Online youth mental health supports allow people to access information and communicate with others.
They fall into three categories:
These categories can overlap with some organisations providing support across a combination of these.
These provide accurate information on mental health issues.
Information of this kind can benefit young people who themselves are experiencing mental health difficulties, helping them better understand and manage what they’re experiencing. Psychoeducational resources can also be of use for people concerned about the mental health of others. They can also help educate the population generally and contribute to higher levels of mental health literacy.
The advantages of this type of support include the relative safety associated with accessing quality assured content. The main disadvantage relates to the reliability of the information provided.
Services should be clear on where, and by whom, their content has been created. As long as the content is from reliable and validated sources, information-based resources are relatively problem-free. They are useful for both people who work with young people and the young people they work with.
Many psychoeducational or information-based sites will also provide the opportunity for interaction, use social networking platforms and/or provide some further therapeutic intervention.
ReachOut.com is now well-established as an information-based online youth mental health resource in Ireland. Reachout.com which was launched in 2009, provides quality assured mental health information and inspiring real life stories by young people to help other young people get through tough times.
Reachout.com is run by the Inspire Ireland Foundation, which is a not for profit non-government registered charity.
Online support services based around person-to-person interaction can be delivered through dedicated websites covering specific issues or through more general social networking platforms.
A common way of delivering this type of service is through online forums, where users discuss and comment on issues of interest or concern. A key issue in the delivery of these services is the nature of moderation employed in providing the service, i.e. are comments checked before or after they are posted on the site?
An advantage of peer-to-peer interaction is a sense of community online. It also provides the opportunity to learn how others managed to deal with mental health problems.
However, peer-to-peer forums moderated after comments go live are open to abuse or inappropriate comments. This may have a distressing impact on other members of the community using the site. People are less inhibited when communicating online and in a perceived state of anonymity deep personal disclosures, including thoughts of suicide, are sometimes communicated.
On the other hand, forums that moderate before comments go live are less appealing to people because interaction does not take place in real time. To safely operate a healthy online community that discusses mental health issues in an open and unregulated way, considerable resources and clinical expertise are required. Care always needs to be used when signposting young people to this kind of internet site.
In Ireland, www.turn2me.org is an example of a website that provides peer-to-peer support through forums (it is moderated after comments are left).
Apart from dedicated mental health websites that operate forums, mental health is also discussed on general social networking platforms. These websites build online communities around common or general interests and the best known example is Facebook.
Mental health organisations can use social networking sites to build brand and service awareness. By joining or ‘liking’ a mental health organisation’s social network online, people can endorse and support the issue of mental health generally and support specific organisations.
Using social networking sites in this way is relatively safe. However, social networking sites also encourage discussion and this can include discussion of sensitive or potentially distressing issues.
When it comes to moderating, social networking sites often rely on community regulation of content and a system of reactive moderating, whereby the community effectively moderates and manages the tone and nature of content on any given page. This provides the opportunity for the development of communities within communities to form around sensitive issues, including suicide, and discuss them in deeply personal and open ways.
While there is little or no research into the overall effect of such a community, it is important that you never assume that interaction on Facebook or other social networking communities is safe, healthy and regulated as this may not be the case.
While the support service types outlined above may provide a therapeutic benefit, there are a range of supports that specifically target mental health problems, or seek to enhance aspects of a person’s mental health.
These supports fall under the general category of “online therapy”.
Online therapies can fall into one of the following four categories:
While there are a number of advantages associated with therapist-led interventions, including the relative anonymity and therefore reduced inhibition on the part of the young person using the service, the absence of non-verbal communication and cues is a major disadvantage.
For people at risk, this approach does not provide an immediate response.
Organisations must be careful in managing expectations of potential users. Anyone investigating online counselling services should aim to determine the accreditation status of those delivering the service to ensure that they are suitably qualified and adhere to appropriate standards.
An emerging area, based on multi-disciplinary research across the world, is the area of self-administered online therapy programmes and applications. There is a growing evidence base supporting the efficacy of these interventions in dealing with less severe mental health problems and some of these interventions can be accessed for free online.
Most are based on the principles of cognitive behavioural therapy. It should be underlined that these services are likely to benefit those with less severe problems.
Examples of this type of service include:
• Beating the Blues – an eight week online intervention for people aged 18+ which mild to moderate mental health problems (available under GP supervision in UK)
• MOODGym – online programme for young people designed to prevent depression. It consists of five modules with interactive games, information about anxiety and depression, relaxation audio and a workbook. The programme was developed in Australia but young people in Ireland can register and take part in it. https://moodgym.anu.edu.au/welcome
• Living Life to the Full access to Living Life to the Full is available for free through the Online Skills Programme on www.headsup.ie.
Moderation refers to the monitoring of communication online, particularly relevant to forum-based services and social networking platforms. There are three main approaches to moderating:
• Pre-moderation – any communication is checked before it is posted. This protects the wider online community from any inappropriate or unhealthy content. The can be unappealing to users who don’t get to see their content being posted instantly, as it would be on other sites.
• Post-moderation – content is reviewed after it has gone live on the site. A user can post content on the site and it will automatically be uploaded for anyone to see. The content is then reviewed from time-to-time by the organisation running the service. This creates a vibrant community in real-time but has the disadvantage of being open to inappropriate or harmful content appearing on a site.
• Reactive moderation – this depends on the community of users to ‘flag’ or ‘report’ content they consider to be inappropriate to the administrators. The site administrators can then review any reported content before deciding whether or not it should be removed. Sites like Facebook and YouTube operate on this basis.
All organisations that provide youth mental health support online should have a set of guidelines for staff and volunteers if they are contacted by a person in distress. While they might not publish details online, these guidelines should detail the basic steps required in putting someone in touch with emergency services.
If, as a parent you have any concerns about a particular service it is worth contacting the organisation to ensure that these guidelines are in place for staff and volunteers.