How a Mental Health App is Tackling Depression in High-Risk Youth


A cognitive behavioural therapy (CBT) app has been found to significantly prevent increases in depression among young people at high risk, offering a cost-effective public mental health measure. With growing concerns over the rising rates of anxiety and depression in youth, digital tools like mobile apps have been suggested as a scalable solution. The project, led by the University of Exeter, is the first to rigorously test a mental health app on such a large scale across four countries.

Two papers, published in Lancet Digital Health, report on the ECoWeB-PREVENT and ECoWeB-PROMOTE trials, which were part of a four-year Horizon 2020-funded study. The research concluded that a CBT self-help app could help protect vulnerable young people against depression. Professor Ed Watkins from the University of Exeter, who led the project, said,

“For young people with elevated risk, our findings suggest the CBT app does have a preventative effect on depression and could have a public health benefit. Participants’ quality-of-life measures were better, and their reported work and social functioning was better.”

The study, involving 3,700 participants aged 16 to 22 from the UK, Germany, Belgium, and Spain, was one of the largest of its kind. It divided participants based on emotional competence levels, focusing on both those at higher risk of depression and those without such risk. Each group was randomly assigned one of three apps: a self-monitoring app for tracking emotions, a self-help app focused on emotional competence, and a self-help app based on CBT principles. Results were measured after three and 12 months.

The trials showed that the CBT app effectively prevented an increase in depression for the high-risk group, but there was no difference between the interventions for the lower-risk group. Professor Watkins noted,

“Our findings add to the evidence that prevention for depression works best when we identify and select individuals who are more at risk, rather than take a more universal approach. This identification could be done by an online self-screening process or through professional referral.”

Even when participants used the self-help app only a few times, there was a small but meaningful benefit. Watkins added, “Because the app is scalable to large numbers of people in a cost-effective way, these effects have potential value as a public health intervention, within a broader portfolio of digital and in-person services and interventions.”

Recently, MQ, in collaboration with Melbourne University, Harvard University’s Digital Psychiatry Institute and researchers from the Oxford Internet Institute, conducted a comprehensive review of the research into the effects of the internet on youth mental health, both positive and negative. Read more about the report here.



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