Use of Online Tools for Mental Health Among Racially and Ethnically Diverse College Students: Mixed Methods Study

Anxiety and depression symptoms have been rising among college students, with many increasingly meeting the criteria for 1 or more mental health problems. Due to a rise in internet access and lockdown restrictions associated with the COVID-19 pandemic, online mediums, such as teletherapy, repositories for mental health information, discussion forums, self-help programs, and online screening tools, have become more popular and used by college students to support their mental health. However, there is limited information about individual-level factors that lead college students to use these online tools to support their mental health.

This mixed methods study aimed to examine the associations between demographics, symptom severity, mental health literacy, stigma, attitudes, and self-efficacy and the use of online tools to seek psychological information and services among racially and ethnically diverse college students. This study also aimed to qualitatively characterize types of online tools used, reasons for using tools or lack thereof, and perceived helpfulness of tools.

Undergraduate students (N=123) completed validated measures and provided open-ended descriptions of the types of online tools they used to seek psychological information and services and their reasons for using those tools. Logistic regression analyses were used to test associations of online tool use to seek mental health information and hypothesized predictors. Descriptive statistics were conducted to examine online tool types, reasons for using online tools, and helpfulness explanations.

In total, 49.6% (61/123) of the participants used online tools (eg, search engines) to seek mental health information, while 30.1% (37/123) used online tools (eg, medical websites) to seek mental health services. Mental health literacy (P=.002; odds ratio 1.14, 95% CI 1.05-1.24) was associated with greater use of online tools to seek mental health information. None of the hypothesized variables predicted online tool use to seek mental health services. In total, 82% (50/61) of participants who sought information found online tools somewhat helpful, while 49% (18/37) of participants who sought services found online tools very helpful. Of the students who did not use online tools to seek information, 19% (12/62) reported it was because they did not know which online tools to use and 31% (19/62) stated they would be encouraged to use online tools if it was recommended by professionals, therapists, family, or friends. Of the students who did not use online tools to seek services, 33% (28/86) reported it was because they did not think mental health help was necessary.

These findings highlight the use of online tools to provide mental health information and connect to professional services, suggesting that online tools are widely used to access mental health support.