A randomised controlled trial of a relationship-focussed mobile phone application for improving adolescents' mental health

Background This study evaluated the acceptability and effectiveness of a relationship-focussed mobile phone application (WeClick) for improving depressive symptoms and other mental health outcomes in adolescents. Methods A randomised controlled trial involving 193 youth (M age: 14.82, SD: 0.94, 86.5% female) from Australia was conducted. Youth were recruited via the Internet and randomly allocated to the intervention or a 4-week wait list control condition, stratified for age and gender. The primary outcome was change in depressive symptom scores measured using the Patient Health Questionnaire for Adolescents (PHQ-A) at baseline, 4-week post-test and 12-week follow-up. Secondary outcomes included anxiety, psychological distress, wellbeing, help-seeking intentions for mental health, social self-efficacy and social support. Participants in the intervention condition received access to the intervention for four weeks. Thematic analysis was utilised to identify and examine acceptability. Results The change in PHQ-A scores from baseline to 4-week post-test did not differ significantly (d = 0.26,p = .138) between the intervention (Mchange = -2.9,SD = 5.3) and wait list control conditions (Mchange = -1.7,SD = 4.3). However, significant between-group improvements were observed in wellbeing (d = 0.37,p = .023), help-seeking intentions (d = 0.36,p = .016) and professional help-seeking intentions for mental health problems (d = 0.36,p = .008). Increases in help-seeking intentions were sustained at follow-up in the intervention condition. No differential effects were found for generalised anxiety, separation anxiety, social self-efficacy or for any social support outcomes. Over 90% of participants indicated the app was enjoyable, interesting and easy to use. The app provided 'advice and direction' (n = 42; 46.15%), an 'opportunity for self-reflection' (n = 33; 36.3%) and 'normalised experiences' (n = 21; 23.1%). Conclusions The WeClick app was found to be effective for improving wellbeing and help-seeking intentions for mental health in adolescents. A larger, adequately powered trial is now required to establish differential effects on depressive symptoms. This trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618001982202.