What Are Young Adults Saying About Mental Health? An Analysis of Internet Blogs

Background Despite the high prevalence of mental health concerns, few young adults access treatment. While much research has focused on understanding the barriers to service access, few studies have explored unbiased accounts of the experiences of young adults with mental health concerns. It is through hearing these experiences and gaining an in-depth understanding of what is being said by young adults that improvements can be made to interventions focused on increasing access to care. Objective To move beyond past research by using an innovative qualitative research method of analyzing the blogs of young adults (18–25 years of age) with mental health concerns to understand their experiences. Methods We used an enhanced Internet search vehicle, DEVONagent, to extract Internet blogs using primary keywords related to mental health. Blogs (N = 8) were selected based on age of authors (18–25 years), gender, relevance to mental health, and recency of the entries. Blogs excerpts were analyzed using a combination of grounded theory and consensual qualitative research methods. Results Two core categories emerged from the qualitative analysis of the bloggers accounts: I am powerless (intrapersonal) and I am utterly alone (interpersonal). Overall, the young adult bloggers expressed significant feelings of powerlessness as a result of their mental health concerns and simultaneously felt a profound sense of loneliness, alienation, and lack of connection with others. Conclusions The present study suggests that one reason young adults do not seek care might be that they view the mental health system negatively and feel disconnected from these services. To decrease young adults’ sense of powerlessness and isolation, efforts should focus on creating and developing resources and services that allow young adults to feel connected and empowered. Through an understanding of the experiences of young adults with mental health problems, and their experiences of and attitudes toward receiving care, we provide some recommendations for improving receptivity and knowledge of mental health care services.

[1]  M. Murray,et al.  Passing notes: The use of therapeutic letter writing in counseling adolescents. , 2002 .

[2]  J. Pennebaker Writing About Emotional Experiences as a Therapeutic Process , 1997 .

[3]  Jodi M. Gonzalez,et al.  HOW DO ATTITUDES TOWARD MENTAL HEALTH TREATMENT VARY BY AGE, GENDER, AND ETHNICITY/RACE IN YOUNG ADULTS? , 2005 .

[4]  Vincent W. Hevern Threaded Identity in Cyberspace: Weblogs & Positioning in the Dialogical Self , 2004 .

[5]  R. Andersen Revisiting the behavioral model and access to medical care: does it matter? , 1995, Journal of health and social behavior.

[6]  L. Zoellner,et al.  Providing a treatment rationale for PTSD: does what we say matter? , 2009, Behaviour research and therapy.

[7]  J. Whitlock,et al.  The virtual cutting edge: the internet and adolescent self-injury. , 2006, Developmental psychology.

[8]  D. Goldberg ‘Emplotment’: Letter Writing with Troubled Adolescents and their Families , 2000 .

[9]  G. Eysenbach Infodemiology and Infoveillance: Framework for an Emerging Set of Public Health Informatics Methods to Analyze Search, Communication and Publication Behavior on the Internet , 2009, Journal of medical Internet research.

[10]  E S Buchholz,et al.  Adolescents' perceptions of aloneness and loneliness. , 1999, Adolescence.

[11]  Christian Köhler,et al.  What is the prevalence of health-related searches on the World Wide Web? Qualitative and quantitative analysis of search engine queries on the Internet , 2003, AMIA.

[12]  H. Wittchen,et al.  Prevalence of mental disorders and psychosocial impairments in adolescents and young adults , 1998, Psychological Medicine.

[13]  E. Gullone,et al.  The clinical significance of loneliness: a literature review. , 2006, Clinical psychology review.

[14]  D. Rennie,et al.  Grounded theory: A promising approach to conceptualization in psychology? , 1988 .

[15]  J. Mackenbach,et al.  Young adults face major barriers to seeking help from mental health services. , 2008, Patient education and counseling.

[16]  R. Rosenthal Experimenter effects in behavioral research , 1968 .

[17]  B. Glaser Theoretical Sensitivity: Advances in the Methodology of Grounded Theory , 1978 .

[18]  D. Meyer Online self-help: Developing a student-focused website for depression , 2007 .

[19]  Anthony F Jorm,et al.  Recognition of depression and psychosis by young Australians and their beliefs about treatment , 2005 .

[20]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[21]  P. Draper Reflexive methodology - new vistas for qualitative research: Media Reviews , 2008 .

[22]  P Bebbington,et al.  Unequal access and unmet need: neurotic disorders and the use of primary care services , 2000, Psychological Medicine.

