Why do young people use online forums for mental health and emotional support? Benefits and challenges

Searching for Love and Babies: A Qualitative Study on Online Social Support Among Women with Infertility

With the popularity of computer-mediated communication, accessing online social support has become more accessible for women confronting infertility, yet the role of such support for Chinese women remains understudied. This study investigates the online social support experiences of Chinese women navigating infertility within the framework of Cutrona and Suhr's social support. Employing netnography and semi-structured interviews alongside thematic analysis, the findings highlight challenges in informational support due to limitations in online information dissemination, with some degree of overlap observed between informational support and network support. Emotional support proves crucial and esteem support aids in mitigating self-blame among online forum members. Tangible assistance primarily involves expressed willingness to help. This research advances social support theory by exploring new areas, clarifying online support mechanisms using Daena Goldsmith's normative approach, highlighting sociocultural influences, and enhancing understanding of esteem support in the context of stigmatization.

The Mediating Role of Students' Health Information Literacy Skills: Exploring the Relationship Between Web Resource Utilization and Health Information Evaluation Proficiency

BACKGROUND

In an increasingly digital age, students rely heavily on web resources to access health information. However, evaluating the reliability and relevance of such information is crucial for informed decision-making. This study examines the importance of students' health information literacy skills (HILS) as mediators, particularly their ability to utilize web resources and successfully evaluate health information.

OBJECTIVES

This research investigates the mediating role of students' HILS in the relationship between their utilization of web resources and their proficiency in evaluating health information.

METHOD

An online survey was distributed to current students at a public university in Bangladesh as part of the data collection process for this study. Using Google Forms, the authors created a structured questionnaire. The survey was distributed through Messenger groups, Facebook pages and email invitations to reach the target audience effectively. The researchers thoroughly analysed the gathered data using structural equation modelling (SEM) techniques and SmartPLS-4 software to look for correlations between the variables.

RESULT

The study revealed that among the 122 participants, a significant number (N = 47) accessed internet health information on an occasional basis, whereas 30 individuals reported using it infrequently. The data revealed that 58 individuals, accounting for 47.5% of the sample, possessed the necessary abilities to access and assess online health information. Additionally, 57 participants, representing 46.7% of the sample, demonstrated proficiency in conducting online health information searches. The measurement model demonstrated good convergent validity, as evidenced by composite reliability (CR) scores and Cronbach's ⍺ values over 0.700 and an average extracted variance (AVE) of 0.500. The structural model demonstrated R2 values exceeding 0.1, thus validating its dependable forecasting capability. Notable effects were seen, with f2 values of 0.335 and 0.317 for the challenges in accessing and evaluating health information (CAEHI) to health information evaluation (HIE) and CAEHI to HILS relationships, respectively. The mediation analysis found that HILS act as a mediator between types of web resources (TWRs) and HIE, with TWR having an indirect impact on HIE through HILS.

DISCUSSION

The result supports all hypotheses. Therefore, it is evident that students' HILS mediate the relationship between utilization of web resources and their proficiency in evaluating health information.

CONCLUSION

This study's findings could significantly impact instructional practices meant to raise students' health information literacy. This initiative seeks to enable students to make informed decisions about their health by providing them with the necessary tools to analyse and evaluate health-related information.

PATIENT OR PUBLIC CONTRIBUTION

Research on health information literacy can assist patients and the general public by instructing them on how to assess trustworthy online health resources. Students gave insightful feedback that assisted in shaping the study and guaranteeing its relevancy. If they better comprehend health information literacy, patients and the general public can use web-based resources and critically evaluate health information more accurately.

Coping with Non-COVID-19 Health Problems Through Communicative Action in Cyberspace

This study investigated how the online health information behaviors of U.S. adults with illnesses unrelated to COVID-19 virus infection affected their coping with health problems and concerns during the COVID-19 pandemic. Guided by the cybercoping model (Kim & Lee, 2014), the study examined associations between these patients' online information behaviors (information seeking and information forwarding) and coping outcomes (health problems and affective states). The study further explored the mediating roles of health coping processes (problem-and emotion-focused) in the associations between these information behaviors and coping outcomes. Survey data from 687 participants were analyzed using structural equation modeling. The results highlighted the significance of information forwarding in enhancing both coping processes and outcomes, while information seeking enhanced problem-focused coping and health-problem coping outcomes alone. These associations were more pronounced among U.S. adults without chronic conditions than among those with chronic illnesses. These findings' implications, the study's limitations, and suggestions for future research were also addressed.

