Knowing How to Ask About Digital Culture in Youth Mental Health Care: A Co-Designed Tool

With the digital cultures that youth are exposed to and participating in come potential risks and protective factors for their mental health. However, despite clear need there is a lack of guidance to help mental health professionals evaluate the role of social media, artificial intelligence, and other technologies in young people's mental health.

To co-design with young people the Digital Culture Interview, an interview tool to support the clinical assessment of digital cultural factors in mental health care.

We recruited a diverse group of 12 participants aged 16-35 years (mean age 22 years) from outpatient mental health clinics in Montreal, Canada. Using the nominal group technique, they identified topics they found most relevant for exploring in a clinical assessment the experiences and practices involving digital technologies. Based on the topics that received the most votes from participants, we co-developed a list of interview questions and written guidance for their administration.

Participants identified and ranked 48 themes. Drawing from these, 14 questions were developed for inclusion in the Digital Culture Interview, covering four topics: identity and worldview, negative experiences online, coping, and understanding of mental health. Participants emphasised that exploring digital culture in mental health care requires patients' trust and a baseline of knowledge. If done sensitively, this may enhance the patient-clinician alliance and improve mutual understanding.

The Digital Culture Interview has the potential to enhance rapport and reveal risk and protective factors that are salient to and actionable in mental health care.