Investigating Knowledge, Attitudes and Challenges for Digital Mental Health Interventions Among Youth in Soweto, South Africa

Abstract

Background: Poor mental health in South Africa has been reported to be higher than it has been in previous years and research has shown that prevalence is mostly among adolescents and youth. According to the World Health Organisation (WHO), mental health in adolescents and young people is a major health crisis. Several studies have provided evidence that although efforts have been made mental health services are not easily available to adolescents and youth in low and middle income settings. Digital health interventions could help alleviate this gap. This study aimed to investigate knowledge, attitudes and challenges for digital mental health interventions among youth in Soweto, South Africa. Methods: Our study used a mixed-methods research design, data was collected through an online survey amongst youth (18-24 years) in Soweto, South Africa. The online survey was administered through REDCap and took +/- 30 minutes to complete. The survey included close-ended and open-ended questions using a combination of self-constructed questions and the Mental Health Literacy Scale. Descriptive analysis was conducted using the IBM SPSS Software. Open-ended questions were analysed using content analysis. Results: We had 77 participants in total who completed the survey. Most of the participants identified as female (61%), 26% identified as male and only 1 participant identified as transgender. Majority of the participants were above the age of 20 years (66.3%). We had a representation amongst the different age groups, with 18 (18.2%) and 21 (18.2%) being the most represented age groups, with a mean age of 20.14. Majority of the participants had access to mobile phones (93.5%) and had access to mobile data (87%) through prepaid cellular data (36.4). Participants had adequate knowledge of mental health (m=119.53) and available digital mental health interventions. Almost all participants (n=60) noted that access to data and mobile phones might be a challenge in implementing these interventions in the community. Participants noted that digital interventions are easily accessible and would be helpful for youth mental wellbeing and also potentially assist with stigma. However they perceived digital interventions as lacking in human interaction. Data costs, access to mobile phones, lack of knowledge, lack of trust in digital platforms and lack of interest in general health interventions were noted as barriers to the use of digital interventions. Participants recommended the use of data free platforms, more community education/awareness and using hybrid approaches to mitigate some of the key barriers mentioned above. Conclusion: Our study highlights the growing interest among young people in South Africa for digital mental health interventions, particularly in light of the accessibility and convenience these platforms offer. However, our findings also underscore the importance of addressing key barriers, such as the cost of data and limited access to reliable internet, which continue to hinder the widespread implementation of digital interventions in low-resource communities. While most participants in this study had access to mobile phones, the financial constraints associated with prepaid data plans remain a significant challenge for consistent engagement with digital mental health platforms. Furthermore, the preference for a hybrid model—integrating both digital and in-person interventions should be adopted by stakeholders when developing interventions for young people.