Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview
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Abstract
BACKGROUND: An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low- and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues. OBJECTIVE: This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low- and middle-income countries). METHODS: We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews. RESULTS: In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings. CONCLUSIONS: Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low- and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.
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Recent reviews and meta-analyses on adolescents report small but significant pooled effect sizes in favor of Internet interventions compared to predominantly non-active control groups.
“Most of them report small but significant pooled effect sizes in favor of Internet interventions compared to predominantly non-active control groups (i.e., waitlist or placebo) [47, 59, 60].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [47]
In Results > Effectiveness Across Clinical Symptom Targets (page unavailable), the overview reports small, statistically significant pooled effects against nonactive controls in some reviews, including Harrer et al. and Garrido et al. Its overall conclusion is a small-to-medium effect across reviews, however, and it does not establish that most reviews found specifically small effects for Internet interventions. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe evidence base for internet interventions targeting university students is cautiously positive, but currently not robust.
“The evidence base for internet interventions targeting university students is cautiously positive, but currently not robust [11–13].”
From Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial (2024) · cites this paper as [12]
A later synthesis of data from 18 systematic reviews and meta-analyses for a wider group of adolescents and young people concluded that CBT-based interventions for depression and anxiety could be termed effective.
“a later synthesis of data from 18 systematic reviews and meta-analyses for a wider group of adolescents and young people concluded that CBT-based interventions for depression and anxiety could be termed effective”
From Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial (2024) · cites this paper as [12]
The same synthesis concluded that involvement of human support could improve effectiveness and intervention adherence.
“and that involvement of human support could improve effectiveness and intervention adherence [12].”
From Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial (2024) · cites this paper as [12]
Many reviews of the evidence for web-based interventions for specific disorders and for specific populations have been undertaken in recent years.
“many reviews of the evidence for web-based interventions for specific disorders (eg, depression [29-31]) and for specific populations (eg, adolescents and young adults [32,33]) have been undertaken in recent years.”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [33]
While CBT has been successfully translated into digital interventions for depression and anxiety, it appears to have little impact on ideation or other suicidal outcomes in comparison to alternative therapies such as DBT.
“Certainly, while cognitive behavioral therapy (CBT) has been successfully translated into digital interventions for depression and anxiety [35], it appears to have little impact on ideation or other suicidal outcomes in comparison to alternative therapies such as DBT [14].”
From The effect of a therapeutic smartphone application on suicidal ideation in young adults: Findings from a randomized controlled trial in Australia. (2022) · cites this paper as [35]
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MENTAL HEALTH AND DIGITAL TECHNOLOGY: A PUBLIC HEALTH REVIEW OF CURRENT TRENDS AND RESPONSES
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A Novel Peer-to-Peer Coaching Program to Support Digital Mental Health: Design and Implementation
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Digital Methods for the Spiritual and Mental Health of Generation Z: Scoping Review
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Analyzing the Challenges Facing Digital Mental Health (DMH) Between Aspiration and Reality
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Understanding Lay Counselor Perspectives on Mobile Phone Supervision in Kenya: Qualitative Study
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Psychotherapy, Artificial Intelligence and Adolescents: ethical aspects
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The Appa Health App for Youth Mental Health: Development and Usability Study
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Digital Mental Health Amid COVID-19
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Digital Treatment Paths for Substance Use Disorders (SUDs)
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“…of data from 18 systematic reviews and meta-analyses for a wider group of adolescents and young people concluded that CBT-based interventions for depression and anxiety could be termed effective, and that involvement of human support could improve effectiveness and intervention adherence [12].”
BackgroundJaegere, E. D., van Heeringen, K., Emmery, P., Mommerency, G., & Portzky, G. (2024) · JMIR Serious Games · doi:10.2196/47513 · Cited by 13 · see citing works
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RetractedGudka, R., McGlynn, E., Lister, K., Shaw, N., Pitchforth, E., Mughal, F., French, B., Ward, J. H., Newlove‐Delgado, T., & Price, A. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02676-y · Cited by 13 · see citing works
Exploring Youth Perspectives on Digital Mental Health Platforms: Qualitative Descriptive Study
Daniel, S., Volcko, L., Bassi, E. M., Hews‐Girard, J., Bright, K. S., Barker, M., Norman, L., Pintson, K., Henry, G., Soufi, S., et al. (2025) · JMIR Human Factors · doi:10.2196/69907 · Cited by 11 · see citing works
- Authors
- Lehtimaki, S., Martic, J., Wahl, B., Foster, K. T., & Schwalbe, N.
- Affiliations
- Johns Hopkins University (US)
- University of Washington (US)
- United Nations University-International Institute for Global Health (MY)
- Corresponding author
- Schwalbe, Nina
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2021-04-29
- Volume
- 8
- Issue
- 4
- Pages
- e25847
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC8120421
- OpenAlex
- W3134071992
- Cited by
- 488
- References
- 52
- Citations by year
- 2026: 120 · 2025: 136 · 2024: 116 · 2023: 82 · 2022: 28 · 2021: 5
- FWCI
- 9.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Fondation Botnar
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- digital mental health interventions, adolescents, youth, computerized cognitive behavioral therapy, anxiety, depression, low- and middle-income countries, cost-effectiveness, treatment accessibility, intervention adherence, dropout
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