Optimising the implementation of a universal web-based mental health service for Australian secondary schools - a cluster randomised controlled trial

Sep 29, 2026

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Trial examined how two implementation strategies affect engagement with Smooth Sailing, a universal web-based mental health service for Australian secondary students. Over 12 weeks, Grade 8–9 students from 20 schools were assigned to the standard service, the service plus extra class time, or the service plus financial incentives. Primary outcome measured module access at 12 weeks, with secondary outcomes including uptake, retention, help-seeking intentions, satisfaction, and barriers. Enhanced conditions increased module access but were not statistically significant; allocation and incentives did not improve engagement overall.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Subotic-Kerry et al. Child and Adolescent Psychiatry and Mental Health (2026) 20:1 [https://doi.org/10.1186/s13034-025-00975-5](https://doi.org/10.1186/s13034-025-00975-5) Child and Adolescent Psychiatry and Mental Health RESEARCH Open Access Optimising the implementation of a universal web-based mental health service for Australian secondary schools: a cluster randomised controlled trial Mirjana Subotic-Kerry 1*, Andrew Mackinnon 1, Dervla Gallen 1, Simon Baker2, Belinda Louise Parker 1, Melinda Rose Achilles 1, Cassandra Chakouch 1, Nicole Cockayne 1, Helen Christensen 1,3 and Bridianne O’Dea 1,4 Abstract Background Secondary schools are increasingly delivering a range of mental health interventions with varied success. This trial examined the effectiveness of two implementation strategies, allocation of class time and provision of financial incentives, on the engagement of secondary students with a universal web-based mental health service, Smooth Sailing. Methods A three-arm, cluster-randomised trial was conducted over 12 weeks with Grade 8 and 9 students from 20 schools in two Australian states. Schools were randomised to: (1) the standard Smooth Sailing service,(2) the standard service plus extra class time, or (3) the standard service plus financial incentives. The primary outcome was student engagement, measured by the number of modules accessed at 12-weeks post-baseline. Secondary outcomes included uptake, retention, help-seeking intentions for mental health problems, service satisfaction, and barriers to use. Results A total of 20 schools consented, and 1295 students participated. Students accessed a higher number of modules in the enhanced conditions compared with the standard service, but the differences were not statistically significant (p = 0 . 14) . There were no significant differences in uptake (p = 0 . 55) or retention (p = 0 . 95) between conditions. Help-seeking intentions significantly improved at 6-and 12-weeks in the standard service and class time conditions only. Common barriers to service use among students were forgetfulness and low motivation. Conclusions Neither class time allocation nor financial incentives significantly increased student engagement, as measured by modules accessed, highlighting the challenges of optimising engagement with digital mental health services in schools and emphasising the need to consider the broader school context. Trial registration Australian New Zealand Clinical Trial Registry (ACTRN12621000225819) and Universal Trial Number (U1111-1265-7440). Keywords School, Web-based, Digital, Student, Help-seeking, Mental Health, Implementation *Correspondence: Mirjana Subotic-Kerry [m.subotic-kerry@blackdog.org.au](m.subotic-kerry@blackdog.org.au) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ([http://creativecommons.org/publicdomain/zero/1.0/](http://creativecommons.org/publicdomain/zero/1.0/)) applies to the data made available in this article, unless otherwise stated in a credi

FAQs

What was the purpose of the trial?

To assess the effectiveness of two implementation strategies—extra class time and financial incentives—on student engagement with the universal web-based mental health service Smooth Sailing.

How was the trial designed and conducted?

A three-arm, cluster-randomised trial ran for 12 weeks with Grade 8 and 9 students from 20 schools across two Australian states.

What were the main findings about engagement?

Students accessed more modules in enhanced conditions, but differences were not statistically significant. Neither class time allocation nor financial incentives significantly increased engagement measured by modules accessed.

Sep 29, 2026

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