“I Wanted to See How Bad it Was”: Online Self-screening as a Critical Transition Point Among Young Adults with Common Mental Health Conditions

Kruzan, Kaylee Payne; Meyerhoff, Jonah; Nguyen, Theresa; Reddy, Madhu; Mohr, David C.; Kornfield, Rachel

doi:10.1145/3491102.3501976

Cited by 26 publications

(25 citation statements)

References 76 publications

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“…The transtheoretical model of behavior change (also called the “stages of change” model) posits that particular processes of change align better or worse with individuals depending on where they fall on a spectrum of readiness for change [ 31 ]. These participants are likely in the contemplation stage (ie, considering whether they will make a change in how they manage mental health) or preparation stage (ie, making plans to take action in support of recovery), but many have not committed to or carried out a plan of action to improve their mental health [ 32 , 33 ]. In these early stages of change, helpful processes are proposed to include consciousness raising (gaining information and awareness about a problem and its solutions), dramatic relief (getting in touch with one’s emotions and expressing oneself), environmental reevaluation (assessing how the problem affects the physical and social environment), and self-reevaluation (emotional and cognitive reappraisal of one’s values as they relate to the problem) [ 31 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Mental Health Self-Tracking Preferences of Young Adults With Depression and Anxiety Not Engaged in Treatment: Qualitative Analysis

Beltzer¹,

Meyerhoff²,

Popowski³

et al. 2023

JMIR Form Res

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Background Despite the high prevalence of anxiety and depression among young adults, many do not seek formal treatment. Some may turn to digital mental health tools for support instead, including to self-track moods, behaviors, and other variables related to mental health. Researchers have sought to understand processes and motivations involved in self-tracking, but few have considered the specific needs and preferences of young adults who are not engaged in treatment and who seek to use self-tracking to support mental health. Objective This study seeks to assess the types of experiences young adults not engaged in treatment have had with digital self-tracking for mood and other mental health data and to assess how young adults not seeking treatment want to engage in self-tracking to support their mental health. Methods We conducted 2 online asynchronous discussion groups with 50 young adults aged 18 years to 25 years who were not engaged in treatment. Participants were recruited after indicating moderate to severe symptoms of depression or anxiety on screening surveys hosted on the website of Mental Health America. Participants who enrolled in the study responded anonymously to discussion prompts on a message board, as well as to each other’s responses, and 3 coders performed a thematic analysis of their responses. Results Participants had mixed experiences with self-tracking in the past, including disliking when tracking highlighted unwanted behaviors and discontinuing tracking for a variety of reasons. They had more positive past experiences tracking behaviors and tasks they wanted to increase, using open-ended journaling, and with gamified elements to increase motivation. Participants highlighted several design considerations they wanted self-tracking tools to address, including building self-understanding; organization, reminders, and structure; and simplifying the self-tracking experience. Participants wanted self-tracking to help them identify their feelings and how their feelings related to other variables like sleep, exercise, and events in their lives. Participants also highlighted self-tracking as useful for motivating and supporting basic activities and tasks of daily living during periods of feeling overwhelmed or low mood and providing a sense of accomplishment and stability. Although self-tracking can be burdensome, participants were interested and provided suggestions for simplifying the process. Conclusions These young adults not engaged in treatment reported interest in using self-tracking to build self-understanding as a goal in and of itself or as a first step in contemplating and preparing for behavior change or treatment-seeking. Alexithymia, amotivation, and feeling overwhelmed may serve both as barriers to self-tracking and opportunities for self-tracking to help.

