title: E-mental health care among young adults and help-seeking behaviors: a transversal study in a community sample.
abstract: BACKGROUND
  The Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete.
  
  
  OBJECTIVE
  In a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care.
  
  
  METHODS
  Using data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen's behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents' income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not.
  
  
  RESULTS
  Overall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03).
  
  
  CONCLUSIONS
  E-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.
authors.affiliation: Centre Hospitalier de Versailles, Le Chesnay, France. nyounes@ch-versailles.fr.
authors.forename: Nadia
authors.identifier: http://orcid.org/0000-0002-0877-7944
authors.initials: N
authors.lastname: Younes
authors.forename: Aude
authors.identifier: http://orcid.org/0000-0001-6866-3167
authors.initials: A
authors.lastname: Chollet
authors.forename: Estelle
authors.identifier: http://orcid.org/0000-0003-0048-6015
authors.initials: E
authors.lastname: Menard
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0002-2377-619X
authors.initials: M
authors.lastname: Melchior
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003865:Major Depressive Disorder; D005260:Female; D006297:Health Services Accessibility; D000066505:Help-Seeking Behavior; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration; D012944:Social Support; D017216:Telemedicine / Q000458:organization & administration*; D055815:Young Adult
keywords: Internet; epidemiology; health care disparities; mental health services; young adult