A study of college students’ preferences to e-mental health support and its implications for e-mental health service

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Mental health issues have long been a serious concern in Hong Kong and have received additional attention due to the COVID-19 pandemic. In a survey that targeted Hong Kong students aged between 11 and 15, approximately 40% of respondents reported symptoms of mental health issues, such as feeling low-spirited, nervous, or bad-tempered, while 34.1% of respondents experienced sleeping difficulties at least once a week (Ho et al., 2021). In addition, the Hospital Authority recorded that the number of psychiatric patients aged 18 and below increased to 40,350 in 2019-2020, approximately 2.4 times as many as the recorded total in 2015-2016 (The Government of Hong Kong Special Administrative Region, 2021).

While there is emerging need for mental health support for teenagers, the use of online mobile counseling applications for mental health issues is growing and becoming important (Beintner, Jacobi, & Taylor, 2012; Wind, Rijkeboer, Andersson, & Riper, 2020). Online mental health services by lay counselors can provide a solution to the lack of dedicated resources to support mental health during COVID-19. However, there is lacking of research to discuss how the effectiveness of e-mental health support can be improved (Musiat, Goldstone, & Tarrier, 2014; Marshall et al., 2020). Therefore, to explore the possibility and benefits of e-mental health support to college students, this study aims to 1) identify the dimensions used by teenagers to choose and evaluate e-mental health services; 2) determine the impact of emotional state, social media experience, and self-disclosure behaviors to their attitude and preferences to e-mental health services.

A multistage method is adopted in this study. In-depth interviews to twenty-one users (age: 19 and 21) of a e-mental health support mobile app were first conducted to explore teenagers’ stressors, self-disclosure in social media and experience in e-mental health services. A questionnaire was developed from the interview results and it was then administered to 297 participants in a university in Hong Kong by convenience sampling.

Factor analysis was conducted to reveal several dimensions used by college students to evaluate e-mental health services. The salient dimensions were credibility of service provider, confidentiality of personal information, feedback quality, and autonomy in modes of communication. The results also show that social media experience and self-disclosure behaviors had an impact on these evaluative dimensions. This study will inform education and e-mental health service sectors regarding the features of e-mental health service platform they should develop and improve in the future.

Beintner, I., Jacobi, C., & Taylor, C. B. (2012). Effects of an Internet-based prevention programme for eating disorders in the USA and Germany--a meta-analytic review. European eating disorders review : the journal of the Eating Disorders Association, 20(1), 1–8. https://doi.org/10.1002/erv.1130
Musiat, P., Goldstone, P., & Tarrier, N. (2014). Understanding the acceptability of e-mental health--attitudes and expectations towards computerised self-help treatments for mental health problems. BMC psychiatry, 14, 109. https://doi.org/10.1186/1471-244X-14-109
Ho, S.C., Fung, Y.H., Lee, L. (2021). Health Behaviour in School-aged Children Study in Hong Kong: Assessing the Physical, Emotional and Social Well-being. Hong Kong Centre for International Student Assessment, The Chinese University of Hong Kong.
Marshall JM, Dunstan DA, Bartik W (2020). Treating Psychological Trauma in the Midst of COVID-19: The Role of Smartphone Apps. Front Public Health, 18(8), 402. doi: 10.3389/fpubh.2020.00402.
The Government of Hong Kong Special Administrative Region. (2021, March 24). Mental health of students [Press Release]. https://www.info.gov.hk/gia/general/202103/24/P2021032400314.htm?fontSize=1
Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pandemic: The ‘black swan’for mental health care and a turning point for e-health. Internet interventions, 20.


ConferenceFederation for Self-financing Tertiary Education Conference, FSTE Conference 2022
Country/TerritoryHong Kong
Internet address


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