Using an Integrated Self-Care Digital Platform to Reduce Depression and Anxiety Among Substance Abusers in Recovery: An Exploratory Implementation Study

Introduction: Mental illness is prevalent among adults with substance use disorders (SUD). Anxiety and depression frequently co-occur with SUD, often exacerbating symptoms. Reducing symptom burden among this comorbid population often requires a personalized, integrated treatment approach. This exploratory study will focus on the impact of myStrength, a digital self-care behavioral health and well-being platform, on the reduction of depression and anxiety symptoms among a comorbid population in SUD treatment. Secondarily, in-depth interviewing will seek to identify key factors driving the platform’s success.

Methods: Research took place at DCCCA, a Kansas-based outpatient and residential behavioral health treatment facility. At baseline, a total of 937 myStrength clients completed symptom severity assessments using the Depression Anxiety Stress Scales 21 (DASS). Clients were prompted to complete follow-up assessments on/around days 14, 60, 180, and 365. Changes in self-reported depression and anxiety symptom burden, as well as descriptive statistics measuring platform engagement, were analyzed over time. Semi-structured telephone interviews lasting between 25-40 minutes were conducted among 5 managerial staff and 3 clients.

Results: On average, clients engaged with myStrength at least two times during their first 30 days, in addition to multiple group setting exposures. This initial time period often coincides with the most significant symptom burden reduction for users of the platform. Clients spent an average of 11 minutes during each interaction. A total of 164 clients with extremely severe depression at baseline significantly improved to the point of being downgraded to only moderately depressed (DASS 34.4 vs. 18.5). Similarly, clients slightly less distressed with severe depression experienced a reduction in symptoms (DASS 24.1 vs. 16.6; n=104). Clients with the most debilitating anxiety achieved the greatest clinical improvement (DASS 27.8 vs. 17.7; n=269). Telephone interviews underscored the need to integrate a highly customizable digital platform, like myStrength, into the treatment flow to achieve the greatest symptom reduction. Both staff and clients emphasized the importance of acknowledging depression and anxiety as common co-occurring conditions with SUD. myStrength’s content-driven approach and repeated assessments offers concrete support to address this unmet need by demonstrating significant reductions in both depressive and anxious symptoms.

Conclusion: By partnering with a well-established behavioral health treatment facility, myStrength usage further enhanced client outcomes, particularly among those in most need of depression and anxiety support. Incorporating scalable digital tools for integrated mental health and SUD treatment into clinical practice could provide effective supplemental services for populations with multiple behavioral health comorbidities.