A socially assistive robot to support mental wellbeing in LGBTQ+ young people at risk of self-harm: a randomised controlled trial

LGBTQ+ youth commonly have unmet mental health needs and are at elevated risk for self-harm, yet many face persistent institutional barriers to accessing support. One impactful way to reduce risk and promote well-being is by supporting emotion regulation; that is, the process by which individuals can influence which emotions they feel, when they feel them, and how they experience or express these emotions. This universal, modifiable process is widely considered a key transdiagnostic target for mental ill-health prevention and intervention efforts. We conducted a randomised controlled trial using Purrble, a socially assistive robot designed to provide in-the moment emotion regulation support through intuitive tactile interaction. Between 12th January 2024 and 1st September 2024, 153 LGBTQ+ youth with self-harm ideation were randomised 1:1 to receive Purrble and safety planning (Purrble + SP) or safety planning alone (SP-Only), stratified by gender identity (50.3% transgender/gender diverse). Data were collected over 13 weeks, with data collection closing on the 22nd of October 2024. The primary outcome was perceived emotion regulation difficulties at follow-up, adjusted for baseline, gender identity, and age. Participants allocated to the Purrble intervention reported fewer emotion regulation difficulties at follow-up than those allocated to safety planning alone (adjusted mean difference: –3.04; 95% CI: –4.92 to –1.16; p = .002; partial η² = .07). For secondary outcomes, participants in the Purrble intervention also reported significantly lower symptoms of anxiety and depression, but there was no significant main effect for self-harm. No serious Purrble-related adverse events were observed. Purrble may offer a scalable intervention to complement existing therapeutic approaches to support LGBTQ+ youth to enhance their emotion regulation. ClinicalTrials.gov: NCT06025942.