Understanding the Differences Between Online and Offline Mental Health Help Seekers: Cross-Sectional Comparative...

Telepsychiatry has gained considerable attention, particularly during the COVID-19 pandemic. Although various factors influence the choice between online and offline modalities, differences among populations remain underexplored.

This study aims to compare adults seeking mental health support online and offline in private clinics.

In this cross-sectional study, we assessed differences in sociodemographic factors, internet accessibility and usability, previous help-seeking history, personality traits assessed using the Arabic Big Five Personality Inventory, and levels of self-stigma measured using the Self-Stigma of Seeking Help Scale.

In total, 259 participants were included (136 online and 123 offline). The online group had a higher proportion of university graduates (P=.02), employed individuals (P<.001), and those with better internet access (P=.03) and higher internet usability (P=.001). The offline group showed higher levels of conscientiousness (P=.003). The primary reasons for choosing online therapy were ease of access and time-saving. Logistic regression identified previous use of online psychiatry as the strongest factor associated with choosing online services (odds ratio [OR] 28.90, 95% CI 11.739-71.165; P<.001). Employment (OR 5.01, 95% CI 1.781-14.080; P=.002), better internet usability (OR 1.69, 95% CI 1.069-2.664; P=.03), and agreeableness (OR 1.16, 95% CI 1.001-1.351; P=.05) were also significant factors. In contrast, previous in-person visits (OR 0.11, 95% CI 0.048-0.269; P<.001), openness (OR 0.85, 95% CI 0.748-0.975; P=.02), and conscientiousness (OR 0.86, 95% CI 0.758-0.971; P=.02) were negatively associated with online preference.

This study highlights key differences between online and offline mental health help seekers, enhances our understanding of treatment modality preferences, and paves the way for future research.