Online Mental Health Services Research Articles

Exploring the Transition from Online Mental Health Services to Face-to-Face Support for Young Adults 18–25 Years

Online mental health services offer programs and resources for users to better manage their mental health, where part of the process of engaging in these services involves initiatives that attempt to motivate a transition from online to face-to-face support. What can we make of those initiatives through the insight of users? This research, platforming the voices of young adults aged 18–25 years, provides valuable insights into the unique help-seeking experiences of this demographic and the effectiveness of online mental health services in facilitating a transition to face-to-face support. Using an online survey comprising of open-response and Likert scale questions, 101 participants provided qualitative and quantitative feedback. Key quantitative findings revealed 66% of participants had transitioned from online mental health services to face-to-face supports following their initial engagement. Moreover, a substantial 57.05% of participants expressed satisfaction with their online experiences. Mental health education pages were the most accessed resource by service users, with 82.18% of participants having used them. Emerging from a series of 10-point Likert scale questions, “contact with a professional” (7.58) and “receiving a referral” (9.25) were the highest rated predictors of transition, while barriers such as a “lack of motivation” and “bureaucratic complexities” were identified from qualitative data as the dominant inhibiting factors. Lastly, psychoeducation emerged as a crucial tool for empowering participants toward overcoming stigma, with the theme of trust highlighted as the most critical factor in determining the confidence of young adults attempting to transition from online to face-to-face support.

Digital Mental Health: Role of Artificial Intelligence in Psychotherapy

Background: It is estimated that 6%–7% of the population suffers from mental disorders. WHO reported that one in four families is likely to have at least one member with a behavioural or mental disorder. Post-pandemic, the world has experienced a huge surge in mental health issues. Unfortunately, not everyone is able to access the available mental health services due to constraints such as lack of financial assistance, living in remote areas, fear of being stigmatised and lack of awareness. The emergence of online mental health services could solve some of these problems, as these are easily accessible to people from anywhere, are cost effective and also reduce the fear of being judged or labelled. Lots of efforts are being made today to integrate artificial intelligence with the traditional form of psychotherapy. The role of chatbots for mental health services in the form of e-therapies has been found to be highly relevant and important. Summary: The present study aims to systematically review the evidence on the use of AI-based methods for treating mental health issues. Overall, 95 studies were extracted using some of the popular databases such as Mendeley, PubM, INFO and DOAJ. The terms used in the search included ‘psychotherapy’, ‘online therapies’, ‘artificial intelligence’ and ‘online counselling’. Finally, after screening, 13 studies were selected based on the eligibility criteria. Most of these studies had employed conversational agents as an intervention. The results obtained showed the significant positive consequences of using AI-based approaches in treating mental health issues. Key Message: The study strongly suggests integrating AI with the traditional form of counselling.

The Online Support System for Mental Health Problems After the Earthquake: A Prompt Response from The Psychiatric Association of Turkey

IntroductionPrevious research demonstrated that disasters have adverse mental health outcomes. Preventive mental health interventions in the golden hours/days after a disaster may reduce psychological harm by getting in the way of emerging mental disorders or alleviating existing ones. The widespread use of smartphones and broad internet access enabled remote mental health interventions during disasters. After the 2023 Turkey earthquake, observing the mental health burden of the earthquake, The Psychiatric Association of Turkey conducted an online platform for psychological first aid. The aim was to unite volunteer psychiatrists and disaster survivors.ObjectivesThis study presents the organization of an online mental health service during a disaster while reporting the characteristics of the service users.MethodsThe Psychiatric Association of Turkey called its members to volunteer for an Online Support System for Mental Problems After the Earthquake. The group regularly united to set standards of care. An action plan and algorithm were set up for applicants with acute suicidal, homicidal risk, or active psychotic symptoms in collaboration with local institutions and field volunteers. Volunteer psychiatrists were asked to collect information on the applicant’s sociodemographic characteristics, disaster experience, and mental health status.ResultsVolunteer psychiatrists collected data on 180 applications. Most cases applied for themselves (%95.5), and some asked for advice to care for their relatives (%4.5). Earthquake survivors have the highest psychopathology rate (%64.9), followed by healthcare workers and search and rescue personnel (%61.1). Figure 1 summarizes the subgroups of the service users. The earthquake survivors group had a mean age of 34.45, % and 76.1 of them were female. Only %15.7 of them had lower educational levels than high school. %75 cases reached safe places on the 5th day of the disaster. Applicants reported discrimination and aggression after the catastrophe, related to experiencing mental health problems, owning a pet, looting, and being seen as less traumatized since their relatives are alive.Image:ConclusionsThe present experience of the Psychiatric Association of Turkey is an example of a fast and collaborative response to a disaster regarding mental health. Our results also represent the characteristics of online mental health service users during a disaster.Disclosure of InterestNone Declared

