Executive Summary
From 2023–2025, a large Division I university implemented Sharpen® DTX — a digital care coordination and therapeutics platform combining universal mental health and suicide risk screening (CAT-MH®) with peer-focused mental health literacy and athlete wellness modules. Over three years, 1,275 student-athletes completed mandatory CAT-MH® screenings. During this period, 126 athletes (9.9%) flagged for elevated suicide risk and received same-day clinical triage via real-time dashboard.
"The platform successfully bridged universal screening with immediate clinical response, creating a scalable pathway for suicide prevention that would be impossible through traditional clinical workflows."
At the onset, the Sharpen® DTX platform was a standalone prevention toolkit containing a self-guided library of over 100 psychoeducational modules. By 2025, it had evolved into a fully integrated DTX system with screenings, modules, and interventions unified in one platform — demonstrating progressive improvements in both reach and engagement quality.
This progression led to improved email open rates from 22% to 69%, driven by community-based focus groups with athletes discussing injury, loneliness, and strategies for self-care and supporting teammates. The 2025 integrated DTX platform transformed engagement from passive email opens to active platform participation, engaging 491 student-athletes throughout the academic year. Among 2025 platform users, 98% returned for multiple sessions, averaging 7.2 visits and 104 actions per user — representing sustained, meaningful engagement.
Implementation Overview
Setting & Population
The Sharpen® DTX platform was deployed at a Division I university athletic program as part of mandatory summer orientation for incoming and continuing student-athletes. The implementation included three integrated components:
- Universal screening: All athletes completed the CAT-MH® assessment containing twelve modules, including depression, anxiety, substance use, and two validated suicide screening tools
- Automated triage: A real-time dashboard enabled licensed psychotherapists to provide same-day analysis, safety planning, and crisis intervention
- Evidence-based prevention: The two-month Sharpen Athlete™ mobile course provided peer-focused documentary films covering athlete health, mental health literacy, stigma reduction, coping skills, and suicide prevention
Clinical Triage & Immediate Intervention
100% of the 126 student-athletes who flagged for elevated suicide risk received same-day clinical intervention by licensed psychotherapists. When students completed the CAT-MH®, clinicians received real-time alerts for any athlete at increased risk.
100%
Same-day clinical intervention rate for all 126 flagged athletes across three years — a standard impossible to achieve through traditional clinical workflows
The real-time Sharpen DTX dashboard enabled immediate safety planning and risk assessment, same-day clinical outreach to at-risk students, and deployment of targeted interventions including digital safety plans and additional protective content based on risk level and diagnostic category.
Three-Year Engagement Evolution
| Year | Athletes Screened | Elevated Risk Flagged | Delivery Method |
|---|---|---|---|
| 2023 | 413 | 43 (10.4%) | Email campaigns |
| 2024 | 451 | 44 (9.8%) | Optimized email campaigns |
| 2025 | 411 | 39 (9.5%) | Integrated Sharpen DTX Platform |
| Total | 1,275 | 126 (9.9%) | — |
2023
Email Baseline — Sharpen evidence-based prevention content delivered via six email campaigns to 270 athletes. Content focused on mental health literacy modules. Average open rate of 363 opens from 1,620 sent.
22%
2024
Optimized Campaigns — Content expanded to 10 modules based on athlete feedback, incorporating peer voices from coaches, athletes, and athletic leadership. January campaign reached 72.2% open rate; March cohort averaged 78.7%.
78%
2025
Integrated DTX Platform — Full platform transition. 491 athletes generated 51,243 platform interactions. Engagement shifted from passive email opens to active, sustained platform participation.
98%
2025 Integrated Platform: Full Engagement Data
| Metric | Value |
|---|---|
| Unique athletes engaged | 491 |
| Return rate (2+ visits) | 98% |
| Average visits per athlete | 7.2 |
| Total actions (clicks/views/interactions) | 51,243 |
| Average actions per athlete | 104 |
| Athletes with 50+ actions | 82.5% |
| Total engagement time | 146.7 hours |
Module Engagement (2025)
In the 2025 integrated platform, 491 athletes interacted extensively with the mental health education content, generating 4,830 page views totaling 44.2 hours of cumulative engagement. Top-performing modules demonstrated the platform's ability to reach nearly all athletes with foundational mental health literacy:
| Module Topic | Unique Athletes | % Engagement |
|---|---|---|
| Athlete Mental Health | 464 | 94.5% |
| Overcoming Loneliness | 411 | 83.8% |
| Optimizing Energy for Athletes | 395 | 80.4% |
| Improving Emotional Wellness | 336 | 68.4% |
| Female Athlete Triad Syndrome | 271 | 55.2% |
Key Findings & Implications
Finding 01
Platform Integration Drives Sustained Engagement
The evolution from email (22%) to optimized campaigns (78%) to integrated DTX platform (98% return rate) demonstrates that seamless integration fundamentally transforms how young adults engage with mental health content. When mental health literacy is embedded in an accessible, mobile-first platform, athletes engage repeatedly and deeply.
Finding 02
Peer-Focused Content Normalizes Mental Health Conversations
The 3× engagement improvement from 2023 to 2024 (22% to 78% open rates) resulted directly from incorporating peer voices through documentary-style content featuring athletes, coaches, and athletics leadership. Authentic peer narratives are critical for reducing stigma and building trust in mental health interventions.
Finding 03
Universal Screening Enables Proactive Safety Planning
100% of 126 at-risk athletes received same-day clinical intervention through automated real-time dashboard alerts. Digital therapeutics platforms can successfully bridge universal screening with immediate clinical response — at a scale that is simply not achievable through traditional clinical workflows.
Finding 04
Clinician Satisfaction: 100% / NPS 10/10
Clinician satisfaction surveys (n=4 licensed psychotherapists) showed 100% satisfaction across all metrics: ease of deployment, same-day access capability, care coordination, and clinical outcome support. Net Promoter Score: 10/10.
Conclusion
This three-year implementation demonstrates that integrated digital therapeutics platforms can simultaneously achieve three critical goals: universal suicide risk screening with 100% clinical follow-up, sustained engagement with prevention content (98% return rate), and scalable deployment across large populations (1,275 athletes over three years).
The dramatic engagement evolution — from 22% email opens to 98% platform return rates — proves that delivery method fundamentally shapes mental health intervention effectiveness. When suicide screening, clinical triage, and peer-focused prevention content are unified in a mobile-accessible platform, young adults will engage deeply and repeatedly.
"When mental health literacy is embedded in an accessible platform built with and for athletes — not designed for them from the outside — engagement stops being a challenge. It becomes the outcome."
About the Platform
Sharpen® DTX, developed by Resiliency Technologies, is a digital therapeutics platform designed to integrate evidence-based mental health screening, clinical triage, and peer-focused prevention content. The platform is live at Prisma Children's Hospital and is being implemented at Stanford Medicine and UCSF, with partnerships focused on collaborative care management with an emphasis on pediatric behavioral health.
Adaptive Testing Technologies (ATT) is the leader in the design, testing, and implementation of large-scale, cloud-based mental health assessment tools based on Computerized Adaptive Testing (CAT). The CAT-MH® is the first and only validated, comprehensive, multidimensional item-response-theory-based adaptive screening system in the world.
References
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- Levy, J., et al. (forthcoming). A program evaluation of the Sharpen® MHL college course. Journal of American College Health.
- Minkel, J., Pish, M., & Hussa Farrell, R. (2024). Sharpen® Platform Engagement & Activation. Resiliency Technologies.
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