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

Journal article

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 wellbeing 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 randomized controlled trial using Purrble, a socially assistive robot designed to provide in-the-moment emotion regulation support through intuitive tactile interaction. Between 12 January and 1 September 2024, 153 LGBTQ+ youth with self-harm ideation were randomized 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 22 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% confidence interval (CI): −4.92 to −1.16; P = 0.002; partial η2 = 0.07). For secondary outcomes, participants in the Purrble intervention also reported significantly lower symptoms of anxiety and depression, but no significant main effect was observed 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.

Authors: Williams, AJ; Rhodes, CA; Cleare, S; Borschmann, R; Gross, JJ

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Nature Research
• Journal: Nature Medicine
• Volume: 32
• Issue: 6
• Pages: 2267-2276
• Publication date: 2026-06-04
• Acceptance date: 2026-04-24
• DOI: 10.1038/s41591-026-04422-6
• EISSN: 1546-170X
• ISSN: 1078-8956
• Language: English
• Keywords: Randomized controlled trial; Intervention (counseling); Mental health; Anxiety; Suicidal ideation; Exploratory research