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A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial

Jess Williams Orcid Logo, C Aubrey Rhodes, Seonaid Cleare Orcid Logo, Rohan Borschmann Orcid Logo, James J Gross, Kate Petrova, Lauren Posada, Christopher R Tench, Amelia Chapman-Nisar, Lucy Martin, Chris Hollis, Ellen Townsend, Petr Slovak Orcid Logo

Nature Medicine

Swansea University Author: Jess Williams Orcid Logo

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DOI (Published version): 10.1038/s41591-026-04422-6

Abstract

LGBTQ+ youth commonly have unmet mental health needs and are at elevated risk for self-harm, yet many face persistent institutional barriers to accessing support. One impactful way to reduce risk and promote wellbeing is by supporting emotion regulation; that is, the process by which individuals can...

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Published in: Nature Medicine
ISSN: 1546-170X
Published: Springer Nature
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa72106
Abstract: LGBTQ+ youth commonly have unmet mental health needs and are at elevated risk for self-harm, yet many face persistent institutional barriers to accessing support. One impactful way to reduce risk and promote wellbeing is by supporting emotion regulation; that is, the process by which individuals can influence which emotions they feel, when they feel them and how they experience or express these emotions. This universal, modifiable process is widely considered a key transdiagnostic target for mental ill-health prevention and intervention efforts. We conducted a randomized controlled trial using Purrble, a socially assistive robot designed to provide in-the-moment emotion regulation support through intuitive tactile interaction. Between 12 January and 1 September 2024, 153 LGBTQ+ youth with self-harm ideation were randomized 1:1 to receive Purrble and safety planning (Purrble + SP) or safety planning alone (SP-Only), stratified by gender identity (50.3% transgender/gender diverse). Data were collected over 13 weeks, with data collection closing on 22 October 2024. The primary outcome was perceived emotion regulation difficulties at follow-up, adjusted for baseline, gender identity and age. Participants allocated to the Purrble intervention reported fewer emotion regulation difficulties at follow-up than those allocated to safety planning alone (adjusted mean difference: -3.04; 95% confidence interval (CI): -4.92 to -1.16; P = 0.002; partial η  = 0.07). For secondary outcomes, participants in the Purrble intervention also reported significantly lower symptoms of anxiety and depression, but no significant main effect was observed for self-harm. No serious Purrble-related adverse events were observed. Purrble may offer a scalable intervention to complement existing therapeutic approaches to support LGBTQ+ youth to enhance their emotion regulation. ClinicalTrials.gov: NCT06025942.
College: Faculty of Medicine, Health and Life Sciences
Funders: A.J.W., L.P., C.A.N., L.M., A.C.-N., C.H., E.T. and P.S. acknowledge the support of the UK Research and Innovation Digital Youth Programme award (Medical Research Council) as part of Digital Youth—a large multi-institutional program of research (https://digitalyouth.ac.uk) (MR/W002450/1; chief investigators: C.H. and E.T.)—that is part of the Adolescence, Mental Health and the Developing Mind program. A.J.W., C.A.R. and P.S. also acknowledge the support of the UKRI Future Leaders Fellowship (MR/T041897/1), which supported the time and resources involved in this trial. R.B. receives salary support from the Better Health & Care Hub at King’s College London.

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