Facilitators and barriers to digital mental health interventions for depression, anxiety, and stress in adolescents and young adults : scoping review

Abstract

Background: Digital mental health interventions (DMHIs) offer unique strengths as emerging services with practical applications for adolescents and young adults (AYAs) experiencing depression, anxiety, and stress. Although promising, acceptance and participation in DMHIs vary across interventions, participants, and contexts. It is essential to delineate and synthesize the factors that promote or hinder DMHI use. Objective: This review aims to assess and synthesize the facilitators and barriers to accessing DMHIs for depression, anxiety, and stress in AYAs through a scoping review. Methods: A comprehensive search was conducted across multiple databases, including PubMed, Web of Science, PsycINFO, CNKI, OpenGrey, and APA PsycExtra, up to October 31, 2023. Articles examining facilitators and barriers to DMHIs among AYAs with disorders or symptoms of depression, anxiety, and stress were included. Data synthesis and analysis involved quality assessment, thematic analysis, and relative frequency meta-analysis. Results: A total of 27 records met the eligibility criteria, and 14 facilitators and 13 barriers were identified across the external, intervention, and individual levels. The relative frequency meta-analysis indicated that factors influencing AYAs’ use of DMHIs varied based on delivery modes. Among these factors, “quality and effect” emerged as the predominant theme—high quality and effect served as the primary facilitator, while low quality and effect acted as a barrier across both portable and nonportable devices, as well as single and multiple platforms. Conclusions: The uptake of DMHIs among AYAs is influenced by a complex interplay of facilitators and barriers, particularly those related to quality and effect. Our syntheses provide crucial guidance for intervention designers, emphasizing the importance of user-centered approaches that balance scientific rigor with engaging and adaptive features. Enhancing the alignment of DMHIs with adolescent needs can improve both adoption and real-world mental health impact.