Mental health and online activity – exploring training needs

Young people – aged 16-24 – are more likely to use digital technology to access work, health consultations, and social media. Online activity can be beneficial for mental health, but it can also be harmful and contribute to:

• disordered eating
• self-harm behaviours
• poor sleep quality
• isolation

Many people who develop depression or anxiety start experiencing symptoms by their mid-20s. Most will not become unwell enough to be referred to secondary care such as a hospital or specialist clinic. This means that primary care appointments with GPs, or therapists in talking therapy services, could provide an opportunity to discuss online activity and its impact on mental health with young people.

Such conversations could prevent young people from becoming unwell by increasing their awareness of where their online behaviour may be negative. They may also provide an opportunity to identify risk and suggest strategies for safer online behaviour. However, many GPs and therapists report a lack of confidence or knowledge in discussing this topic with this age group.

Project aims

During this project we aimed to:

• explore the views and experiences of discussing the impact of online activity on young people’s mental health with primary care therapists, GPs, wellbeing coaches and nurses
• identify practitioner training needs

What we did

We conducted semi-structured interviews with 24 mental health practitioners.

We recruited interviewees from 5 GP practices and 2 talking therapy services based in South West England.

What we found

We found that not all practitioners are routinely discussing online activity with young people and not all of them consider these conversations to be appropriate in a primary care setting. Even when conversations were happening, practitioners were unable to access guidance or training as neither currently exists.

According to practitioners, there were several factors influencing their attitudes towards conversations about online activity:

• Practitioners own understanding of the online world
• Practitioners feeling unable to change the impact of online activity on mental health
• Practitioners being unable to signpost young people to appropriate services
• Limited time
• Lack of confidence
• Lack of awareness

Practitioners had some insight into the complex relationship between the helpful and harmful aspects of the online world in relation to young people’s mental health. This included having an awareness of the sense of social inclusion that the online world can create, as well as the potentially more negative aspects, such as exposure to harmful content.

Practitioners highlighted that there is currently no existing guidance or training on how to discuss online activity with young people presenting with anxiety or depression in primary care. They said this would be needed to inform future conversations about online activity and that guidance should cover:

• Potential online harms
• What young people are exposed to when they engage with online content
• How to structure such conversations