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      Peer Communication in Online Mental Health Forums for Young People: Directional and Nondirectional Support

      research-article
      , PhD 1 , , , PhD 2 , , BSc (Hons) 1
      (Reviewer), (Reviewer), (Reviewer)
      JMIR Mental Health
      JMIR Publications
      adolescence, Internet, social media, mental health, qualitative research

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          Abstract

          Background

          The Internet has the potential to help young people by reducing the stigma associated with mental health and enabling young people to access services and professionals which they may not otherwise access. Online support can empower young people, help them develop new online friendships, share personal experiences, communicate with others who understand, provide information and emotional support, and most importantly help them feel less alone and normalize their experiences in the world.

          Objective

          The aim of the research was to gain an understanding of how young people use an online forum for emotional and mental health issues. Specifically, the project examined what young people discuss and how they seek support on the forum (objective 1). Furthermore, it looked at how the young service users responded to posts to gain an understanding of how young people provided each other with peer-to-peer support (objective 2).

          Methods

          Kooth is an online counseling service for young people aged 11-25 years and experiencing emotional and mental health problems. It is based in the United Kingdom and provides support that is anonymous, confidential, and free at the point of delivery. Kooth provided the researchers with all the online forum posts between a 2-year period, which resulted in a dataset of 622 initial posts and 3657 initial posts with responses. Thematic analysis was employed to elicit key themes from the dataset.

          Results

          The findings support the literature that online forums provide young people with both informational and emotional support around a wide array of topics. The findings from this large dataset also reveal that this informational or emotional support can be viewed as directive or nondirective. The nondirective approach refers to when young people provide others with support by sharing their own experiences. These posts do not include explicit advice to act in a particular way, but the sharing process is hoped to be of use to the poster. The directive approach, in contrast, involves individuals making an explicit suggestion of what they believe the poster should do.

          Conclusions

          This study adds to the research exploring what young people discuss within online forums and provides insights into how these communications take place. Furthermore, it highlights the challenge that organizations may encounter in mediating support that is multidimensional in nature (informational-emotional, directive-nondirective).

          Related collections

          Most cited references25

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          Mental health of young people: a global public-health challenge.

          Mental disorders account for a large proportion of the disease burden in young people in all societies. Most mental disorders begin during youth (12-24 years of age), although they are often first detected later in life. Poor mental health is strongly related to other health and development concerns in young people, notably lower educational achievements, substance abuse, violence, and poor reproductive and sexual health. The effectiveness of some interventions for some mental disorders in this age-group have been established, although more research is urgently needed to improve the range of affordable and feasible interventions, since most mental-health needs in young people are unmet, even in high-income countries. Key challenges to addressing mental-health needs include the shortage of mental-health professionals, the fairly low capacity and motivation of non-specialist health workers to provide quality mental-health services to young people, and the stigma associated with mental disorder. We propose a population-based, youth focused model, explicitly integrating mental health with other youth health and welfare expertise. Addressing young people's mental-health needs is crucial if they are to fulfil their potential and contribute fully to the development of their communities.
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            Social support in a wired world: use of online mental health forums in Norway.

            This study explored the use of the four major Norwegian mental-health-related online discussion forums; who participate, why, and what implications use may have. The objective was to provide a basis for proposing relevant research questions and issues for public policy attention. A total of 492 responses to a web-based questionnaire were received. The respondents, predominantly women (78%) in the age range 18--35 years, found forum participation useful for information, and social contact and support. A majority (75%) found it easier to discuss personal problems online than face-to-face, and almost half say they discuss problems online that they do not discuss face-to-face. A majority would not have participated had they not had the option of using a pseudonym. Respondents perceive discussion groups as a supplement rather than a replacement of traditional mental health services, reporting no change in the amount or type of service used. A clear majority want professionals to take an active role in these types of forum. Comments from respondents indicate that forums may have an empowering effect. We believe that online interaction can have unique benefits for people suffering from mental disorders. Professionals will need new knowledge and perceptions of their roles, and public authorities will have to decide their role in influencing the quality of services offered, and the social values conveyed, to those who seek help through the Internet.
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              An evaluation of an online peer support forum for university students with depressive symptoms.

              Depression is the most common mental health problem among young people, particularly university students, with prevalence rates as high as 48% reported. This population however, is reluctant to seek professional help. Online interventions may be particularly appealing to students, with evidence suggesting that they use the Internet for mental health support. While there are many mental health resources on the Internet few focus specifically on the needs of young people and few have been evaluated. This research aimed to develop and pilot test an online peer support intervention for students experiencing depressive symptoms.
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                Author and article information

                Contributors
                Journal
                JMIR Ment Health
                JMIR Ment Health
                JMH
                JMIR Mental Health
                JMIR Publications (Toronto, Canada )
                2368-7959
                Jul-Sep 2017
                02 August 2017
                : 4
                : 3
                : e29
                Affiliations
                [1] 1 School of Education and Psychology University of Bolton Bolton United Kingdom
                [2] 2 School of Environment, Education and Development University of Manchester Manchester United Kingdom
                Author notes
                Corresponding Author: Julie Prescott j.prescott@ 123456bolton.ac.uk
                Author information
                http://orcid.org/0000-0001-8612-2495
                http://orcid.org/0000-0001-5861-9170
                http://orcid.org/0000-0002-1396-9588
                Article
                v4i3e29
                10.2196/mental.6921
                5559647
                28768607
                83044327-0497-4679-bedf-c7e91d1a63ed
                ©Julie Prescott, Terry Hanley, Katalin Ujhelyi. Originally published in JMIR Mental Health (http://mental.jmir.org), 02.08.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

                History
                : 30 October 2016
                : 28 January 2017
                : 5 April 2017
                : 2 June 2017
                Categories
                Original Paper
                Original Paper

                adolescence,internet,social media, mental health,qualitative research

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