Digital disclosures: Exploring the role of online mental health services in supporting young people who disclose violence or maltreatment

BackgroundMental health practitioners can play a role in identifying and responding to young people at risk of harm and connecting them with appropriate supports. However, little is known about how clinicians providing mental health services through digital platforms support young people disclosing experiences of violence. ObjectiveThis study sought to understand the perspectives of clinicians working within digital mental health services on supporting young people disclosing violence. Participants and settingThis study recruited 19 practitioners who were currently or had recently worked within The Digital Mental Health Programs of an Australia-wide mental health service, which provides online chat, email, and phone support to young people aged 12–25. MethodsSixteen individual interviews and one focus group were recorded, transcribed, and analysed using a reflexive thematic analysis approach. FindingsThe analysis generated six themes relating to clinicians' experiences: balancing a client centered and empowering approach with clinicians’ duty of care; systemic or structural challenges; navigating a sense of dilemma and the impacts upon clinicians; tensions around anonymity; differing understandings of violence; and navigating the transparency continuum. ConclusionsMental health clinicians work to reconcile a client centered approach with their professional duty of care and at times legal mandate to report abuse concerns. Clinicians navigate structural challenges, the anonymous nature of an online service, and work to develop common ground with young people and communicate transparently. Despite challenges, online services may provide a space for young people experiencing violence to be heard, provided with information, and connected with supports.

Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach

ABSTRACT Purpose This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach. Design A cross-sectional design including an online self-reported questionnaire survey was used. Methods A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS. Findings Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences. Conclusions Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses’ perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses’ help-seeking preferences and behaviors to reduce mental illness during public health emergencies. Clinical Evidence Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.

Impact of COVID-19 on the use of online mental health services among adults in Riyadh: a cross-sectional study.

Online therapies are licensed online programs designed to aid the use of psychotherapy via the Internet or mobile phone applications by providing effective treatments through digital communication. The number of individuals seeking online therapy has increased during the COVID-19 pandemic. Thus, this study aimed to assess the impact of COVID-19 on the use of online mental health services among Saudi adults in Riyadh. The research design was a cross-sectional descriptive study. The data collection tool was an online survey distributed through social media and email. The survey consisted of two parts: a sociodemographic questionnaire and the e-Therapy Attitudes and Process (eTAP). A total of four hundred participants have completed the survey. Most of the respondents had used online therapy for the first time during the COVID-19 pandemic, and most of the users had a relatively positive experience with online interventions for mental health services. The findings showed that COVID-19 had an impact on the use of online therapy, as it caused an increase in the number of users of these services, and most of the users have found online therapy to be helpful.

An Exploratory Evaluation of Implementing a Rapid-response Online Mental Health Service During the COVID-19 Pandemic: A Mixed Methods Study from India.

Strict social distancing and lockdown measures imposed to curb transmission during the early phase of the outbreak of the COVID-19 pandemic posed challenges to people's psychological wellbeing, limited access to social support, and disrupted routine mental health service delivery. In response, a consortium of mental health stakeholders from Goa, India launched the COVIDAV program, which provided pro-bono virtual psychiatric and counselling consultations across India through an online platform. This study describes the acceptability and feasibility of the program from the perspective of various stakeholders. Data were collected via a survey with clinicians who had volunteered on COVIDAV (n = 40), in depth interviews of the clinicians (n = 14), and focus group discussion with key collaborators (n = 1). Process data were mapped at various stages during the online platform's development and use. The qualitative and quantitative data was analysed using thematic analysis and a descriptive analysis respectively. Over 17 months, 63 clinicians conducted 2245 online sessions through the COVID platform, primarily accessed by youth across the country. The clinicians acknowledged the online platform's ability to enhance access and reduce stigma. Challenges included session time constraints, connectivity issues, and user interface inconsistencies that interfered with clients' accessibility to the services. High satisfaction rates amongst the service providers were reported, with 79.3% content with the service provision and 82.8% with pro bono contributions through the platform. This study illustrates the feasibility, flexibility, and applicability of a rapidly designed pro-bono online platform for delivering mental health care services through the collaboration of stakeholder groups in the mental health care, private, social, and governmental sector. Our findings highlight the potential of rapidly deployed digital platforms, developed via cross-sector partnerships, to meet mental health care needs during unprecedented global emergencies such as the COVID-19 pandemic.

