BackgroundYoung 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.ObjectiveThe 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.MethodsA 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.ResultsOverall, 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.ConclusionsApproaches 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.

Background Young people are particularly vulnerable to experiencing mental health difficulties, but very few seek treatment or help during this time. Online help-seeking may offer an additional domain where young people can seek aid for mental health difficulties, yet our current understanding of how young people seek help online is limited. Objective This was an exploratory study which aimed to investigate the online help-seeking behaviors and preferences of young people. Methods This study made use of an anonymous online survey. Young people aged 18-25, living in Ireland, were recruited through social media ads on Twitter and Facebook and participated in the survey. Results A total of 1308 respondents completed the survey. Many of the respondents (80.66%; 1055/1308) indicated that they would use their mobile phone to look online for help for a personal or emotional concern. When looking for help online, 82.57% (1080/1308) of participants made use of an Internet search, while 57.03% (746/1308) made use of a health website. When asked about their satisfaction with these resources, 36.94% (399/1080) indicated that they were satisfied or very satisfied with an Internet search while 49.33% (368/746) indicated that they were satisfied or very satisfied with a health website. When asked about credibility, health websites were found to be the most trustworthy, with 39.45% (516/1308) indicating that they found them to be trustworthy or very trustworthy. Most of the respondents (82.95%; 1085/1308) indicated that a health service logo was an important indicator of credibility, as was an endorsement by schools and colleges (54.97%; 719/1308). Important facilitators of online help-seeking included the anonymity and confidentiality offered by the Internet, with 80% (1046/1308) of the sample indicating that it influenced their decision a lot or quite a lot. A noted barrier was being uncertain whether information on an online resource was reliable, with 55.96% (732/1308) of the respondents indicating that this influenced their decision a lot or quite a lot. Conclusions Findings from this survey suggest that young people are engaging with web-based mental health resources to assist them with their mental health concerns. However, levels of satisfaction with the available resources vary. Young people are engaging in strategies to assign credibility to web-based resources, however, uncertainty around their reliability is a significant barrier to online help-seeking.

Seeking help is often an important step in addressing mental health difficulties. Evidence suggests that positive helpseeking experiences contribute to an increased likelihood of future help-seeking and achieving improved outcomes. However, help-seeking is a complex process. Alongside traditional sources, digital technologies offer many pathways to help. Using a mixed methods approach across two studies, this paper explores key design factors for online mental health resources that can support young people's helpseeking. First, a large online survey (n=1308) highlighted challenges and identified common help-seeking scenarios, including information-seeking, person-centred approaches and crisis situations. Using survey data, personas were developed to represent different help-seekers -each characterised by a particular help-seeking scenario. The personas were then used in co-design workshops to facilitate further exploration of help-seeking needs. Four key design considerations were identified: connectedness, accessible information, personalisation, and immediacy. Based on our findings, we provide design recommendations that are grounded in existing theories of help-seeking.

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Young adulthood represents a sensitive period for young people's mental health. The lockdown restrictions associated with the COVID-19 pandemic have reduced young people's access to traditional sources of mental health support. This exploratory study aimed to investigate the online resources young people were using to support their mental health during the first lockdown period in Ireland. It made use of an anonymous online survey targeted at young people aged 18–25. Participants were recruited using ads on social media including Facebook, Twitter, Instagram, and SnapChat. A total of 393 respondents completed the survey. Many of the respondents indicated that they were using social media (51.4%, 202/393) and mental health apps (32.6%, 128/393) as sources of support. Fewer were making use of formal online resources such as charities (26%, 102/393) or professional counseling services (13.2%, 52/393). Different social media platforms were used for different purposes; Facebook was used for support groups whilst Instagram was used to engage with influencers who focused on mental health issues. Google search, recommendations from peers and prior knowledge of services played a role in how resources were located. Findings from this survey indicate that digital technologies and online resources have an important role to play in supporting young people's mental health. The COVID-19 pandemic has highlighted these digital tool's potential as well as how they can be improved to better meet young people's needs.