Skip to main content
SpringerLink
Log in

Filling the mental service gap on campus: an effectiveness trial testing the utility of app-based mindfulness psychological intervention for college students

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

The number of students reporting mental health problems has been increasing, and university counseling centers are struggling to fill the mental health service gap. Telepsychological services such as app-based interventions have been proposed as viable alternatives; however, research on their effectiveness is insufficient. This study tested the effectiveness of an app-based intervention for college students on comprehensive indicators of mental health (depression, anxiety, stress, positive affect, and satisfaction with life) in a real-world setting. A total of 352 Korean undergraduates were initially enrolled and randomly allocated to either an intervention (four-week app-based intervention) or control (waitlist) group. Finally, the data of 185 students (intervention group, n = 91; control group, n = 94) were analyzed (attrition rate, 43%). The intervention group demonstrated improved mental health for all outcomes compared with the control group. When symptom severity was considered, participants with moderate-severe depression or anxiety symptoms at baseline displayed a greater reduction in symptoms than participants with mild symptoms. Our results suggest that app-supported interventions can serve as feasible and effective measures to satisfy the mental health needs of college students, even for those with considerable subclinical levels of depression and anxiety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Abrams, Z. (2022). Student mental health is in crisis. Campuses are rethinking their approach. Monitor on Psychology, 12, 60–67. Retrieved Feb 19, 2023 from https://www.apa.org/monitor/2022/10/mental-health-campus-care

  • Ahn, J. K., Kim, Y., & Choi, K. H. (2019). The psychometric properties and clinical utility of the Korean version of GAD-7 and GAD-2. Frontiers in Psychiatry, 10, 127.

    Article  PubMed  PubMed Central  Google Scholar 

  • Alhawatmeh, H., Alshammari, S., & Rababah, J. (2022). Effects of mindfulness meditation on trait mindfulness, perceived stress, emotion regulation, and quality of life in hemodialysis patients: A randomized controlled trial. International Journal of Nursing Sciences, 9(2), 139–146.

    Article  PubMed  PubMed Central  Google Scholar 

  • An, J. Y., Seo, E. R., Lim, K. H., Shin, J. H., & Kim, J. B. (2013). Standardization of the Korean version of screening tool for depression (Patient Health Questionnaire-9, PHQ-9). Journal of the Korean Society of Biological Therapies in Psychiatry, 19(1), 47–56.

    Google Scholar 

  • Appel, J., & Kim-Appel, D. (2009). Mindfulness: Implications for substance abuse and addiction. International Journal of Mental Health and Addiction, 7, 506–512.

    Article  Google Scholar 

  • Arch, J. J., & Ayers, C. R. (2013). Which treatment worked better for whom? Moderators of group cognitive behavioral therapy versus adapted mindfulness based stress reduction for anxiety disorders. Behaviour Research and Therapy, 51(8), 434–442.

    Article  PubMed  Google Scholar 

  • Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., ... & Kessler, R. C. (2018). WHO world mental health surveys international college student project: Prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623. https://doi.org/10.1037/abn0000362

  • Bamber, M. D., & Morpeth, E. (2019). Effects of mindfulness meditation on college student anxiety: A meta-analysis. Mindfulness, 10(2), 203–214.

    Article  Google Scholar 

  • Berg, D., & Perich, T. (2022). Use of mobile mindfulness apps in young adults with depression: Results from a cross-sectional survey. Professional Psychology: Research and Practice, 53(1), 42.

    Article  Google Scholar 

  • Borjalilu, S., Mazaheri, M. A., & Talebpour, A. (2019). Effectiveness of mindfulness-based stress management in the mental health of Iranian university students: A comparison of blended therapy, face-to-face sessions, and mHealth app (Aramgar). Iranian Journal of Psychiatry and Behavioral Sciences, 13(2).

  • Center for Collegiate Mental Health (2016). 2015 Annual Report. (Publication No. STA 15-108).

  • Chen, B., Yang, T., Xiao, L., Xu, C., & Zhu, C. (2023). Effects of mobile mindfulness meditation on the mental health of university students: Systematic review and meta-analysis. Journal of Medical Internet Research, 25, e39128.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cheng, H. L., Wang, C., McDermott, R. C., Kridel, M., & Rislin, J. L. (2018). Self stigma, mental health literacy, and attitudes toward seeking psychological help. Journal of Counseling & Development, 96(1), 64–74.

