Student Psychological Intervention Trial (SPIT)

Conducted at Ulster University (UU) and Letterkenny Institute of Technology (LYIT) as part of the WHO World Mental Health International College Student Initiative, funded by Cross-border Healthcare Intervention Trials in Ireland Network (CHITIN).

Student Psychological Intervention Trial (SPIT)


The Student Psychological Intervention Trial (SPIT) is a study consisting of two-phases. Phase 1 aims to gather information relating to emotional wellbeing when students first begin university. The wellbeing of these students will then be monitored over three years, as they progress through their degree courses.

In September 2019, SPIT recruited 1,948 first year undergraduate students who had commenced university, across the four Ulster University campuses (Belfast, Coleraine, Magee and Jordanstown) and in Letterkenny Institute of Technology (LYIT), County Donegal. In September 2020, 939 second year students fully completed the follow-up survey.

In September 2021, the final follow-up survey will be completed by the now third year students across the UU campuses and at LYIT.

The primary goal of Phase 2 is to determine whether a new guided, online therapy programme is effective in improving the wellbeing of students at college and university.

The Phase 2 randomised control trial commenced in March 2021 and the recruitment for new student participants will continue until Autumn 2021. Participation in Phase 2 of the study is open to all UU and LYIT students over the age of 18 who are completing degree courses at any level.

Students who have been experiencing difficulties with emotional wellbeing may be interested in taking part in the trial. Some examples of such difficulties include:

  • Experiencing low mood
  • Excessive worry
  • A dip in motivation
  • Procrastinating more often
  • Finding it difficult to relax (feeling tense or on edge)
  • Feeling tired or lacking in energy
  • Loss of interest in things you used to enjoy (hobbies/socialising)
  • Difficulties with sleep
  • Feelings of hopelessness
  • Low self-esteem

To learn more about ICare, the online therapy programme being trialed, please watch the short video below.

If you wish to learn more about the Phase 2 trial, further information is provided below. Additionally, if you are interested in participating in the study, please find links for the Phase 2 Participant Information Sheet and online consent form at the bottom of this web page. Here you will also find important contact information relating to the SPIT study.

The project is supported by the European Union’s INTERREG VA Programme, managed by the Special EU Programmes Body (SEUPB).



Background

A number of recent studies have documented the increasing incidence of depression, anxiety and other psychological disorders among the student population. In September 2015, as part of the World Mental Health International College Student Initiative, we invited first year undergraduate students to take part in the Ulster University Student Wellbeing Study.

Over 1600 first year undergraduate students participated, providing a saliva sample to analyse the biological factors related to mental health disorders, and approximately 900 completed a survey to establish rates of mental disorders (Overall, 739 fully completed the survey).

Similar to other recent studies in the UK and Ireland, we found very high rates of mental health issues among our students, with over half of all students reporting that they had experienced a mental health disorder at some point in their life.

Another important finding was that, although many students reported mental health problems, a low percentage of these students were willing to seek help using the on-campus counselling service or other available options.

Research has suggested that there may be a reluctance among students, due to embarrassment, fear of stigma or a lack of awareness of their problems.

The internet can play an important role in developing new, accessible interventions that may appeal to student populations. Online interventions may facilitate help-seeking among young people, as they are mostly anonymous and private, which may reduce the stigma associated with seeking help. Furthermore, many students report a preference for self-management when it comes to dealing with mental health problems, therefore the self-directed nature of online interventions may be appealing.

Recently, online therapeutic programmes, based on the principles of cognitive behavioral therapy (CBT), have shown promise in improving psychological wellbeing.


Objectives

One of the main aims of this study is to assess risk and protective factors for mental health problems among students in Ulster University and LYIT, in order to ensure that their college experience is a positive one. The primary goal of the study is to determine whether a recently developed web-based intervention is effective in improving emotional wellbeing among third level students.

  • To test this, we will compare the emotional wellbeing of students in a randomised control trial. The effects of routine campus-based wellbeing services will be compared with the effects of the new online therapy programme.
  • We will determine each student’s emotional wellbeing and quality of life before and after the interventions.
  • The results of this study will determine whether the addition of the online intervention, to the current mental health services, would enhance the support options, and increase help-seeking among students.
  • We will also collect saliva samples from participating students in order to analyse biological factors related to mental disorders, and examine biological changes that influence adherence, and response to the intervention.

We will conduct focus groups to establish the factors that influence treatment uptake, adherence and the success of the online intervention.


Our Research

Phase 1

Phase 1 of the study involved providing all first-year undergraduate students with details about the study prior to them registering at the university/college. See Participant Information Sheet – Phase 1.

At the start of their first semester volunteers provided further information about the SPIT project, took informed written consent, collected a saliva sample and provided a link to an online survey.

When this cohort commenced second year, in September 2020, a follow up survey was circulated to all those who consented to take part in the SPIT study. Data collection for year 3 will commence in September 2021.

Initial Results from Phase 1

Results from the Year 1 (September 2019) data indicate that many students were experiencing difficulties relating to their psychological and emotional wellbeing upon entry into university or college.

Overall, the highest prevalence rates in students in UU and LYIT were for suicide ideation (28%), anxiety (25.5%) and depression (14.9%). It was found that females were more likely to have depression and to have engaged in self-harm, whereas males were significantly more likely to have drug use problems. Furthermore, students who identified as LGBTQ+ were between two and three times more likely to experience all problems investigated.

Similar to previous research, the current data suggests that help-seeking remains low among university students, with only 24% having received treatment for an emotional problem. Despite the high rates of mental health problems within the student population, there is a reluctance to access current support services. This highlights the need to develop novel, accessible interventions that encourage engagement with treatment.


Chart of Emotional wellbeing of first-year undergraduate Students
Emotional wellbeing of first-year undergraduate Students a Ulster University and Letterkenny Institute of Technology in September 2019.

Help seeking among first-year undergraduate Students
Help seeking among first-year undergraduate Students a Ulster University and Letterkenny Institute of Technology in September 2019.

Phase 2

Phase 2 of the study will involve a telephone interview, conducted by a trained researcher, and participants will be sent a link to an online mental health questionnaire.

Participants will be randomly assigned to one of two groups: treatment as usual (TAU) only, or TAU plus a web-based intervention.  If assigned to the intervention group, they will be given access to the web-based intervention.

If they are part of the TAU group, they will be provided with information about the care available at their institution (UU/LYIT) and encouraged to contact them to avail of the services.

Following the intervention or TAU, participants will be sent a link to the online post-treatment questionnaires and asked to complete follow-up questionnaires at 6 and 12 months after beginning the study. At 12 months they will be asked to take part in a follow-up phone interview.


Focus Groups

Some students may also be asked to consider taking part in a focus group to establish the factors that influence uptake, adherence and the success of the intervention in targeting depression and anxiety.

(Note, these may be held online depending on local restrictions related to Covid-19 at the time or a personal interview or short survey will be undertaken to gain feedback if it is not feasible to conduct a focus group.)

If you are interested in participating, please contact us. Contact details are located below.




Contact

Dr Elaine Murray (PI)
Email: e.murray@ulster.ac.uk

Dr Margaret McLafferty (Research Associate, UU)
Email: m.mclafferty@ulster.ac.uk

Natasha Brown (Research Assistant, LYIT)
Email: Natasha.Brown@lyit.ie

Caoimhe Ward (PhD Researcher)
Email: ward-c36@ulster.ac.uk