Background Given the high prevalence of mental illnesses in adolescents, there is an urgent need for effective prevention strategies. The aim of this study was to evaluate the school-based internet intervention StresSOS for the universal prevention of mental illnesses in youth.Methods A two-arm, randomized controlled trial was conducted. Participants were recruited from schools across five regions of Germany. Young people between the ages of 12 and 25 years without mental health problems were invited to the trial and randomly assigned to StresSOS or to the attention placebo control condition, stratified by sex. Participants in both conditions received eight web-based sessions with information and exercises and weekly e-mail teasers about program content and a monitoring survey. StresSOS comprised content on life skills, particularly stress management and mental health literacy, and the control condition content comprised healthy nutrition. The primary outcome was self-reported mental health status at a 12-month follow-up. Intention-to-treat analyses were calculated. The trial was preregistered with the German Register of Clinical Trials (DRKS00014693, see https://drks.de/search/en/trial/DRKS00014693).Results A total of 5,268 eligible students were invited to participate, 2,327 (44%) activated their account and were randomized to StresSOS (n = 1,154) or to the control condition (n = 1,173). Due to COVID-19-related school closures, 1,209 were lost to follow-up, and data from 1,118 students were analyzed (535 in StresSOS and 583 in the control group). Participation in StresSOS led to significantly reduced incidences of emerging mental health problems at the 12-month follow-up (controls: n = 162 28% 'with problems'; StresSOS: n = 113 21% 'with problems'; OR 0.70, 95% CI 0.52, 0.92, p = .01).Conclusions StresSOS was effective in universally preventing the onset of mental health problems, with a small effect. Internet interventions have the potential to contribute to a reduction of the disease burden in young people.
Lehner et al. (Fri,) studied this question.