Digital Mental Health Promotion Services for Youth: A Qualitative Study of Help-Seeking Through Mindhelper.dk (Preprint)

BACKGROUND Young people increasingly experience mental health challenges and often turn to the internet for support. Self-guided digital mental health promotion services have become widely used resources for youth seeking help and guidance. These platforms offer accessible, anonymous support, yet little is known about the concerns young people articulate when engaging with them. OBJECTIVE This study examines inquiries submitted to a digital letterbox on one of Denmark’s most widely used digital mental health promotion services, Mindhelper.dk, to identify recurring themes in young people's inquiries about mental health and well-being. In addition, it explores how gender influences these experiences in the context of engagement with a self-guided digital platform. METHODS Employing an inductive analysis strategy and a grounded theory–inspired coding framework, this study analyzes a dataset of 2,523 inquiries submitted to the Mindhelper letterbox between March 2016 and August 2023. The archive provides rare, unsolicited first-person accounts from young people in moments of emotional vulnerability, providing immediate and authentic insights into their mental health concerns. RESULTS The analysis identifies 17 recurring themes that reflect the mental health challenges young people seek help for. These themes are grouped into three overarching analytical categories: Social Relations and Social Contexts, Emotional Life, and Body and Illness, with the first two dominating the material. The most prominent themes include Sociality, Love Life, Unease, Self-Criticism and Insecurity, and Communication and Reaching Out for Support. The intersection of themes underscores the central role of social relationships in young people's mental health and well-being, with frequent co-occurrence of inquiries addressing both Love Life and Sociality. Regardless of gender, users frequently inquire about Sociality and Love Life, indicating shared concerns related to social relationships. However, girls were markedly overrepresented among inquirers, highlighting potential gender differences in help-seeking behavior. CONCLUSIONS Social relationships play a central role in young people's lives, yet many also face emotional struggles, particularly related to anxiety, self-esteem, and despair. The letterbox serves as an important help-seeking channel for youth who may lack access to support elsewhere, with a marked overrepresentation of girls, indicating gender patterns in help-seeking behavior. This study provides novel insights into the mental health challenges Danish youth face and their engagement with digital support services, informing the design of targeted, gender-sensitive self-help content and guiding future efforts to promote well-being and reduce barriers to help-seeking.