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University counseling services constitute a valuable resource to support college student mental health and wellness ( Spooner, 2000) and a challenge that seems to be common across several counseling services is the growing student demand for these services and the limited resources to face these demands ( Johnson and Kalkbrenner, 2017 Shaw et al., 2017 Auerbach et al., 2018 Lee and Jung, 2018). Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) were identified as the most common disorders found in college students ( Auerbach et al., 2018).
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College years are a sensitive period to the onset of several mental health disorders ( Kessler et al., 2007) and many studies have reported a significant rise in serious mental health illness among college students ( Hunt and Eisenberg, 2010 Storrie et al., 2010 Auerbach et al., 2018). One of the areas were mental health apps can have a significant impact is in universities.
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However, despite clinical potential, interest and early supporting evidence, one factor that seems to limit mental health apps is low engagement or poor adherence to the intervention ( Torous et al., 2018). Several studies have shown that mental health apps and cognitive behavioral therapy (CBT)-based apps are efficacious ( Rathbone et al., 2017 Linardon et al., 2019). In clinical settings, mHealth may enhance face-to-face treatments, increase patient engagement in therapy sessions and adherence to therapy principles provide better use of clinician time and resources and improve treatment outcome and risk of relapse ( Clough and Casey, 2015b). The enthusiasm of smartphones for healthcare initiatives led to the emergence of a novel field called mHealth ( Ben-Zeev et al., 2014) defined as the use of mobile technologies to deliver or support psychological or mental health interventions and includes mobile devices such as smartphones, tablets, Personal Digital Assistants, and wearable devices ( Clough and Casey, 2015b Alyami et al., 2017). Smartphones demonstrate numerous advantages such as great computing capacity, mobility, and more rapid and efficient access to information by using mobile applications ( Donker et al., 2013). Over the last decade numerous mental health mobile applications have been developed and made available for users ( Bakker et al., 2016). Specifically in covid-19 pandemic context, these interventions may contribute significantly by promoting and delivering psychological interventions at a safe distance. We conclude that universities, particularly college counseling services, may benefit from mhealth interventions, not only to address college students' mental health but to decrease some of its difficulties related to lack of human resources. Results suggested that college students accept and adhere to these interventions and preliminary evidence of efficacy was demonstrated in different disorders, such as stress, anxiety, depression and risky behaviors such as alcohol and tobacco abuse and sexual knowledge. A total of 2,158 participants were included in the 8 selected studies and most interventions were delivered through mobile apps only and based in cognitive behavioral therapy. We selected studies with mobile applications addressing psychological interventions for college students. A search in app stores was not conducted, thus regarding commercially available apps, only those found in our database search were included in our review. The literature search was conducted in scientific databases, namely, Web of Science, Pubmed, and Scopus. Our main objectives are to explore mhealth interventions in universities, regarding its conceptual framework, acceptability and efficacy outcomes and understand its impact and contributions to address treatment delivery and psychological difficulties resulting from covid-19 pandemic. Additionally, considering the recent covid-19 pandemic, mHealth interventions, due to its nature and possibilities, may play an important role in these institutions. Mobile applications for mental health have been growing exponentially in the last decade and they are emerging in university settings as a promising tool to promote and intervene in college students' mental health. Serious mental health disorders are increasing among college students and university counseling services are often overburdened. 2Department of Psychology and Education, Portucalense Institute for Human Development (INPP), Universidade Portucalense, Porto, Portugal.1Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.Carla Oliveira 1 *, Anabela Pereira 1, Paula Vagos 2, Catarina Nóbrega 1, José Gonçalves 1 and Beatriz Afonso 1