Using a School-Based Depression Literacy Psychoeducation Program With AI Chatbot to Improve Depression Literacy and Help-Seeking Among High School Students

Effects of an AI Chatbot-Enhanced School-Based Depression Literacy Psychoeducation Intervention on Adolescents' Help-Seeking Attitudes: A Randomized Controlled Trial

The primary purpose of this randomized controlled trial is to evaluate the effectiveness of an AI chatbot enhanced school-based depression literacy psychoeducational program, combined with a resource navigation booklet, on high school students in Taiwan.

Despite the high prevalence of depression among adolescents, the treatment gap remains significantly large due to low mental health literacy and high stigma. This study aims to bridge this gap by implementing a 4-week structured psychoeducational intervention. The investigators hypothesize that participants in the experimental group will demonstrate a significant improvement in depression literacy, a reduction in stigmatizing attitudes toward depression, and more positive attitudes toward seeking professional psychological help compared to those in the control group (regular classes as usual). Outcomes will be assessed at baseline and immediately post-intervention.

Depression is a leading cause of disability among adolescents globally, yet a significant treatment gap remains, with up to 70 to 90 percent of adolescents experiencing depressive symptoms failing to receive adequate professional care. Major barriers to accessing appropriate treatment include a widespread lack of mental health literacy and pervasive public and personal stigma surrounding psychological disorders. This study aims to address these barriers by investigating whether a structured psychoeducational intervention can effectively improve depression literacy, reduce stigma, and enhance positive attitudes toward seeking professional psychological help among high school students.

This study employs a quantitative, randomized controlled trial design to evaluate the effectiveness of the proposed psychoeducation intervention. The study population consists of 15 to 19-year-old students recruited from public and private high schools in Taiwan, who will be randomly assigned to either an experimental group or a control group.

Participants assigned to the experimental group will receive an AI chatbot enhanced structured, school-based depression literacy psychoeducation program consisting of four weekly 50-minute sessions. The curriculum is designed to cover the etiology of depression, symptom recognition, and strategies for stigma reduction, and will conclude with the distribution of a physical resource navigation booklet that serves as an actionable emotional first-aid kit detailing local help-seeking channels. Conversely, participants in the control group will receive regular classed as usual, maintaining their standard school curriculum and routine health education classes without exposure to this specific depression literacy intervention.

Inclusion Criteria:

• Students aged 15 to 19 enrolled in participating high schools in Taiwan. Fluent in speaking, reading, and writing traditional Chinese, capable of independently completing self-report questionnaires. Willing to participate and provide signed informed assent, alongside signed informed consent from a parent or legal guardian.

Exclusion Criteria:

• Diagnosed with severe cognitive impairment or developmental delay that prevents understanding the curriculum or completing the questionnaires. Currently experiencing an acute psychiatric crisis or exhibiting high risk for self-harm/suicide (e.g., active suicidal ideation, or scoring >= 15 on the baseline Patient Health Questionnaire-9 [PHQ-9], or scoring >= 1 on item 9 of the PHQ-9). These individuals will be referred to immediate standard psychiatric or school counseling care.