A qualitative exploration of online forums to support resilience of rural young people in Australia

Introduction

Prevention and early intervention are crucial strategies for improving young people's mental health and well-being. Building resilience is a key component of these strategies, especially among young individuals in rural areas who face well-documented mental health disparities. This study aimed to investigate how online mental health forums can contribute to enhancing individual resilience in young rural users.

Methods

A sample of forum posts (n = 1,000) made by Australian rural users (18-25 years) on an online peer support mental health forum were qualitatively analyzed. The analysis was guided by themes derived from the literature on indicators of rural resilience.

Results

Analysis of forum posts showed evidence of rural resilience in forum users. Online peer support forums offered a virtual space for individuals to establish social connections, experience a sense of belonging, share information, acquire knowledge, and offer mutual support. There were indications of increased self-efficacy among forum users, as they demonstrated their ability to implement strategies for better managing their mental health.

Discussion

These findings significantly contribute to our understanding of how online forums can enhance resilience factors that are beneficial for young people living in rural communities. In the context of prevention and early intervention, this study illustrates the intricate connections between forum design and user activity with resilience outcomes, providing valuable insights into the underlying causal mechanisms. Consequently, it emphasizes the importance of incorporating such digital interventions as integral components of mental health service ecosystems.

Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis

BACKGROUND

Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation.

OBJECTIVE

This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.

METHODS

We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.

RESULTS

Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.

CONCLUSIONS

This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.

TRIAL REGISTRATION

PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.

"I *know* all the things I should be doing …": accounting for mental health and illness in an online mental health discussion forum during the COVID-19 pandemic

BACKGROUND

Mental health is highly correlated with a person's social and economic circumstances, and the recent COVID-19 pandemic made this connection uniquely visible. Yet a discourse of personal responsibility for mental health often dominates in mental health promotion campaigns, media coverage and lay understandings, contributing to the stigmatisation of mental ill-health.

METHODS

In this study, we analysed how the concept of 'mental health' was discursively constructed in an online mental health peer-support forum in Australia during 2020, the period of the first two waves of the COVID-19 pandemic. An approach informed by Critical Discursive Psychology was employed to analyse all posts made to a discussion thread entitled "Coping during the coronavirus outbreak" in 2020, a total of 1,687 posts.

RESULTS

Two main interpretative repertoires concerning mental health were identified. Under the first repertoire, mental health was understood as resulting largely from the regular performance of a suite of self-care behaviours. Under the second repertoire, mental health was understood as resulting largely from external circumstances outside of the individual's control. The existence of two different repertoires of mental health created an ideological dilemma which posters negotiated when reporting mental ill-health. A recurring pattern of accounting for mental ill-health was noted in which posters employed a three-part concessive structure to concede Repertoire 1 amid assertions of Repertoire 2; and used disclaimers, justifications, and excuses to avoid negative typification of their identity as ignorant or irresponsible.

CONCLUSIONS

Mental ill-health was commonly oriented to by forum posters as an accountable or morally untoward state, indicating the societal pervasiveness of a discourse of personal responsibility for mental health. Such discourses are likely to contribute to the stigmatisation of those suffering from mental ill-health. There is a need therefore for future communications about mental health to be framed in a way that increases awareness of social determinants, as well as for policy responses to effect material change to social determinants of mental health.

The intersection of technology and mental health: enhancing access and care

In recent times, technology has increasingly become a central force in shaping the landscape of mental health care. The integration of various technological advancements, such as teletherapy, virtual care platforms, mental health apps, and wearable devices, holds great promise in improving access to mental health services and enhancing overall care. Technology's impact on mental health care is multi-faceted. Teletherapy and virtual care have brought about a revolution in service delivery, eliminating geographical barriers and offering individuals convenient and flexible access to therapy. Mobile mental health apps empower users to monitor their emotional well-being, practice mindfulness, and access self-help resources on the move. Furthermore, wearable devices equipped with biometric data can provide valuable insights into stress levels and sleep patterns, potentially serving as valuable indicators of mental health status. However, integrating technology into mental health care comes with several challenges and ethical considerations. Bridging the digital divide is a concern, as not everyone has equal access to technology or the necessary digital literacy. Ensuring privacy and data security is crucial to safeguard sensitive client information. The rapid proliferation of mental health apps calls for careful assessment and regulation to promote evidence-based practices and ensure the delivery of quality interventions. Looking ahead, it is vital to consider future implications and adopt relevant recommendations to fully harness technology's potential in mental health care. Continuous research is essential to evaluate the efficacy and safety of digital interventions, fostering collaboration between researchers, mental health professionals, and technology developers. Proper training on ethical technology utilization is necessary for mental health practitioners to maintain therapeutic boundaries while leveraging technological advancements responsibly.

