Health Needs for Suicide Prevention and Acceptance of E-Mental Health Interventions in Adolescents and Young Adults: A Qualitative Study (Preprint)

Abstract

Adolescence is a phase of higher vulnerability for suicidal behavior. In Germany, almost 500 adolescents and young adults aged 15 to 25 years commit suicide each year. Youth in rural areas are characterized by a higher likelihood of poorer mental health. In rural areas, appropriate support for adolescents in mental health crises is difficult to access. The general acceptability of digital communication in youth can make the provision of an E-Health tool a promising strategy.

The aim of this study is to explore the health needs regarding suicide prevention for adolescents and young adults in rural areas of Germany and Switzerland and to identify characteristics of suitable E-mental health interventions.

This study reports on a qualitative secondary analysis (QSA) of archived data, which had been collected through formative participatory research. Using 32 semi-structured interviews (individually, groups of two) with n=13 adolescents and young adults (18-25 years of age) and with n=23 experts from relevant fields, we applied a deductive-inductive methodological approach and we used qualitative content analyses according to Kuckartz (2016).

Experts as well as adolescents have reported health needs in digital suicide prevention. Those health needs for rural adolescents in crises were characterized by several categories: First, the need for suicide prevention in general was highlighted. Additionally the need for a peer concept and need for online suicide prevention were stressed. The factors influencing the acceptability of a peer-driven, web-based support were related to a low-threshold access, a lifelike intervention, anonymity and trustworthiness.

The results suggest a need for suicide prevention services for adolescents in this rural setting. Peer-driven and web-based suicide prevention services for adolescents and young adults may add an important element of support during crises in this age group. These services should be developed with participation of the target group, taking anonymity, trustworthiness and low-threshold access into account.