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Cited by 60Digital Mental Health InterventionsMental Health Treatment and AccessSuicide and Self-Harm Studies

Technology-Based Interventions to Improve Help-Seeking for Mental Health Concerns: A Systematic Review

Open access
Johnson, Jemimah A., Sanghvi, Prachi, Mehrotra, Seema·2022·Indian Journal of Psychological Medicine
DOI 10.1177/02537176211034578PMC PMC9301737
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Abstract

Background: Despite the high prevalence of mental health disorders worldwide, a significant proportion of distressed individuals do not seek professional help. Digital technology can be a potential bridge to reduce the treatment gap for mental disorders. A systematic review was undertaken to examine the technology-based interventions aimed at improving help-seeking attitude, intention, or behavior for mental health concerns. Methods: The literature search was conducted in January–February 2020 through various e-databases using relevant keywords that targeted help-seeking interventions for mental health disorders via different technology modes. Results: 21 studies (15 randomized controlled trials and six non-randomized studies) were reviewed. The included studies were published between April 2006 to February 2020. Majority of the interventions led to an increase in the help-seeking variables. The crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking is highlighted. The review emphasizes the need for understanding utility of multicomponent interventions with personalized elements targeting help-seeking behavior, particularly in low-middle-income countries, and studies involving longer duration follow-ups. Conclusion: This systematic review is the first of its kind to examine technology-based interventions to improve help-seeking for mental health and suggests that such interventions play a crucial role in positively impacting help-seeking. The complex interplay between the relevant variables such as mental health literacy, stigma, help-seeking attitude, intention and behavior, and the intervention components that may have a differential bearing on these variables are issues that merit urgent attention in further research.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review examined 21 technology-based interventions (15 RCTs, six non-randomized studies) aimed at improving help-seeking for mental health concerns. Most interventions increased at least one help-seeking variable, with online delivery, participant involvement, and embedded links to professional services highlighted as important.

Key findings

  • The review included 21 studies published between April 2006 and February 2020; 18 (85%) used internet-based programs or apps, 13 (61.9%) had a psychoeducational component, and 14 (66.7%) addressed depression/anxiety/stress/suicidality or a combination.
  • Help-seeking intention was examined in 16 studies (>75%): 50% showed an increase, nearly 43% showed no significant effect, and one inactive-control intervention showed a reduction. Help-seeking attitude was examined in seven studies (33.3%): three intervention groups showed increased positive attitude versus active control, while some showed no significant change. Help-seeking behavior was examined in 11 studies (52.4%): five showed an increase and five showed no change.
  • Reported effect sizes varied: help-seeking intentions Cohen’s d = –0.27 to 0.78; help-seeking attitudes Cohen’s d = –0.04 to 0.58; help-seeking behavior OR = 0.69 to 3.48.
  • More than 60% of studies examined mental health literacy and/or stigma: seven showed increased mental health literacy, two reported no change, and eight showed reduced stigma after intervention or at follow-up.

Methods

  • Systematic review conducted and reported in line with PRISMA. Searches were run in January–February 2020 across Springer, Wiley Online Library, PubMed, Taylor & Francis, SAGE Journals, IEEE Xplore, and EBSCO, plus Google and manual reference-list scanning, using keyword combinations targeting help-seeking interventions via online/web/app/internet modes.
  • Inclusion criteria: published intervention studies aimed at improving help-seeking attitude, intention, or behavior for any mental health condition; interventions using internet/app/other technology partly or completely; help-seeking as primary or secondary outcome; English language; published April 2006–February 2020. Exclusions included book chapters, conference papers, abstract collections, theoretical papers, reviews, meta-analyses, qualitative studies, and secondary analyses of RCTs.
  • Quality was assessed with the Cochrane “Risk of Bias” Tool for RCTs and the modified Newcastle–Ottawa Scale for non-randomized studies; authors assessed studies independently. A meta-analytic approach could not be used due to heterogeneity.

