A Mental Health App: How A Health Promoting University Improved Access for Students and Employees

Known for its innovative and interdisciplinary approach to education at both the graduate and the undergraduate levels, the University of Alabama at Birmingham (UAB) is an internationally renowned public research university and academic medical center, as well as Alabama's largest employer, with some 23,000 employees. Situated in an urban setting in the heart of downtown Birmingham, UAB has a diverse student body with an eye toward academic success and research and career opportunities.

Since March 2020, UAB students have been attending hybrid courses—a mix of online and in-person classes—to accommodate the challenges of the COVID-19 pandemic. As we entered the fall 2020 semester, students had been experiencing all of the usual stresses associated with college, in addition to the tensions caused by the COVID-19 pandemic, the divisive US national political climate with the upcoming presidential election, and the racial injustice and police brutality issues ignited by the deaths of George Floyd and many others. Our student leaders reported that UAB students struggled with increased rates of anxiety, depression, isolation, and loneliness. We also saw a significant increase in students seeking services through our student counseling center, and our National College Health Assessment Data collected in the fall of 2020 outlined a number of troubling statistics around student mental health and coping.

At a Student Counseling Services Student Advisory Board meeting in late October, student leaders shared that they really wanted a UAB-specific mental health app that would be a "one-stop shop" for students who were trying to find resources to get help and to take care of their mental health. Students noted that their peers needed help now more than ever and that, although everything was available in some way on UAB websites, the information wasn't in an app and wasn't all in one place. The students needed a new mental health app with functionality that did not currently exist—and they needed it now. Specifically, students expected a mental health app that provided an integrated experience.

Meanwhile, in December 2020, UAB had become the first university in the United States to be recognized as a "Health Promoting University," part of "an international community that aspires to transform the health and sustainability of current and future societies, strengthen communities, and contribute to the well-being of people, places and the planet."^Footnote1 So when UAB students expressed their need for help, a cross-campus team was rapidly formed. Professionals from UAB Human Resources, Information Technology, and Student Affairs—including counselors, health educators, and recreation specialists—joined in a productive partnership to develop an aggressive timeline for the app and to deliver the app at the beginning of the spring semester.

Student Health and Wellbeing staff met with the Student Counseling Services Student Advisory Board, the undergraduate and graduate student government associations, and numerous other student groups and quickly mapped out a scope for the student side of the project. The initial phase included the following:

• An interactive self-care plan
• Crisis help
• Links to a calendar feature with all UAB events related to mental health
• Links to resources for getting involved with student mental health organizations
• A link to assistance provided by Student Counseling Services, including the ability to make or change appointments and log into self-help resources and trainings

Conversations with the Human Resources team to produce employee-equivalent content created a decision point in the project. The original goal had been to provide a mental health app for both students and employees by the start of spring 2021. However, the cross-campus team agreed that although the two groups had overlapping needs, different requirements and resources existed. For this reason, the team decided to provide a dedicated employee profile by the midway point of the spring semester, with a limited employee resource hub upon initial launch.

All parties associated with the project understood the importance of this app and its context in the bigger mission of the university, resulting in a shared sense of urgency. The close collaboration and shared values also supported a transparent decision-making process that aligned intent and that accelerated development. With the quick delivery of content by the Student Affairs staff and the IT mobile development and technology communications teams' willingness to work through the holidays, it became clear that the B Well app project had established a unique network of trust on which future endeavors could model a pattern of success.

Process

The project to build the mental health app—called B Well—was a sprint. The Student Health and Wellbeing Team provided the content and initial ideas, and the IT team used a rapid prototype methodology to confirm requirements, provide feedback on what was in the realm of the possible for prioritization, and deliver functionality. At the end of November 2020, Student Affairs staff firmed up the initial specification; the final requirements were locked down on December 11; and the IT team delivered a beta version on January 6 for user-acceptance testing. Numerous ideas evolved as the cross-functional team continued to collaborate. A second prototype was delivered on January 13. The shared values, close collaboration, and transparent decision-making of a cross-functional team ultimately resulted in success. The beta launch of the app occurred the third week of January—giving students a new wellness tool just as they returned to campus for a busy semester and giving employees resiliency resources that had previously been available only on websites.^Footnote2

With less than two weeks between the initial request and the lock-in for requirements, the Student Affairs staff who had developed the initial content and provided the requirements had to get everything quickly to the IT team. The IT mobile development and technology communications teams worked through the holidays to take that content and vision and make it a reality. As noted above, everyone associated with the project understood the importance of this app. They knew that this kind of tool could help to improve access to mental health resources not only for UAB students but also for university and hospital employees.

The app is also a natural progression of the other work the IT team has done over the past year to protect the health and well-being of students, staff, and faculty: leading the statewide GuideSafe exposure notification app;^Footnote3 directing the informatics portion of statewide COVID-19 sentinel testing; assisting and supporting a HealthCheck survey that students and staff complete daily to monitor COVID-19 symptoms; creating a "safe study occupancy program";^Footnote4 and providing drive-in WiFi access.

Lessons Learned

Early and consistent engagement and collaboration allowed each team involved in the project to do its part, whether that was developing the requirements, writing content, coding the app, or designing the interface. From the beginning, and especially since this was an app requested by students, everyone focused on amplifying students' voices in what was needed for the content and functionality of the final product. The rapid prototype approach allowed the IT team to validate the app with student testers and Student Affairs staff to ensure we had the right app for our campus.

Because of the tight timeline, we focused on a minimum viable product—which may seem counterintuitive but has given us a solid base to build an enhanced product as the initially tight timelines relax. The timing of the app release was important also; we wanted a tool that students could use when they returned to campus in January to begin the spring semester.

The first iteration of the student app includes the following: a personalized self-care plan with a wellness journal and habit tracker; wellness exercises; an integrated calendar with mental health and wellness events; and resources for crisis help. The second version of the app (Phase Two), delivered on April 5, includes the next set of requirements: notifications and expanded wellness video content, along with minor changes in the design and interface to make it more user-friendly. Phase Two also integrates a full employee profile, providing content tailored to employees.

This wasn't the IT team's first sprint during the pandemic. Many of its technology projects over the past twelve months have focused on the health and well-being of our students and employees. UAB's history of open collaboration has been essential to the success of all of those projects—as well as to the success of the B Well app.

Notes

1. Shannon Thomason, "UAB Becomes First Health Promoting University in the United States," UAB News, December 15, 2020. Jump back to footnote 1 in the text.↩
2. Jennifer Fortier, "UAB Creates Mental Health App That Puts Wellness in Students' Hands," WVTM13, February 19, 2021. Jump back to footnote 2 in the text.↩
3. See Curt Carver, Brian Rivers, and Robert Howard, "Exposure Notification: Saving Lives through Partnership and Trust," EDUCAUSE Review, January 22, 2021. Jump back to footnote 3 in the text.↩
4. The "safe study occupancy program" focused on creating campus safe study spaces with high-speed internet, occupancy monitors that provided real-time data on capacity so that students could make informed safe choices, and student safety officers who helped ensure that conditions in these safe spaces remained secure. Jump back to footnote 4 in the text.↩

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Curtis A. Carver Jr. is Vice President and Chief Information Officer at the University of Alabama at Birmingham.

Rebecca E. Kennedy is Assistant Vice President for Student Health and Wellbeing at the University of Alabama at Birmingham and a licensed psychologist.

Daniel W. Jones is Director of Student and Advancement at the University of Alabama at Birmingham.