May is Mental Health Awareness month. To shed light on this pressing issue, we interviewed Dr. Daniel Vigo about his most recent publication, “Effectiveness of the Minder Mobile Mental Health and Substance Use Intervention for University Students: Randomized Controlled Trial.”

 

Dr. Daniel Vigo holds diverse roles as a psychiatrist, clinical psychologist, public health specialist and assistant professor in the UBC Department of Psychiatry and the UBC School of Population and Public health. At UBC, Dr. Vigo leads several projects, such as the Needs-Based Planning for Mental and Substance Use Disorder Project, the Student E-Mental Health Project, and several psychiatric epidemiology studies of regional, national, and global scope.

 

University life and our early 20s are often romanticized as the best times of our lives, filled with excitement and possibilities. However, this period of transition can also be incredibly challenging, leaving many students vulnerable to unexpected stressors and mental health struggles. With the loss of familiar support systems and the pressure to succeed, it is no wonder that the onset of mental health disorders and substance use peaks during this time.

In Canada, accessing mental health treatment can be hindered by various barriers. According to Dr. Vigo, there are certain obstacles in the way of effective coverage such as availability, accessibility, and acceptability. Some services may simply be unavailable, inaccessible due to cost or location, and even unacceptable – provided in ways that do not suit their target population. But amidst these challenges, there’s growing potential in e-Interventions.

“In theory, a digital tool can be available to anyone, anywhere at any time,” Dr. Vigo explains. “So that’s a phenomenally important asset because this overcomes the first constraint on effective coverage.”

The student e-mental health project led by Dr. Vigo aims to investigate student wellbeing and provide personalized e-interventions based on collaborations with UBC student groups. These digital platforms offer easily scalable solutions, bridging the gap between students in need and the support they deserve.

Introducing the Minder app:

“So that is what we tried to do with the Minder app. We tried to create a tool that would expand the range of services available to everyone’s issues related to the lived experiences of a student,” Dr. Vigo remarks.

Minder, a mobile app developed by the Vigo lab with funding from Health Canada, is designed “with the goal of creating a public good” as Dr. Vigo emphasizes. Because it is free to use for any Canadian student, it does not have any constraints on availability or accessibility.

From advisory committees, bootcamps and focus groups, the Vigo lab has engaged hundreds of students in the development of Minder. Due to this ongoing collaboration and open dialogue, the app is designed specifically for Canadian university students, thus checking the last box of acceptability.

 

“Our app, based on this co-development work with students, delivers interventions through an automated chatbot and through peers that can connect either through chat, video or phone.” Dr. Vigo explains. “It delivers tailored recommendations based on a triage tool that we have. And then there is a community component: for a university student, it matches them with the right student group on campus based on their interests.”

The Minder app interface. Peer coach, services, and community components. (A) The peer coach component allows users to connect with trained student volunteers, (B) the services component matches users with resources, and (C) the community component lists student groups by interest.

By addressing factors like anxiety, depression, substance use, and overall mental well-being, Minder aims to enhance users’ readiness to change, self-efficacy, and connection to support.

As noted in Dr. Vigo’s most recent publication, 1,496 UBC Vancouver students were involved in the study which established that Minder was effective in decreasing depression, anxiety, binge drinking, cannabis use, and improving wellbeing. Participants with full access to Minder’s features showed significant reductions in depression and anxiety after the follow up questionnaire.

Future directions

“We’ve already established the effectiveness and feasibility of this app, and now what we want to do is something more along the lines of precision medicine, where we can have many pathways built into the app,” says Dr. Vigo.

Due to concerns about the current effectiveness and safety of using existing artificial intelligence tools in a psychotherapeutic context, Minder does not currently use artificial intelligence (AI). However, he is enthusiastic about the possibility of integrating AI to enhance Minder’s personalization, flexibility, and responsiveness, seeing its potential as “a tool which is responsive, flexible and has a lot of advantages over a highly structured chatbot.”

Dr. Vigo’s lab is exploring the possibility of incorporating large language models allowing the chatbot to provide more personalized but nonetheless curated responses to students in need. Currently, the chatbot is very structured, with separate options for each type of intervention. Students can respond to prompts with multiple-choice answers and in unstructured text boxes.

Moving forward, the lab plans to leverage AI to analyze student responses and let it flag content, creating a more responsive interaction. In addition, Dr. Vigo wants to incorporate AI into the suggestion algorithm of the app. Unlike the current model, which requires students to select areas of interest, he envisions a more personalized approach where students are “nudged into the best choice for them.” This would result in each student receiving a unique pathway tailored to their needs.

Dr. Vigo envisions a future where technology in mental health becomes increasingly integrated and adept at detecting variations in disorders.

“It will be more and more integrated, and much more skillful at detecting phenotypical variations of any disorder. We could predict how the disorder will evolve or what the best treatment would be for it,” he explains.

However, he also acknowledges the potential drawbacks, cautioning against the exploitation of untested technologies for profit or malicious purposes. He warns that such misuse could have serious repercussions, emphasizing the importance of responsible, evidence-based use of chatbots and diagnostic tools.

Dr. Vigo’s insights extend beyond the realm of technology, emphasizing the importance of community and support in addressing mental health challenges. He underscores the significance of recognizing signs of distress in peers and students, urging us to be vigilant and proactive in reaching out to those who may be struggling.

“Let’s try to be a community for that person,” he encourages. Furthermore, he highlights the importance of informal resources and assistance within academic environments, affirming that help from peers, faculty, and others in the community can be accessible: “Try reaching out, because help will materialize.”

In fostering a culture of compassion, awareness, and support, both students and faculty alike can contribute to a community where individuals feel empowered to seek help and receive the support, both formal and informal, they need to thrive.

The Minder App Interface Image: Copyright ©Melissa Vereschagin, Angel Y Wang, Chris G Richardson, Hui Xie, Richard J Munthali, Kristen L Hudec, Calista Leung, Katharine D Wojcik, Lonna Munro, Priyanka Halli, Ronald C Kessler, Daniel V Vigo. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 27.03.2024.