Personalized and collaborative use of digital measurement-based care tools enhances engagement among young adults: a mixed-methods study

BACKGROUND: Measurement-based care (MBC) enables personalised and proactive mental healthcare through regular symptom monitoring and review, allowing clinicians to make timely adjustments to clients' interventions for improved outcomes. Yet, its uptake in youth mental health services remains minimal. This study aims to explore perceived barriers and facilitators for sustained use of MBC and potential of digital technologies to enhance its engagement in young adults. METHODS: A mixed-methods study, comprising focus groups and surveys, was conducted with young adults who had previously accessed mental health services. Template analysis was used to analyze qualitative data, and descriptive analyses were performed with quantitative data. RESULTS: Eighteen young adults (mean age = 21.7 years; SD = 3.4) participated in this study. Survey results showed that young adults agreed with the value of MBC in their care (15/18) and reported low rates of discomfort with progress evaluation (11/18). Focus groups revealed collaborative data review with clinicians as a key facilitator in MBC uptake, driving repeated engagement with data input and review. Participants expressed that generalized interpretation of data that does not consider individual context, and the use of standard measures that were perceived to be irrelevant to their personal treatment goals discouraged their future engagement with MBC. Digital features that improve accessibility and data interpretation were expected to enhance consistent engagement with MBC. CONCLUSIONS: The findings indicate that the motivation and sustained engagement in MBC stem from young adults' comprehension of how collected data fosters shared decision-making and personalize treatment. Therefore, regular, collaborative data reviews would be crucial in cultivating a sense of autonomy and purpose within MBC for young adults. This study highlights the importance of data review in enhancing the uptake of MBC, a factor that is often overlooked. By demonstrating this, the study provides a deeper understanding of motivators in MBC and valuable insights for mental health services to explore strategies that could support clinicians to integrate data review as part of routine care. To this end, one effective approach could be developing technologies that facilitate client-clinician communication and empower young adults to advocate for personalized care.