Pilot evaluation to assess the effectiveness of youth peer community support via the Kooth online mental wellbeing website

Abstract

Background Mental health problems among young people are of growing concern globally. UK adolescent mental health services are increasingly restricted to those with the most severe needs. Many young people turn to the internet for advice and support, but little is known about the effectiveness, and potential harms, of online support. Kooth is a widely-used, anonymised and moderated online platform offering access to professional and peer support. This pilot evaluation sought to assess changes in the wellbeing and mental health of Kooth users, and changes in their use of formal services, over one month. We explored how community aspects of the site were used, and we considered the economic implications for commissioners making Kooth available to young people. Methods We surveyed young people when they first accessed Kooth and again one month later (n = 302). Respondents completed measures of mental health and wellbeing, including family relationships and pandemic-related anxiety, and reported on their use of services and, at follow-up, their perceptions of whether and how they had benefitted. We carried out qualitative interviews with ten participants, exploring perceptions of the Kooth community and its impact. Results We found improvements across nearly all measures, including reductions in psychological distress, suicidal ideation and loneliness. Subsample analyses suggested similar benefits for those who used only the community/peer parts of Kooth as for those who engaged with Kooth’s counsellors. Participants reported learning from peers’ suggestions and experiences, described as different from the advice given by professionals. Helping others gave users a sense of purpose; participants learnt self-help strategies and became more confident in social interactions. Service use and opinion data suggested Kooth experiences may help users make more appropriate and effective use of formal services. Conclusion This pilot evaluation suggests that Kooth is likely to be a cost-effective way of providing preventative support to young people with concerns about their mental health, with possible benefits across a range of domains which could be investigated in a future controlled trial.

An early economic evaluation of Kooth, a web-based mental health platform for children and young people with emerging mental health needs

“…The economic burden of these services is also substantial. When inflated to 2020 levels, the average annual cost of CAMHS is £1521 per CYP aged 5 to 15 ( Stevens et al, 2022 ). The importance of investing in mental health services is recognised in the NHS Long Term Plan ( NHS, 2019 ).…”

“…Evidence suggests that engagement with Kooth is associated with reductions in psychological distress, suicidal ideation, loneliness, and reported self-harm ( Stevens et al, 2022 ). Notably, the observed benefits were similar between users who only used the community/peer-support functionality of Kooth and for those who engaged with Kooth's counsellors ( Stevens et al, 2022 ). However, the study was limited by the absence of a control group and only evaluated the impact after one month of use.…”

What are practitioners' views of how digital health interventions may play a role in online child sexual abuse service delivery?

“…This issue seemed particularly pertinent to address as OCSA impacts a substantial number of CYP ( 63 ) and there is a growing awareness of this among CAMHS providers, but there appear to be few resources for mental health practitioners to draw on ( 28 ). Current access to CAMHS is universally poor ( 64 ) and there is growing evidence post-COVID-19 of the need for sustained implementation of digital tools and interventions to encourage both help-seeking and competence by CYP ( 65 , 66 ). There is also evidence that DHIs could cater to diverse mental health problems at scale for CYP ( 67 , 68 ).…”

Digital mental health outcome monitoring for a structured text‐based youth counselling intervention: Demographic profile and outcome change

“…Digital mental health support services seem to be less accessible for older adolescents and emerging adults, with just 3% of the sample aged over 21 years. This may be an artefact of the way Kooth is promoted, with school settings being the main way that users hear about the service (Stevens et al, 2022), but also a complex transitional age from CYP to adult services bringing further challenges to access and reach as a continuation of care and transition between statutory professionals may bring more difficulties to engage with the platform and interventions. Promisingly, rates of young people from racialised groups registering with the service (14%, increasing to 18% for a structured online intervention) are comparable with what we would expect when compared with national data (17.3% Black and Minority Ethnic young people aged 16-24 years; Lewis, 2018).…”