Digital natives favour in-person mental health support over virtual bots

A young generation of digital natives show a clear preference for receiving in-person mental health support rather than getting help virtually, new research led by the University of Otago, Wellington, has found.

The researchers asked almost 1,500 people between 15 and 30 years of age for their views on digital mental health support via an online survey in 2022. The study was done in partnership with a group of youth co-researchers.

One of the academic researchers, Sue Garrett, from the Department of Primary Health Care and General Practice, says technologies to provide virtual mental health support, such as computerised therapies, apps, websites and telehealth services, are increasingly suggested as a way of reducing the burden of mental distress in a cost-effective and accessible way, particularly for young people.

Sue Garrett

“However, the young people we surveyed had a strong preference for in-person mental health support. They also emphasised the importance of trustworthy, high-quality, tailored support and messaging, whether it was delivered in person, or online.”

The rates of mental distress among young people have increased rapidly in recent years, both globally and in Aotearoa. The New Zealand Health Survey for 2021/2022 showed that almost one in four (23.6 per cent) young people aged 15-24 experienced high or very high levels of psychological distress, compared to 5.1 per cent 10 years earlier.

Almost half of the young people surveyed (44 per cent) had looked for mental health support online. Websites were the most commonly used digital medium, with 58 per cent of users finding them helpful.

A small group reported using other digital forms of support - engaging in performing arts online, such as skits or songs, or having video consultations with counsellors or therapists. Both were rated highly, with 91 per cent saying watching performing arts online was helpful and 84 per cent saying a video consultation was helpful.

“In contrast, although more people had talked to a ChatBOT, or used text counselling or self-help apps, they were perceived as less helpful. ChatBOTs were regarded as least helpful.

“One participant specified the lack of connection as one reason for his dislike of ChatBOTs, noting ‘Being online, speaking to AI just doesn’t feel real, it’s hard to gain connection’.”

Online games designed to provide mental health support, such as the New Zealand-developed SPARX game, rated in the middle of the pack in terms of popularity. One young woman observed, ‘Games such as SPARX can be really helpful to redirect your attention when you’re struggling’.

Participants were also asked if there were other forms of digital support they had not yet tried, but would like to. Of the options, listening to podcasts was the most popular, followed by phone consultations with a counsellor or therapist. Talking to a ChatBOT and watching or listening to performing arts online were the least preferred.

Sue Garrett says young people listed privacy concerns, technical issues, lack of quality and the need to be self-motivated as the drawbacks of using online support, while the benefits included ease of access, anonymity and a non-threatening starting point.

“Respondents thought digital resources did have a place in mental health support, but more as an adjunct, or to complement in-person support. For example, they thought going online could be a good option for people beginning their search for mental health support, or to help them figure out what kind of support would suit them. They emphasised though that the actual support should be provided by a ‘real person’.”

Sue Garrett says making a connection with real people was of greater importance than games or other online activities to the young people surveyed.

“Our findings show digital mental health supports for youth are never ‘one-size-fits-all’ and it should not be assumed that digital support or digital modes of publicising support will be universally effective for a generation of digital natives.

“Digital mental health support works best for young people when it is tailored to them. Our respondents wanted to see something relatable that would make them think, ‘oh, that’s me’.”

She says ensuring young people are involved in the design of digital support services would help make online platforms more relevant to them.