The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials.

Background: Mental health symptoms are common among college and university students and these can affect their academic performance. E-mental health interventions have proven effective in addressing mental health complaints but their effect on academic performance has not been synthesized yet.
Objectives: To synthesize the evidence from randomized controlled trials for the effectiveness of e-mental health interventions on academic performance in college and university students compared to inactive controls.
Data Sources and Eligibility Criteria: We searched six databases (PubMed, Cochrane library, CINAHL, ERIC, PsycINFO, Web of Science) during the period January 2000 until September 2019 for randomized controlled trials that reported on e-mental health interventions (guided or unguided) for college and university students and measured academic performance (e.g. grade point average).
Study Appraisal and Synthesis Methods: Study and participant characteristics and the academic performance measures at post-intervention were extracted. The latter were pooled and Hedges' g was calculated as the effect size. Heterogeneity and publication bias were investigated.
Results: Six studies containing 2428 participants were included in the meta-analysis. These focussed on either mood and anxiety or alcohol and tobacco use. The pooling of data resulted in a small but non-significant effect of g  = 0.26 (95% CI, -0.00, 0.52; p  = .05) on academic performance, favouring e-mental health interventions over inactive controls. Interventions had positive effects on depression ( g  = -0.24) and anxiety ( g  = -0.2). Heterogeneity was high.
Discussion: Despite the small and non-significant effect, our meta-analysis points to a promising direction for the effectiveness of e-mental health interventions on academic performance. Yet, these results must be interpreted with caution, as heterogeneity was high and few studies on the effectiveness of e-mental health interventions for students reported academic performance measures.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Ebert has served as a consultant to/on the scientific advisory boards of Sanofi, Novartis, Minddistrict, Lantern, Schoen Kliniken, Ideamed and German health insurance companies (BARMER, Techniker Krankenkasse) and a number of federal chambers for psychotherapy. He is also stakeholder of the Institute for health training online (GET.ON), which aims to implement scientific findings related to digital health interventions into routine care.
(© 2020 The Authors.)