An analysis of cannabinoid hyperemesis syndrome Reddit posts and themes

INTRODUCTION

Reddit hosts a large active community of members dedicated to the discussion of cannabinoid hyperemesis syndrome. We sought to describe common themes discussed and the most frequently mentioned triggers and therapies for cannabinoid hyperemesis syndrome exacerbations in the Reddit online community.

METHODS

Data collected from six subreddits were filtered using natural language processing to curate posts referencing cannabinoid hyperemesis syndrome. Based on a manual review of posts, common themes were identified. A machine learning model was trained using the manually categorized data to automatically classify the themes for the rest of the posts so that their distributions could be quantified.

RESULTS

From August 2018 to November 2022, 2683 unique posts were collected. Thematic analysis resulted in five overall themes: cannabinoid hyperemesis syndrome-related science; symptom timing; cannabinoid hyperemesis syndrome treatment and prevention; cannabinoid hyperemesis syndrome diagnosis and education; and health impacts. Additionally, 447 trigger and 664 therapy-related posts were identified. The most commonly mentioned triggers for cannabinoid hyperemesis syndrome episodes included: food and drink (n = 62), cannabinoids (n = 45), mental health (e.g., stress, anxiety) (n = 27), and alcohol (n = 22). Most commonly mentioned cannabinoid hyperemesis syndrome therapies included: hot water/bathing (n = 62), hydration (n = 60), antiemetics (n = 42), food and drink (n = 38), gastrointestinal medications (n = 38), behavioral therapies (e.g., meditation, yoga) (n = 35), and capsaicin (n = 29).

DISCUSSION

Reddit posts for cannabinoid hyperemesis syndrome provide a valuable source of community discussion and individual reports of people experiencing cannabinoid hyperemesis syndrome. Mental health and alcohol were frequently reported triggers within the posts but are not often identified in the literature. While many of the therapies mentioned are well documented, behavioral responses such as meditation and yoga have not been explored by the scientific literature.

CONCLUSIONS

Knowledge shared via online social media platforms contains detailed information on self-reported cannabinoid hyperemesis syndrome disease and management experiences, which could serve as valuable data for the development of treatment strategies. Further longitudinal studies in patients with cannabinoid hyperemesis syndrome are needed to corroborate these findings.

A study on the effects of perceived playfulness and emotional support in interactive learning environments for German language acquisition-A role-playing library system case

Introduction

This study examines the emotional support offered by the non-player characters (NPCs) in an interactive learning environment, as well as the effects of the perceived playfulness of the interactive system on German language learning.

Method

We developed a role-playing library system to serve this purpose. 2,377 Chinese Internet users were surveyed using online questionnaire.

Results

A theoretical model of emotion- driven learning (ELM) was proposed based on the analysis results of valid recovered data. Additionally, NPCs were found to be effective in improving learning outcomes through emotional support.

Discussion

An interactive education system may be able to enhance the perceived playfulness of learning in order to enhance the learning experience.

Wellness Impacts of Social Capital Built in Online Peer Support Forums

The study reported in this paper sought to explore whether and how social capital resources were generated on online peer support mental health forums, and how they were used by rural users to influence mental health outcomes. Interviews with rural users of three Australian online peer support mental health forums were analysed to identify interactions that accessed social capital resources and mental wellness outcomes that flowed from these. Analysis drew on a model of simultaneous building and using of social capital to uncover the nature of the social capital resources present on the forum and how they were built. Findings show that forums were sites for building 'knowledge resources' including archives of users' experiences of navigating mental illness and the mental health service system; and 'identity resources' including a willingness to contribute in line with forum values. The knowledge and identity resources built and available to rural users on the forums are facilitated by forum characteristics, which can be viewed as affordances of technology and institutional affordances. Operation by trusted organisations, moderation, a large network of users and anonymity created a safe space that encouraged reciprocity and where users exchanged information and social support that helped them maintain better mental wellness.

The Helpfulness of Web-Based Mental Health and Well-being Forums for Providing Peer Support for Young People: Cross-sectional Exploration

BACKGROUND

Young people are increasingly seeking out web-based support for their mental health and well-being. Peer support forums are popular with this age group, with young individuals valuing the fact that the forums are available 24/7, providing a safe and anonymous space for exploration. Currently, little systematic evaluation of the helpfulness of such forums in providing support has been conducted.