Boots UK shuts online mental health service to new patients

Boots UK shuts online mental health service to new patients

Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study.

Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.

'I probably wouldn't want to talk about anything too personal': A qualitative exploration of how issues of privacy, confidentiality and surveillance in the home impact on access and engagement with online services and spaces for care-experienced young people.

This paper draws on a qualitative interview-based study that explored online mental health and wellbeing interventions and services for care-experienced young people. The study involved young people (n = 4), foster carers (n = 8), kinship carers (n = 2) and social care professionals (n = 9) in Wales, UK. The paper reflects on the complexities of online communication in the space of 'the home'. It documents the ways in which care-experienced young people's living arrangements can restrict access to services and complicate confidentiality within portals to the virtual world, creating an environment where young people and their carers 'wouldn't want to talk about anything too personal'. Drawing on data generated in a study focused on services and interventions to support the mental health and wellbeing of care-experienced children and young people, the paper considers privacy, confidentiality and surveillance in the home and reflects on how associated relational practices impact on care-experienced young people. While the data discussed in this paper was generated during the Covid-19 pandemic, its findings have implications for how care-experienced young people and their carers can be supported to engage with the digital world in the future.

Developing Marketing Strategy Initiatives to Enhance Customer Acquisition and Customer Retention for MedTech Startup (Case Study: Riliv)

In response to increased consumption, the MedTech market in Indonesia, which includes applications for mental health services, has experienced phenomenal growth. However, customer acquisition and retention have emerged as significant obstacles for businesses such as Riliv, a prominent mental health service application. This study seeks to identify the factors that influence and improve Riliv user acquisition and retention among non-users, current users, and former users. A quantitative research strategy employing descriptive statistics and a non-probability sample of 200 respondents were utilized. To capture data, the Likert scale questionnaire was distributed online. The research included both internal and external analyses (STP, 7Ps of the marketing mix, and VRIO) as well as PESTEL, Porter’s Five Forces, competitor, and customer analyses. The SWOT and TOWS analyses were then conducted. The findings highlight the importance of effective promotional activities, competitive pricing, and superior product quality and service in attracting and retaining Riliv users. Increasing brand recognition, enhancing product attributes, and ensuring service quality have been identified as crucial factors positively influencing consumer acquisition and retention. Riliv can implement strategic marketing initiatives such as targeted advertising, influencer collaborations, refined messaging, content marketing, personalized experiences, trial periods, referral programs, and continuous engagement in order to overcome these obstacles. By adopting these strategies, Riliv can position itself as a dependable online mental health services provider and accomplish sustainable growth in the highly competitive MedTech industry.

Online mental health services during COVID-19 pandemic in Indonesia: Challenges from psychologist perspective.

COVID-19 are causing many psychological impacts and change many aspects of human life. Mental health services also experiencing changes because of COVID-19 outbreak. In Indonesia, COVID-19 outbreak prompted the rapid development of online mental health services. These online mental health services which will help people to connect with professional mental healthcare providers using technology were created in response to this pandemic. Therefore, converting mental health services into online services in a state of urgency is challenging. This qualitative case study aims to provide a map of the service challenges that professional healthcare providers face while providing online services at present time by interviewing eight Indonesian psychologists as one of the mental health professionals who provided the online mental health services. Semi-structured interviews were done using interview guidelines with open-ended questions, and any other complementary data was collected using questionnaire. The data gathered from interviews was first performed through triangulation and then analyzed using thematic network analysis, which resulted in the following challenges: (1) building engagement; (2) risk of getting distracted during the sessions; (3) maintaining professional boundaries during the sessions; (4) keeping the personal information and confidentiality of the sessions; (5) perceived efficacy; and (6) attitudes towards online sessions. According to the results, the relevant organization can use this finding to contribute and develop the online mental health services both in this COVID-19 situation and in the future.

Parenting amidst COVID-19: Pandemic-related stressors, inequities, and treatment utilization and perceptions.

