Young People’s Online Help-Seeking and Mental Health Difficulties: Systematic Narrative Review
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Abstract
Background: Young 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. Objective: The 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. Methods: A 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. Results: Overall, 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. Conclusions: Approaches 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.
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Confidentiality and anonymity are a particular concern for mental health tool users, given the stigma associated with mental ill-health.
“Further, confidentiality and anonymity are a particular concern for mental health tool users, given the stigma associated with mental ill-health [24,25]”
From Providing Self-Led Mental Health Support Through an Artificial Intelligence–Powered Chat Bot (Leora) to Meet the Demand of Mental Health Care (2023) · cites this paper as [25]
The Results (Limitations to Online Help-Seeking) link young people’s privacy concerns to the stigma of friends or family learning about their mental health concerns. The Discussion (Tensions and Opportunities in Online Help-Seeking) also identifies confidentiality and anonymity as important, but the review concerns young people seeking help online, not mental health tool users generally. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA systematic narrative review of 28 studies found that many young people with mental health problems spend time online seeking ways to alleviate and better understand their symptoms.
“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, 2019).”
From Annual Research Review: Adolescent mental health in the digital age: facts, fears, and future directions. (2020) · cites this paper as Pretorius, Chambers, & Coyle, 2019
Many young people turn to social media for support and advice related to their mental health symptoms.
“many young people turn to social media for support and advice related to their mental health symptoms”
From Annual Research Review: Adolescent mental health in the digital age: facts, fears, and future directions. (2020) · cites this paper as Pretorius et al., 2019
Online help-seeking seems related to increased anonymity, accessibility, and inclusivity.
“Online help-seeking seems related to increased anonymity, accessibility, and inclusivity [31], and social media shows benefits for offering mental health care [32].”
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- Authors
- Pretorius, C., Chambers, D., & Coyle, D.
- Affiliations
- University College Dublin (IE)
- Health Service Executive (IE)
- Corresponding author
- Pretorius, Claudette
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2019-11-19
- Volume
- 21
- Issue
- 11
- Pages
- e13873
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC6891826
- OpenAlex
- W2969598449
- Cited by
- 506
- References
- 57
- Citations by year
- 2026: 100 · 2025: 93 · 2024: 91 · 2023: 75 · 2022: 82 · 2021: 46 · 2020: 19
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Repository UCD (University College Dublin) (acceptedVersion, cc-by)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-nd)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion, cc-by)
- Funders
- European Commission (HORIZON2020, 722561)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- online help-seeking, youth, youth mental health, mental illness, help-seeking barriers, help-seeking facilitators, mental health literacy, privacy and confidentiality, self-determination theory, online communities, social media, stigma, self-reliance, online mental health resources, anonymity
- MeSH terms
- Help-Seeking Behavior, Adolescent, Adult, Child, Female, Humans, Male, Mental Health, Internet, Qualitative Research, Young Adult
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