Exploring the Nuances of Digital Mental Health: Insights from Youths’ Video Consultation Experiences
A recent qualitative study, “Digital mental health: locations and contexts in youths’ presentation of self in video consultations—a qualitative study,” offers in-depth insights into the experiences of young people (aged 16-23) receiving mental health therapy via video consultations (VC) during the COVID-19 pandemic. Published in BMC Digital Health, this research highlights the diverse and often complex ways digital tools impact therapeutic interactions and youths’ self-presentation.
Key Findings and Insights:
- VC vs. Face-to-Face (F2F) Therapy:
- While many youths found VC counselling resembled in-person encounters, significant differences emerged.
- A major challenge in VC was the difficulty in sharing deeper feelings and thoughts; some informants struggled to open up and felt less talkative or willing to express emotions compared to F2F sessions.
- Body language observation was significantly hampered in VC, with youths noting therapists could only see their faces and audible words, making it harder to interpret moods and emotions.
- Eye contact differed: While F2F allows for direct eye contact, some youths felt less pressure to maintain it in VC, which paradoxically made it easier for them to talk without feeling overly scrutinized.
- F2F communication is generally seen as more natural, reducing ambiguity and uncertainty, requiring less cognitive effort, and offering a richer exchange of nonverbal signals and cues.
- Impact of Physical Contexts:
- Therapy at Home:
- For some, being at home provided a comfortable, relaxed environment, increasing a sense of control and enabling them to speak more openly. The screen could act as a “shield,” reducing vulnerability.
- However, privacy concerns were a major issue for others, particularly those living with families, due to fears of being overheard in non-soundproof rooms.
- An advantage was avoiding public spaces after demanding sessions and the convenience of not having to dress formally or travel.
- Therapy at School:
- Most informants felt discomfort with VC at school due to privacy issues, such as teachers potentially entering the room or the uncertainty of being overheard.
- This lack of privacy could hinder their willingness to express sensitive topics.
- A significant challenge was the difficulty of transitioning from an emotional therapy session back to a classroom environment, unlike the buffer provided by travel time after a clinic visit.
- Some did appreciate the time saved by not having to travel to the clinic.
- Therapy at Home:
Theoretical Framework and Implications:
The study utilizes Goffman’s dramaturgical approach (frontstage and backstage) and Meyrowitz’s medium theory to analyze how physical and digital spaces influence self-presentation, interaction, and trust in therapy. It underscores that the interaction order in VC is disrupted, requiring youths to navigate a hybrid public/private space.
The findings emphasize the need to reorganize mental health services and develop blended and person-centered care models where the use of digital tools is discussed early in treatment to assess individual situations and contexts. VC can offer empowerment by providing choice and enhancing accessibility, especially for those with physical limitations or long travel distances.
This research, conducted through 33 qualitative interviews in northern Norway, provides a profound understanding of youths’ life-world experiences with VC. It serves as a crucial foundation for future research to develop robust, evidence-based, customized, safe, and accessible mental health services for young people in our increasingly digital world.
Reference for this article:
Gullslett, M. K., Larsen, F., & Nybakke, H. L. (2024). Digital mental health: locations and contexts in youths’ presentation of self in video consultations—a qualitative study. BMC Digital Health, 2(1), 83. https://doi.org/10.1186/s44247-024-00139-z
