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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH FRONT

eMental health service use among Australian youth: a cross-sectional survey framed by Andersen’s model

Teghan Leech A B , Diana S. Dorstyn A and Wenjing Li A
+ Author Affiliations
- Author Affiliations

A School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia. Email: teghan.leech@student.adelaide.edu.au; wenjing.li@adelaide.edu.au

B Corresponding author. Email: diana.dorstyn@adelaide.edu.au

Australian Health Review 44(6) 891-897 https://doi.org/10.1071/AH19095
Submitted: 24 April 2019  Accepted: 19 August 2019   Published: 16 December 2019

Abstract

Objective Young adults aged 18–24 years often delay or avoid seeking help for their mental health concerns. eMental health, the use of the Internet to deliver mental health information, services and care, offers a low-cost, easy-access option. However the factors that influence online help-seeking among this cohort remain unclear.

Methods Andersen’s healthcare utilisation model was adapted to examine correlates of eMental health use among Australian youth. In all, 161 young adults completed an online survey comprising sociodemographic questions, online feature preferences, the Actual and General Help-seeking Questionnaires, Berkman–Syme Social Network Index, General Self-Efficacy Scale, Service Obstacles Scale and Depression, Anxiety and Stress Scales.

Results Almost 70% of young people reported having previously accessed some form of online support for their personal or emotional problems. This included informal information via social media and formalised counselling services. Notably, perception of service satisfaction was low. Hierarchical logistical regression identified two significant predisposing factors to subsequent online help-seeking: prior face-to-face service use and living or cohabitating with others.

Conclusions eMental health is accessed by young people in Australia, yet more needs to be done to better integrate this service model into the healthcare system. This includes training and education for consumers and professionals about existing, effective programs.

What is known about this topic? eMental health platforms can bridge the gap between technology and conventional mental health care. Despite its rapidly expanding evidence base, the implementation of eMental health into the Australian healthcare system remains slow. More work needs to be done to elucidate the factors underlying preferences for online help-seeking.

What does this paper add? Young adult perspectives on the delivery of mental health information, services and care via the Internet are examined in accordance with a major conceptual model, namely Andersen’s behavioural model of health services use. The majority of those surveyed reported having accessed some form of online support for an emotional issue, although dissatisfaction with the quality of this support was expressed. Andersen’s model can guide future research in this area and potentially help target eMental health initiatives to individual service users’ needs.

What are the implications for practitioners? eMental health interventions offer an alternative for young adults who have difficulty accessing traditional mental health care services, but are also an adjunct to those experiencing mild to moderate symptoms of mental illness. Practitioners can introduce young adults to eMental health by discussing the benefits and limitations and by providing information about available and secure online programs delivered by trusted service providers.


References

[1]  Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 2010; 10 113–21.
Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review.Crossref | GoogleScholarGoogle Scholar | 21192795PubMed |

[2]  Australian Institute of Health and Welfare. Mental health services in Australia. 2019. Available at: https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary [verified 16 July 2019].

[3]  Christensen H, Petrie K. State of the e-mental health field in Australia: where are we now? Aust N Z J Psychiatry 2013; 47 117–20.
State of the e-mental health field in Australia: where are we now?Crossref | GoogleScholarGoogle Scholar | 23297367PubMed |

[4]  Lal S, Adair CE. E-mental health: a rapid review of the literature. Psychiatr Serv 2014; 65 24–32.
E-mental health: a rapid review of the literature.Crossref | GoogleScholarGoogle Scholar | 24081188PubMed |

[5]  Rickwood D, Thomas K. Conceptual measurement framework for help-seeking for mental health problems. Psychol Res Behav Manag 2012; 2012 173–83.
Conceptual measurement framework for help-seeking for mental health problems.Crossref | GoogleScholarGoogle Scholar |

[6]  Andersen RM. A behavioral model of families’ use of health services. Chicago: University of Chicago, Center for Health Administration Studies; 1968.

[7]  Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 1995; 36 1–10.
Revisiting the behavioral model and access to medical care: does it matter?Crossref | GoogleScholarGoogle Scholar | 7738325PubMed |

[8]  Andersen RM, Davidson PL. Improving access to care in America: individual and contextual indicators. In: Andersen RM, Rice TH, Kominski EF, editors. Changing the U.S. healthcare system: key issues in health services, policy, and management. San Francisco: Jossey-Bass; 2001. pp. 3–31.

