Acceptability and implementation of digital mental health supports for marginalised young people across Ireland: A mixed-methods study
This mixed-methods study evaluating 11 digital mental health tools among marginalised young people in Ireland found that while digital literacy was high, successful implementation depends on overcoming usability barriers and ensuring tools are trustworthy, culturally relevant, and co-designed with youth to meet their specific emotional and engagement needs.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
The Digital Mental Health Playground
Imagine the internet as a massive, bustling city. In this city, there are thousands of shops, parks, and libraries dedicated to helping people feel better when they are sad, anxious, or overwhelmed. These are "digital mental health tools"—apps, websites, and programs designed to offer support, advice, and coping strategies. For a long time, scientists and policymakers have hoped these digital tools would be like a super-highway, allowing anyone, anywhere, to zoom straight to help without waiting in long lines or feeling too shy to walk through a clinic door.
However, just because a road exists doesn't mean everyone can drive on it. Some roads are full of potholes (bad design), some have confusing signs (unclear instructions), and some toll booths ask for money that people don't have (paywalls). This is especially true for "marginalised" young people—those who might be new to the country, part of the LGBTQ+ community, living with disabilities, or simply struggling to find their place in the world. They face extra hurdles, like not trusting the people running the shops or finding the maps too complicated to read. The big question researchers are asking is: If we build these digital support systems, will young people actually use them, and will they feel safe and understood while doing so?
The Great Digital Tool Trial
In this study, a team of researchers decided to stop guessing and start testing. They gathered a group of 38 young people, aged 18 to 25, from across Ireland (both the Republic and the North). These weren't just any young people; the team specifically invited those who often get left behind, including migrants, refugees, Travellers, and those not in school or work. The researchers gave these young people a "digital toolkit" containing 11 different mental health apps and websites. These tools covered everything from mood tracking and emotional regulation to positive news feeds and skills-based support.
The young people were asked to try out these tools for two weeks, using them however they wanted, just like they would in real life. Afterward, the researchers asked them a bunch of questions: Was the tool easy to use? Did it feel trustworthy? Did it actually make them feel better? They used special scorecards to measure "usability" (how easy it was to navigate) and "engagement" (how much the users liked sticking with it).
What They Found: The Good, The Bad, and The "Just Right"
The results were like a map showing which paths in the city were smooth and which were blocked.
The Usability Gatekeeper
The most important discovery was that usability is the front door. If a tool is hard to use, it doesn't matter how good the advice inside is; nobody gets in. The researchers found that only two of the 11 tools passed the "usability test" with a high score (above 68 out of 100). These were the spunout Navigator and the Student Health App. Young people described these as simple, clear, and easy to navigate. In contrast, tools that required too many clicks, had confusing menus, or felt like "schoolwork" were quickly abandoned. It's like trying to enter a fun club: if the bouncer makes you fill out a 20-page form just to get in, you're going to walk away, even if the party inside is amazing.
Trust is the Key
Before a young person even tries a tool, they check if it's safe. The study found that credibility is the main reason people decide to try something in the first place. If an app was made by a trusted organization like the HSE (Health Service Executive), a university, or a well-known charity, young people felt safer using it. They were wary of commercial apps that seemed to want their money or their data. Interestingly, for some tools that just offered "good news" or positive vibes, the young people didn't even check the source—they just used them because they felt good. But for anything claiming to be "help" or "therapy," they wanted to know who was behind it.
Emotions Beat Design
Here is a surprising twist: Feeling better matters more than looking perfect. The researchers found that some tools had lower usability scores (they were a bit clunky or hard to use) but still had very high engagement. Why? Because they provided an immediate emotional boost. Tools like Bearable (for tracking moods) and the Good News Network were used frequently because they offered instant relief, distraction, or a sense of calm. It's like a slightly messy but cozy blanket: it might not be perfectly folded, but if it makes you feel warm and safe, you'll grab it every time.
The "Just Right" Features
The study also highlighted what makes a tool stick:
- Personalisation: Young people loved tools that let them track their own moods or tailor the content to their lives. However, if there were too many options, it became overwhelming, especially for those with ADHD or autism. It's a bit like a buffet: you want choices, but if the menu is too huge, you might not know what to pick.
- Habit Helpers: Features like reminders, "streaks" (keeping a daily record), and short tasks helped young people build a routine. It turned mental health care into a small, manageable "win" every day.
- The Dealbreakers: Anything that felt like a barrier—paywalls (charging money), intrusive ads, or long, repetitive logging—killed the experience.
The Bottom Line
This study suggests that for digital mental health tools to work for marginalised young people, they need to be simple, trustworthy, and emotionally resonant. You can't just build a fancy app and hope people use it. It has to be easy to open, backed by people they trust, and able to give them a little boost of positivity or calm when they need it.
The researchers didn't find a magic bullet that solves all mental health problems. Instead, they found that the best tools are the ones that respect the user's time, feel safe to explore, and fit naturally into a young person's daily life. If developers and policymakers want these tools to succeed, they need to stop building complex labyrinths and start building clear, welcoming doors that lead straight to support.
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