Limitations

  • The paper states that heterogeneity and the broad-based review prevented meta-analysis; intervention and digital-platform details could not be commented on due to limited published information; relevant studies in core technology journals may have been missed; and grey literature and non-English studies were excluded.
  • The paper lists limitations of the reviewed studies: possible self-selection bias, reliance on self-report in some studies, convenience sampling, small sample sizes, mostly upper-middle- and high-income country settings, low calculated effect sizes, several studies not correcting for multiple testing, and short follow-up periods.
  • Evident from the text: all reviewed studies were conducted in upper-middle- or high-income countries, with 15 of 21 conducted in Australia, so the review’s call for low-middle-income country research is not supported by included data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/02537176211034578

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 62 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The remaining included studies used text messages or multi-component interventions such as messages through social media, emails, posters, and mental health first aid training.

    “The remaining included text messages or multi-component interventions like messages through social media, emails, posters, mental health first aid training, etc.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In more than 66% (n = 10) of the included studies, low risk was found for reporting and detection bias.

    “In more than 66% (n = 10) of the studies, low risk was found for reporting and detection bias.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Internet-based programs or apps were used as an intervention strategy in 18 (85%) of the selected studies.

    “Internet-based programs or apps were used as an intervention strategy in 18 (85%) selected studies.”
    Quote in the paperNot a substantial claim
  • Findingown data

    While most studies aimed at one help-seeking variable, only three targeted all outcome categories (attitude, intention, and behavior).

    “While most studies aimed at one of these variables, only three targeted all the outcome categories.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The majority of studies included an active control group (e.g., psycho-education, other health-related material, or a list of helpline numbers).

    “The majority of the studies included an active control group (e.g., psycho-education, other health-related material, or a list of helpline numbers).”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 38
  • May combine two claims. 31

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    Findingown data

    One study used a wait-list control.

    “One study used a wait-list control, and seven did not have any control condition.”
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    Findingown data

    The duration of interventions ranged from 40 minutes to six weeks and from one to two modules.

    “The duration of the interventions ranged from 40 minutes to six weeks and from one to two modules.”
    Quote in the paperNot a substantial claim

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    Findingown data

    Three studies used an inactive control (e.g., no feedback condition, links to online measurement surveys without feedback, or mental health information).

    “However, three studies used inactive control (e.g., no feedback condition, links to online measurement surveys without feedback, or mental health information).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Eight studies looked at the effectiveness of the intervention on two help-seeking variables.

    “Eight studies looked at the effectiveness of the intervention on two help-seeking variables.”
    Quote in the paperNot a substantial claim

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    Findingown data

    Seven studies did not have any control condition.

    “One study used a wait-list control, and seven did not have any control condition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Other recurring intervention elements included case vignettes aiding symptom or problem recognition, personalized feedback, and links or lists to seek help from mental health professionals.

    “Other recurring elements included case vignettes aiding in symptom or problem recognition, personalized feedback, and links or lists to seek help from mental health professionals.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A total of 21 studies (15 RCTs and six non-randomized studies) published between 2006 and 2020 were included.

    “21 studies (15 randomized controlled trials and six non-randomized studies) were reviewed. The included studies were published between April 2006 to February 2020.”
    • Also stated in: § Results · plain
      “A total of 21 studies (15 RCTs and six NRS) published between 2006 and 2020 were included.”
    Quote in the paperNot a substantial claim

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    Findingown data

    The total Newcastle-Ottawa Scale scores for non-randomized studies ranged from 5 to 8, indicating fair and satisfactory quality.

    “The total NOS scores (Table S1) for the NRS ranged from 5–8, indicating fair and satisfactory quality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The calculated effect sizes varied for help-seeking intentions (Cohen's d = -0.27 to 0.78), help-seeking attitudes (Cohen's d = -0.04 to 0.58), and help-seeking behavior (OR = 0.69 to 3.48).