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Section: Discussionmentioning

confidence: 99%

Mental Health Self-Tracking Preferences of Young Adults With Depression and Anxiety Not Engaged in Treatment: Qualitative Analysis

Beltzer¹,

Meyerhoff²,

Popowski³

et al. 2023

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although results are mixed, in some cases, positive online self-screening results lead to requests for referrals to mental health professionals, such as with mental health and alcohol screening [51,52]. Online mental health selfscreening may validate the experiences of young adults and contribute to self-understanding, although many may not know what steps to take next [53]. Online testing, followed by connecting with others with similar experiences, helps some people adjust to cognitive and mental disabilities and prepare for seeking professional help [37].…”

Section: Benefits Of Online Screeningmentioning

confidence: 99%

Implications of Online Self-Diagnosis in Psychiatry

Monteith,

Glenn,

Geddes

et al. 2024

Pharmacopsychiatry

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Online self-diagnosis of psychiatric disorders by the general public is increasing. The reasons for the increase include the expansion of Internet technologies and the use of social media, the rapid growth of direct-to-consumer e-commerce in healthcare, and the increased emphasis on patient involvement in decision making. The publicity given to artificial intelligence (AI) has also contributed to the increased use of online screening tools by the general public. This paper aims to review factors contributing to the expansion of online self-diagnosis by the general public, and discuss both the risks and benefits of online self-diagnosis of psychiatric disorders. A narrative review was performed with examples obtained from the scientific literature and commercial articles written for the general public. Online self-diagnosis of psychiatric disorders is growing rapidly. Some people with a positive result on a screening tool will seek professional help. However, there are many potential risks for patients who self-diagnose, including an incorrect or dangerous diagnosis, increased patient anxiety about the diagnosis, obtaining unfiltered advice on social media, using the self-diagnosis to self-treat, including online purchase of medications without a prescription, and technical issues including the loss of privacy. Physicians need to be aware of the increase in self-diagnosis by the general public and the potential risks, both medical and technical. Psychiatrists must recognize that the general public is often unaware of the challenging medical and technical issues involved in the diagnosis of a mental disorder, and be ready to treat patients who have already obtained an online self-diagnosis.

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“…A self-diagnosis of a mental illness may also decrease further online searches related to mental health [ 109 •]. Many young people feel a self-diagnosis validates their symptoms but are unsure of what to do next [ 110 ]. Self-stigma occurs frequently in people with mental disorders [ 111 – 113 ] and is a known barrier to seeking professional help including among college students [ 114 – 116 ].…”

Section: Self-diagnosismentioning

confidence: 99%

Telepsychiatry in an Era of Digital Mental Health Startups

Achtyes

Glenn²,

Monteith

et al. 2023

Curr Psychiatry Rep

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Purpose of Review Telepsychiatry practiced by psychiatrists is evidence-based, regulated, private, and effective in diverse settings. The use of telemedicine has grown since the COVID-19 pandemic as people routinely obtain more healthcare services online. At the same time, there has been a rapid increase in the number of digital mental health startups that offer various services including online therapy and access to prescription medications. These digital mental health firms advertise directly to the consumer primarily through digital advertising. The purpose of this narrative review is to contrast traditional telepsychiatry and the digital mental health market related to online therapy. Recent Findings In contrast to standard telepsychiatry, most of the digital mental health startups are unregulated, have unproven efficacy, and raise concerns related to self-diagnosis, self-medicating, and inappropriate prescribing. The role of digital mental health firms for people with serious mental illness has not been determined. There are inadequate privacy controls for the digital mental health firms, including for online therapy. We live in an age where there is widespread admiration for technology entrepreneurs and increasing emphasis on the role of the patient as a consumer. Yet, the business practices of digital mental health startups may compromise patient safety for profits. Summary There is a need to address issues with the digital mental health startups and to educate patients about the differences between standard medical care and digital mental health products.

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“I Wanted to See How Bad it Was”: Online Self-screening as a Critical Transition Point Among Young Adults with Common Mental Health Conditions

Cited by 26 publications

References 76 publications

Mental Health Self-Tracking Preferences of Young Adults With Depression and Anxiety Not Engaged in Treatment: Qualitative Analysis

Mental Health Self-Tracking Preferences of Young Adults With Depression and Anxiety Not Engaged in Treatment: Qualitative Analysis

Implications of Online Self-Diagnosis in Psychiatry

Telepsychiatry in an Era of Digital Mental Health Startups

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