UvA PhD student researched digital platform for showing early signs of mental health issues: “Now there is no treatment”
The mental health of young people has been alarmingly poor for years. UvA PhD student and GZ psychologist Marilon van Doorn has implemented a digital platform for young people with beginning mental health complaints. “It’s low-threshold, inexpensive, and it works.”
What makes your platform different from the E-Health modules that already exist, for example, from the UvA student GPs?
“This platform comes from Australia and has been researched there for more than 14 years; other platforms don’t have that scientific foundation. Also, the platform works differently. It has an algorithm that develops a personalized therapy path with exercises tailored to a young person’s symptoms and strengths. Video calls are held with psychologists and experienced experts via computer or a smartphone. There is also an online community where young people can exchange tips and messages. It is anonymous and not public and is moderated by psychologists and experienced experts. Young people can support each other there. On top of that, the platform was designed by cartoonists and artists, so it also looks really fun!”
What are young people struggling with?
“Anxiety symptoms were most common, followed by gloominess. We also saw many young people with a negative self-image. The origin here often lies in the tendency to compare yourself a lot with others. Evolutionarily speaking, comparison is important. In the time of hunters and gatherers, we lived in groups of a hundred people, and if you fell outside the group, you were on your own. On Instagram, you compare yourself to thousands of others at the same time. Those groups are huge. Also, social media often gives a more positive representation of reality. can create a negative self-image.”
More than half of Dutch young people experience mental health problems. Why has the mental health of young people deteriorated so much in recent years?
“Good question. The corona pandemic played a role in this, but even before that, complaints were increasing. There are several factors involved. Society places high demands on young people and there is a lot of pressure to find a job or course of study that is also your passion. There is also a stigma attached to having mental health problems and accessing care is extremely difficult. Where can you turn? Aren’t there others who need help more? There are also long waiting lists and insufficient capacity to treat young people.”
How can this digital platform help with this?
“In the mental health system, you need an official diagnosis to get care. Emerging mental health issues do not qualify for that. That’s why in my dissertation I looked at a clinical staging model, which describes the different stages of psychological complaints rather than ‘to label or not to label.’ In diseases such as cancer and diabetes, this is already quite normal. With those illnesses, you adjust the diagnosis and treatment according to the severity of the complaint. But for psychological complaints, we do not yet apply such a model. Based on this model, we implemented a digital platform, called ENgage YOung people earlY (ENYOY), for young people with incipient psychological symptoms. We investigated whether you can use an intervention to prevent the symptoms from getting worse.”
Who participated in the study?
“More than 600 adolescents with incipient psychological symptoms signed up. Over 131 adolescents from the Netherlands participated, including many UvA students. The percentage of participants from the university was relatively high; we also had many more women than men.”
How come more women participated?
“We asked the participants this same question. They indicated that it was mainly because of the stigma that men associate with talking about emotions. The idea is that you shouldn’t be vulnerable as a man. What we also know from research is that partly because of this, men raise the alarm later, when symptoms have already gotten worse.”
Ideally, wouldn’t it be better to see young people ‘physically’?
“As a psychologist, I also prefer to see someone face-to-face. But the advantage of digital technology is that the threshold is much lower to get started. That way we could help young people all over the Netherlands, even if they lived in the countryside. Besides, young people have already let us know that they like the autonomy it offers and the fact that they can work on it themselves at a time and place that suits them.”
Does it work?
“The results are very positive. Young people were allowed to use the platform for six months and we found a significant reduction in psychological symptoms after three months, even more improvement after six months, and a stabilization of symptoms after one year. Young people’s functioning also improved significantly and their quality of life increased.”
That sounds promising. Where can students register?
Unfortunately, that is not yet possible. This research was a first step. First, we have to do research with a control group. In addition, the platform is not yet easy to roll out. For the last few years, the policy of the GGZ (the Dutch Association of Mental Health and Addiction Care) has been divided into regions. Therefore, agreements must be made per municipality and money must be found to implement this. In addition, although the Youth Act states that preventive treatment of incipient mental health problems is necessary, it is not yet included in health insurance.’
“As a psychologist, I prefer to start working on it as soon as possible. There are so many young people with mental health issues’for which there is no treatment now. Patients who have been in the mental health system for some time that I talk to in my work as a psychologist often say, ‘If there had been care earlier, it would have made so much difference.’ Meanwhile, two grants have come in to continue working on the platform.”
Marilon van Doorn will receive her doctorate on Wednesday, February 28th at 4:00 p.m. for her dissertation, “Revolutionizing youth mental health: Unlocking hope and healing: A digital transdiagnostic moderated social therapy platform (ENYOY) for youth with emerging mental health complaints.” The defense will take place in the Agnietenkapel and is free to attend.