    “The calculated effect sizes indicate that the effect of the interventions varied for help-seeking intentions (Cohen’s d = –0.27 to 0.78), help-seeking attitudes (Cohen’s d = –0.04 to 0.58), and help-seeking behavior (OR = 0.69 to 3.48, Tables 2 and 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Two studies examined changes in help-seeking beliefs.

    “Two studies examined changes in help-seeking beliefs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the studies examining help-seeking intention, 50% showed an increase and nearly 43% showed no significant effect of the intervention.

    “Of those, 50% showed an increase, whereas nearly 43% showed no significant effect of the intervention on the outcome variable.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Help-seeking intention was examined in most studies, followed by help-seeking behavior and help-seeking attitude.

    “Help-seeking intention was examined in most studies, followed by help-seeking behavior and help-seeking attitude.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Eight studies measured formal help-seeking and seven examined changes in both formal and informal help-seeking.

    “Eight studies measured formal help-seeking and seven examined changes in both formal and informal help-seeking.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the 11 studies that included help-seeking behavior as an outcome (52.4%), five showed an increase in behavior and five showed no change.

    “Of the 11 studies that included help-seeking behavior as an outcome (52.4%), five showed an increase in behavior, whereas the other five showed no change.”
    Quote in the paperNot a substantial claim

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    Findingreasoning

    Three studies looked at the effectiveness of the intervention in reducing the barriers.

    “Three studies looked at the effectiveness of the intervention in reducing the barriers.”
    Quote in the paperNot a substantial claim

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    Findingnone given

    Most of the studies targeted the community population.

    “While most of the studies targeted the community population”
    Quote in the paperNot a substantial claim

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    Findingnone given

    Most studies were internet-based.

    “This may be because most studies were internet-based.”
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    Findingcitation

    A few others incorporated the cognitive bias modification paradigm.

    “and the cognitive bias modification paradigm 27 to develop the intervention.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Stanley IH, Hom MA, and Joiner TE. Modifying mental health help-seeking stigma among undergraduates with untreated psychiatric disorders: A pilot randomized trial of a novel cognitive bias modification intervention [Internet]. Behav Res Ther, 2018; 103. DOI: 10.1016/j.brat.2018.01.008 29428819 source

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    Help-seeking attitude was seen as the most malleable outcome of the intervention, followed by help-seeking intention.

    “Help-seeking attitude was seen as the most malleable outcome of the intervention, followed by help-seeking intention.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Suka et al. based their intervention on theories of persuasion, decision-making, and attitude-behavior relations.

    “whereas Suka et al. 34 based their intervention on theories of persuasion, decision-making, and attitude-behavior relations.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Suka M, Yamauchi T, and Yanagisawa H. Responses to persuasive messages encouraging professional help seeking for depression: Comparison between individuals with and without psychological distress. Environ Health Prev Med, 2019; 24(1): 1– 9. 31068125 PMC6507167 source

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    Findingcitation

    Reupert et al. utilized a competence enhancement model.

    “Reupert et al. 39 utilized a competence enhancement model”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Reupert A, Maybery D, Bartholomew C,. The acceptability and effectiveness of an online intervention for youth with parents with a mental illness and/or substance use issue [Internet]. J Adolesc Heal, 2020; 66(5). DOI: 10.1016/j.jadohealth.2019.11.309 32001142 source

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    Findingcitation

    Griffiths et al. employed the social anxiety help-seeking behavior framework.

    “whereas Griffiths et al. 40 employed the social anxiety help-seeking behavior framework.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Griffiths KM, Walker J, and Batterham PJ. Help seeking for social anxiety: A pilot randomised controlled trial [Internet]. Digit Heal, 2017; 3. DOI: 10.1177/2055207617712047 PMC6001205 29942603

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    Findingcitation

    A few others incorporated cognitive-behavior principles.

    “A few others incorporated cognitive-behavior principles41–43”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [41] Collin PJ, Metcalf AT, Stephens-Reicher JC,. Reachout.com: The role of an online service for promoting help-seeking in young people. Adv Ment Heal, 2011; 10(1): 39– 51. source

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    • cites [42] Shandley K, Austin D, Klein B,. An evaluation of “Reach Out Central”: An online gaming program for supporting the mental health of young people. Health Educ Res, 2010; 25(4): 563– 574. 20150530 source

      Not checked in the free run.