Many parents of children under age 18 are faced with additional COVID-19 parenting-related stressors and may be experiencing increases in psychological difficulties;however, we have yet to investigate parent's levels of posttraumatic stress symptoms (PTSS) and adjustment disorder. Further, COVID-19 has served as a sobering reminder of the significant public health disparities in our society and it is critical to identify risk factors for poorer clinical outcomes. The primary objectives of the present study were to: (a) determine whether parents are reporting higher levels of pandemic-related stress, PTSS, and adjustment disorder than controls, (b) identify specific individual-level factors (e.g., age, gender, race, number of children, age of children) that may be related to higher levels of stress and symptoms among parents, and (c) report parents' utilization of, and perceived efficacy of, psychological interventions during COVID-19. A U.S. nationally representative sample (N = 2,019) from Qualtrics Data panels was recruited in July-August 2020. Parents endorsed higher levels of stress, PTSS, and adjustment disorder, particularly younger parents. Further, 38.3% of parents reported PTSS above clinical cutoff. Younger participants and persons of color reported higher levels of pandemic-related stress. One-third of parents (33.1%) reported using online mental health services. Taken together, parents may be at greater risk for pandemic stress, PTSS, and adjustment disorder symptoms. Individual-level risk factors, such as age and minority status, are important to consider when understanding COVID-19 stress. Clinical intervention efforts should prioritize trauma-focused treatments for parents, especially those who are younger and identify as a person of color. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

The Effectiveness of Online vs Face-to-Face Psychotherapy During the COVID-19 Pandemic in the United Arab Emirates

The COVID-19 pandemic caused an abrupt and immediate change to the way in which mental health services are delivered. To mitigate against lockdown protocols imposed on a global scale, many individuals seeking mental health services were obliged to use online mental health services in place of face-to-face services. The study reported here investigated the differences in individuals’ experiences of online psychotherapy sessions compared to in-person psychotherapy services using a cross-sectional, within groups design. Forty-nine clients from a mental health clinic in the UAE, who received psychotherapy in both modalities, completed self-report questionnaires measuring satisfaction with therapy and working alliance. Results indicate that clients’ satisfaction levels did not significantly differ between online and in-person therapy sessions. However, clients rated their perceived working alliance with their therapist for in-person therapy sessions significantly higher than for online therapy sessions. Implications for future research are discussed.

Increasing Access to Mental Health Services: Videogame Players’ Perspectives

Young men's mental health is at the forefront of global public health concerns. Young males, who have a high incidence of mental health disorders, are a population that accesses services at lower rates than females and makes up the majority of videogame players. By considering the unique perspectives of digitally connected individuals on mental health service delivery, interventions may be designed to address their needs with a higher likelihood of success. This study investigated international male videogamers' perspectives on how their access to mental health services could be improved via an open-ended survey question. From a total of 2515 completed surveys, 761 responded to the qualitative question. Of these, the 71 responses that discussed access to and provision of mental healthcare services are reported in this article. Results suggest that digital mental health services were a promising way to reach this group. Anonymity and confidentiality were found to be important factors when considering online mental health services. Male videogame players identified a preference for both online and in-person services that are delivered synchronously, one-on-one with an expert practitioner, and readily available in settings that individuals find comfortable.

Text4Hope Effectiveness in Reducing Psychological Symptoms among Young Adults in Canada: Longitudinal and Naturalistic Controlled Program Evaluation

Chronic stress, anxiety, and depression are psychological problems that can hurt young adults, interfering with their everyday function, academic achievement, and interpersonal relationships. This study aimed to assess the impact of Text4Hope, an online mental health service, on the psychological well-being of young adults. This study adopted both longitudinal and naturalistic controlled trial designs. It examined clinical outcomes in young adult (≤26 years old) subscribers of Text4Hope who completed surveys at baseline and six weeks and compared clinical parameters in two groups of subscribers. The first group comprised the intervention group (IG) (young adult subscribers who received once-daily supportive text messages for six weeks and completed sixth-week evaluation measures between 26 April and 12 July 2020), and the second group was the control group (CG) (young adult subscribers who joined Text4Hope in the same time frame and completed a baseline survey and were yet to receive any text messages). The prevalence of moderate to high stress, anxiety, and depression was measured at baseline and six weeks in the longitudinal study and between the two groups for the naturalistic controlled study using the Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Inferential statistics, including the t-test, McNemar test, chi-square, and binary logistic regression analyses, were used to evaluate the differences in the prevalence and severity of the psychological symptoms. In the longitudinal study, of the 9214 subscribers to Text4Hope who completed the baseline survey, 1047 (11.4%) were identified as youth. For the young adult subscribers who completed both the baseline and sixth-week surveys (n = 114), a significant reduction in the prevalence of moderate to high stress (8%) and likely GAD (20%) from baseline to six weeks was reported. Similarly, there was a significant reduction in the mean scores on the PSS-10, GAD-7, and Composite Mental Health score but not the PHQ-9 from baseline to six weeks. The largest reduction in mean scores was for the GAD-7 scale (18.4%), with a small effect size overall. For the naturalistic study, the IG included 173 young adult subscribers of Text4Hope who completed the sixth-week survey compared to 92 subscribers in the CG who completed the baseline survey during the designated period. There was a significantly lower prevalence for likely Moderate Depressive Disorder (MDD) (25.2%) and suicidal thoughts/thoughts of self-harm (48.4%), with a small effect size in the IG compared to the CG. Similarly, lower mean scores were reported for all outcome variables in the IG compared to the CG, with a small to medium effect size. The receipt of daily supportive text messages for six weeks resulted in significantly lower odds of both likely GAD and experiencing thoughts of self-harm or death wish while controlling for sociodemographic characteristics. The Text4Hope service is an effective tool for mental health support for young adult subscribers. Young adults receiving the service exhibited a reduction in psychological symptoms, including thoughts of self-harm or death wish. This population-level intervention program can be used to effectively support young adult mental health and in suicide prevention programs.