    Article  Google Scholar 

  • Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67, 404–424. https://doi.org/10.1002/jclp.20776

    Article  PubMed  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.

    Article  PubMed  Google Scholar 

  • Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.

    Article  PubMed  Google Scholar 

  • Elices, M., Pérez-Sola, V., Pérez-Aranda, A., Colom, F., Polo, M., Martín-López, L. M., & Gárriz, M. (2022). The effectiveness of mindfulness-based cognitive therapy in primary care and the role of depression severity and treatment attendance. Mindfulness, 13, 362–372.

    Article  PubMed  Google Scholar 

  • Firth, J., Torous, J., Nicholas, J., Carney, R., Pratap, A., Rosenbaum, S., & Sarris, J. (2017). The efficacy of smartphone-based mental health interventions for depressive symptoms: A meta-analysis of randomized controlled trials. World Psychiatry, 16(3), 287–298.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fish, M. T., & Saul, A. D. (2019). The gamification of meditation: A randomized-controlled study of a prescribed mobile mindfulness meditation application in reducing college students’ depression. Simulation and Gaming, 50, 419–435. https://doi.org/10.1177/1046878119851821

    Article  Google Scholar 

  • Flett, J. A. M., Conner, T. S., Riordan, B. C., Patterson, T., & Hayne, H. (2020). App-based mindfulness meditation for psychological distress and adjustment to college in incoming university students: A pragmatic, randomised, waitlist-controlled trial. Psychology Health, 35, 1049–1074. https://doi.org/10.1080/08870446.2019.1711089

    Article  PubMed  Google Scholar 

  • Furnham, A., & Henderson, M. (1982). The good, the bad and the mad: Response bias in self-report measures. Personality and Individual Differences, 3(3), 311–320.

    Article  Google Scholar 

  • Goldberg, S. B., Tucker, R. P., Greene, P. A., Simpson, T. L., Kearney, D. J., & Davidson, R. J. (2017). Is mindfulness research methodology improving over time? A systematic review. PLoS One, 12(10), e0187298.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., … Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357–368.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harrer, M., Adam, S. H., Fleischmann, R. J., Baumeister, H., Auerbach, R., Bruffaerts, R., … Ebert, D. D. (2018). Effectiveness of an internet-and app-based intervention for college students with elevated stress: Randomized controlled trial. Journal of Medical Internet Research, 20(4), e136.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hintz, S., Frazier, P. A., & Meredith, L. (2015). Evaluating an online stress management intervention for college students. Journal of Counseling Psychology, 62(2), 137–147. https://doi.org/10.1037/cou0000014

    Article  PubMed  Google Scholar 

  • Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the mindfulness meditation mobile app “calm” to reduce stress among college students: Randomized controlled trial. JMIR mHealth and uHealth, 7(6), e14273.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hwang, M. H., & Hwang, H. (2020). Challenges and tasks of technology-based counseling practice. Korean Journal of Counseling, 21(4), 219–245. https://doi.org/10.15703/kjc.21.4.202008.219

    Article  Google Scholar 

  • Johnson, K. F., & Kalkbrenner, M. T. (2017). The utilization of technological innovations to support college student mental health: Mobile health communication. Journal of Technology in Human Services, 35, 314–339. https://doi.org/10.1080/15228835.2017.1368428

    Article  Google Scholar 

  • Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47. https://doi.org/10.1016/0163-8343(82)90026-3

    Article  PubMed  Google Scholar 

  • Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.

    Google Scholar 

  • Kang, H. (2021). Sample size determination and power analysis using the G* power software. Journal of Educational Evaluation for Health Professions, 18, e1149215. https://doi.org/10.3352/jeehp.2021.18.17

    Article  Google Scholar 

  • Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., ... & Hofmann, S. G. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763–771.

  • Kim, U. A., Son, H. L., & Kim, E. H. (2018). A review on the predisposing factors for seeking professional help in counseling. Korean Journal of Counseling, 19(1), 87–111.

