JMIR Publications

ABSTRACT

Background:

New Zealand youth, especially those of Māori and Pacific descent, have high rates of depression, anxiety and self-harm, yet have low rates of help-seeking from mental health professionals. Digital tools can be effective, highly scalable treatments for anxiety and depression. Co-design processes are often used to foster engagement with end-users, but this does not always lead to high levels of engagement.

Objective:

We aimed to carry out preliminary scoping to understand adolescents’ current internet use and diversity of preferences in order to inform a planned co-design process for creating digital mental health tools for teenagers.

Methods:

Interactive workshops and focus groups were held with young people. Data were analyzed using a general inductive approach.

Results:

Participants (n=58) engaged in two whānau (extended family) focus groups (4, 5), two school or community-based focus groups (9, 9), and two workshops (11, 20). Three overarching themes were identified. Theme 1: This theme reflected respondents’ views that digital mental health tools are unlikely to be successful if they rely solely on youth help-seeking. Theme 2: A single approach is unlikely to appeal to all. Importantly, different groups and individuals had diverse, non-compatible preferences in terms of ‘look or feel’ of an app or digital tool. In particular some considered gamification important, while others considered this trivializing. Theme 3: Digital mental health tools should provide an immediate response to a range of different issues and challenges that a young person may face.

Conclusions:

There were diverse and often conflicting preferences in terms of look and style of an internet intervention, highlighting the need for targeted or segmented approaches. We have proposed a taxonomy of four user groups who differed by age and degree of current mental health need: ‘players / gamers’, ‘engagers’, ‘sceptics’ and ‘straight-talkers’. These groups: preferred gamified or fun approaches; were open to a range of approaches; were generally disinterested; or preferred direct-to-the-point, serious approaches, respectively. This study demonstrates the importance of scoping possible user needs to inform design processes.