Do children and young adults using a 24/7 messenger-based psychosocial chat counselling service benefit in terms of seeking further help? (Preprint)

BACKGROUND Mental crises have high prevalences in adolescence. Early interventions seem highly important to diminish the risk of deterioration, recurrence, or chronification of symptoms. In recent years, various providers started offering live chat support in psychological crises. krisenchat too aims to support young people in crises and, if necessary, give a recommendation for a referral to the health care system or to seek further help from a trusted adult person. OBJECTIVE This study investigated the impact of using krisenchat’s counselling on the further help-seeking behavior of young people, and to identify associated factors of further help-seeking. METHODS This longitudinal study analyzed anonymous data of N = 247 individuals using krisenchat between October 2021 and March 2022 who received a recommendation for further help-seeking. An online survey directly after the chat assessed the perceived helpfulness of the chat and well-being after the chat. After four weeks, further help-seeking, facilitators and barriers to help-seeking, and self-efficacy were assessed in an online follow-up survey. RESULTS In total, n = 120 (48.6%) users indicated to have contacted the recommended service or person. Of these, n = 87 (72.5%) stated that they had already had an appointment (or a talk) with the respective service or person or that an appointment (or talk) was scheduled. Of the users following the recommendation for further help-seeking, the most frequent recommendations were to seek help from a psychotherapist or social psychiatric service (n = 38, 34.2%), a school psychologist or school social worker (n = 23, 20.7%), or from the user’s parents (n = 21, 18.9%). The most frequently reported facilitators for further help-seeking were mental health literacy (n = 54, 45.0%), improvement of self-efficacy (n = 55, 45.8%), and symptom recognition (n = 40, 33.3%). In users not displaying further help-seeking behavior, the most frequent barriers included stigmatization (n = 60, 47.2%), lack of mental health literacy (n = 59, 46.5%), need for self-reliance and autonomy (n = 53, 41.7%), and negative family beliefs regarding help services (n = 53, 41.7%). Subgroup comparisons indicated significantly higher levels of self-efficacy in users displaying further help-seeking behavior than in those not displaying further help-seeking behavior. Both subgroups did not differ in gender, age, recommended service or person, chat topics, perceived helpfulness, and well-being. CONCLUSIONS This study implies that children and young adults receiving counselling at krisenchat benefit in terms of seeking further help. Further help-seeking seems to be associated with higher levels of self-efficacy. CLINICALTRIAL Drks00026671