    • cites [43] Christensen H, Leach LS, Barney L,. The effect of web based depression interventions on self-reported help seeking: Randomised controlled trial [ISRCTN77824516]. BMC Psychiatry, 2006; 6 1– 11. 16595018 PMC1501008 source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    Reviewed studies highlighted the crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking.

    “Reviewed studies highlighted the crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Many studies reasoned that the interventions' short duration might not be sufficient to change help-seeking behavior.

    “Moreover, many studies reasoned that the interventions’ short duration might not be sufficient to change this outcome variable.”
    Quote in the paperNot a substantial claim

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    Findingcitation

    King et al. used the motivational interviewing approach.

    “King et al. 38 used the motivational interviewing approach”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] King CA, Eisenberg D, Zheng K,. Online suicide risk screening and intervention with college students: A pilot randomized controlled trial [Internet]. J Consult Clin Psychol, 2015 Jun 1 [cited 2020 Dec 31]; 83(3): 630– 636, https://pubmed.ncbi.nlm.nih.gov/25688811/ 25688811 PMC4446155 source

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  • May combine two claims.

    Findingcitation

    With increased mental health literacy and reduced stigma, Griffiths et al. observed an increase in both help-seeking intention as well as behavior.

    “With increased mental health literacy and reduced stigma, Griffiths et al. 40 observed an increase in both help-seeking intention as well as behavior.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Griffiths KM, Walker J, and Batterham PJ. Help seeking for social anxiety: A pilot randomised controlled trial [Internet]. Digit Heal, 2017; 3. DOI: 10.1177/2055207617712047 PMC6001205 29942603

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Most research has focused on individuals 18 years or older.

    “Most research has focused on individuals 18 years or older.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Three studies noted an increase in mental health literacy and help-seeking intention, as well as a decrease in stigma.

    “Three studies noted an increase in mental health literacy and help-seeking intention, as well as a decrease in stigma.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the current review, reduced stigma or improved literacy are not essential for improving help-seeking intention.

    “However, in the current review, it was observed that reduced stigma 33 or improved literacy31,49 are not essential for improving help-seeking intention.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [33] Howard KA, Griffiths KM, McKetin R,. Can a brief biologically-based psychoeducational intervention reduce stigma and increase help-seeking intentions for depression in young people? A randomised controlled trial. J Child Adolesc Ment Health, 2018; 30(1): 27– 39. 29764293 source

      Not checked in the free run.

    • cites [31] Reavley NJ, McCann T V, Cvetkovski S,. A multifaceted intervention to improve mental health literacy in students of a multicampus university: A cluster randomised trial. Soc Psychiatry Psychiatr Epidemiol, 2014; 49(10): 1655– 1666. 24797396 source

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    • cites [49] Costin DL, Mackinnon AJ, Griffiths KM,. Health e-cards as a means of encouraging help seeking for depression among young adults: Randomized controlled trial. J Med Internet Res, 2009; 11(4): 1– 18. PMC2802564 19850549 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Men were more likely to use informal sources, whereas women preferred to approach a combination of formal and informal sources.

    “Reportedly, men were more likely to use informal sources, whereas women preferred to approach a combination of formal and informal sources.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Shandley K, Austin D, Klein B,. An evaluation of “Reach Out Central”: An online gaming program for supporting the mental health of young people. Health Educ Res, 2010; 25(4): 563– 574. 20150530 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Closing the treatment gap for mental disorders requires attention to both supply-side and demand-side barriers.

    “The role of help-seeking as a variable assumes importance in the context of the growing recognition that closing the treatment gap for mental disorders requires attention to the supply-side and the demand-side barriers. 3”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Patel V, Xiao S, Chen H,. The magnitude of and health system responses to the mental health treatment gap in adults in India and China [Internet]. Lancet, 2016 [cited 2021 Mar 14]; 388: 3074– 3084, https://pubmed.ncbi.nlm.nih.gov/27209149/ 27209149 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Nearly two-thirds of individuals with mental disorders do not seek professional help, resulting in a large treatment gap.

