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A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial

Williams, A. Jess, Rhodes, C. Aubrey, Cleare, Seonaid, Borschmann, Rohan, Gross, James J., Petrova, Kate, Posada, Lauren, Tench, Christopher R., Chapman-Nisar, Amelia, Martin, Lucy, Hollis, Chris, Townsend, Ellen, Slovak, Petr, on behalf of Digital Youth research team·2026·Nature Medicine
DOI 10.1038/s41591-026-04422-6PMC PMC13279257
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Abstract

LGBTQ+ youth commonly have unmet mental health needs and are at elevated risk for self-harm, yet many face persistent institutional barriers to accessing support. One impactful way to reduce risk and promote wellbeing is by supporting emotion regulation; that is, the process by which individuals can influence which emotions they feel, when they feel them and how they experience or express these emotions. This universal, modifiable process is widely considered a key transdiagnostic target for mental ill-health prevention and intervention efforts. We conducted a randomized controlled trial using Purrble, a socially assistive robot designed to provide in-the-moment emotion regulation support through intuitive tactile interaction. Between 12 January and 1 September 2024, 153 LGBTQ+ youth with self-harm ideation were randomized 1:1 to receive Purrble and safety planning (Purrble + SP) or safety planning alone (SP-Only), stratified by gender identity (50.3% transgender/gender diverse). Data were collected over 13 weeks, with data collection closing on 22 October 2024. The primary outcome was perceived emotion regulation difficulties at follow-up, adjusted for baseline, gender identity and age. Participants allocated to the Purrble intervention reported fewer emotion regulation difficulties at follow-up than those allocated to safety planning alone (adjusted mean difference: –3.04; 95% confidence interval (CI): −4.92 to −1.16; P = 0.002; partial η 2 = 0.07). For secondary outcomes, participants in the Purrble intervention also reported significantly lower symptoms of anxiety and depression, but no significant main effect was observed for self-harm. No serious Purrble-related adverse events were observed. Purrble may offer a scalable intervention to complement existing therapeutic approaches to support LGBTQ+ youth to enhance their emotion regulation. ClinicalTrials.gov: NCT06025942 .

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Fig. 1 Purrble: socially assistive robot intervention device. Image of the socially assistive robot provided to participants in the intervention condition. Interactive features include touch-responsive sensors in the ears, feet and back stripe, a gyroscope for movement detection and an internal vibration motor that generates heartbeat-like and purr-like sensations.
Fig. 1 Purrble: socially assistive robot intervention device. Image of the socially assistive robot provided to participants in the intervention condition. Interactive features include touch-responsive sensors in the ears, feet and back stripe, a gyroscope for movement detection and an internal vibration motor that generates heartbeat-like and purr-like sensations.CC BY · PubMed Central
Fig. 2 CONSORT flow diagram of participant progression through the trial. Diagram showing the numbers of participants assessed for eligibility, excluded, randomized to each study condition, retained at follow-up and included in the final analyses. SH, self-harm.
Fig. 2 CONSORT flow diagram of participant progression through the trial. Diagram showing the numbers of participants assessed for eligibility, excluded, randomized to each study condition, retained at follow-up and included in the final analyses. SH, self-harm.CC BY · PubMed Central

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Metadata

Authors
Williams, A. J., Rhodes, C. A., Cleare, S., Borschmann, R., Gross, J. J., Petrova, K., Posada, L., Tench, C. R., Chapman-Nisar, A., Martin, L., Hollis, C., Townsend, E., Slovak, P., & on behalf of Digital Youth research team
ORCID
Venue
Nature Medicine
Publisher
Springer Science and Business Media LLC
Published
2026-06
Volume
32
Issue
6
Pages
2267-2276
ISSN
  • 1078-8956
  • 1546-170X
DOI
10.1038/s41591-026-04422-6
PMC
PMC13279257
Cited by
2
References
21
Language
en
Licence
Funders
RCUK | Medical Research Council (RE23499, RE19205)

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