How can we support young people in dealing with stress? - A nationwide consortium breaks new ground

“With our project, we want to respond to the fact that young people have proven to be a particularly vulnerable group in recent years. Compared to other age groups, mental illness among young people has increased significantly, which is also reflected in significantly longer waiting times for outpatient and inpatient care”, says Monika Equit, professor of psychology at Saarland University. Together with Jun.-Prof. Sarah Schäfer, Leibniz Institute for Resilience Research in Mainz, and Prof. Daniela Fuhr, Leibniz Institute for Prevention Research and Epidemiology (BIPS) in Bremen, she is leading the large Germany-wide multicenter study.

In this study, the researchers want to find out how young people can be supported in an accessible manner in school and personal life so that they are empowered to actively address their mental health and learn to cope better with psychological problems. “Universities and research institutions in seven federal states are participating in the multicenter study, and we are also cooperating with statutory health insurance companies, school social workers, and local school psychology services. Together, we want to develop an innovative prevention approach that can be offered in many schools in the long term and may eventually become standard care in Germany”, explains Sarah Schäfer.

This concept also convinced the Federal Joint Committee: the highest self-governing body in the German healthcare system has now commissioned the research team to implement the large-scale project called “STRESS Care” over the next three and a half years. To this end, the Federal Joint Committee is providing a total of €5.8 million from the Innovation Fund, which is intended to be used to develop and test new forms of care in the healthcare sector. In a two-stage process, a total of 15 initiatives were selected from 47 project proposals for multi-year funding.

The intervention is aimed at students in grades 8 and 9 at standard schools. The first part of the prevention program consists of a project day on mental health literacy and online training to strengthen emotion regulation. The aim is to teach students what mental health actually is, how to stay mentally healthy, and what options are available for dealing with their own emotions. “For example, they learn what can trigger stress and where to get help when they are feeling down,” explains Monika Equit. These training sessions are conducted by school psychological services or school social workers at the selected schools in class groups. After digitally recording their individual problems and strengths, the young people are given access to a mobile application. Over a period of three weeks, they work on modules tailored to their individual stress areas on their smartphones (e.g., learning to cope better with rumination or improving their ability to fall asleep and stay asleep).

"We want to help young people reduce their own risky behaviors. For example, if someone has sleeping problems, they receive guidance on how to combat them with the help of relaxation techniques and simple rules around sleep. We also try to strengthen their mental resources by giving them tips on how to solve problems or strengthen their social relationships, so they don't feel lonely," says the psychology professor. During this digital training, the young people are accompanied by so-called eCoaches, who can respond to individual questions.

In the first phase of the project, the intervention will be developed together with the target group. The young people themselves can contribute ideas and wishes so that the smartphone application meets their needs exactly. The feasibility and acceptance of the prevention program will then be examined in a pilot study. Finally, the effectiveness of this program will be tested in the third phase of the project in a nationwide study involving around 6000 school students. “With our program, we want to support young people at an early stage in order to prevent the development of mental illness and its chronification. In this way, we want to help ensure that treatment will not be necessary in some cases,” says Monika Equit.

Against the backdrop of the strained healthcare situation in the field of child and adolescent psychotherapy in Germany, the systematic implementation of effective prevention services is of central importance. "Low-threshold, school-based prevention approaches also enable equal opportunities regardless of social background and thus make an important contribution to sustainable relief and, at the same time, to strengthening psychosocial care structures. Successful implementation in existing education and care structures is therefore crucial to establishing mental health prevention as an integral part of healthcare in Germany in the long term," explains Daniela Fuhr.

To ensure that the findings gained in the project contribute to improving school-based prevention services in Germany in the long term, various partners from the public health service and statutory health insurance funds are involved alongside scientific institutions.

On January 28, the kick-off event for the STRESS-Care project will take place at the Innovation Center of Saarland University. STRESS-Care stands for Stepped Care Program for Promoting Resilience and Reducing Psychological Stress in Adolescent Students.

The following scientists are involved in the study:

Jun.-Prof. Sarah K. Schäfer, Leibniz Institute for Resilience Research (LIR) Mainz & Technische Universität Braunschweig, Braunschweig; Prof. Dr. Daniela Fuhr, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen & University of Bremen; Prof. Dr. Julia Asbrand, Friedrich Schiller University Jena, Jena; Prof. Dr. Julian Schmitz, University of Leipzig, Leipzig; Prof. Dr. Michèle Wessa, Central Institute of Mental Health; Mannheim & Leibniz Institute for Resilience Research (LIR), Mannheim/Mainz; Prof. (apl.) Dr. Monika Equit & Prof. Dr. Tanja Michael, together with Prof. Dr. Eva Möhler & Andrea Dixius, Saarland University, and for the external evaluation: Dr. Hermann Pohlabeln,Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen.

Further information:

Press release from the Federal Joint Committee:
https://www.g-ba.de/presse/pressemitteilungen-meldungen/1299/

Answering questions:

Prof. (apl.) Dr. Monika Equit

Chair of Clinical Psychology and Psychotherapy at Saarland University
Head of the University Psychotherapy Outpatient Clinic
Tel. 0681 302-71021
E-Mail: monika.equit(at)uni-saarland.de

Jun.-Prof. Sarah K. Schäfer
Leibniz Institute for Resilience Research (LIR) in Mainz 
and Technische Universität Braunschweig
Tel. 0531 391-2856 
E-Mail: sarah.schaefer(at)tu-braunschweig.de 

Prof. Dr. Daniela Fuhr
Leibniz Institute for Prevention Research and Epidemiology (BIPS) in Bremen
and University of Bremen
Tel. 0421 218-56-754
E-Mail: fuhr(at)leibniz-bips.de