    “Despite prevention and treatment being effective ways to reduce the burden or alleviate the symptoms associated with a mental disorder, nearly two-thirds do not seek professional help, leading to a huge treatment gap. 2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] World Health Organization. Prevention of mental disorders: Effective interventions and policy options. Summary report. Report of the World Health Organization [Internet]. 2004 [cited 2021 Mar 12], https://apps.who.int/iris/handle/10665/43027

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Internet-based interventions provide greater accessibility, acceptability, low cost, anonymity, and flexibility.

    “As the internet-based interventions provide greater accessibility, acceptability, low cost, anonymity, and flexibility, they are increasingly utilized to make mental health services accessible worldwide.13–15”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [13] Wallin EEK, Mattsson S, and Olsson EMG. The preference for Internet-based psychological interventions by individuals without past or current use of mental health treatment delivered online: A survey study with mixed-methods analysis. JMIR Ment Heal, 2016; 3(2): e25. PMC4925931 27302200 source

      Not checked in the free run.

    • cites [14] Lal S and Adair CE. E-mental health: A rapid review of the literature [Internet]. Psychiatr Serv; 2014 [cited 2021 Feb 3]; 65: 24– 32, https://pubmed.ncbi.nlm.nih.gov/24081188/ 24081188 source

      Not checked in the free run.

    • cites [15] Tal A and Torous J. The digital mental health revolution: Opportunities and risks. [Internet]. Psychiatr Rehabil J, 2017 [cited 2021 Feb 3]; 40: 263– 265, http://fulltext/2017-39812-001.html 28891658 source

      Not checked in the free run.

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    Premisecitation

    Technology-based interventions have been used for functions including screening, symptom identification, self-care, improving help-seeking attitudes, and prevention and treatment of mental health concerns.

    “Such interventions have been used to serve a wide range of functions such as screening, symptom identification, self-care, improving help-seeking attitudes, and prevention and treatment of mental health concerns.16,17”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16] Mehrotraa S and Tripathi R. Recent developments in the use of smartphone interventions for mental health [Internet]. Curr Opin Psychiatry, 2018 [cited 2021 Feb 3]; 31: 379– 388, https://pubmed.ncbi.nlm.nih.gov/29985179/ 29985179 source

      Not checked in the free run.

    • cites [17] Olff M. Mobile mental health: A challenging research agenda. Eur J Psychotraumatol, 2015; 6: 27882. 25994025 PMC4439418 source

      Not checked in the free run.

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    Premisecitation

    Systematic reviews have examined help-seeking interventions for men, common mental health disorders, and mental health concerns in general.

    “Systematic reviews have examined help-seeking interventions for men, 18 common mental health disorders in particular, 19 and mental health concerns in general. 11”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [18] Sagar-Ouriaghli I, Godfrey E, Bridge L,. Improving mental health service utilization among men: A systematic review and synthesis of behavior change techniques within interventions targeting help-seeking. Am J Mens Health, 2019; 13(3): 1557988319857009. 31184251 PMC6560805 source

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    • cites [19] Gulliver A, Griffiths KM, Christensen H,. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry, 2012; 12: 81. 22799879 PMC3464688 source

      Not checked in the free run.

    • cites [11] Xu Z, Huang F, Kösters M, Staiger T,. Effectiveness of interventions to promote help-seeking for mental health problems: Systematic review and meta-analysis. Psychol Med, 2018; 48(16): 2658– 2667. 29852885 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Because the interventions were carried out online, attrition rates were unavoidable.

    “Since the interventions were carried out online, the attrition rates were unavoidable.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The first and second authors independently assessed study quality and resolved discrepancies through discussion to reach consensus.

