{
  "abstract": "Objective The study evaluated the effectiveness of headwind service, an online, clinician-led mental health advisory platform, in engaging individuals with moderate to severe psychological distress. It also compared distress reduction achieved through headwind with natural recovery in a community cohort, providing a benchmark for evaluating active interventions.Design, setting and participants The study analysed data from 13 527 people across three cohorts: headwind users (n=3559), participants in a territory-wide youth mental health (YMH) programme (n=6734) and a community youth cohort (n=3234). Data were collected between April 2019 and December 2024 in Hong Kong.Intervention headwind offers single 30 min informal mental health advisory sessions through Zoom or telephone, led by psychiatrists and clinical psychologists. Designed for accessibility and anonymity, the service provides practical advice without establishing a formal doctor-patient relationship.Main outcomes and measures Distress levels were measured using the Kessler Psychological Distress Scale (K6) at baseline and follow-up. Primary outcomes included engagement of individuals with moderate to severe levels of mental distress, reductions in K6 scores and shifts in distress severity categories. Secondary outcomes examined demographic subgroup differences and comparisons with natural recovery in the community cohort.Results At baseline, headwind users reported higher baseline distress levels (mean K6 score: 13.11) than YMH (7.88) and community (7.27) cohorts (p<0.001). Following a single session, headwind participants experienced a substantial reduction in distress (large effect size: 0.74), with the largest improvements observed in individuals with severe distress. Reductions were consistent across age and gender subgroups. headwind users showed significantly greater distress reductions than the naturalistic recovery observed in the propensity score-matched community cohort (p=0.008).Conclusions The headwind service effectively engages young people experiencing moderate to severe mental distress, delivering immediate and significant reductions in distress levels. Its low-barrier design, characterised by anonymity, timely access to professionals and an informal, user-friendly structure, effectively addresses systemic challenges in traditional mental healthcare, making it a scalable, accessible and impactful complement to existing mental healthcare systems.",
  "authors": [
    {
      "affiliations": [
        "School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Yi Nam Suen"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Kai Tai Chan"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Yau Sum Wan"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Melody Miriam So"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Edwin Ho Ming Lee"
    },
    {
      "affiliations": [
        "Department of Social Work and Social Administrations, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Stephanie Ming Yin Wong"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China",
        "State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Sherry Kit Wa Chan"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Christy Lai Ming Hui"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China"
      ],
      "name": "Michael Tak Hing Wong"
    },
    {
      "affiliations": [
        "Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China",
        "Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Eric Yu Hai Chen"
    }
  ],
  "title": "Can headwind, an online clinician-led mental health advisory platform, improve the engagement of distressed young people in community services? A multicohort analysis",
  "uid": "1988ed3d-e0ee-5905-84b1-2be6dd55a57f"
}