Adolescent readiness for mobile mental health support in Soweto: A mixed-methods study

Poor mental health is a growing issue among adolescents, with untreated conditions persisting into adulthood and typically increasing in severity. South Africa's mental health legislation faces key barriers to implementation due to limited access to treatment and support, as well as persistent challenges related to stigma, privacy concerns and affordability. Mobile mental health (M-mHealth) could be a sustainable and scalable alternative for reducing unmet needs for psychological services. This study aims to explore adolescents' perceptions, attitudes and intentions regarding M-mHealth interventions. The study involved two phases and used an explanatory sequential mixed-methods approach. 71 adolescents completed the survey in phase 1, while 56 adolescents participated in 9 focus group discussions in phase 2. Qualitative and quantitative data were analysed using thematic and descriptive analyses, respectively. Findings from both phases were integrated using the pillar integration process. Findings show that adolescents have a limited understanding of the broader concept of mental health, and stigma persists through the use of terms like "crazy" and "bewitched." Adolescents view M-mHealth positively because of its low cost, convenience and privacy. However, issues like data costs, smartphone affordability, and limited privacy at home could hinder its use. M-mHealth extends beyond the health sector and is constrained by infrastructural and socio-cultural barriers, including privacy concerns, high data costs, and stigma.