Optimizing Retention in Mental Health Interventions

Lydia Wang ’26

Figure 1: The prevalence of mental health disorders in adolescents continues to rise

With rising rates of mental health disorders in adolescents, it has become increasingly important to ensure that the right treatment is available for them. Many adolescents do not receive proper mental health care because of structural or psychological barriers. For example, insurmountable costs and transportation fees, as well as the stigma associated with mental health may pose potential barriers. With the advent of the internet, online interventions should mitigate these barriers; however, low retention rates have been observed. As a result, it is important to look at what factors are associated with dropout in online mental health interventions. Stony Brook University researchers Katherine Cohen and Jessica Schleider investigated the factors behind adolescent dropout, along with how demographics affect an individual’s likelihood of dropout.

A total of 2,436 participants between the ages of 11 and 18 were recruited via social media advertisements for this study. These individuals were split into two different 30-minute single-session mental health intervention (SSI) projects that focused on improving their mindsets. Within these projects, individuals were split into a randomized controlled trial (RCT) group, comprising individuals who were given no incentive to finish the session, and another group in which participants were paid $20 if they completed the session. Baseline hopelessness levels, demographics, and sexual orientation were also recorded to determine whether they affected dropout rate. The Beck Hopelessness Scale (BHS) was used to measure hopelessness levels, with higher scores indicating higher levels of hopelessness. The researchers found that patients were significantly (p < 2.2e-16) more likely to finish the session if they were incentivized. Hopelessness scores and demographic groups had no impact on whether an individual completed their study. This suggests that those with minority identities and those with a higher baseline stress level were just as likely to finish (or drop out) as other participants.

The onset of mental disorders peaks at adolescence, lending importance to optimizing the potential of accessible interventions. By identifying predictors of dropout, user-centered design work can be altered to better fit the needs of the target audience. In the future, studying longer and more consistent interventions along with varying incentivization might be beneficial in narrowing down what the best option may be. Given that online interventions are inherently more accessible than in-person interventions, it is important to optimize their use to benefit a vulnerable population.

Works Cited:

[1] K. Cohen and J. Schleider, Adolescent dropout from brief digital mental health interventions within and beyond randomized trials. Internet Interventions 27, (2022). doi: 10.1016/j.invent.2022.100496

[2] Image retrieved from: https://unsplash.com/photos/Of8C-QHqagM


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