Factors Influencing Participation In Online Mental Health Communities and Digital Tools Among Emerging Adults In Two Indian States

Background: India has the World’s largest youth population (~248 million) and among the highest rates of youth suicide globally (Gupta & Basera, 2021). A recent report, State of the World’s Children, found that 1 in 7 young Indians often feel depressed or lack interest in doing things (Keeley, 2021). Despite the scale of the issue, barriers such as stigma, lack of awareness, and limited access to mental health services continue to hinder formal help seeking. As a result, many emerging adults turn to online mental health communities (e.g., forums, social media groups) for support. While these platforms are easy to access and offer a sense of anonymity, they expose users to misinformation or negative reinforcement, which can further impact mental health outcomes. Additionally, digital mental health tools are being promoted as a scalable alternative to traditional care; however, little is known about how Indian emerging adults perceive these resources or the challenges they face in using them. Thus, this study examined perceptions (trust, effectiveness, convenience, and safety) and barriers that influence the use of online mental health communities and digital mental health tools among emerging adults.

Methods: A cross-sectional online survey (N = 547) assessed participation, perceptions, and barriers related to online communities and digital tools among emerging adults. After excluding incomplete responses, the analytic sample included 506 participants. Composite indices were developed for perceptions and barriers, where a higher score suggested greater usefulness and presence of barriers. The Online Community Perception Index (OCPI; α=.91) and Digital Tool Perception Index (DTPI; α=.89) assessed perceived helpfulness, trust, and effectiveness, while the Online Community Barriers Index (OCBI; α=.90) and Digital Tool Barriers Index (DTBI; α=.91) assessed concerns such as privacy, cost, and accessibility. Logistic regression analyses examined predictors of participation and use.

Results: Participation in online mental health communities was significantly predicted by both perceptions and barriers. Higher OCPI scores were associated with increased odds of participation (OR=2.66, p<.001), whereas higher OCBI scores were associated with 78% lower odds of participation in online mental health communities (OR=0.22, p<.001). Similarly, use of digital mental health tools was significantly influenced by perceptions and barriers. Higher DTPI scores were associated with greater likelihood (OR=2.08, p<.001), while higher DTBI scores were associated with a 73% reduction in the likelihood of using digital mental health tools (OR=0.27, p<.001)

Conclusions: Findings indicate that engagement with online mental health communities and digital tools is primarily influenced by perceptions and perceived barriers. This suggests that subjective evaluation of digital resources plays a key role in shaping mental health help-seeking behaviors among emerging adults. In contexts such as India, where stigma and limited access to formal care persist, digital platforms can serve as alternative support systems, though not as a replacement for traditional care. These findings highlight the need to strengthen the design, communication, and implementation of digital mental health resources. Social workers can play a critical role in raising awareness of safe engagement with digital platforms and supporting the development of culturally responsive digital mental health interventions.