26498"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010022\u201013943\u2010x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13033\u2010020\u201000356\u20109"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121\u2010016\u20100662\u20103"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2196\/11349"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.09.045"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710000772"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbct.2023.05.002"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.06.044"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2020.24"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(19)30275\u20105"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.799259"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006\u2010341x.2000.00455.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2017.05.004"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6588"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.2196\/39686"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9275"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.2196\/43727"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.764079"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.08.014"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2022.05.014"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/10447318.2020.1750792"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2020.1763366"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752\u20100118.2012.01285.x"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.13111"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9293"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12441"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.2196\/40719"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.2196\/21737"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2022.06.006"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.2196\/11482"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2021.104028"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e32816ebc8c"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2023.01.003"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/eip.12939"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.07.087"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_8_57_1","doi-asserted-by":"crossref","unstructured":"Kroenke K. R. L.Spitzer F. V.deGruy andR.Swindle.1998.15\u2010Item Patient Health Questionnaire (PHQ\u201015) [Database Record]. APA PsycTests.","DOI":"10.1037\/t19590-000"},{"key":"e_1_2_8_58_1","doi-asserted-by":"crossref","unstructured":"Kroenke K. R. L.Spitzer J. B. W.Williams andB.L\u00f6we.2009.Patient Health Questionnaire\u20104 (PHQ\u20104) [Database Record]. APA PsycTests.","DOI":"10.1037\/t06168-000"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44159\u2010021\u201000003\u20101"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.2196\/12869"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.2196\/25847"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.2196\/36004"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2020.1728281"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000459"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010016\u20100842\u20105"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800332"},{"key":"e_1_2_8_67_1","doi-asserted-by":"crossref","unstructured":"Lovibond S. H. andP. F.Lovibond.1995.Depression Anxiety Stress Scales (DASS\u201421 DASS\u201442) [Database record]. APA PsycTests.","DOI":"10.1037\/t01004-000"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8630"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(24)00163-9"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604.ch3"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2020.1825225"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1602"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2018.0316"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000334"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721004621"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000383"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2021.102425"},{"key":"e_1_2_8_78_1","unstructured":"OECD Indicators.2022.\u201cEducation at a Glance 2022 Editions OECD 2021.\u201dhttps:\/\/www.oecd.org\/en\/publications\/education\u2010at\u2010a\u2010glance\u20102022_3197152b\u2010en.html."},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13033\u2010022\u201000569\u20100"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2018.1515748"},{"key":"e_1_2_8_81_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010021\u201001626\u20104"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.2196\/11467"},{"key":"e_1_2_8_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpra.2022.04.001"},{"key":"e_1_2_8_84_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721001999"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.2196\/35159"},{"key":"e_1_2_8_86_1","doi-asserted-by":"publisher","DOI":"10.21037\/mhealth\u201023\u20106"},{"key":"e_1_2_8_87_1","doi-asserted-by":"publisher","DOI":"10.2196\/17767"},{"key":"e_1_2_8_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.01.227"},{"key":"e_1_2_8_89_1","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_2_8_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2023.06.006"},{"key":"e_1_2_8_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpsm.2022.04.005"},{"key":"e_1_2_8_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2012.02.004"},{"key":"e_1_2_8_93_1","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2021.1961781"},{"key":"e_1_2_8_94_1","doi-asserted-by":"publisher","DOI":"10.1006\/ceps.1999.1020"},{"key":"e_1_2_8_95_1","doi-asserted-by":"publisher","DOI":"10.2196\/13392"},{"key":"e_1_2_8_96_1","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000654"},{"key":"e_1_2_8_97_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2019.05.012"},{"key":"e_1_2_8_98_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.812667"},{"key":"e_1_2_8_99_1","doi-asserted-by":"publisher","DOI":"10.2196\/39516"},{"key":"e_1_2_8_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380\u2010021\u201001161\u20107"},{"key":"e_1_2_8_101_1","doi-asserted-by":"crossref","unstructured":"Spitzer R. L. K.Kroenke J. B. W.Williams andB.L\u00f6we.2006.Generalized Anxiety Disorder 7 (GAD\u20107) [Database Record]. APA PsycTests.","DOI":"10.1037\/t02591-000"},{"key":"e_1_2_8_102_1","doi-asserted-by":"publisher","DOI":"10.1097\/OR9.0000000000000048"},{"key":"e_1_2_8_103_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_8_104_1","doi-asserted-by":"publisher","DOI":"10.2196\/32271"},{"key":"e_1_2_8_105_1","doi-asserted-by":"publisher","DOI":"10.1037\/cou0000568"},{"key":"e_1_2_8_106_1","doi-asserted-by":"publisher","DOI":"10.2196\/43065"},{"key":"e_1_2_8_107_1","volume-title":"Not by Degrees: Improving Student Mental Health in the UK's Universities","author":"Thorley C.","year":"2017"},{"key":"e_1_2_8_108_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000410"},{"key":"e_1_2_8_109_1","doi-asserted-by":"publisher","DOI":"10.2196\/18990"},{"key":"e_1_2_8_110_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1092852900027279"},{"key":"e_1_2_8_111_1","unstructured":"Veritas Health Innovation.2020.Covidence Systematic Review Software.http:\/\/www.covidence.org."},{"key":"e_1_2_8_112_1","doi-asserted-by":"publisher","DOI":"10.1080\/03075079.2020.1744124"},{"key":"e_1_2_8_113_1","doi-asserted-by":"publisher","DOI":"10.2196\/42864"},{"key":"e_1_2_8_114_1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796020000281"},{"key":"e_1_2_8_115_1","doi-asserted-by":"publisher","DOI":"10.1080\/02699931.2014.976544"},{"key":"e_1_2_8_116_1","doi-asserted-by":"publisher","DOI":"10.2196\/30026"},{"key":"e_1_2_8_117_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0266725"},{"key":"e_1_2_8_118_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.233"}],"container-title":["Early Intervention in Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eip.70017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T10:36:25Z","timestamp":1747823785000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eip.70017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":117,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/eip.70017"],"URL":"https:\/\/doi.org\/10.1111\/eip.70017","archive":["Portico"],"relation":{},"ISSN":["1751-7885","1751-7893"],"issn-type":[{"value":"1751-7885","type":"print"},{"value":"1751-7893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70017"}}