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. 2025 Jan;34(1):83-100.
doi: 10.1007/s00787-024-02386-x. Epub 2024 Feb 14.

Barriers to and facilitators of user engagement with web-based mental health interventions in young people: a systematic review

Thi Quynh Anh Ho  1 , Long Khanh-Dao Le  2 , Lidia Engel  2 , Ngoc Le  3 , Glenn Melvin  4 , Ha N D Le #  3 , Cathrine Mihalopoulos #  2
Affiliations

Barriers to and facilitators of user engagement with web-based mental health interventions in young people: a systematic review

Thi Quynh Anh Ho et al. Eur Child Adolesc Psychiatry. 2025 Jan.

Abstract

Many young people (YP) are diagnosed with mental illnesses and require support. Web-based mental health interventions (W-MHIs) have been increasingly utilized by YP, healthcare providers, and parents due to reasons including convenience and anonymity. W-MHIs are effective in improving mental health in YP. However, real-world engagement with W-MHIs remains low. Therefore, understanding barriers/facilitators of user engagement with W-MHIs is necessary to promote W-MHIs and help users gain optimal benefits through higher engagement. This review aims to identify barriers/facilitators of user engagement with W-MHIs in YP aged 10-24 years. A systematic search of five databases for English language, peer-reviewed publications was conducted between January 2010 and February 2023. Studies examining factors influencing user engagement with W-MHIs, described as barriers or facilitators, were included. Study quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was performed. Of 4088 articles identified, 69 studies were included. Barriers/facilitators were reported by young people (63 studies), providers (17 studies), and parents/caregivers (8 studies). YP perceived that usefulness and connectedness were the most common facilitators, whereas low-perceived need was the most reported barrier. Both providers and parents reported that perceived usefulness for YP was the most common facilitator, whereas concerns about program effectiveness and privacy were noted as barriers. This review found that program- and individual-related factors were important determinants of engagement with W-MHIs. This review provides guidance on the future design and development of new interventions, narrowing the gap between existing W-MHIs and unmet needs of users.

Keywords: Adolescents; Digital mental health; User experience; Young people.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors have no competing interests to declare that are relevant to the content of this article. Ethics approval: No ethics approval was required. Informed consent: Not applicable. Consent for publication: Not applicable.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of article screening and inclusion
Fig. 2
Fig. 2
Young people’s barriers and facilitators of engagement (n = 63 studies)
Fig. 3
Fig. 3
Healthcare providers’ barriers and facilitators of W-MHI provision (n = 17 studies)
Fig. 4
Fig. 4
Parents’ barriers and facilitators of engaging with W-MHIs (n = 8 studies)
See this image and copyright information in PMC

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