[9]  Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc 1973; 51 95–124.
Societal and individual determinants of medical care utilization in the United States.Crossref | GoogleScholarGoogle Scholar | 4198894PubMed |

[10]  Babitsch B, Gohl D, Lengerke T. Re-visiting Andersen’s behavioural model of health services use: a systematic review of studies from 1998–2011. Psychosoc Med 2012; 9 Doc11
| 23133505PubMed |

[11]  Staiger T, Waldmann T, Rüsch N, Krumm S. Barriers and facilitators of help-seeking among unemployed persons with mental health problems: a qualitative study. BMC Health Serv Res 2017; 17 39
Barriers and facilitators of help-seeking among unemployed persons with mental health problems: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 28095844PubMed |

[12]  Best P, Manktelow R, Taylor BJ. Social work and social media: online help-seeking and the mental well-being of adolescent males. Br J Soc Work 2016; 46 257–76.
Social work and social media: online help-seeking and the mental well-being of adolescent males.Crossref | GoogleScholarGoogle Scholar |

[13]  Apolinário-Hagen J, Kemper J, Stürmer C. Public acceptability of e-mental health treatment services for psychological problems: a scoping review. JMIR Ment Health 2017; 4 e10
Public acceptability of e-mental health treatment services for psychological problems: a scoping review.Crossref | GoogleScholarGoogle Scholar | 28373153PubMed |

[14]  Judd F, Jackson H, Komiti A, Murray G, Fraser C, Grieve A, Gomez R. Help-seeking by rural residents for mental health problems: the importance of agrarian values. Aust N Z J Psychiatry 2006; 40 769–76.
Help-seeking by rural residents for mental health problems: the importance of agrarian values.Crossref | GoogleScholarGoogle Scholar | 16911752PubMed |

[15]  Stone L, Waldron R. Great expectations and e-mental health: the role of literacy in mediating access to mental healthcare. AJGP 2019; 48 474–9.
Great expectations and e-mental health: the role of literacy in mediating access to mental healthcare.Crossref | GoogleScholarGoogle Scholar | 31256506PubMed |

[16]  Andersson LM, Moore CD, Hensing G, Krantz G, Staland-Nyman C. General self-efficacy and its relationship to self-reported mental illness and barriers to care: a general population study. Community Ment Health J 2014; 50 721–8.
General self-efficacy and its relationship to self-reported mental illness and barriers to care: a general population study.Crossref | GoogleScholarGoogle Scholar | 24676869PubMed |

[17]  Sheffield JK, Fiorenza E, Sofronoff K. Adolescents’ willingness to seek psychological help: promoting and preventing factors. J Youth Adolesc 2004; 33 495–507.
Adolescents’ willingness to seek psychological help: promoting and preventing factors.Crossref | GoogleScholarGoogle Scholar |

[18]  Sawyer MG, Borojevic N, Ettridge KA, Spence SH, Sheffield J, Lynch J. Do help-seeking intentions during early adolescence vary for adolescents experiencing different levels of depressive symptoms? J Adolesc Health 2012; 50 236–42.
Do help-seeking intentions during early adolescence vary for adolescents experiencing different levels of depressive symptoms?Crossref | GoogleScholarGoogle Scholar | 22325128PubMed |

[19]  Li W, Dorstyn DS, Denson LA. Psychosocial correlates of college students’ help-seeking intention: a meta-analysis. Prof Psychol Res Pr 2014; 45 163–70.
Psychosocial correlates of college students’ help-seeking intention: a meta-analysis.Crossref | GoogleScholarGoogle Scholar |

[20]  Kauer SD, Mangan C, Sanci L. Do online mental health services improve help-seeking for young people? A systematic review. J Med Internet Res 2014; 16 e66
Do online mental health services improve help-seeking for young people? A systematic review.Crossref | GoogleScholarGoogle Scholar | 24594922PubMed |

[21]  Rickwood DJ, Braithwaite VA. Social–psychological factors affecting seeking help for emotional problems. Soc Sci Med 1994; 39 563–72.
Social–psychological factors affecting seeking help for emotional problems.Crossref | GoogleScholarGoogle Scholar | 7973856PubMed |

[22]  Kolakowsky-Hayner SA, Kreutzer JS, Miner KD. Validation of the Service Obstacles Scale for the traumatic brain injury population. NeuroRehabilitation 2000; 14 151–8.
| 11455077PubMed |

[23]  Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol 1979; 109 186–204.
Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents.Crossref | GoogleScholarGoogle Scholar | 425958PubMed |

[24]  Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: Johnston M, Wright S, Weinman J, editors. Measures in health psychology: a user’s portfolio. Windsor, UK: NFER-Nelson; 1995. pp. 35–37.

[25]  Lovibond SH, Lovibond PF. Manual for the Depression, Anxiety and Stress Scales. 2nd edn. Sydney: Psychology Foundations; 2005.

