A study of youngsters’ evaluation of e-mental health experiences - identifying factors that motivate young people’s use of e-mental health services

The use of online mobile counseling applications has been growing in response to the increasing need for mental health support during the pandemic (Wind, Rijkeboer, Andersson, & Riper, 2020). Studies have provided evidence that supports the effectiveness of e-mental health services, such as cognitive behavioral therapy and emotional support (Olthuis, Watt, Bailey, Hayden, & Stewart, 2016; Marshall et al., 2020). However, the factors that influence users’ experiences with such applications remain unclear (Musiat, Goldstone, & Tarrier, 2014). Therefore, our research aims are as follows: (1) to understand how young people evaluate e-mental health services and (2) to explore the demographic (e.g. gender) and behavioristic factors (e.g. online self-disclosure and time spent on social media) that influence their evaluation criteria.

In-depth interviews and surveys were conducted. Twenty-one e-mental health users were interviewed to explore the criteria they use to evaluate e-mental health services. Each interview lasted one hour. The interviewees were between 19 and 21 years old. Twenty-eight items in 6- point Likert scale (i.e. “I think a good e-mental health service is…”) were generated from the interviews. These items were used to design a questionnaire to identify the dimensions young people use to evaluate e-mental health services. We used convenience sampling to recruit 1395 participants to complete the questionnaire. 295 participants were from a medium-size university and there were 651 junior secondary students and 449 senior secondary students from two local secondary schools. Their age was between 12 to 25.

Using exploratory factor analysis, five dimensions that young people use to evaluate e-mental health services were identified. The five dimensions are (1) service usability (11-itemed; α=.948, M=4.26); (2) service provider transparency (9-itemed; α=.910, M=3.85); (3) professional counseling (8-itemed; α=.922, M=4.58); (4) user privacy (4-itemed; α=.894, M=4.66); and (5) the counselor’s online communication skills (4-itemed; α=.806, M=3.64). The above results suggest that the conventional criteria for evaluating mental health services are also valid in online environment. Young people expect that e-mental health services should possess transparency in disclosing information of service provider with professional qualifications; while on the other hand the privacy of users should be well-protected. Regarding the online environment, young people prefers mobile service that can overcome time and geographic constraints, and online communication skills of counsellor were essential to motivate youngsters to keep using the service.

However, we found that gender and the time spent on social media influenced these dimensions. The results suggest that compared with male participants, female participants were more concerned about service provider transparency, professional counselling, and user privacy. Additionally, participants that spent more time on social media had higher expectations regarding counselor’s online communication skills. The results of this study will inform e-mental health service providers regarding the features they should develop and improve in the future.