[23]  M. Swartz,et al.  Medication preferences and adherence among individuals with severe mental illness and psychiatric advance directives. , 2010, Psychiatric services.

[24]  G. Eysenbach,et al.  Ethical issues in qualitative research on internet communities , 2001, BMJ : British Medical Journal.

[25]  D. Rickwood The effectiveness of seeking help for coping with personal problems in late adolescence , 1995 .

[26]  F. Deane,et al.  Can hopelessness and adolescents' beliefs and attitudes about seeking help account for help negation? , 2005, Journal of clinical psychology.

[27]  H. Christensen,et al.  Research on mental health literacy: what we know and what we still need to know. , 2006, The Australian and New Zealand journal of psychiatry.

[28]  D. Dozois,et al.  Gaps in accessing treatment for anxiety and depression: challenges for the delivery of care. , 2004, Clinical psychology review.

[29]  I. Hickie,et al.  Perspectives of young people on depression: awareness, experiences, attitudes and treatment preferences , 2007, Early intervention in psychiatry.

[30]  M. Fitzpatrick,et al.  Integrating writing into psychotherapy practice: A matrix of change processes and structural dimensions. , 2007, Psychotherapy.

[31]  M. Heo,et al.  Patients' depression treatment preferences and initiation, adherence, and outcome: a randomized primary care study. , 2009, Psychiatric services.

[32]  James R. Baker,et al.  Distress, Coping, and Blogging: Comparing New Myspace Users by Their Intention to Blog , 2008, Cyberpsychology Behav. Soc. Netw..

[33]  R. Kessler,et al.  Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. , 2002, The American journal of psychiatry.

[34]  K. Schonert-Reichl,et al.  Correlates of help-seeking in adolescence , 1996 .

[35]  Lee R. Smith,et al.  The social side of the internet , 2011 .

[36]  P. McGrath,et al.  Adolescents’ Attitudes and Opinions about Depression Treatment , 2010, Community Mental Health Journal.

[37]  B. Clarke Early Adolescents' Use of Social Networking Sites to Maintain Friendship and Explore Identity: Implications for Policy , 2009 .

[38]  F. Deane,et al.  The Medical Journal of Australia , 2007 .

[39]  C. Hill,et al.  A Guide to Conducting Consensual Qualitative Research , 1997 .

[40]  Anthony F Jorm,et al.  Awareness of Beyondblue: The National Depression Initiative in Australian Young People , 2007, Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists.

[41]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[42]  F. Deane,et al.  Young people’s help-seeking for mental health problems , 2005 .

[43]  Anthony F Jorm,et al.  Influences on young people's stigmatising attitudes towards peers with mental disorders: National survey of young Australians and their parents , 2008, British Journal of Psychiatry.

[44]  Bonnie A. Nardi,et al.  Why we blog , 2004, CACM.

[45]  S. Danoff-Burg,et al.  Health Effects of Expressive Letter Writing. , 2006 .

[46]  E. Guba,et al.  Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.* , 1985 .

[47]  Elizabeth D. Cox,et al.  Feeling bad on Facebook: depression disclosures by college students on a social networking site , 2011, Depression and anxiety.

[48]  Sarah Fortune,et al.  Understanding self-harm and suicide websites: a qualitative interview study of young adult website users. , 2008, Crisis.

[49]  C. Boyd,et al.  Australian rural adolescents' experiences of accessing psychological help for a mental health problem. , 2007, The Australian journal of rural health.

[50]  M. Conner,et al.  Efficacy of the Theory of Planned Behaviour: a meta-analytic review. , 2001, The British journal of social psychology.

[51]  J. Clarke,et al.  A Comparison of Blogs by Depressed Men and Women , 2008, Issues in mental health nursing.

[52]  Anthony F Jorm,et al.  Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy , 2006, BMC public health.

[53]  H. Westra,et al.  Mental Health Literacy in Canadian Young Adults: Results of a National Survey , 2012 .

[54]  U. Schmidt,et al.  Therapeutic writing as an intervention for symptoms of bulimia nervosa: effects and mechanism of change. , 2009, The International journal of eating disorders.

[55]  Charlotte Brownlow,et al.  Ethical Issues for Qualitative Research in On-line Communities , 2002 .

[56]  James R. Baker,et al.  Blogging as a Social Tool: A Psychosocial Examination of the Effects of Blogging , 2008, Cyberpsychology Behav. Soc. Netw..