JMIR Publications

ABSTRACT

Background:

Digital mental health interventions present a unique opportunity to address a lack of social connection and loneliness experienced by young people with First Episode Psychosis (FEP). The first generation of digital interventions, however, are associated with high attrition rates. Social media presents an opportunity to target this issue. A new generation of digital intervention has harnessed the popularity of social media to both promote engagement and foster social connectedness in youth mental health interventions. Despite their potential, little is known about how young people engage and experience social media-based interventions, as well as the optimal design, implementation, and management needed to ensure young people with psychosis receive benefit.

Objective:

This study aims to explore how young people engage with, and experience, a long-term social media-based intervention designed to address social functioning in FEP.

Methods:

This qualitative study was based on 12 interviews with young people who used a long-term social media-based intervention as part of a previous randomized controlled trial. A semi-structured phenomenological interview guide with open-ended questions was used in order to explore young people’s subjective experience of the intervention. All interviews were recorded and transcribed verbatim. Data were analysed according to interpretative phenomenological analysis (IPA).

Results:

Four super‐ordinate themes emerged during analysis including (i) shared experience as the catalyst for a co-created social space, (ii) the power of peer support, (iii) experiences that interrupt ‘being in’ Horyzons, and (iv) unknown social protocol.

Conclusions:

We found that the Horyzon’s therapeutic social network fostered connection and understanding between young people. It also aided in the creation of an embodied experience that afforded young people with FEP a sense of self-recognition and belonging over the longer-term. However, while we did find that most young people had strong positive experiences of social connection on Horyzons, we also found that they experienced significant barriers that could substantively interrupt their ability to use the platform. We found that social anxiety, paranoia, internalized stigma, lack of autonomy, and social protocol confusion interfered with young people’s usage of the platform. From a design perspective, digital interventions are flexible and thus equipped to begin addressing these implications by providing customizable and personalized treatment options that account for varying levels of social connection and psychological need that could otherwise interrupt young people’s usage of social media-based intervention.