Scalable approaches such as digital cognitive-behavioural therapy guided self-help (D-CBTgsh) may help close the treatment gap for college students with mental disorders. In a randomized clinical trial across 26 US colleges, populations were offered a mental health screen (39,194 assessed). Students with clinical levels or high risk for anxiety, depression and/or eating disorders (N = 6,205) were randomized to screening+D-CBTgsh or screening+referral-to-college-provided-care groups.

Findings: Screening+D-CBTgsh reduced prevalence of any mental disorder (primary outcome) at 6 weeks, 6 months, and 2 years. Services uptake was greater in screening+D-CBTgsh (74.4%) versus screening+referral (30.2%) at 6 months and 2 years, including for minoritized groups. Screening+D-CBTgsh (versus screening+referral to college-provided care) also improved dimensional outcomes of generalized anxiety, social anxiety, depression, eating disorder symptoms and mental health functioning. Findings supported transdiagnostic prevention and intervention benefits of screening+D-CBTgsh and its viability as a scalable, population-based approach.

This article features Daniel Eisenberg, director of mental health at the UCLA Center for Health Policy Research.