    Article  Google Scholar 

  • Kingston, J., Becker, L., Woeginger, J., & Ellett, L. (2020). A randomised trial comparing a brief online delivery of mindfulness-plus-values versus values only for symptoms of depression: Does baseline severity matter? Journal of Affective Disorders, 276, 936–944.

    Article  PubMed  Google Scholar 

  • Korea information society development institute. (2015). Smartphone usage behavior of university students. KISDI STAT Report, 15(14), 1–14.

    Google Scholar 

  • Korean Council for University Education. (2021). Psychological and emotional support for university students during COVID-19: Tasks and recommendations. KCUE Higher Education, 11, 1–16.

    Google Scholar 

  • Korean Ministry of Health and Welfare. (2021). 2021 Mental Health Servey Results. Retrieved Feb 19, 2023 from https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=369088

  • Lahtinen, O., Aaltonen, J., Kaakinen, J., Franklin, L., & Hyönä, J. (2021). The effects of app-based mindfulness practice on the well-being of university students and staff. Current Psychology, 5, 1–10.

    Google Scholar 

  • Lattie, E. G., Lipson, S. K., & Eisenberg, D. (2019). Technology and college student mental health: Challenges and opportunities. Frontiers in Psychiatry, 10, 246.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lecomte, T., Potvin, S., Corbière, M., Guay, S., Samson, C., Cloutier, B., ... & Khazaal, Y. (2020). Mobile apps for mental health issues: meta-review of meta-analyses. JMIR mHealth and uHealth, 8(5), e17458.

  • Lee, R. A., & Jung, M. E. (2018). Evaluation of an mhealth app (destressify) on university students’ mental health: Pilot trial. Journal of Medical Internet Research, 5, e2. https://doi.org/10.2196/mental.8324

    Article  Google Scholar 

  • Lee, J. Y., & Shin, Y. J. (2022). Using the theory of planned behavior to predict Korean college students’ help-seeking intention. The Journal of Behavioral Health Services & Research, 1-15. https://doi.org/10.1186/s12888-022-03969-1

  • Levin, M. E., Haeger, J. A., Pierce, B. G., & Twohig, M. P. (2016). Web-based acceptance and commitment therapy for mental health problems in college students: A randomized controlled trial. Behavior Modification, 41(1), 141–162. https://doi.org/10.1177/0145445516659645

    Article  PubMed  Google Scholar 

  • Lim, Y. (2012). Psychometric properties of the satisfaction with life scale among Korean police officers, university students, and adolescents. Korean Journal of Psychology: General., 31(3), 877–896.

    Google Scholar 

  • Lim, Y. J., Yu, B. H., Kim, D. K., & Kim, J. H. (2010). The positive and negative affect schedule: Psychometric properties of the Korean version. Psychiatry Investigation, 7(3), 163.

    Article  PubMed  PubMed Central  Google Scholar 

  • Linardon, J., & Fuller-Tyszkiewicz, M. (2020). Attrition and adherence in smartphone-delivered interventions for mental health problems: A systematic and Meta-analytic review. Journal of Consulting and Clinical Psychology, 88(1), 1–13.

    Article  PubMed  Google Scholar 

  • Lipson, S. K., Lattie, E. G., & Eisenberg, D. (2018). Increased rates of mental health service utilization by US college students: 10-year population-level trends (2007–2017). Psychiatric Services, 70(1), 60–63. https://doi.org/10.1176/appi.ps.201800332

    Article  PubMed  Google Scholar 

  • Mabo Corporation. (2016). Mabo (Version 2.9.3) [Mobile app]. Retrieved March, 2023 from Google Play Store. https://play.google.com/store/apps/details?id=com.mabopractice.app

  • Mani, M., Kavanagh, D. J., Hides, L., & Stoyanov, S. R. (2015). Review and evaluation of mindfulness-based iPhone apps. JMIR mHealth and uHealth, 3(3), e4328.

    Article  Google Scholar 

  • Oliveira, C., Pereira, A., Vagos, P., Nóbrega, C., Gonçalves, J., & Afonso, B. (2021). Effectiveness of mobile app-based psychological interventions for college students: A systematic review of the literature. Frontiers in Psychology, 12, 647606.