OBJECTIVE

This study examined the helpfulness of the support offered within web-based mental health and well-being peer support forums for young people. It specifically investigated the self-reported user ratings of helpfulness reported through the completion of a developing experience measure. The ratings will be used to consider further development of the measure and reflect upon the overall helpfulness of the forums as indicated by the reported scores.

METHODS

The study used routinely collected practice-based outcome data from web-based mental health forums for young people. These forums are hosted by the UK-based web-based therapy and support service, Kooth. A cross-sectional design was used to explore-using a range of inferential statistical measures-the outcomes reported by those accessing the forums using a Peer Online Community Experience Measure (POCEM). To consider the helpfulness in general, 23,443 POCEMs completed in 2020 were used. A second data set of 17,137 completed POCEMs from the same year was used to consider whether various engagement indicators had an impact upon the helpfulness rating.

RESULTS

Female users aged between 11 and 16 years predominantly completed the POCEM. This is in keeping with the majority of those using the service. In total, 74.6% (8240/11,045) of the scores on the POCEM indicated that the individuals found the posts helpful. An ANOVA indicated that male users were more likely to report obtaining intrapersonal support, whereas female users obtained interpersonal support. Furthermore, the POCEM scores reflected the internal consistency of the measure and provided an insight into the way that young people made use of the peer support resource; for instance, posts that were rated more helpful were correlated with spending longer time reading them, and the topics discussed varied throughout the day with more mental health issues being discussed later at night.

CONCLUSIONS

The results seem to demonstrate that, overall, the young people involved in this study found web-based peer support helpful. They indicate that peer support can provide an important strand of care within a supportive mental health ecosystem, particularly during time periods when in-person support is typically closed. However, limitations were noted, suggesting that caution is needed when interpreting the results of this study. Although such services are incredibly well used, they have received little research attention to date. As such, further investigation into what constitutes helpful and unhelpful peer support is needed.

Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review

BACKGROUND

The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions.

OBJECTIVE

To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions.

METHODS

We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care.

RESULTS

Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence.

CONCLUSIONS

Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.

Experience of Peer Bloggers Using a Social Media Website for Adolescents With Depression or Anxiety: Proof-of-Concept Study

Background

Supporting Our Valued Adolescents (SOVA) is a moderated and anonymous social media website intervention. SOVA ambassadors are adolescents and young adults (AYA) asked to write monthly blog posts and comments on others’ posts on topics surrounding mental health.

Objective

This study aims to understand the feasibility and acceptability of peer blogging for a moderated mental health intervention website and explore whether bloggers—AYA who self-report symptoms of depression and anxiety—experience potential benefits.

Methods

AYA aged 14 to 26 years with a self-reported history of depression or anxiety were recruited to the SOVA Peer Ambassador Program. Participants were asked to write one blog post a month and comment at least four times a month on other blog posts, for which they were compensated for up to US $15 monthly. Outcome variables measured at baseline and 3 months after intervention included website usability and feasibility, depressive symptoms, anxiety symptoms, mental health treatment history, cybercoping, personal blogging style, self-esteem, loneliness, mental health stigma, social support, and positive youth development characteristics. Open-ended questions were asked about their blogging acceptability and usability.

Results

Of 66 AYA showing interest and completing onboarding, 71% (47/66) wrote at least one blog post, with an average of 3 posts per person. A sample of 51% (34/66) of participants completed a 3-month survey for the full analysis. Almost all 34 participants were satisfied with the experience of blogging (32/34, 94%) and rated the website usability as good (80.1, SD 14.9). At 3 months, self-esteem scores increased by 2.1, with a small-medium effect size (P=.01; Cohen d=0.45), and youth competence and confidence increased by 0.7 (P=.002) and 1.3 (P=.002), with medium effect sizes (Cohen d=0.62 and 0.60), respectively.

Conclusions

A blogging intervention for AYA with a history of depression or anxiety was feasible with regular and active engagement and shows evidence in a one-sample design for positive changes in strength-based assets—self-esteem, competence, and confidence—which map onto resilience.

