An exploration of e-mental health apps for gender minority youth in New Zealand

Abstract

Background: Gender minority youth in New Zealand experience a significantly elevated prevalence of depression and anxiety compared to their cisgender peers. Access to mental health care in New Zealand can be difficult and may come with long wait times. Digital mental health interventions are rapidly proliferating and are proven to be effective at treating or reducing symptoms of depression and anxiety in youth, while being easily accessible. However, there is a significant gap in research addressing their acceptability and feasibility for gender minority youth. Aim: The overarching aim of this study is to explore gender minority youths’ preferences of engaging with digital mental health interventions and their acceptability and feasibility of them, while also exploring ways to improve their adherence to them. The three specific aims of this research are (1) explore gender minority community preferences of how they would like to convey their gender identity when engaging with digital mental health interventions. (2) To explore the acceptability and feasibility of Headstrong for gender minority youth by getting the app into their hands and seeking feedback on its look/feel and acceptability for gender minority youth. (3) To explore what improvements or adjustments to Headstrong would be required to increase use, retention, and adherence of gender minority youth with this app. Methods: A qualitative thematic analysis of individual interviews with gender minority youth participants was conducted. Participants were asked about their preferences when disclosing their gender identity, and demonstrated the Headstrong chatbot. Results: Seven gender minority youth participated in individual interviews. The interviews identified the importance of informed and inclusive gender-identity data collection practice. Thematic analysis highlighted that Headstrong is a feasible and acceptable intervention for them, while also identifying unique gender minority ways in which it could be improved to increase gender minority youth adherence. The three main thematic areas were ‘identity politics’, ‘recommendations for gender minority youth informed practice’ and ‘potential impact’. Conclusion: This study indicates that Headstrong is acceptable and feasible for gender minority youth participants. Furthermore, findings highlight the importance of digital mental health interventions being developed in a way that is informed by gender minority youth and utilises gender minority unique aspects to increase therapeutic benefit.