Exploring caregiver experiences with the altitudes digital mental health program: A thematic analysis

Caregivers play an important role in the recovery of young people experiencing early psychosis, though they often experience high distress and have limited access to support for their own wellbeing and mental health needs. Digital mental health interventions (DMHIs) such as Altitudes offer scalable and flexible support through the provision of psychoeducation, therapy content, and opportunities for social connection in a secure online platform. The objective of this study was to explore caregivers' subjective experiences using Altitudes, a digital mental health intervention designed to support the wellbeing of caregivers of young people experiencing early psychosis.

Semi-structured interviews were conducted with 21 caregivers who participated in a 6-month open trial of Altitudes in the United States. A reflexive thematic analysis was used to examine perceived benefits, challenges, and recommendations for improvement.

Four themes were identified: (1) Altitudes as a trusted resource in a confusing journey, reflecting caregivers' appreciation for clear, credible information and normalization through peer connection; (2) The importance of human support, emphasizing the role of Clinical Moderators and Family Peer Workers as sources of empathy, accountability, and hope in the digital space; (3) Striking a balance and overcoming barriers to engagement, highlighting how caregiving demands and illness phase shaped participation and preferences for support; and (4) Recommendations for future development, including requests for more interactive features, notifications and reminders, and opportunities for live or in-person connection.

Participants viewed Altitudes as a caregiver-focused resource that reduced isolation and stigma, and improved access to credible psychosis-specific information and therapy strategies. Embedding human-supported DMHIs within coordinated specialty care may strengthen continuity of care and improve outcomes for both caregivers and young people early in the course of psychotic illness.