JMIR Publications

ABSTRACT

Background:

Background:

High rates of mental illness, stress, and suicidality among teens represent a major public health concern in the United States; however, rates of treatment remain low, partially due to barriers that could be mitigated with effective, evidence-based telemental health (TMH) resources.

Objective:

Objective:

TMH resource usage by high school students was analyzed to establish characteristics of current TMH users and provide a framework for future research and development.

Methods:

Methods:

2,789 students were educated about TMH resources during live assemblies and surveyed regarding anxiety, depression, suicidal ideation, stress, with whom they discuss problems, and prior TMH use. Statistical analysis was performed to establish relationships between variables, including demographic and mental health characteristics predicting TMH use.

Results:

Results:

30.58% and 22.9% of the sample reported moderate to severe anxiety and depression symptoms, respectively, in the past two weeks, and 16.24% had considered suicide in the past year, consistent with national averages. Nearly 20% reported discussing problems with “no one” in their lives; 16% had previously used a TMH resource. Those who had considered suicide were less likely to talk to a parent (p < .001) and more likely to talk to “no one” (p < 0.10) and to have used all types of TMH: self-help (p < .01), anonymous chat (p < .05), online counselor (p < .01) and the crisis text line (p < .001). Those experiencing depressive symptoms were less likely to talk to a parent (p < .001) or friend (p < 0.05) and more likely to talk to “no one” (p < 0.001) and to have used anonymous online chat and the crisis text line (p < 0.001). Those with high stress were less likely to talk to a parent (p < 0.01), more likely to talk to “no one” (p < 0.05), and more likely to have used an online counselor (p < 0.05). Those reporting anxiety symptoms were less likely to talk to “no one” (p < 0.05) and more likely to have used a self-help resource (p < 0.001).

Conclusions:

Conclusion: Youth struggling with mental health symptoms and lacking “real life” confidants are using existing TMH support--teens reporting depression, suicidal thoughts, and stress were more likely to have used resources that involve communicating via chat or video, and teens with anxiety were more likely to have used self-help apps and websites. Future research should consider these differences in symptom-related resource usage and assist the creation of specialized, evidence-based TMH resources.