Changing the way we treat young adults mental health

It is no secret that the UK is also struggling to address the mental health crisis alongside the rest of the global community. Young adults 18 - 28 years old are the most vulnerable population to mental health issues of which 29% are living with a diagnosed mental illness. Of these, less than 35% have access to therapy and psychological care, making it pressing to develop therapeutic tools that are cost-efficient, effective and ‘sticky’. The broad distribution of smartphones offers a compelling platform in the form of applications, but evidence-based apps struggle with high attrition rates. Additionally, prevention programs have attrition rates of up to 99%, making them difficult to implement. Research suggests gamification to be a valid strategy to intrinsically motivate patients to adhere to prevention and early-stage mobile interventions.

eQuoo, the Emotional Fitness Game, with a top ORCHA Score, teaches psychological skills, such as emotional bids, generalization, and reciprocity - which are needed to prosses emotional and mental stress - through psychoeducation, storytelling, and gamification. It is a 5-week course, with 2 skills per level, where the player goes on to implement the skills in the safe yet stimulating environment of a choose-your-own-adventure game

eQuoo was tested with 358 participants in a 5-week, 3-armed randomized controlled clinical trial, of which a third used eQuoo, a third used a ‘Treatment as Usual’ CBT Journal app and a third was on a waitlist with no intervention. All 3 groups filled out the following questionnaires at 3 time-points: The Adult Resilience Scale, The Personal Growth Inventory Scale, the Psychological well-being: Positive Relations With Others Scale by Ryff and a 1 Item Anxiety Likert scale.

eQuoo users showed statistically significant increases in the well-being metrics and a significant decrease in anxiety when using the app over a timeframe of 5 weeks. The app significantly increased resilience as measured with the ARS by d .37, personal growth as measured by PGIS by d .67, positive relations with others as measured by Ryff’s PWB by d .42 and anxiety as measured with a 1 Item Ankiety Likert Scale lowered by d .20. With 90% adherence, eQuoo was able to retain 21% more participants than the control or waitlist group.

By being able to prove that eQuoo, as a mental health game, significantly raises mental well-being and lowers anxiety as well as maintains high adherence, there is now a much-needed tool for prevention and early intervention that young adults actually stick to. With 35k downloads worldwide, eQuoo sports a 17% course completion rate - more than 5 times higher than average mental health apps.