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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
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URI: https://cronfa.swan.ac.uk/Record/cronfa72106
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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&#x2009;weeks, with data collection closing on 22 October 2024. 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spelling 2026-06-18T11:22:20.2287560 v2 72106 2026-06-18 A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial 587989a3ed68b49c028a2cdf1c3375d8 0000-0002-3987-3824 Jess Williams Jess Williams true false 2026-06-18 MEDS 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. Journal Article Nature Medicine 0 Springer Nature 1546-170X 0 0 0 0001-01-01 10.1038/s41591-026-04422-6 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee 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. 2026-06-18T11:22:20.2287560 2026-06-18T11:10:47.9677393 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Jess Williams 0000-0002-3987-3824 1 C Aubrey Rhodes 2 Seonaid Cleare 0000-0002-2728-9356 3 Rohan Borschmann 0000-0002-0365-7775 4 James J Gross 5 Kate Petrova 6 Lauren Posada 7 Christopher R Tench 8 Amelia Chapman-Nisar 9 Lucy Martin 10 Chris Hollis 11 Ellen Townsend 12 Petr Slovak 0000-0001-8458-7715 13 72106__36993__27f61fff176c4f78952a4f77168e14b3.pdf 72106.VOR.pdf 2026-06-18T11:18:04.7946402 Output 8528693 application/pdf Version of Record true © The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
spellingShingle A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
Jess Williams
title_short A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
title_full A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
title_fullStr A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
title_full_unstemmed A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
title_sort A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomized controlled trial
author_id_str_mv 587989a3ed68b49c028a2cdf1c3375d8
author_id_fullname_str_mv 587989a3ed68b49c028a2cdf1c3375d8_***_Jess Williams
author Jess Williams
author2 Jess Williams
C Aubrey Rhodes
Seonaid Cleare
Rohan Borschmann
James J Gross
Kate Petrova
Lauren Posada
Christopher R Tench
Amelia Chapman-Nisar
Lucy Martin
Chris Hollis
Ellen Townsend
Petr Slovak
format Journal article
container_title Nature Medicine
container_volume 0
institution Swansea University
issn 1546-170X
doi_str_mv 10.1038/s41591-026-04422-6
publisher Springer Nature
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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description 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.
published_date 0001-01-01T06:03:09Z
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