    “The first and second authors assessed the studies independently, and discrepancies were discussed to reach a consensus.”
    Quote in the paperNot a substantial claim

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    Study design and conductcitation

    The modified Newcastle-Ottawa Scale was used to assess quality of non-randomized studies.

    “The modified Newcastle–Ottawa Scale (NOS) was used for the non-randomized studies (NRS). 22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Moskalewicz A and Oremus M. No clear choice between Newcastle–Ottawa scale and appraisal tool for cross-sectional studies to assess methodological quality in cross-sectional studies of health-related quality of life and breast cancer. J Clin Epidemiol [Internet], 2020; 120. DOI: 10.1016/j.jclinepi.2019.12.013 31866469

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    Study design and conductcitation

    The systematic review was conducted and reported in line with the PRISMA statement.

    “The systematic review was conducted and reported in line with the PRISMA statement. 20”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Moher D, Liberati A, Tetzlaff J,. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med, 2009; 2 1– 2. PMC3090117 21603045

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The quality of individual RCTs was assessed using the Cochrane Risk of Bias Tool.

    “The quality of individual RCTs was assessed using the Cochrane “Risk of Bias” Tool. 21”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Higgins JPT, Altman DG, Gøtzsche PC,. The Cochrane collaboration’s tool for assessing risk of bias in randomised trials [Internet]. BMJ, 2011 Oct 29 [cited 2021 May 17]; 343(7829), http://www.bmj.com/content/343/bmj.d5928/suppl/DC1 PMC3196245 22008217 source

      Not checked in the free run.

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    Study design and conductown data

    The first and third authors independently evaluated selected studies based on aim and eligibility criteria and resolved discrepancies through discussion.

    “The first and the third authors evaluated the selected studies based on the aim and eligibility criteria independently and discussed to resolve any discrepancies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    This systematic review is the first of its kind to examine technology-based interventions to improve help-seeking for mental health.

    “This systematic review is the first of its kind to examine technology-based interventions to improve help-seeking for mental health and suggests that such interventions play a crucial role in positively impacting help-seeking.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Online delivery, participant involvement, and embedded links to professional services play a crucial role in encouraging help-seeking.

    “The crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking is highlighted.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' measures of help-seeking attitude, intention, and behavior are valid and comparable enough to synthesize.

  • May combine two claims.

    Premisecitation

    Personalizing the intervention can improve its effectiveness and lead to provision of quality care.

    “Personalizing the intervention can improve its effectiveness and the lead to provision of quality care. 32”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Iorfino F, Cross SP, Davenport T,. A digital platform designed for youth mental health services to deliver personalized and measurement-based care [Internet]. Front Psychiatry, 2019 Aug 23 [cited 2020 Dec 13]; 10: 595, https://www.frontiersin.org/article/10.3389/fpsyt.2019.00595/full 31507465 PMC6716201 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Common mental health problems are highly prevalent in young adults.

    “given the high prevalence of common mental health problems in this population. 30”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [30] Gustavson K, Knudsen AK, Nesvåg R,. Prevalence and stability of mental disorders among young adults: Findings from a longitudinal study. BMC Psychiatry, 2018; 18(1): 1– 15. 29530018 PMC5848432 source

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Improving mental health literacy is only "half the battle."

    “improving mental health literacy is only “half the battle.” 37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Tomczyk S, Muehlan H, Freitag S,. Is knowledge “half the battle”? The role of depression literacy in help-seeking among a non-clinical sample of adults with currently untreated mental health problems [Internet]. J Affect Disord, 2018; 238. DOI: 10.1016/j.jad.2018.05.059 29902732 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Stigma and reduced mental health literacy were hindrances in help-seeking.

    “Even though stigma and reduced mental health literacy were hindrances in help-seeking, 26”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Moessner M, Minarik C, Özer F,. Can an internet-based program for the prevention and early intervention in eating disorders facilitate access to conventional professional healthcare? J Ment Heal, 2016; 25(5): 441– 447. 26850624 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisereasoning

    In social anxiety, providing feedback to the users based solely on the screening may be detrimental for help-seeking outcomes.

