Young People’s Online Help-Seeking and Mental Health Difficulties: Systematic Narrative Review

Abstract

BackgroundYoung people frequently make use of the internet as part of their day-to-day activities, and this has extended to their help-seeking behavior. Offline help-seeking is known to be impeded by a number of barriers including stigma and a preference for self-reliance. Online help-seeking may offer an additional domain where young people can seek help for mental health difficulties without being encumbered by these same barriers.ObjectiveThe objective of this systematic literature review was to examine young peoples’ online help-seeking behaviors for mental health concerns. It aimed to summarize young peoples’ experiences and identify benefits and limitations of online help-seeking for this age group. It also examined the theoretical perspectives that have been applied to understand online help-seeking.MethodsA systematic review of peer-reviewed research papers from the following major electronic databases was conducted: PsycINFO, Cumulative Index of Nursing and Allied Health Literature, PubMed, Cochrane Library, Association for Computing Machinery Digital Library, and Institute of Electrical and Electronics Engineers Xplore. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search was conducted in August 2017. The narrative synthesis approach to reviews was used to analyze the existing evidence to answer the review questions.ResultsOverall, 28 studies were included. The most common method of data collection was through the use of surveys. Study quality was moderate to strong. Text-based query via an internet search engine was the most commonly identified help-seeking approach. Social media, government or charity websites, live chat, instant messaging, and online communities were also used. Key benefits included anonymity and privacy, immediacy, ease of access, inclusivity, the ability to connect with others and share experiences, and a greater sense of control over the help-seeking journey. Online help-seeking has the potential to meet the needs of those with a preference for self-reliance or act as a gateway to further help-seeking. Barriers to help-seeking included a lack of mental health literacy, concerns about privacy and confidentiality, and uncertainty about the trustworthiness of online resources. Until now, there has been limited development and use of theoretical models to guide research on online help-seeking.ConclusionsApproaches to improving help-seeking by young people should consider the role of the internet and online resources as an adjunct to offline help-seeking. This review identifies opportunities and challenges in this space. It highlights the limited use of theoretical frameworks to help conceptualize online help-seeking. Self-determination theory and the help-seeking model provide promising starting points for the development of online help-seeking theories. This review discusses the use of these theories to conceptualize online help-seeking and identify key motivations and tensions that may arise when young people seek help online.

Annual Research Review: Adolescent mental health in the digital age: facts, fears, and future directions

“…However, as detailed below, a review of meta‐analytic work and narrative reviews, recent large‐scale public access and preregistered studies, and daily and momentary assessments of digital technology usage and mental health, show that that associations between time online and internalizing symptoms are often (a) mixed between positive, negative, and null findings, (b) when present, are likely too small to translate into practically or clinically meaningful effects (explaining less than 0.5% of the variance in symptoms with poor adjustment for relevant confounding factors and estimates that are virtually always derived from correlation designs), and (c) are typically not distinguishable in terms of likely cause and effect. In addition, a recent systematic narrative review of 28 studies of online help‐seeking behaviors indicated that many young people suffering from mental health problems are spending their time online searching for means of alleviating and better understanding their symptoms (Pretorius, Chambers, & Coyle, ).…”

“…Young people report going online frequently to seek out health information (Kauer, Mangan, & Sanci, ) and, those with lower social and emotional well‐being, are more likely to report going online to seek support and to feel better about themselves (Rideout & Fox, ). Social networking sites may be used by young people in the face of setbacks (Toma & Hancock, ) and many young people turn to social media for support and advice related to their mental health symptoms (Pretorius et al, ), with some research suggesting that adolescents with moderate to severe depressive symptoms may be more likely (2×) than their peers to turn to social media for emotional support (Rideout & Fox, ).…”

Producing a new website for a paediatric liaison mental health team with our service users

“…Given this context, mental health service providers have been asked to consider providing online resources as an 'adjunct to offline help seeking'. 5 Our service pages within the Trust website were aimed at professionals only, were difficult to find and did not give details about what to expect at a first assessment or how to travel to the clinic. The Trust website was awaiting redesign, but this wait had been some years with no clear date set.…”

Adolescent development and growing divides in the digital age

“…A large US study suggests that the vast majority (87%) of adolescents have gone online to seek information about mental health, while most (64%) have used a mental health app. 1 Social media is also endorsed by young people as a source of mental health advice, 35 especially for adolescents already struggling with moderate to severe depressive symptoms who, in one study, were more likely than their nondepressed peers to report using social media to access emotional support. 36 Given that the majority of youth in high-income countries are online, that youth are naturally turning to online spaces for information and support, and evidence-based mental health interventions are increasingly made available online, it seems that online platforms could be effectively mobilized to support youth mental health and respond in times of crisis.…”

“…A large US study suggests that the vast majority (87%) of adolescents have gone online to seek information about mental health, while most (64%) have used a mental health app. 1 Social media is also endorsed by young people as a source of mental health advice, 35 especially for adolescents already struggling with moderate to severe depressive symptoms who, in one study, were more likely than their nondepressed peers to report using social media to access emotional support. 36…”