Help-Seeking from a National Youth Helpline in Australia: An Analysis of Kids Helpline Contacts

Counselling helplines or hotlines are key support services for young people with mental health concerns or in suicide and self-harm crises. We aimed to describe young peoples' use of a national youth helpline (Kids Helpline, Australia, KHL) to understand how usage changed over time. A descriptive analysis was conducted on 1,415,228 answered contacts between 2012-2018. We described the trend of service usage over the observed period, the types of youth who used the service, and the problems young people contacted the service about. Phone (APC = -9.1, KHL: -10.4 to -7.8, p < 0.001) and email (APC = -13.7, 95%CI: -17.1 to -10.2, p < 0.001) contacts decreased over time whereas webchat contacts increased (APC = 16.7, 95%CI: 11.7 to 22.0, p < 0.001). With this increase in webchat contacts, there was an associated increase in total webchat contact duration. Concerns raised in contacts to the service were primarily related to emotional wellbeing and mental health concerns (53.2% phone, 57.3% webchat, 58.2% email) followed by social relationship issues (20.4% phone, 20.3% webchat, 16.8% email) and family relationships (19.4% phone, 17.2% webchat, 21.8% email). The increased preference for online text-based information and counselling services can help inform development of services for young people and allocation of staff/service training and resources.

The COVID-19 pandemic and eating disorders in children, adolescents, and emerging adults: virtual care recommendations from the Canadian consensus panel during COVID-19 and beyond

OBJECTIVE

The COVID-19 pandemic has had detrimental effects on mental health. Literature on the impact on individuals with eating disorders is slowly emerging. While outpatient eating disorder services in Canada have attempted to transition to virtual care, guidelines related to optimal virtual care in this field are lacking. As such, the objective of our Canadian Consensus Panel was to develop clinical practice guidelines related to the provision of virtual care for children, adolescents, and emerging adults living with an eating disorder, as well as their caregivers, during the COVID-19 pandemic and beyond.

METHODS

Using scoping review methodology (with literature in databases from 2000 to 2020 and grey literature from 2010 to 2020), the Grading of Recommendations, Assessment, Development, and Evaluation system, the Appraisal of Guidelines, Research and Evaluation tool, and a panel of diverse stakeholders from across Canada, we developed high quality treatment guidelines that are focused on virtual interventions for children, adolescents, and emerging adults with eating disorders, and their caregivers.

RESULTS

Strong recommendations were supported specifically in favour of in-person medical evaluation when necessary for children, adolescents, and emerging adults, and that equity-seeking groups and marginalized youth should be provided equal access to treatment. For children and adolescents, weak recommendations were supported for telehealth family-based treatment (FBT) and online guided parental self-help FBT. For emerging adults, internet cognitive-behavioural therapy (CBT)-based guided self-help was strongly recommended. Weak recommendations for emerging adults included CBT-based group internet interventions as treatment adjuncts, internet-based relapse prevention Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) guided self-help, telehealth relapse prevention using MANTRA, and guided CBT-based smartphone apps as treatment adjuncts. For caregivers of children and adolescents, weak recommendations were supported for virtual parent meal support training, and moderated online caregiver forums and support groups. For caregivers of emerging adults, guided parental self-help CBT was strongly recommended, and unguided caregiver psychoeducation self-help was weakly recommended.

CONCLUSIONS

Several gaps for future work were identified including the impact of sex, gender, race, and socioeconomic status on virtual care among children, adolescents, and emerging adults with eating disorders, as well as research on more intensive services, such as virtual day hospitals.

A Theory of Change for Web-Based Therapy and Support Services for Children and Young People: Collaborative Qualitative Exploration

BACKGROUND

Web-based counseling and support has become increasingly commonplace for children and young people (CYP). Currently, there is limited research that focuses on the mechanisms of change within complex telepsychology platforms, a factor that makes designing and implementing outcome measures challenging.

OBJECTIVE

This project aims to articulate a theory of change (ToC) for Kooth, a web-based therapy and support platform for CYP.

METHODS

A collaborative qualitative research design involving professional staff, academic partners, and young people was used to develop the ToC. The following three major reflective phases were engaged: a scoping workshop involving professional staff and academic partners, a series of explorative projects were completed to inform the development of the ToC, and the draft ToC was reviewed for coherence by key stakeholders (young people, online professionals, and service managers).

RESULTS

A collaboratively developed ToC was presented. This was divided into the conditions that lead to individuals wanting to access web-based therapy and support (eg, individuals wanting support there and then or quickly), the mode of service delivery (eg, skilled and experienced professionals able to build empathetic relationships with CYP), and the observed and reported changes that occur as a consequence of using the service (eg, individuals being better able to manage current and future situations).

CONCLUSIONS

Developing the ToC helps to shed light on how web-based therapy and support services aid the mental health and well-being of CYP. Furthermore, it helps to understand the development of positive virtual ecosystems and can be used to devise evaluative tools for CYP telepsychology providers.