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12 January 2021

There’s an app for that! So why isn’t everyone using it?


Investigating young people’s attitudes towards using digital mental health interventions


Kellie Mote 
Subject Specialist: Strategy (Accessibility), Jisc


Kellie Mote describes how undertaking research for an MSc in Children and Young People’s Mental Health and Psychological Practice with the University of Edinburgh presented an opportunity to examine why many young people may be reluctant to use digital mental health tools. Learn more about the project in this recent TechAbility Webinar.

Demand for mental health support already outstrips available provision. Adding a pandemic into the mix only ramps up the urgency to find cost effective, scalable methods to deliver mental health services, both to students and the wider population.

Technology is frequently seen as one answer, but in delivering support digitally it is important to recognise why some young people may be reluctant to use it to manage their mental health.

Digital mental health interventions such as mobile apps and web-based resources present the potential to provide support at scale, with additional opportunities for personalisation and capturing the impact of day-to-day experiences. And there is no shortage of tools - it is estimated there are more than 10,000 mobile apps alone that focus on mental health.

Research tells us that digital mental health interventions have a high abandonment rate, and that’s if people use them even once. Use of apps and web-based tools can be surprisingly low and the reasons for this are not fully understood.

As students are increasingly offered digitally mediated support, it is essential to investigate why many students will not engage with it.

Technology acceptance

Along with my supervisor and research teammates, I was curious to investigate whether the use of technology was itself influencing young people’s attitudes towards uptake.

Models of technology acceptance have been applied in a wide range of contexts, including assistive technology. These models aim to predict how likely it is that people will use a new device, software or system. So, as well as capturing the demographic and mental health profiles of study participants, we included questions related to technology acceptance.

Using a digital mental health intervention is a form of behaviour change, so we also added these elements to the mix, along with enquiring about feelings of trust, which has been shown to influence the extent to which an individual will engage with online systems.

Disentangling the web

Among our sample of 248 young people from across the UK, we found that having more of a mental health need did not influence young people’s intentions to use digital mental health interventions. This challenges an implicit assumption that if young people need mental health support, they will be motivated to use these tools.

The factors that appeared to most influence willingness to use digital mental health tools were much more aligned to factors like trust, beliefs about the expectations of others, and technology acceptance variables like perceived usefulness.

If these findings were found to hold true among the larger population, what might help HE providers and students make decisions about using digital mental health interventions? Some initial thoughts that come to mind:

  • Bear in mind that a mental health need alone may not be a sufficient motivator to use digital mental health tools.
  • If suggesting a digital intervention, check out with the young person how they feel about it - do they trust it, understand it, see it being useful to them?
  • Focus on the practical usefulness of the tool - what will it enable them to do, what are the typical outcomes?
  • How do you know it is a quality intervention? Is there an evidence base?
  • What alternatives are available? What is student feedback telling you about preferences?

What next?

As with any study, there are limitations. We did not differentiate between different types of digital provision. There is an ever-growing range of technologically mediated mental health support with enormous variation in quality and levels of embedded human support. It would be worth comparing perceptions of different types of intervention.

As more of these platforms and tools become available, it is essential to expand the evidence base and establish what a quality digital mental health intervention looks like.

QAA Scotland

What do you think of these initial findings? Do they chime with your experience? Do you have experience in this area that you would like to share? If so, please contact QAA Scotland.

If you found this blog useful, you might also be interested in the work of the Student Mental Wellbeing Collaborative Cluster and the new Enhancement Theme, Resilient Learning Communities, which focuses on meeting the changing needs and values of an increasingly diverse student community and a rapidly changing external environment.