[26]  Rosenberg S, Redmond C, Boyer P, Gleeson P, Russell P. Culture clash? Recovery in mental health under Australia’s National Disability Insurance Scheme – a case study. Public Health Res Pract 2019; 29 e29011902
Culture clash? Recovery in mental health under Australia’s National Disability Insurance Scheme – a case study.Crossref | GoogleScholarGoogle Scholar | 31800650PubMed |

[27]  Mental Health Victoria. Saving lives. Saving money. The case for better investment in Victorian mental health. 2019. Available at: https://www.mhvic.org.au/images/PDF/Policy/FINAL__Saving_Lives_Money_Brochure_HR.pdf [verified 16 July 2019].

[28]  Parliament of Australia. Provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition. Canberra: Commonwealth of Australia; 2017. Available at: www.aph.gov.au/Parliamentary_Business/Committees/Joint/National_Disability_Insurance_Scheme/MentalHealth/Report [verified 16 July 2019].

[29]  Burns J, Hickie I, Christensen H. Strategies for adopting and strengthening e-mental health. A review of the evidence. Mental Health Commission of New South Wales; 2014. Available at: https://nswmentalhealthcommission.com.au/sites/default/files/assets/File/Report%20-%20The%20Sax%20Institute%20E-Mental%20Health%20Evidence%20Review%20cover%20page.pdf [verified 16 July 2019].

[30]  Rickwood DJ, Deane FP, Wilson CJ. When and how do young people seek professional help for mental health problems? Med J Aust 2007; 187 S35–9.
When and how do young people seek professional help for mental health problems?Crossref | GoogleScholarGoogle Scholar | 17908023PubMed |

[31]  Burns JM, Davenport TA, Durkin LA, Luscombe GM, Hickie IB. The Internet as a setting for mental health service utilisation by young people. Med J Aust 2010; 192 S22–6.
The Internet as a setting for mental health service utilisation by young people.Crossref | GoogleScholarGoogle Scholar | 20528703PubMed |

[32]  Best P, Gil-Rodriguez E, Manktelow R, Taylor BJ. Seeking help from everyone and no-one: conceptualising the online help-seeking process among adolescent males. Qual Health Res 2016; 26 1067–77.
Seeking help from everyone and no-one: conceptualising the online help-seeking process among adolescent males.Crossref | GoogleScholarGoogle Scholar | 27179020PubMed |

[33]  Seabrook EM, Kern ML, Rickard NS. Social networking sites, depression, and anxiety: a systematic review. JMIR Ment Health 2016; 3 e50
Social networking sites, depression, and anxiety: a systematic review.Crossref | GoogleScholarGoogle Scholar | 27881357PubMed |

[34]  Younes N, Chollet A, Menard E, Melchior M. E-mental health care among young adults and help-seeking behaviors: a transversal study in a community sample. J Med Internet Res 2015; 17 e123
E-mental health care among young adults and help-seeking behaviors: a transversal study in a community sample.Crossref | GoogleScholarGoogle Scholar | 25979680PubMed |

[35]  Sykes DH, Arveiler D, Salters CP, Ferrieres J, McCrum E, Amouyel P, Bingham A, Montaye M, Ruidavets JB, Haas B, Ducimetiere P, Evans AE. Psychosocial risk factors for heart disease in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME). Int J Epidemiol 2002; 31 1227–34.
Psychosocial risk factors for heart disease in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME).Crossref | GoogleScholarGoogle Scholar |

[36]  Rueger SY, Malecki CK, Pyun Y, Aycock C, Coyle S. A meta-analytic review of the association between perceived social support and depression in childhood and adolescence. Psychol Bull 2016; 142 1017–67.
A meta-analytic review of the association between perceived social support and depression in childhood and adolescence.Crossref | GoogleScholarGoogle Scholar | 27504934PubMed |

[37]  Ren P, Qin X, Zhang Y, Zhang R. Is social support a cause or consequence of depression? A longitudinal study of adolescents. Front Psychol 2018; 9 1634
Is social support a cause or consequence of depression? A longitudinal study of adolescents.Crossref | GoogleScholarGoogle Scholar | 30233469PubMed |

[38]  Zhang B, Yan X, Zhao F, Yuan F. The relationship between perceived stress and adolescent depression: the roles of social support and gender. Soc Indic Res 2015; 123 501–18.
The relationship between perceived stress and adolescent depression: the roles of social support and gender.Crossref | GoogleScholarGoogle Scholar |

[39]  Robards F, Kang M, Usherwood T, Sanci L. How marginalized young people access, engage with, and navigate health-care systems in the digital age: Systematic review. J Adolesc Health 2018; 62 365–81.
How marginalized young people access, engage with, and navigate health-care systems in the digital age: Systematic review.Crossref | GoogleScholarGoogle Scholar | 29429819PubMed |