Brief Digital Interventions: Scalable, available brief mental health support in schools
As the pandemic surged and Ontario was faced with school closures and a shift toward virtual mental health care in 2020, School Mental Health Ontario partnered with Harvard University and McMaster University to develop Brief Digital Interventions (BDIs) to help respond to students’ emerging mental health needs.
Since that time, over 650 regulated school mental health professionals across 66 French and English school boards in Ontario have participated in training in this innovative intervention for students with mild to moderate mental health concerns.
What are Brief Digital Interventions (BDIs)?
BDIs are brief, student-centred interventions that are useful with students, ages 8-17, who struggle with anxiety, depressed mood, and/or other emotional difficulties that impact their sense of wellness, relationships, or academic performance. They are one of several brief evidence-informed protocols that a regulated school mental health professional (e.g., social worker, psychologist, psychological associate, psychotherapist) may introduce as part of the therapeutic plan.
If BDIs are deemed an appropriate intervention for the situation the clinician works with the student to:
- identify their top problems / goals for change
- select one of four on-line coping kits that provide psychoeducation and techniques for helping students to:
- solve problems
- feel calm
- change unhelpful thoughts
- try the positive opposite of unhelpful behaviours
- engage with the material in one of the coping kits (independently or during a session)
- then choose, using a progress monitoring system, their next steps.
How can Ontario students access BDIs?
When a student is struggling with a mental health problem and is referred to their school board’s mental health support services, a school mental health professional will assess the needs of the student and will select an approach, which may include BDIs.
Innovative adaptations for school-based mental health
While BDIs were initially designed to be offered virtually, regulated school mental health professionals indicated through ongoing provincial learning collaboratives that the intervention could be used in many ways. For example:
Completing the coping kits in-session with the student
Benefits:
- Ensures that the student is completing the coping kit
- Provides additional psychoeducational teaching moments
- Allows for extra explanations for younger students or students with special learning needs
Using the coping kits with another intervention
As coping kits are a comfortable way for students to learn new skills, school mental health professionals have started using these within other structured psychotherapy approaches.
Benefits:
- Compatible with the Brief Intervention for School Clinicians, a widely used protocol among Ontario school mental health professionals
- Provides consistent language and reinforces skill building
Feedback from clinicians using BDIs also led to the development of resources to support early learners and adaptations for students with special education needs. The BDI Learning Collaborative has also explored group delivery of the coping kits and best practices in identity affirming practice with BDIs.
Promising preliminary findings for Brief Digital Interventions in Ontario schools
A pilot study was conducted in the 2021-2022 school year by McMaster University/Offord Centre for Child Studies. It included three early-adopter Ontario school boards, 14 regulated school mental health professionals and 64 students. Though the sample size was small, the results showed a statistically significant decreasein:
- the severity score of students’ top problems
- internalizing and externalizing scores from the Behavior and Feelings Scale
These findings align with those from a randomized control trial done by a team from Harvard University, where students, ages 12-15, reported a statistically significant reduction in their anxiety and depression symptoms three months after doing the Project SOLVE coping kit, in comparison to a control group who didn’t do the intervention.
We are currently expanding the BDI study and would welcome the involvement of any Ontario school board in this effort. Interested in joining our research work? Contact Alexandra Fortier at afortier@smho-smso.ca.
Meeting the needs of Ontario students
While BDIs were developed to meet the emerging mental health needs of Ontario students during the pandemic, the intervention has continued to evolve based on ongoing collaborative learning and rapid feedback loops with the field. This has resulted in adaptations that fit Ontario’s school context, and which ultimately benefit students.
BDIs are one of a range of interventions offered by regulated school mental health professionals in Ontario schools. School Mental Health Ontario has been offering training for school mental health professionals since 2019. School mental health professionals interested in incorporating BDIs into their practice should speak with the mental health leader about upcoming training opportunities or contact Tracy Weaver at School Mental Health Ontario for more information at tweaver@smho-smso.ca.