BACKGROUND
Accelerated by technological advancements and the recent global pandemic, there is burgeoning interests in digital mental health literacy interventions (DMHL) that can positively impact mental health at scale and translate into real-world benefits. Existing work, however, remain inconclusive about the effectiveness of DMHL interventions on mental health functioning.
OBJECTIVE
This systematic review and meta-analysis investigated components and modes of DMHL interventions, moderating factors, and long term impacts on mental health literacy and mental health.
METHODS
We used a random-effects model in conducting meta-analyses and meta-regressions on moderating effects of the effectiveness of DMHL interventions on mental health.
RESULTS
Using random-effects modelling, which included 77 interventions with 80 effect sizes, we found a moderate effect of DMHL in enhancing distal outcome on mental health, with pooled effect size of SMD=0.35, P<0.001 [95% CI: -0.18 to 0.72], and large effect in increasing proximal outcome on mental health literacy, with pooled effect size of SMD=0.62, P<0.001 [95% CI: 0.55 to 0.69]. DMHL interventions were as effective as face-to-face ones and did not differ by platform type or dosage. DMHL PLUS interventions (DMHL psychoeducation coupled with other active treatment) produce large effects in bolstering mental health, are more effective than DMHL ONLY interventions (self-help DMHL psychoeducation) and comparable to non-DMHL ones (treatment as usual). Beyond fundamental effectiveness (pre-post intervention), strong inferences can be drawn about the effectiveness of DMHL interventions, which enhance mental health more than waitlist control condition. DMHL interventions demonstrated long-term positive effects on mental health that sustained over follow-up assessments, and were most effective in enhancing mental health of emerging adults and older adults.
CONCLUSIONS
Our findings advance theory and practice on DMHL and mental health. For theory building, our review and meta-analysis found that DMHL interventions are as effective as face-to-face ones. DMHL interventions confer optimal effect on mental health when DMHL psychoeducation is incorporated with informal, non-professional active treatment components, such as skill training and peer support, which demonstrate comparable effectiveness as treatment as usual with client-professional interactions and therapies. These findings are practically meaningful and underscore the feasibility and promise of digital modalities for improving mental health. DMHL interventions greatly increased literacy outcomes and moderately improved mental health functioning by reducing depression, anxiety, loneliness, and internalizing and externalizing symptoms and enhancing quality of life and resilience. These effects, which did not differ by platform type or dosage, were sustained over time. Such evidence can drive the adoption and implementation of DMHL interventions at scale, which represent a key foundation for practice-changing impact in the provision of mental health resource for individuals and the community.
CLINICALTRIAL
Prospero registration: NCT0 CRD42023363995. Registered 21 May 2023