Improving mental health outcomes through online brain health training in adults with or without mental illness.

Background: Mental health promotion aims to improve well-being and quality of life for individuals and communities. However, most existing interventions target specific populations and are designed to address particular symptoms or diagnoses, limiting their reach to the general population. Therefore, there is a need to better understand the potential benefits of universal mental health promotion programs. Objective: This quasi-experimental pre-post study with matching examined the impact of an online brain health training as a mental health promotion tool for adults with and without mental illness. The program included Strategic Memory Advanced Reasoning Training (SMART), an executive function strategy training, combined with education on daily practices that support overall health. Methods: Participants included a matched sample of 370 adults (185 with and 185 without mental illness), ages 18-87. Linear mixed-effects models were used to (1) examine baseline group differences in mental health outcomes (psychological distress, resilience, quality of life, and engagement in meaningful activities) and high-level cognitive function, operationalized as a composite measure of complex cognition ("clarity"); (2) evaluate changes in these outcomes following 6 months of online brain health training; and (3) assess associations between changes in cognitive clarity and mental health outcomes over time. Results: At baseline, participants with mental illness reported greater psychological distress, lower resilience, poorer quality of life, reduced engagement in meaningful activities, and lower cognitive clarity compared with those without mental illness. Following training, both groups demonstrated significant improvements, including reduced psychological distress and increased resilience, quality of life, and engagement in meaningful activities. Clarity improved only among participants without mental illness who completed at least the core SMART training. Across the full sample and within both groups, improvements in clarity were significantly associated with improvements in mental health outcomes, with some group differences observed. Conclusion: Online brain health training warrants further study as a mental health promotion intervention, with potential to complement standard care for individuals with mental illness and prevent emerging concerns among those without a diagnosis. Delivering this training online offers a promising, accessible pathway for population-level mental health promotion.