    “The authors’ reasoned that in social anxiety, providing feedback to the users based solely on the screening may be detrimental for help-seeking outcomes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Batterham PJ, Calear AL, Sunderland M,. Online screening and feedback to increase help-seeking for mental health problems: Population-based randomised controlled trial. BJPsych Open, 2016; 2(1): 67– 73. 27703756 PMC4995576 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Greater literacy and diminished stigma are associated with a positive help-seeking attitude.

    “and a positive help-seeking attitude. 48”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [48] Abi Doumit C, Haddad C, Sacre H,. Knowledge, attitude and behaviors towards patients with mental illness: Results from a national Lebanese study [Internet]. PLoS One, 2019 Sep 16 [cited 2020 Dec 31]; 14(9): e0222172, https://dx.plos.org/10.1371/journal.pone.0222172 PMC6746362 31525219 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Men are less likely to seek help for their mental health concerns in general or psychotherapies in particular.

    “This is consistent with the previous findings that men are less likely to seek help for their mental health concerns in general or psychotherapies in particular. 45”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Calear AL, Banfield M, Batterham PJ,. Silence is deadly: A cluster-randomised controlled trial of a mental health help-seeking intervention for young men. BMC Public Health, 2017; 17(1): 1– 8. 29061168 PMC5653993 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    High-income countries use more apps targeting health monitoring while low-middle-income countries use technology to target mental health awareness and promotion.

    “Previous studies showed that high-income countries use more apps targeting health monitoring while low-middle-income countries use technology to target mental health awareness and promotion. 50”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] Abaza H and Marschollek M. mHealth application areas and technology combinations: A comparison of literature from high and low/middle income countries [Internet]. Methods of Inf Med, 2017 [cited 2021 May 17]; 56: e105– e122, https://pubmed.ncbi.nlm.nih.gov/28925418/ 28925418 PMC6291822 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    A few studies relied on self-report alone rather than using standardized measures and hence may be prone to response bias.

    “A few studies relied on self-report alone rather than using standardized measures and hence may be prone to response bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Greater literacy and diminished stigma are associated with a positive help-seeking intention.

    “This pattern is consistent with previous findings of greater literacy and diminished stigma being associated with a positive help-seeking intention46,47”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [46] Lally J, Conghaile AO, Quigley S,. Stigma of mental illness and help-seeking intention in university students [Internet]. Psychiatrist, 2013 Aug [cited 2021 Jan 11]; 37(8): 253– 260, https://www.cambridge.org/core/journals/the-psychiatrist/article/stigma-of-mental-illness-and-helpseeking-intention-in-university-students/B86F23B88A147D071B19F7552405DBD5 source

      Not checked in the free run.

    • cites [47] Smith CL and Shochet IM. The impact of mental health literacy on help-seeking intentions: Results of a pilot study with first year psychology students. Int J Ment Health Promot, 2011 Jan; 13(2): 14– 20. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The nature of recruitment could have led to self-selection bias, leading to over- and under-representation of specific sample characteristics.

    “The nature of recruitment could have led to self-selection bias, leading to over- and under-representation of specific sample characteristics.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    An attempt was made to use multiple mainstream health science databases and platforms with technology backgrounds for literature search.

    “An attempt was made to use multiple mainstream health science databases and platforms with technology backgrounds for literature search.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    It is plausible that a few relevant studies in core technology journals might have been missed out.

    “However, it is plausible that a few relevant studies in core technology journals might have been missed out.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Due to the heterogeneity of the studies and the review being broad-based, a meta-analytic approach could not be used.

    “Due to the heterogeneity of the studies and the review being broad-based, a meta-analytic approach could not be used.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Several studies did not report correction for multiple testing.

    “Moreover, several studies did not report correction for multiple testing.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The nature of the interventions and the digital platforms could not be commented upon due to limited information available in the published papers.