    Article  PubMed  PubMed Central  Google Scholar 

  • Park, J., & Seo, Y. S. (2010). Validation of the Perceived Stress Scale (PSS) on samples of Korean University students. Korean Journal of Psychology: General, 29(3), 611–629.

    Google Scholar 

  • Pascoe, M. C., Thompson, D. R., & Ski, C. F. (2017). Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology, 86, 152–168.

    Article  PubMed  Google Scholar 

  • Roos, C. R., Bowen, S., & Witkiewitz, K. (2017). Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention. Journal of Consulting and Clinical Psychology, 85(11), 1041–1051. https://doi.org/10.1037/ccp0000249

    Article  PubMed  PubMed Central  Google Scholar 

  • Ruxton, G. D., & Beauchamp, G. (2008). Time for some a priori thinking about post hoc testing. Behavioral Ecology, 19(3), 690–693.

    Article  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68.

    Article  PubMed  Google Scholar 

  • Serrano-Ripoll, M. J., Zamanillo-Campos, R., Fiol-DeRoque, M. A., Castro, A., & Ricci-Cabello, I. (2022). Impact of smartphone app–based psychological interventions for reducing depressive symptoms in people with depression: Systematic literature review and Meta-analysis of randomized controlled trials. JMIR mHealth and uHealth, 10(1), e29621.

    Article  PubMed  PubMed Central  Google Scholar 

  • Singal, A. G., Higgins, P. D., & Waljee, A. K. (2014). A primer on effectiveness and efficacy trials. Clinical and Translational Gastroenterology, 5(1), e45.

    Article  PubMed  PubMed Central  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Patient Health Questionnaire Primary Care Study Group, & Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Jama, 282(18), 1737–1744.

    Article  PubMed  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

    Article  PubMed  Google Scholar 

  • Statistics Korea. (2021). Causes of Death Statistics. Retrieved Feb, 2023 from Korean Statistical Information Service. https://kosis.kr

  • Taylor, C. B., Fitzsimmons-Craft, E. E., & Graham, A. K. (2020). Digital technology can revolutionize mental health services delivery: The COVID- 19 crisis as a catalyst for change. International Journal of Eating Disorders, 53, 1155–1157. https://doi.org/10.1002/eat.23300

    Article  PubMed  Google Scholar 

  • The jamovi project. (2022). jamovi. (Version 2.3) [Computer Software]. Retrieved Feb, 2023 from https://www.jamovi.org

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063.

    Article  PubMed  Google Scholar 

  • Yusainy, C., & Lawrence, C. (2015). Brief mindfulness induction could reduce aggression after depletion. Consciousness and Cognition, 33, 125–134. https://doi.org/10.1016/j.concog.2014.12.008

    Article  PubMed  Google Scholar 

  • Zhang, D., Lee, E. K., Mak, E. C., Ho, C. Y., & Wong, S. Y. (2021). Mindfulness-based interventions: An overall review. British Medical Bulletin, 138(1), 41–57.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the University Innovation Support Project through the National Research Foundation of Korea funded by Ministry of Education.

Author information

Authors and Affiliations

  1. Student Counseling Center, Gachon University, Seongnam, South Korea

    Yeseul Min, Yong-Seok Choi & Bin-Na Kim

  2. Department of Education, Seoul National University, Seoul, South Korea

    Yeseul Min

  3. Department of Psychology, Gachon University, Gachon Hall 926, Seongnam-daero 1342, Sujeong-gu, Seongnam, 13120, South Korea

    Bin-Na Kim

Authors
  1. Yeseul Min
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yong-Seok Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bin-Na Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BNK designed the study based on literature review with YM. Material preparation and data collection were mainly performed by YSC with help of other authors. Statistical analyses were conducted by YM. The first draft of the manuscript was written by YM and revised by BNK. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bin-Na Kim.

Ethics declarations

Ethics approval

All procedures performed in this study was approved by the Institutional Review Board of Gachon University (No. 1044396-202203-HR-053-01).

Competing interests

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Min, Y., Choi, YS. & Kim, BN. Filling the mental service gap on campus: an effectiveness trial testing the utility of app-based mindfulness psychological intervention for college students. Curr Psychol 43, 15434–15444 (2024). https://doi.org/10.1007/s12144-023-05402-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-023-05402-6

Keywords

Search

Navigation