The Impact of a Messenger-Based Psychosocial Chat Counseling Service on Further Help-Seeking Among Children and Young Adults: Longitudinal Study

Abstract

Background Mental crises have high prevalences in adolescence. Early interventions appear to be highly important to diminish the risk of the deterioration, recurrence, or chronification of symptoms. In recent years, various providers have started offering live chat support in psychological crises. The messenger-based psychological counseling service krisenchat aims to support young people in crises and, if necessary, provide a recommendation for a referral to the health care system or to seek further help from a trusted adult person. Objective This study aimed to investigate the impact of using the counseling service of krisenchat on the further help-seeking behavior of young people, and to identify associated factors of further help-seeking. Methods This longitudinal study analyzed anonymous data from 247 individuals who used krisenchat between October 2021 and March 2022, and received a recommendation for further help-seeking. An online survey directly after the chat assessed the perceived helpfulness of the chat and well-being after the chat. After 4 weeks, further help-seeking, facilitators and barriers to help-seeking, and self-efficacy were assessed in an online follow-up survey. Results The most frequently recommended services or persons to seek further help from included a psychotherapist or social psychiatric service (75/225, 33.3%), a school psychologist or school social worker (52/225, 23.1%), and the user’s parents (45/225, 20.0%). Of the 247 users, 120 (48.6%) indicated that they contacted the recommended service or person, and of these, 87 (72.5%) stated that they already had an appointment (or talk) with the respective service or person or that an appointment (or talk) was scheduled. The most frequently reported facilitators for further help-seeking were mental health literacy (54/120, 45.0%), improvement of self-efficacy (55/120, 45.8%), and symptom recognition (40/120, 33.3%). In users not displaying further help-seeking behavior, the most frequent barriers included stigmatization (60/127, 47.2%), lack of mental health literacy (59/127, 46.5%), need for self-reliance and autonomy (53/127, 41.7%), and negative family beliefs regarding help services (53/127, 41.7%). Subgroup comparisons indicated significantly higher levels of self-efficacy in users displaying further help-seeking behavior than in those not displaying further help-seeking behavior. Both subgroups did not differ in gender, age, recommended service or person, chat topics, perceived helpfulness, and well-being. Conclusions The findings of this study indicate that children and young adults receiving counseling on krisenchat benefit in terms of seeking further help. Further help-seeking seems to be associated with higher levels of self-efficacy. Trial Registration Deutsches Register Klinischer Studien DRKS00026671; https://tinyurl.com/4fm5xe68

Predicting recurrent chat contact in a psychological intervention for the youth using natural language processing

“…We applied a time based train-test split and used the 14,931 chatters that received a consultation before September 2022 as train set and saved the newest 3,942 chatters (21%, consultation between September 2022 and December 2022) for a one-time final evaluation of the algorithm’s performance. As reported elsewhere 14 , those contacting krisenchat are mostly female and aged on average around 17, with psychiatric symptoms as the most likely reason for contacting the service. On average, the first consultation of chatters consisted of 25.4 messages of the chatter (SD = 20.8) and 17.7 by the counselor (SD = 12.1).…”

“…First, studies have shown that chat-based synchronous interventions can be an effective treatment and prevention method for children and young adults with diverse mental health symptoms 10 – 12 . Additionally, those hotlines proved to be a first contact point for the youth 13 , serving as access points into further mental health treatment 14 . Therefore, besides the provision of efficient counseling during the chat interaction, the identification of those in need of additional help and their redirection towards appropriate care is a key task of those hotlines.…”

Predicting Recurrent Chat Contact in a Low-Threshold Psychological Intervention for Children and Young Adults: A Natural Language Processing Approach

“…First studies have shown that chat-based synchronous interventions can be an effective treatment and prevention method for children and young adults with diverse mental health symptoms 10,11,12 . Additionally, those hotlines proved to be a first contact point for the youth 13 , serving as access points into further mental health treatment 14 . Therefore, besides the provision of efficient counseling during the chat interaction, the identification of those in need of additional help and their redirection towards appropriate care is a key task of those hotlines.…”