    “The nature of the interventions (delivery, data security issues, competing interests, etc.) and the digital platforms could not be commented upon due to limited information available in the published papers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    We did not include grey literature or studies in languages other than English, which may have excluded relevant studies in this area.

    “Moreover, we did not include grey literature or studies in languages other than English, which may have excluded relevant studies in this area.”
    Quote in the paperNot a substantial claim
61 of 61

  • The paper relies on this without support.

    The included studies' measures of help-seeking attitude, intention, and behavior are valid and comparable enough to synthesize.

    “The effect of interventions on help-seeking attitude, intention, and behavior was examined.”

  • The paper relies on this without support.

    Existing literature recommends multicomponent interventions.

    “Existing literature recommends multicomponent interventions, and most of the studies incorporated them.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • There is growing evidence that technology can improve help-seeking behaviour.

    “There is growing evidence that technology can improve help-seeking behaviour [Johnson et al., 2022] and that patients prefer interacting with chatbots for self-reported measures [Te Pas et al., 2020] and discussing sensitive topics [Bhakta et al., 2014].”

    From Closing the accessibility gap to mental health treatment with a personalized self-referral chatbot (2024) · cites this paper as Johnson et al., 2022

  • Findings from previous research suggest that digital technologies may facilitate help-seeking for mental health and make it easier for people to disclose personal information.

    “Findings from previous research suggest that digital technologies may facilitate help-seeking for mental health [Johnson et al., 2022] and make it easier for people to disclose personal information [Te Pas et al., 2020, Bhakta et al., 2014].”

    From Closing the accessibility gap to mental health treatment with a personalized self-referral chatbot (2024) · cites this paper as Johnson et al., 2022

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Detection-bias percentage uses the wrong denominator

    Minor

    The review includes 15 randomized controlled trials, so five studies represent 33.3%, not 25%.

    Reported 25 · recomputed 33.333333

  • Intervention duration exceeds the stated range

    Minor

    The stated maximum duration is six weeks, but Table 2 lists an intervention lasting two years.

  • Australian study count differs between discussion and Table 1

    Minor

    Table 1 lists 16 studies located in Australia, whereas the discussion says 15 of the 21 studies were conducted there.

  • Attitude effect-size range omits a lower value

    Minor

    The stated lower bound for help-seeking attitudes is −0.04, but Table 2 reports an attitude effect size of −0.14 for Gulliver et al.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 8

  1. Wilson CJ, 2005, Can J Couns, 39, 15
  2. Rickwood D, 2005, Aust e-Journal Adv Ment Heal [Internet], 4, 34
  3. Moher D, 2009, PLoS Med, 2, 1
  4. Moskalewicz A, 2020, J Clin Epidemiol [Internet], 120
  5. Christensen H, 2010, Med J Aust, 192, 192
  6. Johnson JA, 2020, Cureus, 12
  7. Griffiths KM, 2017, Digit Heal, 3
  8. Chen P, 2020, Front Psychiatry

Cited by

Sorted by citations

Related

Authors
Johnson, J. A., Sanghvi, P., & Mehrotra, S.
Affiliations
National Institute of Mental Health and Neurosciences (IN)
Corresponding author
Mehrotra, Seema
ORCID
Venue
Indian Journal of Psychological Medicine
Publisher
SAGE Publications
Published
2021-09-21
Volume
44
Issue
4
Pages
332-340
ISSN
  • 0253-7176 (ISSN-L)
  • 0975-1564
DOI
10.1177/02537176211034578
PMC
PMC9301737
OpenAlex
W3201094381
Semantic Scholar
eea4ae45a3a1c4eaed6101351cee43428414971c
Cited by
60
References
49
Citations by year
2026: 13 · 2025: 18 · 2024: 12 · 2023: 10 · 2022: 7
FWCI
1.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Indian Journal of Psychological Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
help-seeking, mental health, technology-based interventions, digital interventions, help-seeking intentions, online delivery, multicomponent intervention, personalized interventions, mental health literacy, stigma, treatment gap, low- and middle-income countries

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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