A “Growth Mindset of Mental Health” Online Intervention Increases Self-Help Engagement On A Mental Health App

Abstract Background Mental health applications have the potential to improve access to treatment among people with mental health needs through empirically supported self-help features. However, engagement with these features remains low, with up to 80% of users logging into the app only once and failing to return. A potential psychological barrier to engagement may be a fixed mindset of mental health, the belief that mental health cannot be meaningfully improved. Addressing this maladaptive belief may, therefore, motivate sustained self-help engagement. Objective This randomized controlled trial (RCT) examines whether a brief growth-mindset-of-mental-health intervention—portraying mental health as improvable, not fixed—can increase self-help engagement within an evidence-based mental health app among employees with mental health needs. Method A total of 252 full-time employees across 83 companies were randomly assigned to either the growth-mindset-of-mental-health or active control condition. Baseline measures included demographics and indicators of well-being (i.e., perceived stress, anxiety, depression, and positive mental well-being). The primary outcome was a binary variable assessing whether users repeatedly engaged with the mental health application (i.e., accessed a second self-help feature) over the subsequent three months. Secondary outcomes were binary variables assessing repeated engagement with self-help features of varying dosage, categorized by the increasing time and effort to complete: “low-intensity” features, “moderate-intensity” features, and “high-intensity” features. Results The sample (N = 252) was predominantly male, single, with at least a bachelor’s degree, and an average age of 32 (SD = 7.80). Primary analyses revealed that participants in the growth-mindset condition (vs. control) with poorer mental well-being at baseline (i.e., higher stress, anxiety, depressive symptoms, and lower positive mental well-being) were more likely to repeatedly engage with self-help features overall. Specifically, secondary analyses showed that those with higher anxiety and depressive symptoms repeatedly engaged with moderate-intensity features, while those experiencing higher stress and lower positive mental health were more likely to repeatedly engage with both low- and moderate-intensity features. Conclusion By removing a psychological barrier, the growth-mindset intervention (vs. active control) increased the pursuit of self-care among people with poorer well-being at baseline. We discuss implications for treatment-seeking and targeted approaches to mental health engagement.