Artificial intelligence: An eye cast towards the mental health nursing horizon.

There has been an international surge towards online, digital, and telehealth mental health services, further amplified during COVID-19. Implementation and integration of technological innovations, including artificial intelligence (AI), have increased with the intention to improve clinical, governance, and administrative decision-making. Mental health nurses (MHN) should consider the ramifications of these changes and reflect on their engagement with AI. It is time for mental health nurses to demonstrate leadership in the AI mental health discourse and to meaningfully advocate that safety and inclusion of end users' of mental health service interests are prioritized. To date, very little literature exists about this topic, revealing limited engagement by MHNs overall. The aim of this article is to provide an overview of AI in the mental health context and to stimulate discussion about the rapidity and trustworthiness of AI related to the MHN profession. Despite the pace of progress, and personal life experiences with AI, a lack of MHN leadership about AI exists. MHNs have a professional obligation to advocate for access and equity in health service distribution and provision, and this applies to digital and physical domains. Trustworthiness of AI supports access and equity, and for this reason, it is of concern to MHNs. MHN advocacy and leadership are required to ensure that misogynist, racist, discriminatory biases are not favoured in the development of decisional support systems and training sets that strengthens AI algorithms. The absence of MHNs in designing technological innovation is a risk related to the adequacy of the generation of services that are beneficial for vulnerable people such as tailored, precise, and streamlined mental healthcare provision. AI developers are interested to focus on person-like solutions; however, collaborations with MHNs are required to ensure a person-centred approach for future mental healthcare is not overlooked.

Metaverse as a new place for online mental health services in the post-COVID-19 era: Is it a challenge or an opportunity?

In this article, the author describes the challenges and opportunities of metaverse's presence in the world for online mental health services. Aside from that, the author provides insight that metaverse can become a new place that is more comfortable and enjoyable for everyone who can relish the online mental health meetings with a new atmosphere and sensation, especially in the post-COVID-19 era.

3.129 The Effect of Mobile Digital Interventions on Mental Health Measures During the COVID-19 Pandemic: A Systematic Review of Controlled Studies

The COVID-19 pandemic has resulted in increased demands for online mental health (MH) services because social distancing measures have made access to MH care increasingly difficult. Before the pandemic, many mobile app-based interventions had shown their effectiveness on MH-related measures. However, effectiveness under pandemic conditions has not been systematically reviewed.

Child and youth mental health needs and service utilization during COVID-19.

The COVID-19 pandemic has significantly impacted the lives of children, youth, and their families and their access to mental health services through new virus containment measures, such as social distancing guidelines, school and service closures, and the emergence of online mental health services. In this study, we utilized a total of 47,417 interRAI assessments to evaluate the impact of the current pandemic on the mental health service needs and referral trends of children and youth across 55 mental health service agencies in Ontario, Canada. Child and youth assessments that were conducted in the period of March 1 to October 31 in 2018 and 2019 were compared with the same period in 2020 to assess pandemic-related differences. Findings demonstrated that mental health assessments among children and youth decreased significantly during the pandemic period, with the greatest decline observed among children from low-income neighborhoods. Results also demonstrated a change in the proportion of mental health concerns previously seen in children and youth. Specifically, referrals for anxiety, depression, self-harm, problem videogaming, and Internet use increased, whereas referrals related hyperactivity/distractibility, risk of harm to others, aggressive, and disruptive behavior decreased. A decrease in bullying and increase in domestic violence exposure was also noted during the pandemic, with no reported differences in children and youth's experiences of physical abuse, sexual abuse, emotional abuse, and neglect. The clinical implications for children, youth, and their families, especially those within more vulnerable communities, are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved)