ABSTRACT
BACKGROUND: Digital mental health interventions comprise a potentially effective and accessible form of support for young people, particularly at times when traditional face-to-face service delivery is reduced, as in the COVID-19 pandemic. AIMS: This study assessed the demographic profile of young people using a digital mental health support service and evaluated outcome change over the course of a structured online counselling intervention (synchronous text-chat sessions with a practitioner). MATERIALS AND METHODS: The data were collected from 23,260 young people aged between 10 and 25 years engaging with the intervention between April 2019 and June 2021. RESULTS: Young people accessing these services had high levels of mental health needs, particularly those identifying with non-binary gender identity. Service users were mostly female, with equitable rates of access for young people from racialised communities. Overall outcome change demonstrated small effect sizes according to the YP-CORE (0.19) and CORE-10 (0.38), which increased to a moderate level when young people remained engaged with a dedicated practitioner for at least seven sessions (0.38, 0.58). Regression analysis illustrated the effect of the number of sessions on outcome change, but this can be also influenced by other variables such as age and gender. DISCUSSION AND CONCLUSION: Further research is required to explore ways to engage with young people using digital web-based services for a longer period and to collect and analyse single-session outcome data.
ABSTRACT
Background Public use of digital mental health technologies has informed several studies focusing on patterns of engagement within user-led digital support systems. General engagement with these services has increased since the start of the COVID-19 pandemic. However, to the best of our knowledge, this is the first study to explore how user engagement patterns with these platforms changed during the pandemic. Methods In this cohort study, we included individuals aged 14–25 years who signed up to the online mental health platform Kooth in the UK before the pandemic (May 1, 2019 to March 10, 2020) and during the pandemic (March 11, 2020 to Oct 31, 2021). Routinely collected usage data were assessed for consenting users who returned to Kooth at least once after sign-up. We used logistic regression to compare service component usage and overall engagement across cohorts. Findings 5048 individuals (mean sign-ups per day 9·0 [12·0]) were included in the pre-pandemic cohort and 13 841 (mean sign-ups per day 11·5 [13·9]) in the pandemic cohort, representing a significant increase in sign-ups per day during the pandemic compared with the pre-pandemic period (Welch's t-test p=0·0001). Compared with users pre-pandemic, users during the pandemic were less likely to have a drop-in chat with a practitioner (odds ratio [OR] 0·50 [95% CI 0·47–0·54], p<0·0001) but were more likely to journal (1·92 [1·77–2·07], p<0·0001) and comment on existing content (1·10 [1·03–1·18], p=0·008). Users who signed up to Kooth during the pandemic and requested a chat with a practitioner (7816 [56·5%] of 13 841 users) were also less likely to receive a chat than users who requested a chat pre-pandemic (3791 [75·1%] of 5048 users;OR 0·68 [0·63–0·74], p<0·0001). Interpretation During the COVID-19 pandemic, people with the ability and resources to access digital mental health support were diverted from face-to-face services to digital mental health services. This change might have resulted in an unmet need for drop-in practitioner chats, with users probably resorting to asynchronous support through community interaction or journaling. Funding Kooth Digital Health.