Digital therapy may outperform referrals to campus mental health clinics among college students, according to new research

College students with anxiety, depression, and eating disorders benefit from therapy offered via a digital app, according to new research.

“Overall, these findings support the prevention and treatment benefits of digital therapy as part of the wider set of services available to students,” said Dr. Daniel Eisenberg, a co-author of the study and professor in the UCLA Fielding School of Public Health’s Department of Health Policy and Management. “The intervention reduced symptoms and substantially increased access to care, showing a markedly higher uptake than a passive referral to usual services. This underscores the viability of digital services as a scalable, population-based approach to improving mental health.”

The peer-reviewed research - “Population-based RCT of a digital cognitive-behavioral guided self-help intervention for anxiety, depression, and eating disorders in college students” - was published today (May 7, 2026) in the journal Nature Human Behaviour. RCT in this usage refers to a randomized controlled trial.

“The study is notable because it is one of the largest ever randomized trial to evaluate the impact of offering digital mental health services to college student populations,” said Eisenberg, who also serves as a principal investigator of the annual national “Healthy Minds Study” and as an advisor for UCLA’s own “Hope Connects Us” student-focused mental health initiative. “We used a public health approach that includes both treatment and prevention, and we found significant benefits of the intervention.”

Globally, an estimated 40% to 60% of college students experience a mental health disorder at some point, and the need for campus counseling services has increased faster than institutions’ capacity to provide these services, according to the researchers, said co-author Dr. Michelle Newman, professor of psychology and psychiatry at Penn State.

“One of the challenges with any digital intervention is that people sometimes download an app but then do not use it,” Newman said. “We were also interested in learning the extent to which people received services after being randomized to the app or on-campus counseling center. We found that uptake was significantly better in the digital intervention than referral to the counseling center.”

The commercially available application used in the study incorporates cognitive behavioral therapy (CBT) principles that coach individuals through identifying negative thinking patterns and developing skills and behavioral changes to address these patterns.

The researchers found that students receiving the digital intervention were more likely to report being symptom free at the 6-week, 6-month and 2-year marks, and that these students were more likely to engage these services compared to the campus referral group. Specifically, services uptake - or when a person receives a service - was seven times greater for college students assigned to a digital intervention than to on-campus clinic referrals. Approximately 74% of individuals given access to the digital intervention started the program, compared to 30% of individuals who were given a referral to a campus clinic and received at least one therapy session or a new medication prescription.

“Universities already have excellent mental health services, but not all students will take the steps to make an appointment,” said Dr. Denise Wilfley, a professor of psychological and brain sciences at St. Louis’ Washington University and a co-author of the study. “We were able to offer students an effective resource that they could download on their phones right then and there.”

Along with the significance of the work when it comes to student mental health, Eisenberg suggested the findings may have wider applications.

“Mental health is a challenge for both children and adults, in the U.S. and globally,” he said. “It will be important to continue research that advances how digital services can improve mental health across a variety of communities and populations.”

Methods

All procedures were approved by the Institutional Review Board (IRB) of Washington University. All participating universities reviewed the approval, consent forms, and study protocols and deferred to Washington University’s IRB (201901073). Informed consent was obtained from all participants.

Participants were recruited from October 2019 to November 2021, with data collection completed by October 2023; screening was implemented within 26 U.S. colleges and universities that varied in geographical location and environment (urban/rural, private/public, small/large). Standard statistical analyses were used to examine the resulting data, and draw the conclusions included in the published study. The data itself is available to other qualified researchers through the U.S. National Institute of Mental Health (NIMH) Data Archive. The NIMH is one of the U.S. National Institutes of Health (NIH).

Funding

This study was supported by the NIMH (grant R01 MH115128, M.G.N., E.E.F, D.E., C.B.T., & D.E.W., and NIMH grant K08 MH12034, E.E.F). This manuscript is the result of funding in whole or in part by the NIH and is subject to the NIH Public Access Policy. The NIMH was not involved in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.